Northfield Hospital & Clinics officials are denying allegations that the hospital system violated the state Whistleblower Act by firing a former employee who claimed two of its physicians used improper surgical techniques and delayed follow-up visits, and are asking that the lawsuit be dismissed.

The hospital’s response, filed in Dakota County District Court, pertains to a lawsuit filed by Kaya Latzke, who served as the hospital’s endoscopy program manager for 5½ years. Latzke is seeking damages, back pay and compensation for benefits she would have received if she was still a hospital employee. The allegations of improper surgical techniques involve endoscopic physicians Katya Ericson and Ashley Marek, who both still practice at NH+C.

In seeking a dismissal, hospital officials stated any damages Latzke suffered “were caused by or contributed to by acts, omissions, fault, or other wrongful or improper conduct” by Latzke. They said Latzke’s allegations were barred by the doctrine of after-acquired evidence. The doctrine reportedly pertains to information discovered by NH+C after Latzke’s termination, which, if discovered earlier, could have led to her dismissal. Evidence relating to the hospital’s allegation was not included in its response.

NH+C also refuted Latzke’s statement that she had never been “coached, counseled, disciplined or warned with respect to her performance until she reported the alleged violations.”

Marek is an independent contractor providing services at NH+C since March 2019. Ericson has served as an independent contractor at the hospital since August 2014.

According to her LinkedIn page, Latzke served as a patient care supervisor at Abbott Northwestern Hospital from 2013-14 and as a registered nurse for a group of gastroenterologists from 2006-13. She is now the director of medical content development at Twin Cities-based Provation Medical.

Lawsuit: Physician “was putting patients at serious harm”

In the lawsuit, Latzke said she discovered last year that Ericson “was putting patients at serious risk of harm and breaching national clinical standards,” by having most of her colonoscopy and polypectomy removal procedures last well beyond the American Society for Gastrointestinal Endoscopy standard of 30 minutes, “directly resulting in increased sedation medication well above national standards.”

In late June 2019, Latzke reportedly learned from her staff that Ericson and Marek were putting their patients “at serious risk of injury during colonoscopies by placing an excessive amount of pressure on the abdomen,” also a violation of national clinical standards. According to the complaint, Ericson used “an outdated and dangerous medical technique for the piecemeal removal of colorectal polyps with a forceps instead of a snare, which is now the standard of practice that must be provided.”

Health system officials, in the court filing, haven’t directly admitted to the allegations but did say Latzke “received reports that certain physicians were requiring an amount of abdominal pressure during colonoscopies that (Latzke) deemed excessive.”

They stated they didn’t have “sufficient information to admit or deny” whether Latzke had learned that Ericson’s patients were being called back in three to five years, far beyond the recommended six to 12 months. However, the hospital system admitted the presence of a physician’s report stating patients who had piecemeal polyps removed should be recalled within 12 months.

In mid-October 2019, Latzke said she learned the hospital’s medical malpractice insurance carrier advised Ericson to author a letter for impacted patients informing them of the issues, the deviation from the standard of care and their rights. The carrier also advised the patients should have the choice of where to be seen, have no out-of-pocket expenses and not be operated on by any physician from the surgeon group.

In its response, hospital officials said “a decision was made to advise certain patients that they were due for a follow-up sooner than initially recommended.” However, they denied an allegation that legal counsel had advised NH+C to downplay the risks to guard against malpractice lawsuits following a November 2019 meeting.

“Out of respect for the legal process, we are limited in what we can say at this time,” said Northfield Hospital & Clinics Director of Communications Betsy Spethmann in a written statement. “We can say that this employment lawsuit has no merit.” She emphasized endoscopy care at the health system “is safe, thorough and professional.”

“We fully support all our endoscopy providers,” she said. “We regularly review care provided and contact patients who require followup care. Endoscopy patients who require followup care, for any reason, are notified and discuss their options.”

NH+C: Termination was budget-related

Eight days after the meeting, Latzke was demoted from a full-time managerial position to half-time manager with floor nurse duties. She said the move was retaliation for her reporting on the allegations, but, according to hospital administrators, her position “was restructured as part of an ongoing budgetary process that began in April of 2019,” and that her February termination was a budget-related measure.

In the lawsuit, Latzke said the hospital system posted for an endoscopy nursing position five days after her ouster and later promoted a clinical nurse to clinical coordinator, taking over some of Latzke’s responsibilities.

Hospital officials state the part-time nursing position for Endoscopy Clinic included a compensation rate “that was significantly less than what (Latzke) had been earning in her role as the manager/floor nurse.”

Spethmann noted NH+C officials had worked for months to close a $3 million gap while planning the 2020 budget. She added they engaged an outside expert to review the organization structure and size compared to other health care institutions and “learned that our structure had the benefit of in-house roles that most organizations our size didn’t have.” She said they realigned mid-level and senior leadership “to align with best practices among health care organizations our size. These changes were based on roles, not on individuals.”

“In response to significant health care market changes, NH+C needed to further reduce expenses, including labor costs,” she said. “Unfortunately, we could not close the budget gap without reducing the size of our staff. This included the elimination of 12 positions, including endoscopy program manager.”

A jury trial in the case has not been scheduled. The discovery process is slated to take nine to 12 months, during which documents considered relevant will be shared with opposing counsel. Depositions, including Latzke’s taken under oath, will then be taken. A motion for summary judgment seeking a conclusion of the case could take place before a trial. However, if the presiding judge rejects the motion, the case would then proceed to a jury trial.

Reach Associate Editor Sam Wilmes at 507-645-1115. © Copyright 2020 APG Media of Southern Minnesota. All rights reserved.

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