The former medical partner of a doctor accused by the state medical board of endangering his patients now says he wishes he'd turned in his colleague.
"It would have been easier on me," said Dr. Brian Golden, the former partner of urologist Dr. Michael Kaplan. Kaplan's license was temporarily suspended when he acknowledged reusing single-use medical devices.
But Golden, who worked in an office 12 miles away from Kaplan's Henderson office, said he didn't think he had enough evidence to go to the Nevada State Board of Medical Examiners.
He was told by other employees in the partnership that Kaplan was engaged in questionable medical practices, he said, and didn't report it to the medical board because he "had no firsthand knowledge of Kaplan's practices, since I have been in my own office across town for over two years."
Under Nevada law, Golden only had to be made aware that Kaplan was not following proper protocols, according to Doug Cooper, executive director of the medical board.
The law reads that any doctor, medical school or medical facility that "becomes aware that a person practicing medicine is or is about to become engaged in conduct which constitutes grounds for initiating disciplinary action shall file a written complaint with the board within 30 days after becoming aware of the conduct."
"It only says you have to be aware, not that you have to have firsthand knowledge," Cooper said. "The very least you should do is file a written report, but we can also hear from them other ways."
Golden said he was told by an investigator with the board that he should have reported Kaplan. "They only gave me a slap on the wrist," Golden said.
According to Cooper, a doctor who refuses to report another physician for wrongdoing can receive the same penalties, including license revocation, as a doctor who actually commits an offense.
'Smeared with the same brush'
Had he reported Kaplan, Golden said, he doubts he would have been questioned and investigated by authorities and "smeared with the same brush" as Kaplan by patients.
"Patients were always asking me if I did the same thing as Dr. Kaplan," said Golden, adding that because he understood patients' concerns, he patiently told them that he never reused single-use devices.
"It's not easy to hear that from patients, or to be investigated," he said.
The medical board investigated Golden's practice and found the urologist was not re using single-use medical devices.
A medical assistant who worked for the medical partnership told the Review-Journal that medical assistants asked Kaplan if it was OK to re use devices that were marked for single-use only. "He said it was OK, but when we asked Golden whether he would re use single use medical devices in the same manner as Kaplan, he said he never would," the assistant said.
Kaplan's medical license was suspended in March after a joint investigation by the Nevada State Board of Medical Examiners and the Food and Drug Administration -- authorities said that for three months Kaplan reused single-use-only plastic needle guides for prostate/rectal biopsies, discarding them only when they became "too bloody."
According to Kaplan, a salesman for the medical device told him he could re-use the device even though it was labeled for single-use. Kaplan said he was not trying to excuse his behavior, just explaining what happened.
The Southern Nevada Health District sent letters to more than 100 of Kaplan's patients , advising them to get tested for HIV and hepatitis B and C. So far, the district has not reported a positive case among Kaplan's patients.
In mid-April the medical board reinstated Kaplan's license, saying he could once again perform invasive procedures at his office as long as a "third party" health professional is on hand to monitor his infection control efforts. Cooper said final discipline for Kaplan will be handed down in the coming month.
Golden said he did report Kaplan's behavior to the partnership's office manager, but he doubted that the manager turned in Kaplan.
Cooper said the medical board received a complaint but would not say who filed it or how authorities learned of the allegations that needle guides were being reused. FDA officials did not reply to emails asking how they learned of the accusations against Kaplan or whether undercover work was involved in the investigation.
Golden said that there is no question that "there is tension" when a doctor suspects a colleague of doing something outside standard medical protocols.
"There's a certain amount of professional respect that you have," he said. "You don't want to see bad things happen to a colleague."
Asked if he thinks that if he reported Kaplan's behavior it may have at least spared some patients emotional trauma, Golden said he would rather not comment on that.
Many doctors say there is an unspoken rule that one physician doesn't report another for bad medical practice.
Cooper said doctors do sometimes report other physicians but he doesn't know how often that happens.
A medical assistant who worked with both Kaplan and Golden said many people in the partnership believe that Golden or members of his staff reported Kaplan to authorities.
Leaving for Sacramento
But it is only coincidence, according to Dominic Gentile, Kaplan's attorney, that the doctor decided in recent weeks to dissolve the partnership he had with Golden. "It was strictly a business decision," Gentile said.
Kaplan did not return repeated phone calls seeking comment for this story.
Golden said he never really saw "eye to eye" with Kaplan, so he isn't angry "about being fired."
"I do worry about my patients, though," he said, adding, however, that he looks forward to starting a new practice in Sacramento in July.
It will be nice, he said, not to have patients wondering if had engaged in the unsafe medical practices of his partner.
Tony Crispino, head of the Us TOO prostate cancer support in Las Vegas, said he hates to see Golden leave for California.
"He is young and energetic and good at minimally invasive robotic surgery," he said. "That's something we don't have enough of here."
Contact reporter Paul Harasim at firstname.lastname@example.org or 702-387-2908.