Less than two years after David Berg of Downey suffered irreversible brain damage while undergoing surgery, the Long Beach anesthesiologist accused of malpractice in the case was involved in a second tragedy.
This time the patient died.
The March, 1982, death of Albert Valasquez, 49, a Paramount cabinetmaker and father of four, also led to a malpractice suit that was settled out of court earlier this year.
The anesthesiologist, Dr. Margarita Keusayan, still has a license to practice medicine, although she has voluntarily withdrawn from her practice, according to her lawyer.
According to the lawsuit filed by his family, Valasquez--in surgery to replace an arthritic right hip--died of asphyxia in March, 1982, after Keusayan mistakenly placed an oxygen tube in his esophagus. The tube, which is supposed to be placed in the trachea, pumped oxygen into his stomach instead of his lungs, said Charles Weldon, a lawyer for the Valasquez family.
A settlement in the Valasquez case called for Charter Suburban Hospital of Paramount and three doctors to pay $850,000 to the victim's family, Weldon said. Of that amount, an insurance company for Keusayan paid $500,000, Weldon said.
Last November--more than 2 1/2 years after Valasquez's death and more than four years after Berg's injuries--the attorney general filed charges of gross negligence and incompetence against Keusayan for her handling of the Valasquez case. The attorney general, who functions as prosecutor for the state Board of Medical Quality Assurance, filed the charges in a complaint to the board.
A hearing before an administrative law judge and a medical quality review panel in Los Angeles is tentatively scheduled for Aug. 12-16.
Keusayan, 46, could not be reached for comment. Robert Gans, Keusayan's lawyer for the state hearings, declined comment.
Denise Taylor, a lawyer for a Los Angeles firm that defended Keusayan in both the Berg and Valasquez malpractice suits, said the anesthesiologist is a "very good doctor and a very nice lady who had an unfortunate occurrence."
"They were obviously tragic outcomes and it did affect her desire to practice medicine," Taylor said. She added that Keusayan voluntarily gave up her anesthesiology practice after Valasquez died but hopes to go into another medical field.
The attorney general also has reopened an investigation of Keusayan's role in the Berg case after an original investigation, conducted after Valasquez's death, did not turn up enough evidence to file charges, a deputy attorney general said.
"One of the problems was many people were involved (in the Berg case) and as a result, a filing against Dr. Keusayan at that time was deemed inappropriate because of insufficient evidence against her," said Anne Mendoza, deputy attorney general.
Case Under Review
Mendoza added that because of "additional information" the Berg case is now under review. She declined to say what the additional information is. She added that two other doctors in the Berg case, surgeons Ben T. Chaffey and James Holman, both of Downey, are not under investigation by the board.
Richard B. Aldrich, Berg's lawyer, said he was "shocked" that the board never filed charges against Keusayan for the Berg case. In an interview, he said he hopes the board will now revoke Keusayan's license.
Vernon Leeper, chief investigator for the Board of Medical Quality Assurance, said that it is possible for years to go by before the board finds out about a malpractice case.
Leeper said the typical malpractice settlement case is 4 1/2 years old by the time it gets through the courts and reaches the board. With a staff of 45 investigators to police 55,000 practicing physicians in the state, Leeper said, "We just don't have the number of people to do the job."
He said that hospitals are only required to notify the board if they bring formal charges against a doctor that are filed in a special report. In both the Berg and Valasquez cases, however, no such reports were ever filed because in both cases, Keusayan voluntarily resigned from the staffs of Downey Community Hospital and Charter Suburban Hospital, lawyers for the two hospitals said.
The board also investigates citizen complaints and automatically investigates settlement cases of more than $30,000, Leeper said. But he added that the board is unaware of many cases until it finds out about them in settlements or in the news media.
In the 1983-84 fiscal year, the board revoked the licenses of 27 doctors, had 12 licenses voluntarily surrendered and put 94 other doctors on probation a minimum of five years, with or without suspensions, according to board statistics. Doctors on probation are required to take more training, pass medical exams, or work under supervision of other doctors, board officials said.
Of the board's name, which implies the agency ensures medical quality in the state, Leeper said, "That's a real misnomer. I don't think that there's any agency in the state or the world that can ensure quality medical care."