By Francisco Alvarado
By Trevor Bach
By Chris Joseph
By Michael E. Miller
By Allie Conti
By Keegan Hamilton and Francisco Alvarado
By Jake Rossen
By Allie Conti
It's a medical horror story that never happened as far as the State of Florida is concerned. And it began on New Year's Eve 2001 in the most mundane of places -- a living room.
Mary Emma Marshall thought she simply pulled a muscle in her left hip as she walked across her condo in Fort Lauderdale. The great-grandmother, then 81 years old, was suffering from osteoporosis, but the pain didn't seem that serious until two days later, when it became excruciating and she was taken by ambulance to Broward General Medical Center, the county's flagship public hospital.
The hip was broken. Her general practitioner, Charles Halfpenny, who has a public contract with the tax-subsidized North Broward Hospital District, recommended orthopedist Sein Lwin. Marshall took the advice.
She had no way to know at the time that Lwin, who has refused repeated requests for an interview, isn't board-certified -- the field's leading seal of approval for competency -- and had a growing list of malpractice complaints. The hospital district certainly wasn't doing anything about it. Lwin happens to be the darling of NBHD, which is overseen by a board appointed by Gov. Jeb Bush and supported with 174 million in property-tax dollars. Lwin, a 64-year-old native of Burma, holds a $1.7 million contract to provide orthopedic care at Broward General's emergency room but is known more for his political connections than for his medical expertise (see "All the Governor's Men," New Times,March 4).
Rather than perform a full hip replacement, Lwin secured Marshall's crumbling bones together with a pin, says her daughter, Jody Ledford. It didn't take.
From the beginning, Marshall, who was suffering from senility, complained of pain and, after weeks of rehab in the hospital, still couldn't walk. Perhaps most disturbing, her leg was receding into her torso. Within a couple of weeks, it was two and a half inches shorter than it had been.
Ledford, a Fort Lauderdale native who lives in Miami, says she knew something was terribly wrong. But Lwin assured her everything was fine. The solution, he told her, was to get her mom a special platform shoe, which Ledford did. "Even the man who came to measure her for shoe lift couldn't believe the difference in her legs," says the daughter. "He said he had to come back out and measure again, because it couldn't be right."
After a month in the hospital, Marshall was sent home, still unable to walk and suffering immense pain. Finally, Ledford requested that Lwin x-ray Marshall's hip to see what was wrong. An office appointment was scheduled. "Moving her was a major happening -- it was a huge ordeal getting her to the doctor's office," Ledford says. "We get her over there, and he says the machine isn't working. I was furious."
Lwin made a house call a few days later to Marshall's Fort Lauderdale condo, where he again assured the family all was fine, according to Ledford. But the daughter was desperate. She decided to get a second opinion. In mid-February of 2002, she took her mother to another doctor, Kevin Shrock, who quickly discovered that the screw had come loose in Marshall's hip. Worse, a look at Marshall's medical file revealed that the screw had been coming out two days after the surgery. "He didn't look at the x-ray," Ledford complains.
Shrock performed a hip replacement, and Marshall was soon walking. Her leg, fortunately, returned to near normal length.
But that didn't quell Ledford's fury about the six weeks of hell her mother had to endure and the fact that it took a second doctor to end the needless suffering.
Ledford is one of several of Lwin's former patients with a gripe. He's been the subject of at least four malpractice lawsuits -- which are public record -- during the past decade. That's a higher-than-average number, though it's not wholly unusual, other orthopedists tell me. There are plenty of dubious doctors in Broward County -- orthopedic care is a high-risk specialty, and not all claims have legal merit.
But Lwin is a special case: If you break a bone in Fort Lauderdale, you might not be able to avoid the guy. His contract gives him a virtual monopoly on emergency room care at Broward General. He also has two partners who thankfully are board-certified and don't have histories of malpractice.
The district compensates Lwin and his partners $4,650 a day for their services, but the orthopedist has subcontracted some of the work to other physicians for less than half that, according to several Broward surgeons. A former Lwin partner, Dr. Richard Goldstein, decried the practice of subcontracting ER work in a February 14, 2002, letter to district commissioners in which he asked that the emergency room be open to more doctors. He wrote that Lwin and other partners "recruited [outside doctors] to take their call for a day, or for several hours, or if there is a 'difficult' problem in the emergency room and reimburse these doctors with a fraction of the [district] funds they take for their call each day... the situation has been untenable."
Lwin has denied responsibility in other complaints: