Arnold-Chiari Malformation Support Group
Arnold-Chiari malformation, sometimes referred to as 'Chiari malformation' or ACM, is a congenital anomaly of the brain. Arnold-Chiari Malformation II occurs in almost all children born with both spina bifida and hydrocephalus, but ACM I is typically seen in children and adults without spina bifida.
Below is a story in today's Newsday about an independent analysis on North
Shore-LIJ's Chiari Institute conducted by consultant James Ausman, MD, a
professor of neurosurgery at UCLA and former chairman of neurosurgery at
Henry Ford Hospital and the University of Illinois, who submitted an
extensive report supporting the Chiari Institute's treatment approach. The
story also includes supportive comments from State Health Commissioner
Richard Daines.
Newsday
Consultant review calls embattled Chiari Institute a 'jewel'
April 27, 2010 by RIDGELY OCHS /
ridgely.ochs@newsday.com
A consultant hired by the North Shore-Long Island Jewish Health System
called the organization's embattled Chiari Institute "a jewel" and "the
finest center of its kind in the world" in a report the health system is to
release Tuesday.
State's health commissioner Dr. Richard Daines praised North Shore-LIJ for
commissioning the review and described the institute as "highly respected in
the medical community." Last month, officials said the institute's founder
and leading surgeon remained under investigation by the health department.
Dr. James Ausman, a professor of neurosurgery at UCLA and editor of Surgical
Neurology International, was paid an undisclosed amount by North Shore-LIJ
"to conduct an independent analysis" of the institute, said the health
system's chief medical officer, Dr. Lawrence Smith.
The institute, the largest in the world to treat Chiari malformation, a
relatively rare brain malformation, came under scrutiny last April when two
of its surgeons were accused of not showing up to operate on Jennifer Ronca
of Tunkhannock, Pa., then 32, when she was under anesthesia. Five months
later, the health department cited North Shore for 14 deficiencies in how it
handled that case. The hospital was not fined but submitted a plan to
address most of the state's concerns.
The health department's Office of Professional Medical Conduct - which
conducts its probes in secret - is also investigating the two surgeons, Dr.
Thomas Milhorat and Dr. Paolo Bolognese, two officials with knowledge of the
investigation have said. The probe is focusing on a controversial surgery
for Chiari malformation and related abnormalities. The health department
would not comment on the investigation.
Close to 40 lawsuits have been filed against the institute charging that
some surgeries at Chiari were unnecessary, said attorney Steven Knowlton,
whose firm Goldsmith Ctorides & Rodriguez is representing the patients.
Questions about how and when to operate have prompted a national pilot study
at 12 hospitals sponsored by the nonprofit American Syringomyelia & Chiari
Alliance Project.
The report, which the health department examined, demonstrated that "the
hospital takes a cautious approach to performing surgery," Daines said.
Ronca's attorney, Mark Bodner of Manhattan, said the report was "one-sided"
because it failed to comment on patient safety issues raised by Ronca's
case. "That's glaring if he is going to do a well-balanced report," Bodner
said.
Knowlton declined to comment because he said he had not read the report.
Ausman, who could not be reached for comment, concluded that the institute
thoroughly screened and evaluated patients; performed surgery on 30 percent
of those evaluated, which Daines said showed the institute's caution before
operating; and employed established treatments "used by others around the
world." He also said the institute also saw improvements in more than 80
percent of those operated on, wrote off or discounted 50 percent of charges;
and extensively published on its research.
As part of his review, he examined 15 randomly selected cases and one case
requested by Dr. John Morley, medical director of the Office of Health
Systems Management in the state health department. The case involved an
operation on Katie Bryant, 4, from Hayden, Idaho.
Claudia Hutton, a health department spokeswoman, said Morley made the
request because Bryant's case was identified in a news story that raised
questions about how patients were identified for surgery. Ausman found that
Milhorat and Bolognese had made "a compelling and objectively based case"
for her surgery.
Shore-LIJ's Chiari Institute conducted by consultant James Ausman, MD, a
professor of neurosurgery at UCLA and former chairman of neurosurgery at
Henry Ford Hospital and the University of Illinois, who submitted an
extensive report supporting the Chiari Institute's treatment approach. The
story also includes supportive comments from State Health Commissioner
Richard Daines.
Newsday
Consultant review calls embattled Chiari Institute a 'jewel'
April 27, 2010 by RIDGELY OCHS /
ridgely.ochs@newsday.com
A consultant hired by the North Shore-Long Island Jewish Health System
called the organization's embattled Chiari Institute "a jewel" and "the
finest center of its kind in the world" in a report the health system is to
release Tuesday.
State's health commissioner Dr. Richard Daines praised North Shore-LIJ for
commissioning the review and described the institute as "highly respected in
the medical community." Last month, officials said the institute's founder
and leading surgeon remained under investigation by the health department.
Dr. James Ausman, a professor of neurosurgery at UCLA and editor of Surgical
Neurology International, was paid an undisclosed amount by North Shore-LIJ
"to conduct an independent analysis" of the institute, said the health
system's chief medical officer, Dr. Lawrence Smith.
The institute, the largest in the world to treat Chiari malformation, a
relatively rare brain malformation, came under scrutiny last April when two
of its surgeons were accused of not showing up to operate on Jennifer Ronca
of Tunkhannock, Pa., then 32, when she was under anesthesia. Five months
later, the health department cited North Shore for 14 deficiencies in how it
handled that case. The hospital was not fined but submitted a plan to
address most of the state's concerns.
The health department's Office of Professional Medical Conduct - which
conducts its probes in secret - is also investigating the two surgeons, Dr.
Thomas Milhorat and Dr. Paolo Bolognese, two officials with knowledge of the
investigation have said. The probe is focusing on a controversial surgery
for Chiari malformation and related abnormalities. The health department
would not comment on the investigation.
Close to 40 lawsuits have been filed against the institute charging that
some surgeries at Chiari were unnecessary, said attorney Steven Knowlton,
whose firm Goldsmith Ctorides & Rodriguez is representing the patients.
Questions about how and when to operate have prompted a national pilot study
at 12 hospitals sponsored by the nonprofit American Syringomyelia & Chiari
Alliance Project.
The report, which the health department examined, demonstrated that "the
hospital takes a cautious approach to performing surgery," Daines said.
Ronca's attorney, Mark Bodner of Manhattan, said the report was "one-sided"
because it failed to comment on patient safety issues raised by Ronca's
case. "That's glaring if he is going to do a well-balanced report," Bodner
said.
Knowlton declined to comment because he said he had not read the report.
Ausman, who could not be reached for comment, concluded that the institute
thoroughly screened and evaluated patients; performed surgery on 30 percent
of those evaluated, which Daines said showed the institute's caution before
operating; and employed established treatments "used by others around the
world." He also said the institute also saw improvements in more than 80
percent of those operated on, wrote off or discounted 50 percent of charges;
and extensively published on its research.
As part of his review, he examined 15 randomly selected cases and one case
requested by Dr. John Morley, medical director of the Office of Health
Systems Management in the state health department. The case involved an
operation on Katie Bryant, 4, from Hayden, Idaho.
Claudia Hutton, a health department spokeswoman, said Morley made the
request because Bryant's case was identified in a news story that raised
questions about how patients were identified for surgery. Ausman found that
Milhorat and Bolognese had made "a compelling and objectively based case"
for her surgery.
Everyone has to make up their own minds, and it's good to have both sides.
THX