A heart surgeon who worked at SUNY Downstate Medical Center in Brooklyn charges in a lawsuit he was fired after warning hospital brass about “significant shortfalls” in patient care that led to deaths.

Dr. Robert Poston’s suit, filed in Brooklyn Supreme Court on July 28, follows three other whistleblower lawsuits against the hospital by two cardiac surgeons and a transplant specialist in December, January and February that allege a pattern of retaliation. 

Together, the four lawsuits paint an unsettling portrait of a taxpayer-funded teaching hospital ill-equipped to handle cardiac and transplant surgeries for the immigrant Brooklyn communities of East Flatbush, Prospect-Lefferts Gardens and Crown Heights. 

The suits describe alleged conditions before Downstate was slammed by the coronavirus crisis, temporarily transitioning to a COVID-only hospital in April.

In the two earliest suits, first reported by The Wall Street Journal, Dr. Rainer Gruessner, 63, and Dr. John Renz, 55, accused hospital management of negligence leading to “at least three inpatient deaths within a one-year period” characterized by chronic staff shortages and “a lack of actual patient care.” 

The lawsuits detail instances of a surgeon “abandoning” a transplant patient on the operating table and an attending physician going AWOL.

“In one such alarming instance, in or about June 2019, a patient ‘coded’ (i.e. went into cardiopulmonary arrest) and died on his way to a rehabilitation facility,” Gruessner’s suit claims. “This occurred at a time when there was not a single attending present, and the resident responsible for intubating the patient was so inexperienced that he was almost shocked by the defibrillator during the code.”

The third lawsuit, filed by Dr. Frederic Joyce on Feb. 13, alleges Downstate unlawfully fired the 68-year-old surgeon, citing budgetary constraints. 

“The real reason for SUNY Downstate’s decision to terminate Dr. Joyce’s employment,” the suit maintains, “was that he was vocal and active, together with Drs. Gruessner, Poston, Renz and others, in identifying to senior administration various issues affecting patient health and safety in the cardiothoracic and transplant divisions.”

‘Among the Worst’

In the most recent filing, Poston cites a similar litany of unsound practices that he argues threatened patient safety. 

According to court documents, Downstate hired Poston, a 52-year-old specialist in robotic heart surgery, “to help turn around the division of cardiothoracic surgery, which had been among the worst-performing divisions in the country, based on national database statistics, with a history of poor outcomes resulting from clinical and administrative failures.” 

Backing up that claim, a 2019 state Department of Health report noted that Downstate patients who had undergone coronary artery bypass graft surgeries, valve replacements or joint bypass/valve-replacement surgeries between 2014 and 2016 had “a significantly worse survival rate” and higher readmission rate than the statewide average of 37 hospitals.

Last year, according to Renz’s suit, the transplant surgeon “advised senior leadership on multiple occasions that a scheduled data release in July 2019 by the Scientific Registry of Transplant Recipients would reveal the worst clinical outcomes in the history of SUNY Downstate.”  

Among the registry’s findings in that report, SUNY Downstate data indicate a “97% higher risk of graft failure compared to an average program” after three years for those receiving deceased-donor organ transplants performed between July 1, 2013 and Dec. 31, 2015.

Poston’s suit further alleges that a patient died on May 26, 2019 “at least in part as a result of no in-house cardiothoracic trained Physician Assistant.”

In a statement to THE CITY, Dawn Skeete-Walker, a SUNY Downstate spokesperson, declined to comment on pending litigation. But she acknowledged the hospital had voluntarily and temporarily inactivated both the heart and kidney transplant programs after outside consultants identified troubling issues “with the leadership.” 

“We reactivated our kidney transplant program, and we continue to refine the reorganization of the heart transplant program,” she said. “If we uncover misconduct, policies, procedures, practices of any kind, or substandard care and issues of lack of professionalism that threaten patients’ safety or our learners, as an operational matter, we will move swiftly and firmly to investigate and take appropriate actions to ensure institutional integrity. 

“We make no apologies about our commitment to upholding the highest standards in our hospital and within our university community,” she continued. “Our compassion and commitment to the patients we serve are unwavering.”

‘Campaign to Retaliate’

Beginning in August, 2019, Poston’s suit charges, Downstate’s senior administration “embarked on an unlawful campaign to retaliate against the surgeons” for speaking out.

In 2014, he was suspended from the University of Arizona Medical Center, causing ailing cardiac patients to delay needed surgeries. Poston sued the Tucson hospital, but the details and disposition of the case were not immediately clear. 

Poston’s total compensation for each of his first three years at Downstate, according to his term of employment letter, was to be $600,000. Renz was supposed to have earned $495,000; Joyce, $700,000; and Gruessner, a maximum of $850,000. 

All insist in court filings that they actually earned far less as the hospital did a “bait and switch” to lure them to relocate, then significantly decreased their pay.

The four Downstate docs are seeking lost pay, a reinstatement of their position, and compensatory damages to be determined. Lawyers for the surgeons did not return calls seeking comment. 

In an embarrassing coda to their termination ordeals, the surgeons point out in their suits that they were unceremoniously escorted from the building.

In an Aug. 27, 2019, letter to Downstate President Wayne Riley written after his termination, Renz wrote, “As I left the building, I did not feel sorry for myself; my concern was for the patients at Downstate and the people of Brooklyn. 

“Who will be there for these patients?”