A leading Johns Hopkins cancer surgeon has been suspended for months after an alleged misdiagnosis led to a patient’s bladder being removed — and amid claims he bullied staff.
Eminent pathologist Jonathan I. Epstein, 66, is accused of providing second opinions that matched the diagnoses of his urologist wife, Hillary, 44, and pressuring other doctors at the world-famous hospital to do the same.
In one case, after a double diagnosis by the couple, a man underwent a radical procedure on April 28 to have his bladder removed – only for post-operative analysis to indicate a different diagnosis.
The allegations are contained in a report by the non-profit joint committee on private hospital accreditation, seen by the WashingtonPost, which revealed that Epstein was placed on administrative leave in May.
The report directed Johns Hopkins Hospital to address ongoing concerns about “a culture of bullying and intimidation in the surgical pathology department” that was putting patients at risk.
Eminent pathologist Jonathan I. Epstein, 66, is accused of providing second opinions that matched diagnoses made by his urologist wife Hillary, 44, and pressuring other doctors at the world-famous Maryland hospital to do the same doing
Hillary Epstein practices at Chesapeake Urology Associates in Beltsville, Maryland, according to the organization’s website, after training at Johns Hopkins Hospital
It comes as analyzes of U.S. hospitals in recent years have shown that top-ranked institutions are not necessarily safer for surgical procedures than any other hospitals.
Johns Hopkins Hospital has been ranked among the top five best hospitals in the country for 33 years, according to U.S. News & World Report.
Epstein, who is “recognized as a leader in the field of urologic pathology,” according to the Baltimore hospital’s website, has said he was “deeply saddened” by the allegations in the commission’s report.
“They are the antithesis of everything I stand for and have tried to demonstrate in my professional life during my 35 years at Johns Hopkins,” he told the Post in a written statement.
He declined to discuss the bladder removal case, citing patient privacy, but said medical cases have “many complicating factors.”
Epstein denied that there was any conflict of interest inherent in the practice of providing second opinions on reports from his wife, who practices at Chesapeake Urology Associates in Beltsville, Maryland, according to the organization’s website.
‘As an expert in prostate and bladder pathology, I have reviewed cases where there were disagreements between the (Hopkins) pathologists who had no special training in prostate and bladder pathology and the (Chesapeake) pathologists (who were experts in the field) ,” Epstein wrote to the Post.
Epstein said his diagnoses were “based solely on (his) objective evaluation of the case.”
While it did not refer to Jonathan Epstein by name, the Joint Commission report also says several complaints have been filed by other doctors against the “department leader.”
Researchers reviewed “several comments from pathology physicians and residents stating that they did not feel comfortable speaking out about ‘harassment’ or ‘bullying behavior’ by a department leader.”
“The Department of Pathology at Johns Hopkins is nationally known and we remain confident in the best-in-class services they provide,” spokeswoman Liz Vandendriessche said in an email to the Post. (Photo: The main building of the Baltimore hospital)
The doctors indicated “that they were forced to change their diagnosis, make additions and adhere to the leader’s wishes for several years, which could potentially lead to harm to the patients.”
Physicians also said they “feared retaliation or career repercussions if they spoke up,” according to the report, which included interviews with physicians including physicians, residents, hospital leaders and chief physicians.
Jonathan Epstein claimed that when he worked with other doctors, they would show him difficult cases.
“I have always been under the impression that this discussion was collegial, professional and conducted in the best interests of patient care,” Epstein told the Post. ‘I have only asked for cases to be changed if they had been sent to me specifically for my opinion by patients, doctors and pathologists, and had been initially diagnosed by someone else in my absence. After my review, in a minority of cases I adjusted them so that, based on my expertise, patients would receive the most accurate diagnosis that would lead to optimal therapy.”
Hillary Epstein did not comment on the allegations.
The Johns Hopkins Hospital said its reputation for world-class excellence would not be shaken by the report.
“The Department of Pathology at Johns Hopkins is nationally known and we remain confident in the best-in-class services they provide,” spokeswoman Liz Vandendriessche said in an email to the Post.
She added that the hospital is working with Joint Commission investigators to address the issues raised in the report.
“Several of their citations have already been removed as a result of the information we provided,” she said.
Oversight of hospitals is often done behind closed doors by private accreditation bodies, which rarely make reports public.