Read Part 1 of The Frontier’s investigation
Read Part 2 of The Frontier’s investigation
Dr. Steven Anagnost discusses the state medical board’s lengthy investigation of patient complaints against him. ADAM FORGASH / The Frontier
A spokesman for Gov. Mary Fallin said Thursday that lengthy delays — not a call from Texas Gov. Rick Perry — prompted Fallin’s intervention two years ago in a Tulsa surgeon’s disciplinary case.
But records show some of the delays in Dr. Steven Anagnost’s case before the state medical board were due to his own legal maneuvers or factors outside the board’s control. Anagnost fought release of his internal hospital file to the board and allegedly harassed a surgeon cooperating with the investigation against him, court records show.
Meanwhile, the state spent months searching for an out-of-state expert witness willing to take on the complex case involving 23 patient complaints.
The statement Thursday by Fallin’s spokesman, Alex Weintz, was among several developments that followed a seven-month investigation by The Frontier into how the Oklahoma Board of Medical Licensure and Supervision handled Anagnost’s disciplinary case:
- Oklahoma Democratic Party chairman Mark Hammons called on state or federal authorities to investigate whether Fallin’s involvement in Anagnost’s case violated any laws or ethics rules.
- Weintz reiterated that the governor did not dictate the outcome of Anagnost’s disciplinary case before the medical board. “They absolutely were not told to drop it by anyone in our office,” Weintz said. “They were told to resolve it.”
- Fallin’s general counsel, Steve Mullins, said a memo by a medical board adviser did not accurately describe what Mullins said about Anagnost’s case. The memo said the staff believed Mullins wanted the board’s action against the doctor dropped.
- Critics of a proposal to allow the governor to appoint all state agency heads said the outcome of Anagnost’s case shows why it’s a bad idea.
The Frontier reviewed thousands of pages of records related to Anagnost’s case before the Oklahoma Board of Medical Licensure and Supervision as well as 45 negligence lawsuits against him. The Tulsa-based surgeon, 48, received his Oklahoma medical license in 1999.
The Oklahoma medical board filed a complaint in July 2012 accusing him of violations involving 23 patients: performing surgeries in which patients died or were paralyzed, and charging patients for surgeries not performed.
While the allegations are among the most serious made by the board against a doctor, Anagnost signed a settlement agreement with the board a year later in which he kept his license and admitted no guilt.
He returned to practice five months later and is currently performing surgeries at a hospital in Tahlequah and a Tulsa pain management center. Anagnost no longer has admitting privileges at Hillcrest Medical Center, where he treated patients for several years.
In multiple interviews with The Frontier, Anagnost has described the state’s investigation as a coordinated attack by the board, competing spine surgeons and malpractice attorneys who were part of the investigation and stood to gain from the board’s action. Claims by the former patients and allegations in dozens of lawsuits against him have no merit, he said.
The state’s three-year investigation cost not only money but his reputation, Anagnost said.
“I’ve spent a tremendous amount of money, which I would rather save for my family, my kids,” he said.
While saying he’s “not perfect,” Anagnost said, “I’m also not a bad doctor.”
He said statistics produced by an expert he hired show his patients’ outcomes are above average. However those statistics are based on the doctor’s hospital records, which he fought to prevent the state from accessing.
Anagnost could not be reached for additional comment concerning calls for an investigation into alleged political meddling in his disciplinary case. He has rejected the notion that the board agreed to settle his case due to political pressure.
Officials with the medical board have declined to comment on his case, citing lawsuits the doctor has filed against the board.
Former state lawmaker Joe Dorman said the state’s disciplinary action against Anagnost shows why a new proposal to allow the governor to appoint agency heads could cause problems. Dorman, who made an unsuccessful bid for governor last year, said he has voted against such legislation in the past.
Some state agency heads, including the Oklahoma Board of Medical Licensure and Supervision’s director, are selected by boards whose members are appointed by legislative leaders and the governor.
“I debated against that bill when it came up and fought it tooth and nail. … If there are no checks and balances in place, it is scary what could actually happen,” Dorman said. “They will serve at the political pleasure of a person who relies on campaign donations.”
Mullins: Email ‘not relective of my statements’
In fact, campaign donations may have played a role in Anagnost’s case. But they were made to the governor of Texas.
A memo from Dr. Eric Frische, the board’s medical adviser, recounts a visit Mullins paid to the board in March 2013 about Anagnost. By then, the board had spent $600,000 in its quest to revoke the surgeon’s license.
“He (Mullins) told us that he wasn’t here to interfere with the work of the board but Gov. Fallin didn’t want any more calls from Rick Perry about this, that Gov. Perry said it was a travesty and what would it take to make it go away,” Frische wrote.
Gov. Mary Fallin, left, and former Texas Gov. Rick Perry, right, stand together at the Southern Republican Leadership Conference in Oklahoma City in May.
ALONZO ADAMS / AP
His memo was dated Sept. 11, 2013, the day before the state settled Anagnost’s case. In exchange for keeping his license, Anagnost agreed to attend a spine surgery fellowship in Kentucky, complete training on physician billing practices and pay a $10,000 fine.
Following that meeting, Mullins walked out with the board’s executive director, Lyle Kelsey, who learned “that the doctor had a benefactor by the name of Dick Powell who was very wealthy, a significant contributor to Rick Perry and also a surrogate father to the doctor and that he was behind the effort to get rid of this,” Frische wrote.
Records show both Powell and Anagnost donated the maximum, $2,500, to Perry’s failed presidential bid.
Powell was also a member of the Perry campaign’s Tennessee finance team. His son is a childhood friend of Anagnost’s with ties to the Texas GOP.
Weintz has confirmed that Perry called Fallin about Anagnost’s case.
However Mullins, In an email Thursday, said Frische’s memo “is not reflective of my statements.” Mullins declined a request by The Frontier for an interview about his role in Anagnost’s case.
“However, it is true that I was concerned about the allegations of conflict and the possible bad law regarding due process that this case would produce,” his email states. “Four members of the Supreme Court had similar concerns in their Feb. 2013 opinions. This opinion is the actual reason the meeting was scheduled – to discuss the opinion.”
While critical of the board’s process and apparent conflicts of interest, the justices declined Anagnost’s request for the court to intervene in the state’s case, freeing the board to proceed with action.
Mullins’ email states he was concerned “the board had serious conflict questions and would be violating the rights of the Doctor if further delay occurred.”
“If you read the September 2013 memo you will see that the AG had similar concerns,” he states.
While Mullins and the AG’s office were concerned about Anagnost’s rights, records reflect no discussion at the time about the rights of 23 patients who filed complaints. Two of them died weeks apart in 2008 after Anagnost performed surgeries on vertebrae in their necks.
When asked Thursday whether the governor’s office knew the reasons for the board’s lengthy investigation of Anagnost, Weintz said he was not aware.
The board filed its first complaint involving allegations by five patients against Anagnost in June 2010 as an “emergency action.” However, the board’s expert witnesses were Tulsa neurosurgeons unfamiliar with the “minimally invasive” surgery Anagnost performed.
The board dismissed the emergency portion of its action and began seeking an expert to evaluate patient complaints about Anagnost’s surgeries. Over the next year, discussions with several potential experts who lived out of state fell through, records show.
In June 2011, an out-of-state physician evaluation program agreed to review Anagnost’s case, Frische’s timeline states.
But the board was not able to meet with Anagnost for four months about attending the program, known as CPEP. (It is unclear whether Anagnost or the board was responsible for that delay.)
“We were finally able to meet with the doctor and his attorney about going to CPEP,” Frische’s timeline states.
“We advised that he could go voluntarily making it confidential and that if he could get a favorable evaluation that it would help him. We gave him a few weeks to consider this option but he made no attempt to contact CPEP,” the memo states.
Frische notes that during the meeting, Anagnost “was asked if he had made payments for any of the lawsuits. He responded that there were no payments made on his behalf.”
Later, Anagnost acknowledged paying to settle several lawsuits out of his own pocket and failing to report those settlements to the board as required by state law. He said the settlements weren’t reported because his staff was not aware of them.
Board staff spent several months in 2012 trying to obtain Anagnost’s “peer review” file from Hillcrest Medical Center. Court records show Anagnost fought release of the file showing outcomes of complaints and investigations by the hospital.
At the time of Mullins’ visit in March 2013, the board was still seeking a doctor qualified to evaluate Anagnost’s work. It eventually signed an agreement with a Chicago surgeon billed as one of the nation’s top experts in minimally invasive spine surgery, Dr. Kern Singh.
The board also filed legal action around this time alleging doctors cooperating with the state investigation were being “intimidated and harassed.” Anagnost was trying to depose all of the physicians in one witness’ practice, court records state.
Plan was to ‘frighten board members into voting for settlement’
Ultimately, state officials’ concern over lawsuits by Anagnost apparently outweighed their desire to press forward with the medical board’s investigation into 23 patient complaints. The AG’s office advised the board staff that “we should just drop the matter or settle any way we can.”
“The plan is to frighten the Board members into voting for this settlement or otherwise they might be subject to lawsuits if this case continues,” Frische’s memo states.
Anagnost sued the board anyway, along with three attorneys and four Tulsa neurosurgeons who took part in the investigation. In August, an Oklahoma County district judge dismissed all defendants except for the neurosurgeons from Anagnost’s lawsuit.
Dorman said the way Anagnost’s case had been handled could have an impact on the state’s future ability to oversee medical professionals.
“When the chief legal counsel for the chief executive officer comes in and indirectly threatens you and says for something to go away, that’s scary to those board members. They know the political bullseye has been put on them.”
Several former patients of Anagnost’s contacted The Frontier Thursday to discuss their cases. None agreed to be named, citing fears about legal action or impact on their jobs.
“The only reason I am walking today is the grace of God,” said one former patient. She said she was recently hired and her new employer is not aware of how many back surgeries she has undergone.
The woman said Anagnost performed numerous surgeries on her neck and back but her pain grew worse each time. She said when she finally went to another surgeon, he told her about the dozens of negligence lawsuits filed against Anagnost.
She said she followed the state’s disciplinary case and when she heard about the governor’s intervention, “I was shocked, but then it all made sense.”
