Winkler County Sheriff Robert Roberts is guilty, guilty, guilty, guilty!!

Remember the case of the Winkler County nurses?

This is the story of two nurses who blew the whistle on a bad doctor, a quack even, in my opinion. As a result they faced the very real possibility of jail time. And not just jail time, but serious jail time, up to ten years. I first wrote about this story nearly two years ago, when I first learned of Dr. Rolando Arafiles, his good buddy (and business partner hawking supplements with him) Winkler County Sheriff Robert Roberts, and the administration of a small hospital in the middle of nowhere in west Texas.

Readers might recall that Dr. Arafiles achieved notoriety when these two brave nurses reported their concerns about Dr. Arafiles’ substandard care to the Texas Medical Board. However, it should be noted that the failure to discipline Dr. Arafiles is not simply a problem of the TMB. Remember, prior to going to the TMB, Galle and Mitchell had taken their complaint through formal channels at the 25-bed rural hospital where they worked, Winkler County Memorial Hospital. Their complaints were in essence ignored. Moreover, it’s not as though these problems were subtle. They weren’t, and they became apparent immediately after Dr. Arafiles joined the medical staff of Winkler County Memorial Hospital, as I documented. More appallingly and all too often not mentioned or barely mentioned is that Winkler County Sheriff Robert Roberts, Jr. was not only just Dr. Arafiles friend and patient, but he had been in business with Dr. Arafiles selling supplements. In fact, during crossexamination, Dr. Arafiles even described how Sheriff Roberts had sold his nutritional supplement called “Zrii,” going so far as to hold meetings at the local Pizza Hut to recruit other sellers. No wonder when it came to chasing down these nurses, Sheriff Roberts transformed himself from Barney Fife to, as I once put it, Jack Bauer on crack, from Inspector Clouseau into a veritable Sherlock Holmes. He figured out who the nurses were and brought charges of misusing official information against them. Ultimately, the charges were not pursued against one nurse (Vickilyn Galle) but were against Anne Mitchell.

The trial was a complete farce, and Mitchell was found not guilty in record time.

Unfortunately, there was no good way for Mitchell and Galle. They were out of work, and it’s not as though there were a lot of other job opportunities in that sparsely populated part of west Texas. The entire power structure of Kermit, TX and Winkler County, including Sheriff Roberts, County Attorney Scott Tidwell, and the entire administration of Winkler County Memorial Hospital arrayed against them. You’d think that this was just another story of the good ol’ boys network in a small town banding together to teach a couple of “uppity” women a lesson for daring to go against them, and you’d be right. What’s unusual about this case is that, in the end, it appears that justice will actually be done:

Jurors have convicted a West Texas sheriff of retaliating against two nurses who complained to state regulators about a physician friend.

Winkler County Sheriff Robert L. Roberts Jr. was convicted Tuesday in Midland on all six counts. He faces up to 10 years in prison when the penalty phase of the trial begins later Tuesday or Wednesday.

Roberts is accused of retaliating against the nurses after they sent an unsigned letter to the Texas Medical Board about Dr. Rolando Arafiles Jr. in 2009. The nurses, who alleged Arafiles was endangering patients, were later fired and indicted. One was acquitted and charges were dropped against the other.

Roberts, who has served as sheriff for 20 years, was convicted of retaliation and misuse of official information, both felonies, and one misdemeanor charge of official oppression.

That’s right. Sheriff Roberts is guilty. That’s guilty, guilty, guilty, guilty!

I must admit, I never expected this outcome. I really didn’t. I figured that, at the most, Mitchell and Galle might have gotten a fat settlement in a civil suit, which they would have richly deserved. Actually, they did get a decent settlement of $750,000 from the county, but that strikes me as not enough to repair the damage done. Still, it is reassuring that it looks as though the Sheriff is going to prison, hopefully for a good, long time. His friends might well follow him there, too, as they were indicted by a grand jury on the following charges:

Winkler County Attorney Scott Tidwell: third-degree felony for retaliation; third-degree felony for misuse of official information; Class A misdemeanor for official oppression. Former Winkler County Memorial Hospital Administrator Stan Wiley: third-degree felony for retaliation.

Here’s hoping Tidwell and Wiley soon find themselves wearing bright orange jumpsuits too. And Arafiles, while they’re at it.

In the meantime, if you’re interested, there are two excellent summaries of the long and winding road that is this story. First, there’s a recent segment that appeared on This American Life. Then, there’s a long and detailed telling of the story that appeared in the Texas Observer three months ago. These stories provide lots of details that even I hadn’t known about. Among some of the tidbits:

By July, Warren noticed that the new doctor had begun to “change medicines on patients who had been on thyroid meds for many years and were stable.” Worse, he was not rechecking them to make sure the new medications were working. Arafiles, as the Texas Medical Board would later find, also prescribed powerful thyroid-stimulating drugs to patients who came into the hospital with common maladies like stomach pains or sinus infections. Putting a healthy person on thyroid stimulants is dangerous, Warren says. The drugs can cause hyperthyroidism in healthy patients–unchecked, that can lead to permanent organ damage and death.

More disturbing was that Dr. Arafile’s bad doctoring led to a mass exodus of quality people from Winkler County Memorial Hospital when they saw how he was being protected:

Naomi Warren [a nurse practitioner at the hospital] says she lost hope. “They beat me down,” she says. “I realized they were on a path they didn’t intend to get off of.” She quit in February 2009, 10 months after Arafiles was hired. According to another board member, when Beckham, the board president, learned she had quit, he said, “Well, if she doesn’t like Arafiles, let her go.”

When Warren took a job down the road in Monahans, more than 600 of her loyal patients chose to drive the extra 25 miles to Monahans to see her, resulting in revenue losses for Winkler Memorial. Her departure was part of a larger exodus of hospital and clinic personnel shocked by Arafiles and the hospital’s handling of him. Dr. Khoa Pham, the hospital’s chief of staff, had been fighting with Wiley about Arafiles and left in January 2009 as his contract expired. A few months later, Debby Eggers, the nurse who worked under Arafiles, and Corina Chavez, the clinic manager, quit to join Warren in Monahans.

Eggers says she left because “I couldn’t control Dr. Arafiles. And I couldn’t sleep at night wondering, what if I didn’t catch one of his mistakes?”

And then there was the cronyism and incompetence of the legal establishment in Kermit:

Rounding out the fivesome was Scott Tidwell, Arafiles’ and Roberts’ personal attorney. He had moved to Kermit in 2008 after being convicted of running a prostitution ring out of the Healing Touch massage parlor in Odessa. The sheriff had convinced Tidwell to run for Winkler County attorney, and helped him get elected.

Somehow, it seems so appropriate, doesn’t it?

Looking back over this case, I see that, besides being a massive miscarriage of justice initially, in which the good ol’ boys in a rural town did what they thought they needed to do to protect their good buddy Dr. Arafiles from discipline for his dubious medicine, which included anti-vaccine views and hawking quack treatments for Morgellons’ disease, it’s also a reminder of the failure of state medical boards to discipline errant physicians, much as Dr. Rashid Buttar in North Carolina is another poster child for bad doctors and quacks who is more or less untouchable. True, Dr. Arafiles is facing criminal charges. However, all the discipline he got from the Texas Medical Board was a slap on the wrist. No, it wasn’t even a slap on a wrist. It was the equivalent of being told in a baby-talk voice that he was a bad, bad boy and instructed not to do it again, or I’ll get really cross. Contrary to what he richly deserved, Dr. Arafiles did not lose his medical license. Instead, he was put on probation, required to take continuing medical education classes, and fined $5,000. As Mitchell pointed out, Arafiles would probably have been fined more if he had gotten into a verbal confrontation with her and abused her verbally.

In the end, even though I’m happy to see Sheriff Roberts on his way to prison, with Scott Tidwell and Stan Wiley likely to follow him there, I’m saddened by what this incident says. What it says is that nurses should just shut up and not question the god-like prerogative of doctors and that they are completely expendable, far more so than doctors. Unfortunately, the only way the citizens of Texas will be safe from Dr. Arafiles’ incompetence and quackery will be if he is convicted when his case goes to trial.