Doctor wins lawsuit over ex-employer’s handling of patient concern he “rubbed his nose a lot”

LOUISVILLE, Ky. (WAVE) - In a nearly seven-year lawsuit, a former Baptist Health doctor has won his case before Kentucky’s Supreme Court.

Dr. John Farmer, Jr. was in his final year of residency at Baptist Health-Madisonville on November 4, 2019. The mother of his final patient of the day believed he “rubbed his nose a lot,” and she believed him to be “on something.” She reported her concern to a hospital administrator, sparking next steps that high court judges conclude has left him with a “proverbial scarlet letter.”

According to the court’s majority opinion, Baptist Health did not follow its own policy by investigating the claim themselves. Dr. Farmer was not tested the day of the complaint nor the day after. The hospital’s practice manager, a long-time nurse, believed the complaint was not anything to worry about, describing the doctor’s behavior as “normal.” He had ADHD and exhibited symptoms typical of the disorder.

That nurse reported the concerns to Dr. Farmer’s residency director. In trial, two of Dr. Farmer’s fellow doctors reported to the director that they believed he was not impaired in any way, including one who was in the room with the patient, her mother and Dr. Farmer during the interaction. Those opinions were not passed along to hospital leadership, the opinion reads.

Instead, the residency director told leadership Dr. Farmer had a history of alcohol abuse, based on a 2013 DUI conviction while in medical school, which he disclosed prior to employment with the hospital. She also told leadership he was receiving treatment for suicidal ideation from a psychiatrist, who would later testify the comment that led to that belief was a joke “taken out of context.”

The hospital’s attorneys argued that because the complaint originated from the last patient of the day, they could not test Dr. Farmer for any substance. They said he had already left the hospital and may have had alcohol at home that could impact the results.

The majority opinion concluded that whether alcohol consumption was a factor should never have mattered because leadership said it did not. Dr. Wayne Lipson, the Chief Medical Officer of Baptist Health, testified that the concern was not based on alcohol but could have been “emotional, could have been drug-related...could have been psychiatric, could have been physical.”

However, Dr. Farmer was only ever tested for alcohol, days after the complaint. The judges found no explanation for why a drug test, which they believed to be the root concern based on the alleged behavior, was never conducted.

The judges seem to believe this failure was a violation of the hospital’s own policy.

Dr. Farmer was told he could not see patients until he was tested and treated by the Kentucky Physicians Health Foundation (KPHF). They did a blood test for alcohol using a PEth test, which returned “very high” metabolic markers for alcohol. The judges write, “the record makes clear that a PEth test is a blood test for alcohol markers and can generally determine whether alcohol has been ingested in the last two to three weeks. PEth tests are, however, uncommon in the legal literature.”

They go on to conclude “the PEth test cannot tell whether Dr. Farmer was in fact impaired on November 4, 2019.”

Dr. Farmer was then sent to a third-party treatment center, which diagnosed him with the lowest degree of an alcohol use disorder. The Kentucky Board of Medical Licensure required Dr. Farmer to enter a five-year monitoring agreement to practice medicine, though he could not see patients and it required him to abstain from alcohol or drugs, including his ADHD medication.

Neither the PEth test nor the disorder were introduced in the jury trial, but they were brought up as a dispute in their appeal after a jury ruled in Dr. Farmer’s favor.

The jury unanimously awarded $3.5 million to Dr. Farmer, which the appeals court reversed. The state supreme court then reversed the appellate ruling and restored the award, plus interest, to Dr. Farmer in a majority opinion on June 25.

“Even after all of this was decided in my favor, it will forever lengthen the process for me to get licensed and credentialed to practice medicine,” Dr. Farmer told WAVE News. “In some cases, it has cost me job opportunities.”

The judges concluded the system meant to weed out the bad doctors had served to brand Dr. Farmer with a “proverbial scarlet letter.”

Dr. Farmer’s lead attorney, Kathleen A. DeLaney of Indianapolis law firm DeLaney & DeLaney LLC, told WAVE in a statement, “The Supreme Court’s scholarly and thoughtful decision will provide protection to all health care providers who are wrongly accused of impairment in the future.”

However, dissenting Supreme Court judges and Baptist Health disagree it will provide protection. They believe it will be harmful.

“We are disappointed with the court’s decision. Baptist Health’s goal is to provide high-quality care to patients. The Kentucky legislature passed a law which encourages prompt reporting of potential physician impairment. Because of this opinion, hospitals and physicians who have concerns about potential physician impairment may no longer have the protection of immunity for reporting those concerns,” a Baptist Health spokesperson told WAVE. “The opinion was not unanimous. Three judges wrote a dissenting opinion which states, ‘The current Majority opinion has serious consequences for organizations who should appropriately report concerns of potential impairment, and the safety of the patients they serve.’”

The state supreme court’s full opinion can be found here.

Dr. Farmer is now working as a hospitalist in Eastern Tennessee.