UNIVERSITY OF NORTH DAKOTA VIOLATES MEDICAL CONFIDENTIALITY and Abuses Materials Obtained From Supposedly Confidential Medical Files
Serious problems exist concerning the willingness of University of North Dakota personnel (Harold Vanscoy, Bradley Braunagel and Judy DeMers) to breach medical confidentiality and other rules pertaining to the use of confidential medical information.
I worked as a professional pilot since 1980, however, because aviation is an extremely unstable profession I elected to attend medical school and utilize my aviation skills as an asset to my Wyoming medical practice. Federal Aviation Regulations and company policies require pilots be medically certified on a routine basis and psychiatrically stable-consequently I consulted a psychiatrist. Unbeknownst to me, a Wyoming physician, Kathryn Kohler, who misdiagnosed a problematic levator muscle for irritable bowel wrote a factually incorrect, unauthorized letter to the University of North Dakota. This letter advised the University I consulted a psychiatrist and warned University officials of my "inability to handle the stress of medical school." Harold Vanscoy (Physicians Assistant and Director of Student Health), received this factually incorrect letter from Kathryn Kohler and without my knowledge or permission notified medical school administrators of this correspondence. University administrators immediately contacted my physician, Bradley Braunagel (University of North Dakota Family Practice Resident). Braunagel advised school administrators I consulted a psychiatrist, (but failed to mention these consults were pursuant to a sexual assault, corporate and Federal Aviation Regulations). Subsequently, without my knowledge or consent Associate Dean Judy DeMers repeatedly gained access to the materials in my confidential medical files. DeMers twisted the contents of these materials, distributed my supposedly confidential medical information to individuals throughout North Dakota and further violating regulations utilized this information (plus numerous outright lies) to procure my medical school dismissal!
The State of Wyoming took action against Kathryn Kohler however, North Dakota endorsed these medical confidentiality abuses by invoking sovereign immunity! This ludicrous situation clearly raises questions concerning North Dakotas suitability to operate a medical school. Moreover, the deliberate disregard for medical confidentiality is disturbing and detrimental to all patients seeking medical treatment in North Dakota because University medical personnel practice throughout that state.
Utilizing the following text, I naturally informed the Wyoming Board of Medicine of DK Kohlers inaccurate and unauthorized communication.
Dear Board Members:
In 1983, after I relocated to Laramie, Wyoming to attend the University of Wyoming, I consulted a gynecologist (DK Kohler) for a work-up of episodic pelvic pain as suggested by my out of town physician. Dr. Kohler was unable to establish a diagnosis for the problem although she did perform several pelvic examinations, one laparoscopy and prescribed several painkillers. Afterwards, in 1984, she referred me to Dr. Jackson, an Internist practicing medicine in Laramie, Wyoming. He felt the problem might be "Irritable Bowel" but suggested I work with both Dr. Kohler and himself to resolve the problem.
In 1988, without my knowledge or consent, DK Kohler wrote a factually incorrect letter to the medical school I planned to attend. Afterwards, the medical school employed her report to obtain my dismissal thereby destroying my career! I discovered Kohlers letter in 1992. I asked her to assist in correcting the problems caused by her inappropriate and inaccurate communication, but Kohler did not respond. Therefore, I ask your agency to initiate disciplinary procedures against Kathryn DK Kohler.
Incidentally, a problematic levator muscle, not irritable bowel or some psychiatric illness is the origin of the pain. Flexeril accompanied by decreased caffeine intake accomplishes treatment efficiently. Clearly, this problem never warranted preclusion of my attainment of a medical degree.
Attached is a copy of DK Kohlers factually incorrect letter accompanied by its critique. Also attached are verifications of my emergency room activities, Dr. Jacksons report and statements contained in my University files referencing DK Kohler. I do not appreciate DK Kohlers attack on my livelihood because of her lack of diagnostic expertise and inability to obtain factual data concerning her patients.
Copy of my physician's report to the University of North Dakota-i.e. Dr. Jackson's report
Copy of DK Kohlers factually incorrect letter
Physician's statement pertaining to problematic levator muscle
Verification of my emergency room and other hospital activities-
Letter from the Wyoming Board of Medicine
CRITIQUE OF THE FACTUALLY INCORRECT DK KOHLER LETTER
1. DK Kohler declared in her correspondence I had not taken medications for irritable bowel in several years.
FACT: What medication? My physicians did not prescribe any medication.
2. I underwent only one laparoscopy-the one Kohler performed in 1983. I do not know where Kohler gets all of her misinformation.
3. I consulted Robin Eicher due to anxiety following an assault and some family issues and incidental to corporate and Federal Aviation Regulations. Incidentally, Dr. Eicher did communicate with the University of North Dakota upon my request. Therefore, Kohlers statement that I have "been followed regularly by one of our psychiatrists" is misleading and inappropriate. Additionally, I have the right to consult Dr. Eicher without Kohler, who knows nothing about my situation, divulging this information.
4. Kohler announced "I am concerned about her response to the stresses and anxieties of medical school (not to mention post-graduate medicine)"...
FACT: Kohler scarcity of knowledge regarding my abilities to handle stress is completely evident. I worked throughout my undergraduate education as a professional pilot to obtain funds to make it possible for me to attend medical school. As an Airline Transport Pilot, I will emphatically affirm that professional aviation is far more stressful than any aspect of medical school.
5. Dr. Kohler mentioned numerous emergency room visits without specifying I worked in the emergency room. Additionally, I have the right to go to the emergency room and receive confidential treatment without fearing the destruction of my career. Furthermore, failure to adequately diagnose my condition led to "frequent office and emergency room visits."
6. Furthermore, DK Kohler stated "if you need any other information, I would be happy to talk with you."
FACT: Dr. Kohler lacked the appropriate authorization necessary to establish communication with the University of North Dakota concerning my situation. Likewise, she assuredly neglected to procure the obligatory permission to conduct additional communications with officers of the University pertaining to my case. Her deficiency of knowledge in the subject areas she is discussing is evident. I certainly never granted her permission to disseminate a fairy tale.
Material From My Supposedly Confidential Medical Files Utilized By The University Of North Dakota To Procure My Dismissal From Medical School Without My Knowledge Or Consent
Enclosed medical records and statements made by Judy DeMers utilized to obtain my medical school dismissal verify Harold Vanscoy (Physicians Assistant Director of Student Health) and Bradley Braunagel (Family Practice resident) violated my medical confidentiality. These materials also reveal the University of North Dakota fails to safeguard sensitive medical information. We know Associate Dean Judy DeMers is a liar, however, repeated and unauthorized communications obviously transpired between Judy DeMers, Harold Vanscoy and Bradley Braunagel moreover, the University utilized these materials to procure my dismissal.
Despite guarantees printed on the "Report of Health Evaluation" a form approved by the Liaison Committee of the American College Health Association and the American Medical Association and approved by the American College Health Association. The University of North Dakota utilized DK Kohlers letter to obtain my dismissal from the School of Medicine.
Guarantees printed on the "Report of Health Evaluation"
To the Student:
Information you provide will not be used to influence your situation at the University; it will be used if necessary, solely as an aid to providing necessary health care while you are a student.
This information is strictly for the use of the Health Services and will not be released to anyone without your knowledge and consent.
Statements Utilized By Judy DeMers To Obtain My Medical School Dismissal
Note: I did not authorize the release of these materials. Why did the University permit Judy DeMers to utilize these entries to obtain my dismissal? Moreover, what happened to due process again?
Letter from the University of North Dakota Family Practice Center revealing I did not release medical information to the School of Medicine.
Letter from the University of North Dakota Student Health Service revealing I did no release medical information to the School of Medicine.
Judy DeMers Statement:
8-23-88 (Thursday) Memo sent to first year instructors by Assoc. Dean Ollerich notifying them of Vivian Nelsons diagnosis of Infectious Mononucleosis. Dr. Ollerich had talked with Vivians physician, Dr. Bradley Braunagel. Dr. Braunagel confirmed the diagnosis, but stated that he also felt "something else is going on" and suggested counseling.
FACT: Dr. Braunagel lacked authorization to discuss my case with Professor Ollerich. Moreover, Dr. Braunagel failed to mention the psychological consults resulted from an assault and professional aviation requirements.
Judy DeMers Statement:
8-25-88 I spoke with Harold Vanscoy, Student Health Service, by telephone. Mr. Vanscoy indicated a note from a Wyoming physician existed in Vivian Nelsons SHS file expressing concern about her ability to handle the stress of medical school. Although he could not share the contents with UNDSM due to patient confidentiality, he agreed to share the contents with Dr. Braunagel.
FACT: Judy DeMers, Harold Vanscoy and Bradley Braunagel lacked the required authorizations to conduct these discussions. Attached correspondence thoroughly reviews Kohlers letter.
Judy DeMers Statement:
8-25-88 I spoke by telephone with Dr. Braunagel. He saw Vivian on 8-20-88. He indicated he had arranged an appointment for Vivian for this afternoon with Dr. King, a clinical psychologist.
FACT: Dr. Braunagel did not have permission to conduct this discussion with Judy DeMers or divulge anything pertaining to consultation with Dr. King.
Judy DeMers Statement:
9-1-88 Dr. Braunagel reported he had seen her at 2:00 p.m. on 9-1-88 for a scheduled follow-up appointment and stated she "was fine and appeared calm."
FACT: Resident Bradley Braunagel lacked appropriate authorization to make this report.
Judy DeMers Statement:
9-2-88 (Friday) Vivian left the Student Affairs Office at 1:00 p.m. to go to Histology class. She was described as "spacey, shaky, agitated, and angry at her mother." The course director reported she had left class on 9-1-88, stating she was ill and had not returned this week. Dr. Braunagel reported he had seen her at 2:00 p.m. on 9-1-88 for a scheduled follow-up appointment and stated she "was fine and appeared calm."
FACT: Again, Braunagel lacked the authorization to make this report. Moreover, I question the validity of the remainder of Judy DeMers statement because I do not recall any such incident and my University records contain no description of this account or anything remotely similar.
Judy DeMers Statement:
9-7 - 9-9-88 (Wed-Fri). Telephone call from Vivian (10:15 p.m.) stating they believe she has anemia, is developing hepatitis, and probably will need to be hospitalized. She stated she had seen Dr. Braunagel. I mentioned the possibility of a reduced academic load or withdrawal from medical school. On Thursday, 9-8, Dr. Braunagel called. States Vivian had spoken with the on-call resident, Dr. Joseph. Her complaint had been extreme tiredness. Dr. Braunagel says this is inconsistent with the last time he saw her on 9-1-88. He had not seen her since then and states no conversation regarding anemia, hepatitis, or hospitalization ever took place. We agreed that a psychiatric consult was warranted. Vivian is in counseling on a weekly basis at FPC. I asked Vivian to stop by my office on Friday (9-9-88). I left at 6:00 p.m. when she had not stopped by.
FACT: My records verify I never made this type of statement. Again, Dr. Braunagel lacked the necessary authorizations to initiate this communication with Judy DeMers. Note: Subsequent to my discovery, Judy DeMers inappropriately utilized her University position for her political advantage she constantly mentioned withdrawal from Medical School.
Judy DeMers Statement:
10/18/88 Vivian left a message on my answering machine stating she needed surgery this semester (later determined to be for endometriosis---and later determined to have an actual basis.
FACT: Judy DeMers utilization of this statement to procure my medical school dismissal is inappropriate and illustrates the cavalier handling of sensitive medical information. Moreover, I never had endometriosis.
More Statements Authored By Judy DeMers To Procure My Medical School Dismissal:
10/28/88 (Friday) Vivian slid a note under my office door(10:20 a.m.) stating she was "extremely depressed lately". Thinks she needs to take time off; but, that will probably depress her more. Note: The next block exams are one week away, Th/Fri Nov. 3 and 4, 1988). I immediately arranged to meet her for lunch. Denies thoughts of suicide. She was seen at both SHS and the UND Counseling Center. Wants to defer any decision regarding possible time off until after the 11/3 and 11/4 block exams. Although claiming to have no appetite, she ate a large lunch.
8-23-89 and 8-24-89 - I spoke with Dr. Eickner for approximately 20 minutes, by phone. We discussed how to help Vivian avoid or control her "panic states" I also told Dr. Eickner that Vivian had relayed to me that it was Dr. Eickners recommendation she not continue in therapy in Grand Forks. Dr. Eickner reported Vivian had told her the same thing, stating I had made the recommendation. I set up an 8-24-89 appointment with Vivian. She came in on 8-23-89 instead. I confronted her with this contradiction and provided options for obtaining on-going counseling---which I insisted on.
8-24-89. I met with her again, for an hour, on 8-24-89. She will secure a counselor through UND Psychological Services.
1-11-90. Course directors were notified that Vivian Nelson has been ill since 1-8-90 (taking Erythromycin). She is unable to take the initial Gross Anatomy exam. A make-up exam is scheduled for January 23 or 24, 1990.
FACT: Judy DeMers utilization of these sensitive medical topics to procure my medical school dismissal is inappropriate and further illustrates her disregard for medical confidentiality. Moreover, Dr. Eicher and I fully discussed continuing therapy and we were happy with an arrangement excluding University of North Dakota personnel.
Judy DeMers Statement:
1-31-90. Dr. Hockenberry, Grand Forks Family Practice Center, had written a note stating Vivian Nelson had "musculoskeletal low back strain and fibrositis syndrome". This had been the basis of Vivians request for a postponement of her physiology exam. Dr. Hockenberry states he had not written the note with any indication of excusing or postponing any exams for Vivian. He feels she is capable of taking exams as scheduled. He also stated, "some of the symptoms lack consistency" (for lack of a better word).
FACT: Judy DeMers asked me to obtain a note from my physician subsequent to my fall down icy University stairs. However, records indicate I did not authorize communication between Dr. Hockenberry and Judy DeMers. Moreover, he never told me my symptoms lacked consistency-please see my medical record.
Notes: Obviously, University personnel failed to realize Federal Aviation Regulations and corporate policies require professional pilots undergo routine medical and psychological evaluations. These requirements attempt to prevent tragedies like the fatal air crash in Minnesota.
Naturally, Judy DeMers sensationalized on these psychological consultations-what better way to eliminate me from the University subsequent to my discovery she utilizes her University position for her own political gains-a clear abuse of her position?
Bradley Braunagel's admissions pertaining to medical confidentiality violations
Harold Vanscoy's admissions pertaining to medical confidentiality violations
Psychological records do not support Judy DeMers' allegations of aberrant behavior
Applicable Regulations Concerning Medical Confidentiality
(Ignored By The University Of North Dakota)
Accreditation And The Liaison Committee On Medical Education
(Standards for Accreditation Of Medical Education Programs Leading To The MD Degree)
Personal Counseling; Student Health Services
A school must have an effective system of personal counseling for students. Confidential counseling by mental health professionals must be available to students.
Code of Student Life (Regulations Governing The University of North Dakota)
Medical and Counseling Services
Medical Records--Privileged Information
A student's medical record is confidential and is available to the student through the Director of Student Health Service.
Except as otherwise provided for in this section, information pertaining to a students physical or mental condition may not be released to any party without the written, signed consent of the student.
University of North Dakota-Medical School--Statement of Responsibilities
Standards of Professional Behavior and Academic Honesty
A student-physician shall deal honestly with patients and colleagues, and strive to expose those students/physicians deficient in character or competence, or who engage in fraud or deception.
A student-physician shall respect the rights of patients, of colleagues and of other health professionals, and shall safeguard patient confidences within the constraints of the law.
Medical student shall have the continuing responsibility to comply with federal and state laws; the rules and regulations of the University of North Dakota, the School of Medicine and its individual departments, affiliated hospitals and other medical institutions, and other applicable guidelines.
American Medical Association-Council on Ethical and Judicial Affairs
CONFIDENTIALITY. The information disclosed to a physician during the course of the relationship between physician and patient is confidential to the greatest possible degree. The patient should feel free to make a full disclosure of information to the physician in order that the physician may most effectively provide needed services. The patient should be able to make this disclosure with the knowledge that the physician will respect the confidential nature of the communication. The physician should not reveal confidential communications or information without the express consent of the patient, unless required to do so by law.
The obligation to safeguard patient confidences is subject to certain exceptions which are ethically and legally justified because of overriding social considerations. Where a patient threatens to inflict serious bodily harm to another person and there is a reasonable probability that the patient may carry out the threat, the physician should take reasonable precautions for the protection of the intended victim, including notification of law enforcement authorities. Also, communicable diseases, gun shot and knife wounds, should be reported as required by applicable statutes or ordinances.
RECORDS OF PHYSICIANS AVAILABILITY OF INFORMATION TO OTHER PHYSICIANS. The interest of the patient is paramount in the practice of medicine, and everything that can reasonably and lawfully be done to serve that interest must be done by all physicians who have served or are serving the patient. A physician who formerly treated a patient should not refuse for any reason to make his records of that patient promptly available on request to another physician presently treating the patient. Proper authorization for the use of records must be granted by the patient.
Invoking sovereign immunity, the University of North Dakota refuses to allow me the opportunity to respond to the accuracy of these allegations or the utilization of supposedly confidential medical records to destroy my medical career.
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