A Very Unusual Trial

February 7, 2010 7:14 AM

In Texas, two nurses anonymously reported a doctor to the Texas Medical Board for what they considered to be malpractice. The doctor complained of harrassment and local law enforcement found out who filed the complaint. Now one nurse is being prosecuted for reporting. The charges against the other nurse were dropped due to prosecutor's discretion. The medical board has warned of a dangerous chilling effect if the charges are pursued. But, the sheriff and the DA are convinced that the case is valid. Regardless of the outcome, a civil suit has already been filed against the hospital, the doctor, the sheriff and the DA's office on behalf of at least one of the nurses alleging violations of her First Amendment rights, among other things. Is it a case of prosecutorial misconduct or a vindictive nurse trying to get a doctor ousted? Trial begins Feb. 8.
posted by Leezie (55 comments total)

There isn't enough facepalm for this
posted by MrLint at 7:30 AM on February 7, 2010

Strange case. Based on the FPP text, I was wondering if the report was somehow inflammatory or false, but that dosn't seem to be the case here:

When the medical board notified Dr. Arafiles of the anonymous complaint, he protested to his friend, the Winkler County sheriff, that he was being harassed. The sheriff, an admiring patient who credits the doctor with saving him after a heart attack, obtained a search warrant to seize the two nurses’ work computers and found the letter.
...
The letter also mentioned that Dr. Arafiles was sending e-mail messages to patients about an herbal supplement he sold on the side.

So basically a small-town sheriff and local corruption. There really needs to be more oversight of these people.

If the NYT article is correct, and since the case has been moved to a nearby county where hopefully people don't know the people involved I would be shocked if they were convicted.
posted by delmoi at 7:38 AM on February 7, 2010 [8 favorites]

On the face of it this is so crazy over the top I can't help but wonder if there is information not being reported here.
posted by cccorlew at 7:41 AM on February 7, 2010

On the face of it this is so crazy over the top I can't help but wonder if there is information not being reported here.

Seriously, that's what crazy people count on you to think when they pull something like this.

It was mentioned that the doc may be unusually powerful due to difficulty in attracting other physicians to the area; it disgusts me that these nurses basically stood up to someone providing substandard care to those who can't necessarily go elsewhere and haven't been celebrated.
posted by availablelight at 7:58 AM on February 7, 2010 [15 favorites]

If this is a small Texas town, moving it to a neighboring community won't do anything to help the polarization issue. They need to move it to a place like Houston, San Antonio or Dallas.
posted by Malice at 8:06 AM on February 7, 2010

Sheriff Roberts was later heard muttering to himself, "This is what happens when you teach women how to write..."
posted by bpm140 at 8:13 AM on February 7, 2010 [2 favorites]

Luckily we appoint judges rather than elect them, so we can prevent the influence of local interests in our justice system, in cases like this!

Whats that you say? mhhmmmm....state judges....elected officials.....including Texas.....well shit.
posted by HabeasCorpus at 8:18 AM on February 7, 2010 [3 favorites]

On the face of it this is so crazy over the top I can't help but wonder if there is information not being reported here.

The number of tiny little towns and counties in the US is high enough that even if craziness is distributed normally, there are many small communities that are five and six sigmas out on the BUGFUCK CRAZY tail.
posted by ROU_Xenophobe at 8:22 AM on February 7, 2010 [29 favorites]

Lock them up and throw away the key! This is Texas after all...
posted by Dick Laurent is Dead at 8:24 AM on February 7, 2010

Damn, this is messed up. Even if the prosecution looses the case (which it appears they should based on any legal or moral interpretation of the above), this case has terrorized and impoverished these poor women. This is absurd.
posted by deliquescent at 8:24 AM on February 7, 2010 [1 favorite]

This is absurd.

Agreed.
posted by Dick Laurent is Dead at 8:27 AM on February 7, 2010

Had a co-worker from Kermit. Even she referred to it as the "armpit of Texas".
posted by liquid54 at 8:55 AM on February 7, 2010

This is a fucking absurd story. I initially was going to write a long comment decrying the lack of appropriate legal protections and so on and so on.

But, reading the article it sounds like a whole bunch of noise and bluster over what seems very likely to be a big fat loss for the doctor.

Here are a few good pull quotes:

...the Supreme Court of Texas has held that good faith requires only a reasonable belief that the conduct being reported is illegal.

In a surprise inspection last September, state investigators found several violations by Dr. Arafiles and concluded that the hospital had discriminated against the nurses by firing them for “reporting in good faith.”

Even in small town TX I suspect this is going to end up being a major headache and financial loss to the Doctor and the Hospital. And, it sounds like this might galvanize the community enough to give the Sheriff a good run for his money next election cycle.
posted by edgeways at 9:16 AM on February 7, 2010 [1 favorite]

But, reading the article it sounds like a whole bunch of noise and bluster over what seems very likely to be a big fat loss for the doctor.

Hopefully. But I think the sheriff and prosecutor's actions are outrageous on their face.
posted by grouse at 9:22 AM on February 7, 2010 [1 favorite]

On the face of it this is so crazy over the top I can't help but wonder if there is information not being reported here.

A big part of my job is representing whistleblowers. This aint shit. Seriously, I've seen worse. Happens all the time.
posted by Ironmouth at 9:36 AM on February 7, 2010 [2 favorites]

A big part of my job is representing whistleblowers. This aint shit. Seriously, I've seen worse.

So... are you going to tell us about it or do you just enjoy teasing us?
posted by Xezlec at 9:48 AM on February 7, 2010 [1 favorite]

Ironmouth is such a tease.
posted by jabberjaw at 9:57 AM on February 7, 2010

I think the problem with saying, "this ain't shit" is that there's a problem bigger than what these individual women are facing. The chilling effect on nurses reporting doctors is what scares me most about this.
posted by serazin at 10:03 AM on February 7, 2010 [3 favorites]

Oh hell yeah, when Midland/Odessa is the nearest big city, you're in a world of pain unless there are no humans nearby.

Figures this crap-head "doctor" was pushing herbal hooha, too.
posted by fourcheesemac at 10:18 AM on February 7, 2010

I think the problem with saying, "this ain't shit" is that there's a problem bigger than what these individual women are facing. The chilling effect on nurses reporting doctors is what scares me most about this.

I'm saying its worse. I've done around 10 or 12 of these cases. The worst is always law enforcement top managers. They are used to having power. They do not realize the people here have rights.

I also think in this case, its the dumbest thing they could have done. What "friend" "helps" by drawing huge attention to the fact that the doctor has a troubled history? Instead of just shoving it under the rug and move on somewhere else. This guy's whole professional history is going to be on trial. So dumb. He ended his friend's career, not helped it. That's the thing. The people who do this sort of thing have on thing in common: their dumbshits who are used to getting their way. This kinda thing works for a while, until it hits someone with courage and a sense of right and wrong.

If that whistleblower gets the right lawyer, then others stand up in the same office. Once you have a few witnesses you are in good shape.

If I was Kay Bailey Hutchinson. I'd be watching this case. It typifys the type of abuse of power stories we see coming out of Texas.
posted by Ironmouth at 10:25 AM on February 7, 2010 [13 favorites]

This is Texas and small town Texas at that. I live here and have worked at several small hospitals across the state and I fear that the nurse will be convicted unless they find a jury of 12 people who give a shit. This situation with this doctor is not a one off. There are many of them across the state and no I will not be writting letters. I have been enough trouble just filing complaints up the chain of administration.
posted by bjgeiger at 10:26 AM on February 7, 2010 [1 favorite]

Hopefully. But I think the sheriff and prosecutor's actions are outrageous on their face.

The chilling effect on nurses reporting doctors is what scares me most about this.

See, I don't disagree with either of these statements, but outrageous things happen every single day, there are people that act shockingly bad and abuse their power all the time, these best we can hope for is that they don't get away with it, and from what little I know about the case and about TX law in general seems to suggest that it is quite likely the Dr. and sheriff is going to be seriously smacked down for his actions. If it happens differently then I'll unlock some of my hoarded bile for the case.

As to "chilling effect"... possibly, possibly this will happen. Or possible it will transpire that Dr. Shitface will get sanctioned and dismissed, the nurses will win a large settlement against him and the sheriff, an indeed the opposite will happen. The term "chilling effect" has been so overused in the last decade or so I kind of lump it into scare quotes category. And, I'm not trying to be dismissive of the possibility of what you are saying, actually happening, but again unless it happens and can be shown to be happening my concern shelf is already full to bursting.
posted by edgeways at 10:32 AM on February 7, 2010

I think the problem with saying, "this ain't shit" is that there's a problem bigger than what these individual women are facing. The chilling effect on nurses reporting doctors is what scares me most about this.

By "this ain't shit" I don't think he means it's not significantly problematic. I think he only means he sees more egregious cases of corruption and retaliation against whistle-blowers frequently, perhaps ones that have even greater "chilling effect" potential.
posted by mreleganza at 10:33 AM on February 7, 2010 [1 favorite]

Isn't this what the internet is for? To shine a light on crap like this???
posted by St. Alia of the Bunnies at 10:51 AM on February 7, 2010 [2 favorites]

Texas Monthly ran a story maybe 10-15 years ago about how useless, to the point of being counterproductive, the self-regulation of doctors was in the state. They built it around one egregiously dangerous doctor, but spread their net wide enough to show that it was a systematic problem.

Looks like it didn't do any good.
posted by Jimmy Havok at 11:04 AM on February 7, 2010

Even in small town TX I suspect this is going to end up being a major headache and financial loss to the Doctor and the Hospital.

But this is already a major headache for the woman, financial and emotional, and there is always the chance with juries, that you know, they return a verdict that is bat-shit insane.
This is the point of the entire prosecution. She lost already, the only discussion is if she loses a lot of time, sleep, and money or if she loses her freedom.

This is pretty much a SPAPP (Strategic Prosecution Against Public Participation. It is criminal and it is the state prosecuting. Lawyers might chime in to prove me wrong, but I believe that you really can't get damages or restitution for your lawyers fees even if you are judged innocent. You are Shit out of luck. You could try to sue for malicious prosection etc., but the bar is very high.
posted by xetere at 11:12 AM on February 7, 2010

Following xetere's line of thought, this kind of publicity could easily make it more difficult for these nurses to find work; given multiple applicants at another hospital, a less enlightened medical hiring staff might choose the nurse who hasn't been involved in a whisteblowing scandal, regardless of how this case turns out.

I hope the nurses file a civil suit against the doctor and the sheriff and win a nice chunk of change for themselves to compensate for emotional and reputation damages.
posted by Salvor Hardin at 11:39 AM on February 7, 2010

I hope the nurses file a civil suit against the doctor and the sheriff

They already have. From the NYT story:

The nurses’ lawyers, John H. Cook IV and Brian Carney, have filed a civil lawsuit in federal court charging the county, hospital, sheriff, doctor and prosecutor with vindictive prosecution and denial of the nurses’ First Amendment rights.

We'll have to see if the prosecution backs up its "you don't know the whole story" claim during the trial, but it sure looks crappy from here.
posted by mediareport at 11:46 AM on February 7, 2010

I live in Texas and when it seems that can't do anything more ignorant, they triple vaullt over their last ignorance hurdle into a whole new land of crazy. I mean we have arguments over putting Rush Limbaugh into our history books and taking out MLK Jr (Yes, really.) We have arguments every 5 years over what parts of Evolution not to teach in our classrooms, our Governor threatens to secede publicly and his approval ratings jump. They cling to their ignorance here like Charleton Heston to a .45.
posted by ExitPursuedByBear at 12:17 PM on February 7, 2010 [4 favorites]

Don't worry, it's not limited to Texas. This stuff happened in the small California town where I grew up, too. (It probably still does but I ran ran away!)
posted by small_ruminant at 12:40 PM on February 7, 2010

No, no, no, no, no!

Free market principles will save the day again.

Let the doctor go on about his business and sooner or later maybe he'll kill someone, or a few people, and then word will get around and he'll lose customers and leave the business.

Voila! The miracle of capitalism!
posted by rougy at 12:42 PM on February 7, 2010 [15 favorites]

The office of Sheriff is one which can very easily turn into a personal fiefdom for a power hungry maniac. See Arazona's Joe Arpaio, for example.

A lot of Sheriffs seem to resist that, either that or they're much better at covering up than the ones who make the news are. But if, in general, you want to find a cesspit of corruption, graft, general low level evil, and brutality look no further than the nearest Sheriff. Especially out away from the major cities it seems as if they can often do anything they want and get away with it for quite some time before they get caught.

I'll guarantee that if the story is true, and the Sheriff in question really did do what he's accused of doing, he's done a lot more and a lot worse in the past.
posted by sotonohito at 12:43 PM on February 7, 2010 [2 favorites]

"Isn't this what the internet is for? To shine a light on crap like this???"

No.
posted by mr_crash_davis mark II: Jazz Odyssey at 12:58 PM on February 7, 2010 [1 favorite]

I live in Texas and when it seems that can't do anything more ignorant, they triple vaullt over their last ignorance hurdle into a whole new land of crazy.

I am sorry to say that this story just reinforces my really negative views of Texas. With great apologies to the minority of enlightened folks who live there. That doesn't make everywhere else wonderful, but I'm always unpleasantly surprised by how bad Texas based stories can be.
posted by bearwife at 1:12 PM on February 7, 2010

I get what Ironmouth is talking about; anyone who thinks that this sheriff's actions are particularly heinous should acquaint themselves with the story of A.C. Gilless, the late Shelby County sheriff (whose jurisdiction included Memphis and suburbs), who turned the local jail into a major-league hellhole in which gladiatorial fights were staged between inmates by guards, sold deputyships, and settled two sexual harrassment suits against him in part with public funds. Never saw a day of jail himself.
posted by Halloween Jack at 1:18 PM on February 7, 2010 [2 favorites]

Hold on there, Halloween Jack, are you saying something bad happened in another US state? Was anyone violated by a toilet plunger?

Oh, you're a saucy one, Halloween Jack.
posted by Lesser Shrew at 4:14 PM on February 7, 2010

So, Halloween Jack, what do A.C. stand for in Sheriff Gilless' name? I've googled all over the place, and he's only mentioned by initials.

I see the fucktard died in 2004. Any further updates regarding the consequences of his actions, for the jailed and for the taxpayers?
posted by yesster at 5:06 PM on February 7, 2010

Gilless was subject to an inmate abuse lawsuit even as he took his office.
posted by yesster at 5:12 PM on February 7, 2010

Third comment in a row here, but forgive me.

halloween Jack's link is harrowing. Along with the original post -- WTF?? How does it happen that this shit still goes on these days? Don't we all know about the constitution etc.? Jesus christ folks, we're trying to have a civilization here.


And Sheriff Robert L. Roberts (jr.) can go fuck himself. I feel sorry for any of his family who are trying to live their own lives, still trying to love such a man. Holidays at that house must be hell.
posted by yesster at 5:23 PM on February 7, 2010

This is horrifying. I'm so angry for those nurses! (and for all the patients who won't be protected by whistleblowers, now that it's apparent that it's not safe to do the right thing where they live).
posted by Bergamot at 7:02 PM on February 7, 2010

I am sorry to say that this story just reinforces my really negative views of Texas. With great apologies to the minority of enlightened folks who live there.

As (hopefully) one of the minority, I feel compelled by civic pride to take a minute to defend Austin, at least. Austin is a very blue city with one of the best green energy programs in the nation, a thriving music scene, several colleges (one of which happens to be one of the best in the country), a very diverse international population, a self-consciously "weird" culture, and a well-known homeless transvestite guy who's popular enough that he once ran for mayor.

Oh, and mammals with wings. Wings!
posted by Xezlec at 8:15 PM on February 7, 2010

Texas Monthly ran a story maybe 10-15 years ago about how useless, to the point of being counterproductive, the self-regulation of doctors was in the state.

Don't you know Texas Monthly is full of liberal lies and ranting and you can't take a damn thing it says seriously? For crying out loud, it comes out of AUSTIN.

/proud resident of the People's Republic of Austin, native Texan, shocked but not surprised by this story and hopeful for but not counting on the acquittal of the nurse
posted by immlass at 8:43 PM on February 7, 2010

No defense necessary. Austin is generally acknowledged to be an honorary member of not-Texas.
posted by ryanrs at 9:01 PM on February 7, 2010 [2 favorites]

So, Halloween Jack, what do A.C. stand for in Sheriff Gilless' name? I've googled all over the place, and he's only mentioned by initials.

Go straight to SSDI, do not pass go. It's Alton C. Gilless.

FWIW, I typically do lots of research before selecting doctors. I lived in Texas several years ago and occasionally stumbled across this-doctor-killed-my-family-member websites, backed up quite substantially by newspaper clippings, and one pivotal issue is that these doctors did not get disciplined by the Texas medical board and continued right on practicing. It spooked me enough where I lost all confidence in the medical board and stopped using it to research doctors.

I cross my fingers that the Internet will succeed in holding accountability over bad doctors, and hope that open websites like ratemds.com and Google reviews take off, and hope that the shitty stifled subscription ones stop polluting the search indexes. I hope that folks like you leave reviews on the Internet, somewhere, of doctors you like and don't like. I'd rather sift through questionable and shilled reviews than trust a system of institutionalized corruption.
posted by crapmatic at 9:34 PM on February 7, 2010

If Austin is so good, why do they let all those Texas politicians hang out there? Hmm?

Seriously, I was fortunate enough to spend time in Austin, almost by accident. Some very happy times. Kind of makes my knees hurt, just thinking about it.
posted by Goofyy at 9:40 PM on February 7, 2010 [2 favorites]

Well, while we're hating on Texas, I'd like to say that incompetent doctors being left to run wild isn't unique to them. I was on a mock jury some years ago, a case where a doctor had blinded a patient by doing a shoddy job of pneumatic retinopexy. Standard practice is to have the patient stay face down for a week or so while the retina reattaches, but he simply sent her home, and after the first operation failed, he did it on the other eye, with the same results.

He gave a deposition that he had done thousands of these operations over the years, and that his failure rate was "normal," about 30-40%. The standard failure rate for the operation is under 5%. So he had blinded hundreds and hundreds of people through his incompetence.

It turned out that the hospital where he claimed to have been trained in the procedure doesn't even do it, but the hospital board that certified him didn't even check. Nor did they do any follow up on his results. So he was blinding people for years and years, and until this lawsuit came along, no one had bothered to notice.

He retired from practice when the lawsuit was filed, but the true horror is that he then went on charity missions to third world countries to do the exact same thing.

On the positive side, no one was prosecuted for exposing him....but then again, no one exposed him, except the lawyer for the plaintiff. How about we get some of that there tort reform?
posted by Jimmy Havok at 12:17 AM on February 8, 2010 [2 favorites]

To all above who asked for more info about Gilless: sorry, I really don't have anything that you couldn't find with a Google search. I left Memphis over seven years ago, and although there's a lot of things that I miss about it, the staggering amount of corruption and evil deeds by officeholders that was taken for granted isn't one of them.
posted by Halloween Jack at 9:57 AM on February 8, 2010

From the NY Times article:
"Mrs. Mitchell and Mrs. Galle had worked a combined 47 years at Winkler County Memorial Hospital here, most recently as its compliance and quality improvement officers."

Compliance & quality?! So, they really were fired (and now charged with a felony) for doing very specifically their job responsibilities?
posted by tastybrains at 11:53 AM on February 8, 2010 [3 favorites]

Well, the sheriff seems to think that they were improving the quality of care in the hospital in bad faith.
posted by grouse at 2:57 PM on February 8, 2010

Mitchell has been acquitted.
posted by mr_crash_davis mark II: Jazz Odyssey at 11:46 AM on February 11, 2010

That link doesn't work for me but THANK GOD. Also, I hope the nurses union that represents them sues the living shit out of the county, and that the nurses personally sue everyone involved for as much as possible, and also that the doctor and sheriff and supervisors in question all get crabs. Motherfuckers.
posted by serazin at 12:14 PM on February 11, 2010

Here's an L.A. Times link that hopefully will work better.

Should have known better than to link to KSL. Grrrr.
posted by mr_crash_davis mark II: Jazz Odyssey at 12:40 PM on February 11, 2010

NYT story
posted by Blazecock Pileon at 1:53 PM on February 11, 2010

Winkler County Nurse Anne Mitchell is not guilty, not guilty, not guilty, not guilty!
Verdict in Texas Nurse Trial - Not Guilty
The Texas Nurse Trial - How Did We Get Here?
posted by Decimask at 3:14 PM on February 11, 2010 [1 favorite]

That is such a relief to hear.
posted by mordax at 7:42 AM on February 13, 2010