Dr. Titus In Court: Day 2

Note: The VI Consortium’s first piece on the Titus v. Juan Luis Hospital hearing published on Thursday was meant to be a minute-by-minute account of Wednesday’s court hearing where Dr. Albert Titus took the stand in his defense; the article’s intent was not that of an investigative. Today’s story continues down that path.

On day one of the Titus v. Juan Luis Hospital court proceedings, Dr. Titus took the witness stand to outline his professional life before returning to St. Croix in 2010, building a case as to why he was a good doctor, and why his license to practice medicine, something he hasn’t done in almost a year, should be restored.

On Day 2 at the Superior Court, a very different picture was painted of the St. Croix native when he took the stand to be cross-examined by the defense attorneys. It was there that light would be shed on the story between Titus and his former business partner, Dr. Christopher Seaver, as Luis Hospital attorneys grilled the surgeon, revealing damaging details to the case he had been building the day before.

There were great disagreements between Titus and Seaver at the private practice they formed in 2010 and, according to Titus, the situation became worse when he performed what he described as a “successful hernia operation” on a patient. However, the doctor said that because the patient kept coughing after the surgery was completed, it resulted in the hernia resurfacing.

Titus said Seaver told the patient the operation was botched and was performed incorrectly. The patient sued the private practice owned by the two doctors, causing an apparent irreconcilable rift between the men. This was the first of four malpractice suits that would be leveled against Titus during his brief stint as a surgeon in St. Croix, all of which were discussed at Thursday’s Superior Court hearing.

More allegations of malpractice were brought against Titus on St. Croix by Mr. Warelle, Roberto James and Rochelle Rauch along with her husband. In addition, Dr. Raymond Cintron–gastroenterologist, president of JFL’s medical staff and member of the Medical Executive Committee (MEC)–testified he was aware of a case involving a patient that he said Titus had left unattended, claiming the patient was recovering well.

“Based on the progress notes, the patient was not getting better,” Cintron testified under oath, “because the patient had to be immediately transferred elsewhere.”

Dr. Albert Titus, now in the fight of his life to regain his license, which was revoked by Juan F. Luis Hospital on St. Croix.

The defense had more, however, forcing Titus to read several allegations against him; this time not for malpractice, but alleged cases of harassment at this private practice.

A former female employee, who was also a family friend, accused the doctor of harassing her, and also accused Titus of having a sexual relationship with another employee, which resulted in that employee being impregnated by the doctor. DNA tests confirmed that Titus was the child’s father, the former employee said.

The employee said those allegations were leveled against Titus by his own wife, and alleged that Titus had a pornography problem.

Titus denied the allegations, adding that the reason the first employee, who alleged harassment, did so was because he had asked her to no longer work with him because he had “trust issues” with her; instead, Titus said he suggested the employee work exclusively with Dr. Seaver. With those circumstances in place, Titus said the employee began missing work and was subsequently fired by Seaver. He added that the dismissal occurred while he was off island.

The Juan Luis legal team continued building its case against Titus, forcing cracks into the doctor’s seemingly impeccable testimony on Wednesday. Lawyers raised questions about a 2009 case in Napels, Florida, where Titus, who was not board certified in General Surgery, removed a 19-month old boy’s right testis that should not have been removed in a routine hernia repair operation, according to an administrative complaint filed before the Board of Medicine against Titus by the Florida Department of Health.

In its complaint against Titus, the Department stated that the doctor’s “pre-operative notes do not mention or describe Patient’s C.P.’s testes and do not indicate abnormal genitalia.” Furthermore, the document pointed out that Titus’ “intra-operative findings suggest a relatively routine hernia…without any extenuating circumstances that would justify the removal of the right testis.” The complaint went on to say that the “post-operative surgical pathology report reflected the removal of a normal testis.” In his testimony on Wednesday, however, Titus contended that the infant’s testis was “undeveloped,” suggesting that it was not possible for him to know it was there during the operation.

As a result of that case, Titus said he was fined $7,500 and $1,300 in fees by the Florida Medical Board, and he was ordered to give a lecture on “wrong-site surgery,” as well as visit operation rooms where similar surgeries were being performed.

The numerous complaints brought against Titus, most of them in the Virgin Islands, but some also in Florida, have drawn an unfavorable portrait of the physician, court proceedings revealed. Physicians have access to their individual records through the National Practitioners Databank, where all cases of medical malpractice are stored.

There are many malpractice cases the public will never know about, unless a patient’s family decides to take action. What led to the stripping of Dr. Titus’ license in the Virgin Islands was a malpractice case of negligence that saw Titus leaving island for vacation while one of his patients was chronically ill.

On October 15, 2013, Titus performed a laparoscopic surgery–one he said had gone well–on a female patient. After she was discharged home, however, the woman returned to the hospital two days later complaining of abdominal pain. The woman was then readmitted to the hospital for further care, where she continued to improve, according to Titus’ testimony.

On Tuesday, Oct. 22, Titus–after re-entering the surgical site to correct the source of the patient’s pain, which he described as a standard complication of the laparoscopic surgery–said he performed what is called a “dressing” (protecting and covering a wound), on the patient. However, a day later, another surgeon, Dr. Bennett, performed a dressing on the patient using an unsterile contraption made by Bennett himself, Titus testified. However, Titus admitted that he failed to report the incident and proceeded to leave the island for vacation. He pointed out that reporting a colleague is not something doctors do.

Dr. Cintron, however, disagreed, saying under oath that once a doctor suspects that improper care is being administered, it is that doctor’s duty to file a report.

On October 24, while on vacation, Titus’ privileges at Juan Luis hospital were suspended.

This brings to an end Part II of VI Consortium’s series about the circumstances that led to the revoking of Dr. Titus’ medical license. The hearing at the Virgin Islands Superior Court came to an end on Thursday at 4:30 p.m. On Friday, Titus, along with his attorneys, will be attending a “fair hearing” trial before the Medical Executive Committee and physicians from elsewhere who will make up the panel of surgeons determining whether or not to reinstate Titus’ license. The Virgin Islands Territorial Hospital Board will take the MEC’s recommendations into consideration when making a final decision on whether to reinstate or withhold Dr. Titus’ license.