by Mindy Aguon

Guam - Did the Guam Memorial Hospital break the law when it entered into a settlement that did away with the peer review action taken against a physician who used to work on Guam? The question was the focus of considerable discussion during Tuesday night's continued oversight hearing.

"We've concluded based on the submission and based on the clarification that you've made that no fair hearing was conducted or any request for a hearing was conducted before any settlement was reached," said Senator Denis Rodriguez, Jr. As Healthcare Committee chairman, he believes the hospital violated its own rules when it entered into a settlement with Dr. George Macris. The physician several years ago had his hospital privileges and medical privileges suspended following a peer review that found him to be providing substandard care to his patients.

Macris, now working in Hawaii, argues that the peer review and actions taken against him were a "politically-motivated kangaroo court" and that an unbiased review showed that there no cases of morbidity, mortality or unexpected adverse patient outcomes. A settlement between the hospital and Macris voids the peer review findings and considers Macris' renewal application for privileges to practice medicine on Guam.

Lawmakers were concerned that a fair hearing process wasn't initiated before the settlement was approved. Dr. Larry Lizama, the GMH medical director, said, "We don't know the answer because we were not there at the time of this peer review actions by the medical staff," which led the senator to ask, "So how would you move forward with a settlement, if you didn't know if the fair hearing plan was initiated?"

"It was based on representation of legal counsel given the review of multiple notations and discussions with the medical staff," the doctor responded. Lizama said management and the board's decision to sign off on the settlement was solely based on legal advice by former GMH attorney Rob Weinberg and reviews of the records that had to do with the peer review process.

"This was faulty information that was provided to you and we need to find out who's responsible for this?" Rordiguez questioned. "Somebody has to be accountable for this. If it's your attorney who gave you faulty advice, we need to establish that."

Lizama told the committee that a fair hearing wasn't initiated to his knowledge because it would have been conducted by the same people who conducted the peer review. He added that the peer review process is not supposed to be punitive, but instead is meant to be educational and internal. "This wasn't a good settlement for the hospital. It wasn't good for the peer review process," said the senator.

Rodriguez says he intends to find out who was responsible and if it was the hospital's former legal counsel, he may file ethics violations against that attorney.