Army whistle-blower fights to clear name
Madigan Army Medical Center surgeon Michael Eisenhauer says his military career foundered as he exposed cozy dealings between an Army doctor and a medical-equipment manufacturer. His whistle-blowing helped lead to the criminal conviction of one doctor; but Eisenhauer is still fighting to clear his own name.
Seattle Times staff reporter
In spring 2008, cardiologist Michael Eisenhauer visited the office of the deputy commander at Madigan Army Medical Center to make a disturbing allegation.
Eisenhauer detailed a cozy relationship between the medical-equipment manufacturer Boston Scientific and two Madigan cardiologists, who insisted on sole-source purchases of that company's implant devices.
Eisenhauer hoped the deputy commander, Col. Ronald Place, would be upset. But the colonel appeared unperturbed. "His only response was to quite literally pick up the phone and offer to assist me in an immediate transfer to another facility," Eisenhauer recalled.
Eventually, Army officials followed up on Eisenhauer's concerns and asked him to wear a wire to collect evidence in a joint inquiry with the Justice Department.
In January, that investigation resulted in a guilty plea by Maj. Jason Davis, then Madigan's chief of cardiology, who admitted to taking more than $4,800 in illegal payments from Boston Scientific.
The Seattle Times has learned that the Justice Department and the Army this year also began investigating whether Davis' deal with Boston Scientific affected patient care in the cardiology department, something Eisenhauer says he asked Madigan commanders to look into back in 2010.
As a whistle-blower, Eisenhauer says his own reputation and career came under attack from his supervisors at Madigan, located at Joint Base Lewis-McChord, south of Tacoma.
"Not only did they do nothing to correct the situation, they participated in a scheme to run me off," said Eisenhauer, who was awarded a Bronze Star service medal for his duty in Iraq in 2009. "It was easier to discredit me than address the criminal activity."
Eisenhauer retired from the Army in December and now works as a civilian cardiologist in Casper, Wyo.
But he is still fighting to clear his name. This year, he filed a federal lawsuit to obtain copies of two Army investigations launched by Madigan's former commander, Maj. Gen. Patricia Horoho, in response to his complaints of unfair treatment at Madigan.
Eisenhauer believes the first investigation largely substantiated his claims of reprisals, but the Army refused to respond to his requests to obtain the document. In an unusual action, Horoho then asked for a second investigation, which found no credible evidence of retaliation and was released — with portions redacted — to Eisenhauer.
Horoho, who is serving in Afghanistan, has been nominated by President Obama to be the next Army surgeon general.
In a written response to a Seattle Times query, Horoho defended her handling of Eisenhauer's complaints, saying she took "any issues raised regarding unethical or illegal practices very seriously," and was committed to ensuring that conduct at Madigan was consistent with Army policies.
Davis, the former chief of cardiology, has declined to speak about the case. In his plea agreement, Davis said his actions did not affect patient care.
Madigan's current commander, Col. Dallas Homas, said his top responsibility is to ensure the hospital provides safe care to patients and maintain a work environment where everyone is encouraged to express concerns without fear of retribution.
Excellent, but blunt
Eisenhauer, 47, is a skilled cardiologist who has published more than a dozen papers and co-authored national guidelines for controlling infections during cardiac surgical procedures.
"Eisenhauer was a star," said retired Lt. Col. Edward Horwitz, another cardiologist who served with him at Madigan.
His career, though, was not without controversy.
While serving at William Beaumont Army Medical Center in Texas, his commanders found his performance exceptional and recommended that he be promoted immediately, according to an evaluation report.
Yet his blunt management style rankled some hospital staff members, and Eisenhauer received a reprimand citing several employee complaints about his conduct. After reading his rebuttal, Beaumont's commanding officer decided that the reprimand would not become part of a permanent file forwarded to Madigan, according to the commander's letter.
But that reprimand was forwarded to Madigan, according to Eisenhauer. And even before he started to report wrongdoing, Eisenhauer said several Madigan medical officers sought to use that report to discredit him as an intemperate, verbally abusive doctor.
Eisenhauer contends that Col. Joseph Morris, then the acting chief of medicine, told him he wasn't good enough to practice at Madigan.
Davis, the doctor who eventually pleaded guilty to taking payments from Boston Scientific, offered another reason to Eisenhauer for his hostile Madigan reception. Eisenhauer was not welcome because he too strictly interpreted rules and regulations, according to Eisenhauer's account of his meeting with Davis.
"We just want to be left alone — to do our own thing," Davis told him.
The long-standing practice of drug companies and medical-equipment manufacturers offering doctors free trips, speaking honorariums and other payments is controversial. Critics say the money may often represent kickbacks for favoring a company's drugs or devices.
Still, in civilian practices such payments are generally considered legal. In the military, however, doctors are prohibited from taking such payments.
"Military doctors must owe their allegiance to the soldiers and families they treat — not to drug companies or makers of medical devices," said U.S. Attorney Jenny Durkan in a statement announcing the plea deal reached with Davis.
"That is why we have a bright line rule: doctors employed by the government cannot accept payments or gratuities from an outside source — especially one that is seeking government business."
The full range of charges that the Justice Department considered filing against Davis is not disclosed in the plea agreement.
The Justice Department agreed not to file those charges in exchange for his plea of guilty to a misdemeanor for taking more than $4,800 in "training payments" from Boston Scientific for allowing two of the company's employees to attend his surgeries.
During those operations, Davis did not offer fellow Madigan doctors any special instructions. That teaching was done by company employees in attendance, according to his plea agreement.
Davis, in his plea agreement, also acknowledged that the other charges were "substantially justified" in light of evidence.
In a letter of support to a federal judge, his Madigan colleague, Col. David Schachter, wrote that Davis is "deeply ashamed about what has happened. He is open and forthright about his transgression. He has offered to speak to military doctors as part of his punishment so that others will not succumb to similar mistakes."
Madigan officials, citing federal privacy laws, have declined to say whether the hospital took disciplinary action against Davis or other doctors.
The Justice Department also sued Boston Scientific for paying Davis to use the company's implant devices and recommend them to others. Last October, Boston Scientific paid $600,000 to settle the suit.
At Madigan, Eisenhauer said there was nothing subtle about the efforts to steer business toward Boston Scientific.
In 2008, Eisenhauer said, he received written instructions to use only the company's implant devices. The order came from Schachter, then the chief of cardiology.
This was a markedly different approach from what Eisenhauer had encountered at his last hospital, where cardiologists made a point of using devices from three different manufacturers to avoid an appearance of favoritism.
Madigan's approach drew complaints from two other medical-device manufacturers, who claimed they couldn't get a fair shake at sales, he said.
Eisenhauer says that as he dug into purchasing procedures, he found more than $1.2 million in sole-source acquisitions that were pushed through without proper approvals. Some of these devices, he found, could be purchased at cheaper prices from other companies.
So Eisenhauer blew the whistle, repeatedly outlining his complaints to Horoho and others.
Eisenhauer eventually submitted a written statement to the Army's western region contracting office. In October 2008, he was asked by the Army Criminal Investigation Command to wear a wire in a meeting with Davis and Schachter.
But Davis' relationship with Boston Medical wasn't Eisenhauer's only concern.
Eisenhauer also questioned whether the quality of care in the cardiology department was affected by Davis' dealings with Boston Scientific.
Eisenhauer thought the rate of implants at Madigan appeared higher than at his previous posts, and that several patients had possibly received devices they did not need: pacemakers to help regulate a heartbeat, and defibrillators, which can sense life-threatening changes in a heart rhythm and emit small electrical charges to try to restore normal heartbeat.
In 2009, Eisenhauer said he informed Horoho of his concerns. The following year he sent a note to another Madigan officer, Col. Jerome Penner, expressing concern over a lack of safety monitoring and suggesting a quality review of implants.
Penner thanked Eisenhauer for sharing those concerns, but there were no indications that he followed through on the suggestion, according to Eisenhauer.
Davis, in his plea agreement in January, asserted that patient care had not been compromised. At the time of the agreement, Madigan officials said they had no reason to doubt that claim.
But earlier this year they received what they called "the first credible allegations of patient harm that was connected to alleged criminal activity."
In a statement, Madigan officials say the hospital responded promptly and began its own quality-review investigation.
The U.S. Attorney's Office in Seattle will report its findings on patient care at Davis' sentencing, scheduled for September, according to spokeswoman Emily Langlie.
Passed over for chief's job
Eisenhauer believes he paid a price for his role as a whistle-blower.
When the chief-of-cardiology position came open at Madigan in 2008, Eisenhauer was passed over for the job. Instead, that position was given to Davis, although he was a major two ranks below Eisenhauer.
Once Davis became chief, he was allowed to participate in Eisenhauer's performance reviews. And, at a time Eisenhauer's complaints were well-known, those reviews weren't favorable.
In December 2008, a Davis evaluation scolded Eisenhauer for his "maladaptive" behavior that "contributes to the instability of the Chain of Command."
Eisenhauer also had supporters at the hospital.
They included Horwitz, who wrote a letter to Horoho denouncing attacks on Eisenhauer as "vicious and evil," and Col. James Kinney, a pediatric cardiologist who is one of the longest-serving doctors at Madigan.
"Col. Eisenhauer never created a hostile work environment for anyone," wrote Kinney in a 2009 letter to one of the officers charged with investigating Eisenhauer's complaints.
"In my nearly 40 years of service, I've never seen deplorable behavior like this and am both shocked and deeply saddened to see it tolerated. ... It is past time for MG (Maj. Gen.) Horoho to step up to the plate and take a public position commensurate with our expectations from her leadership."
Kinney, who still serves at Madigan, declined to comment for this story, citing the Justice Department investigation and the possibility that he might be called as a witness.
Bronze Star performance
In March 2009, Eisenhauer headed off to serve nine months in Iraq.
Even his front-line assignment was not free from the infighting at Madigan. Leaders at the hospital sought to steer Eisenhauer toward a position as a battalion surgeon, a job typically held by a more junior officer, according to Eisenhauer.
After a tussle, Eisenhauer was able to secure a position commensurate with his rank. He served as chief of clinical operations for the Multinational Force in Iraq, with responsibilities for oversight of health care to more than 135,000 military personnel.
He earned a Bronze Star for his service. An evaluator hailed his compassion, world-class administrative abilities, affable personality and dedication.
"Mike is exactly the type of Soldier-Medic that we need leading in our operational Army formation," the evaluator wrote. "Tremendous future potential."
But returning to Madigan, Eisenhauer soured on the Army.
Schachter and Davis remained on Madigan's cardiology staff. Though he wanted to keep his surgery skills sharp, Eisenhauer was loath to return to the hospital staff and risk a new round of attacks on his reputation.
After meeting with Horoho, he opted for a year of administrative duties. In December, after 20 years in the Army, he retired.
"The Army had been very good to me. I was very loyal and planned to stay in for 30 years," Eisenhauer said. "But at Madigan, there was no reward for honesty and integrity, and I decided it was time to leave."
Hal Bernton: 206-464-2581 or firstname.lastname@example.org. Seattle Times researcher David Turim contributed to this story.
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