A surgeon who was fired after she anonymously called patients at home and told them that bariatric surgery at NYU Langone Medical Center was too dangerous agreed to settle with her former employer in May, according to court records.

In January 2006, after the post-operative death of a patient, bariatric surgery fellow Neelu Pal, MD, called several patients scheduled for surgery in the following week and told them about her concerns. "I specifically told patients that I worked in the operating room, that a patient had recently died and that I had observed many other problems in the past with regards to patient safety," she said in court documents.

Dr. Pal, who now practices in Jersey City, N.J., sued NYU for whistleblower retaliation and misrepresenting the experience that she would gain during her bariatric surgery fellowship. After she was fired, Dr. Pal finished a fellowship at the University Medical Center at Princeton in 2007. After 5 days in U.S. District Court for Southern New York, Dr. Pal and NYU agreed to settle the case last month.

After Dr. Pal made the calls on a weekend, saying that she was an OR nurse, several patients phoned the NYU bariatric clinic to cancel their surgery appointments. Once the cancellations started coming in, the bariatric clinic scheduler called the clinic's co-director, George Fielding, MD, who called several patients and convinced them to follow through with surgery. Ironically, during the following week, Dr. Pal operated on some of the patients that she had called and warned not to come, according to court documents. Dr. Pal and her attorney did not respond to requests for comment.

In a statement prepared for this article, the NYU Langone Medical Center defended its weight-loss clinic and its physicians: "Our bariatric program has been recognized as a 'Center of Excellence' by both the American Society for Bariatric Surgery and HealthGrades, reflecting our expertise in bariatric surgery and our commitment to patient safety and quality."

A few days after Dr. Pal made the phone calls, she told the clinic's co-director Christine Ren-Fielding, MD, who is married to Dr. George Fielding, that she was the person who had contacted the patients. "I was afraid they were going to have complications," Dr. Pal told Dr. Ren-Fielding, according to court documents.

The medical center suspended and eventually fired Dr. Pal. "I was very disappointed," said Dr. Ren-Fielding, in court documents. "I thought very highly of her. [She] and her husband came over for Thanksgiving dinner. I even considered hiring her as a partner."

Because of her safety concerns, Dr. Pal also filed a complaint with the New York Department of Health, which investigated the clinic during the summer of 2006. The department's report cited the clinic for several violations, including letting 2 non-licensed physicians care for patients and entering false information on a surgical report. During the trial in May, Dr. Ren-Fielding admitted that the NYU weight-loss surgery clinic employed unlicensed physicians aides and that she had altered medical records to disguise care that had been performed by an unauthorized employee. NYU's attorney told the New York Post that the aides' employment was the result of an administrative problem that has since been solved.

The family of the patient who died, Rhonda Freiberg, settled with NYU for $973,000, according to a press report.

This month the state health department began a new investigation of the NYU bariatric facility. Contrary to a press report, the investigation is not a result of information that surfaced during the trial, according to the department.

"Our investigation is complaint-driven," says Jeffrey Hammond, a spokesman for the state health department. Earlier this month the health department received a complaint, which like any compliant, spurred an investigation. "We're looking at the entire bariatric program," adds Mr. Hammond, who says he can't elaborate on the details of the complaint or the investigation.

However, the NYU Medical Center says it hasn't heard from the health department. "The Department of Health has not requested any information regarding our bariatric program at this time," says the medical center in a statement.

The terms of the settlement between Dr. Pal and NYU were not disclosed in court documents.

Kent Steinriede

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