Tuesday, July 14, 2009

Dr. Yorobe and Kaiser Permanente both guilty of "repeated negligent acts"

Dr. Yorobe sounds just like the Kaiser Permanente doctors who treated my friend Sandra Wiltgen.

Sandra died of uterine cancer in 1992 at the age of 44. She went to the Kaiser Emergency Room on Zion in San Diego with bleeding, and each time the doctors did the same thing: a blood test. Each time the blood test revealed that Sandy was severely anemic, so doctors did the usual: a blood transfusion. Each time they sent her home. This went on for a year and a half, at which time the doctors had the brilliant idea of checking for uterine cancer. Sandy received external radiation at a non-Kaiser clinic where the radiologist recommended--no, urged--that a radioactive implant be used. But the gynecologist at Kaiser did not approve this idea. Sandy died without ever having seen an oncologist.



Treatment of patient who died draws fire
Medical Board claims doctor was negligent
By David Hasemyer
San Diego Union-Tribune Staff Writer
July 13, 2009

COLORECTAL CANCER

Incidence: The third most common cancer and the third most common cause of cancer death in the United States.

Detection: Usually no symptoms in the early stages. Can be detected by colorectal cancer screenings. As it progresses, the disease may cause symptoms such as a change in bowel habits, bleeding from the rectum or blood in the stool, or cramping or gnawing stomach pain.

Risks: Chance of developing colorectal cancer increases as people age. Over 90 percent of cases occur in people older than 50. The mortality rate for males was 25.3 per 100,000 and 17.7 per 100,000 for females from 1997 to 2001.

Prevention: About 26,000 deaths a year could be prevented in the U.S. if everyone older than 50 were screened for colorectal cancer.

Source: American Cancer Society

Online: For the California Medical Board accusation against Dr. Edwin Yorobe, go to uniontrib.com/more/documents

When Teodoro Galvez started feeling ill with back pain and rectal bleeding, he sought treatment from a doctor from his native Philippines.

The Navy veteran and Rancho Peñasquitos resident just felt more comfortable in the care of a doctor from his homeland, said his daughter Sucett Galvez. So he became a patient of Edwin Mendez Yorobe, a 1970 graduate of Far Eastern University in Manila who had his medical practice in Tierrasanta.

But the doctor Galvez placed so much trust in has been accused of negligence and incompetence by the Medical Board of California, which says Yorobe overlooked signs of rectal cancer in Galvez for more than a year before Galvez died of the disease.

Yorobe, who has been licensed in California since 1975, did not respond to numerous requests for an interview.

The Medical Board accusation filed in Administrative Law Court says Yorobe failed to properly diagnose the cause of Galvez's rectal bleeding with appropriate diagnostic studies and seeks the revocation or suspension of Yorobe's license.

“(Yorobe) departed extremely from the standard of care for treatment of a 73-year-old man with rectal bleeding by failing to properly and fully investigate the exact cause of (Galvez's) rectal bleeding with timely and appropriate diagnostic studies,” the accusation says.

A hearing date for the case has not been set.

“My dad put his trust in his doctor,” Sucett Galvez said, but throughout repeated visits, he began to wonder why he wasn't starting to feel better. “But we just thought he's going to see a doctor, so he's being taken care of.”

According to the court documents:

Yorobe first examined Teodoro Galvez in March 2003 and noted hemorrhoids, bleeding in the gastrointestinal tract and a stool sample that suggested colorectal cancer.

In response to those findings, Yorobe directed his patient to stop taking ibuprofen, which increases bleeding by thinning the blood, and to start taking Zantac, which is used to treat bleeding ulcers. He told Galvez to come back in three weeks.

After the follow-up visit, Yorobe again noted the bleeding and the warning signs associated with cancer but then “concluded his inquiry into this condition,” the accusation says.

Yorobe, 63, examined Galvez 11 more times between May 2003 and August 2004 without any mention of the bleeding or signs indicating cancer.

During an August 2004 visit, Galvez told Yorobe that he had developed a painful mass in his groin and had lost his appetite.

The doctor diagnosed Galvez with a hernia and recommended the use of an athletic supporter.

Galvez was back in three weeks. He was diagnosed with rectal bleeding and told to take hot baths, use Anusol, watch his diet and exercise.

Two weeks later, in mid-September, with Galvez still bleeding, Yorobe referred his patient to another doctor for a consultation.

“However, before (Galvez) was seen by a specialist, he went to the emergency room at Sharp Memorial Hospital where he was admitted and diagnosed with metastatic inoperable rectal cancer to the liver,” the accusation says.

Galvez died October 27, 2004.

Medical Board authorities say the acceptable standard of care would have been to conduct physical examinations and tests to establish the location of the bleeding and to rule out cancer. Yorobe did not perform those tests, including a colonoscopy and rectal exam.

The Medical Board said that failure constitutes “repeated negligent acts” by the doctor in his care of Galvez.

In 2006, Yorobe and another doctor settled a malpractice lawsuit filed by Sucett Galvez, her brother and mother for $125,000.

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