Trauma unit top officials accept blame 'Breakdown' cited in two lapses of recent weeks; A 'tarnished reputation'; Planned reforms include shifts in senior management


An article in yesterday's editions incorrectly identified the director of the Maryland Shock Trauma Center. His name is John W. Ashworth III.

The Sun regrets the error.

In a 50-minute staff meeting yesterday afternoon at the Maryland Shock Trauma Center, senior officials accepted blame for two recent public embarrassments and acknowledged that a sense of crisis had settled over the elite unit.

The officers, including the board chairmen of the University of Maryland Medical System and the trauma center itself, said a "systematic breakdown" had occurred because staffers and physicians failed to carry out fundamental responsibilities.

"God knows, there's enough blame to go around," said Stewart J. Greenebaum, chairman of the board at the University of Maryland Medical System, of which the trauma center is part. It is also affiliated with the University of Maryland at Baltimore, where its physicians hold academic appointments.

The two senior officers said they would use the two incidents -- the discovery that a physician had performed surgery without a license and the arrest of a nurse's aide who proved to be a convicted murderer -- as a catalyst to reform the administration of the center. They said there would be significant shifts in the center's senior management team.

A Sun reporter attended the staff meeting, along with about 75 physicians, administrators and employees.

The trauma center's medical prowess remains unquestioned, but administrative issues have been allowed to slide, opening the door to compromised standards, Mr. Greenebaum said. "In the past, when bad things have happened, we've accepted tranquillity," he said. That cannot persist, he said.

"You know that I think all of you walk on water," said former state Sen. Francis X. Kelly, chairman of the trauma center's board of visitors. "Collectively, you make us proud." But he added, "Our reputation, I think, has been somewhat tarnished in the public eye. There is no one else to blame but us."

The presence of Mr. Kelly and Mr. Greenebaum at the staff meeting underscored the importance they attached to facing the recent public controversies involving the trauma center.

Former Shock Trauma nursing aide John Wayne Cunningham was accused this month of using his job to steal credit information from a critically wounded police officer. A search of the aide's court records revealed that he had a criminal record, including a conviction for killing his mother.

Also this month, after a reporter's inquiry, hospital officials fired Dr. Arthur B. Boyd, a surgeon who proved to have failed medical licensing exams at least 15 times and who had been convicted of attempting to bribe a Michigan state official to get a copy of the tests before taking them. Dr. Boyd, who had treated hundreds of patients at the center, faked his credentials when applying for the post there.

Dr. Boyd and Mr. Cunningham would not have been hired if their pasts had been known at the time, officials said. But Mr. Greenebaum said many co-workers knew of Dr. Boyd's professional shortcomings, yet failed to report him.

The two episodes, headlines on one coming hard on the heels of the other, prompted senior officials to review the way they look at their institution, officials said. The incidents "hit us right between the eyes," said John W. Ashcroft, director of the Shock Trauma Center. "We need to act on cue in a way that is outstanding."

The two-year reign and forced departure in 1993 of Dr. Kimball I. Maull as trauma center director left unresolved tensions at the center. Since then, senior administrators have been assigned duties at the University of Maryland's hospital and at Shock Trauma, hobbling their ability to address pressing issues, Mr. Greenebaum said.

Mr. Ashcroft -- who is also the UM medical system's senior vice president for strategic planning, program development and communications -- will be asked to concentrate on Shock Trauma at least 80 percent of the time, Mr. Greenebaum said.

Mr. Ashcroft will gain a senior executive aide who will focus solely on budget and management issues. In addition, the board will act to fill several department chairmanships left vacant for too long, Mr. Greenebaum said.

Mr. Greenebaum and Mr. Kelly promised to work more closely with hospital and UMAB officials.

"The real question that was posed and the issue that the board chairman [Mr. Greenebaum] and Frank Kelly helped these people walk away with is that they have responsibility for demanding excellence not only of themselves -- and that they do repeatedly -- but of those around them," Joel Lee, the Shock Trauma Center spokesman, said after yesterday's meeting. "That means not only physicians but their leadership."

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