SIOUX CITY, Iowa (KCAU) — MercyOne in Sioux City is being sued for its actions leading up to, and the termination of an employee who was concerned with the malpractice of a heart surgeon.

According to the suit filings, Cynthia Tener is suing Mercy Health Services – Iowa, corp, MercyOne Siouxland Medical Center, and Trinity Health Corporation for retaliation in accordance with 28 U.S.C. § 1367. 

The lawsuit indicated that Tener was hired as Director of Cardiovascular Service Line, a position in which she provided supervision and coaching for cardiovascular nurses and clinic leaders, handled budgeting for the service line and developed the update of system line programs and technology.  

The lawsuit specified that on or around November 5, 2020, Tener requested a meeting with a cardiothoracic surgeon, and two cardiologists to discuss the actions of the surgeon during a surgical case that had occurred prior to the request.  

The lawsuit alleges that while the treating physicians were not present, the surgeon cut open a patient in the operating room. The patient had a prior agreement with the surgeon and the physicians regarding the surgical plan, but the surgeon allegedly did not follow the agreed-upon plan. It was stated that the patient died not long after surgery.  

Upon raising Tener’s concerns, the surgeon allegedly began to get angry with Tener and made demeaning comments to her. She told him to stop, and he was never disciplined for his conduct during the meeting according to the suit filings.  

During the same month of the meeting, other employees told Tener that they had concerns about the surgeon allegedly performing unsafe add-on procedures during the surgeries, as well as lying to the patients about their expected outcomes and prognoses according to the lawsuit.  

A couple of months later in February 2021, according to the lawsuit, another employee went to Tener with concerns about the surgeons’ practices. The employee alleged that the surgeon was not getting proper informed consent from patients and operating on patients whose risk levels were too high for the procedures. They also told Tener that the number of add-on procedures and patient mortality rate was excessive.  

The lawsuit specified that the bills for the add-on procedures performed by the surgeon were being sent to Medicare.  

The employee who went to Tener also alleged that the surgeon would keep patients alive via ventilators, heart pumps, and feeding tubes for at least 30 days following the patient’s surgery. These patients often had little to no chance for recovery, according to the lawsuit.  

The lawsuit specified that the surgeons alleged reasons for keeping the patients alive for 30 days specifically was due to the Society of Thoracic Surgeons (STS) National Database. The STS National Database tracks surgical outcomes of cardiological symptoms in the first 30 days of surgical recovery.  

According to the suit filings, healthcare facilities receive quality ratings based on their statistics from the STS National Database, including MercyOne.  

The employee who brought up the concerns about preserving patients indicated that the surgeon allegedly followed this practice with their patients as well.  

The lawsuit indicated that the “futile artificial preservation treatments” and equipment were billed to Medicare.  

Tener allegedly reported the concerns of the employees to her supervisor and other medical leadership employees, which resulted in MercyOne giving a sample of the surgeon’s case files to a third-party physician for review. The physician disagreed with the surgeons’ actions in every case file that was provided, except for one. The lawsuit stated that the physician deemed the use of add-on procedures as “medically inappropriate.” 

Tener requested a meeting on May 26, 2021, with her supervisor along with other nursing and clinic staff to discuss the continued concerns with the surgeon’s practices.  

During the meeting, Tener alleged that the surgeon was still failing to obtain informed consent from their patients, adding unnecessary heart valves during coronary artery bypass grafts, and the continued high rates of patients experiencing complications and death following procedures performed by the surgeon in question.  

Tener presented evidence at the meeting that showed mortality rates of under 3.1% for patients undergoing coronary artery bypass grafts, but the surgeon’s mortality rate for the same operations had reached 13%.  

MercyOne allegedly implemented restrictions on the surgeon’s practices and limited the surgeon to surgeries with patients that had minimal risk levels.  

According to the suit filings, the implementations resulted in at least two of the surgeon’s scheduled surgeries being canceled due to their risk level to the patients. However, the surgeon allegedly went ahead with one of the surgeries and the patient died.  

The lawsuit alleged that the surgeon would manipulate the risk scores of patients to make them appear lower in June 2021, resulting in performances of high-risk surgeries. The employee who alleged that the surgeon was keeping employees alive by artificial means checked the scores the surgeon had recorded. The employee found that patient’s risk scores were much higher than the surgeon had reported.  

The employee allegedly went to Tener again and told her about their concerns regarding the altered risk scores. Tener reported the surgeon’s multiple malpractices to her supervisor and other medical leadership employees. The lawsuit filings indicated that her report went unanswered and when she followed up, they told her that they were “handling it.”  

According to the lawsuit, in July 2021, Tener submitted a complaint to MercyOne’s internal ethics committee regarding the surgeons’ actions. Around this time, it was stated that a cardiology nurse practitioner determined that a patient was too high risk for a surgery that the surgeon wanted to perform. The nurse referred the patient to a different healthcare facility, but the surgeon met with the patient and got consent for the procedure. However, the surgeon allegedly did not tell the patient about the risks of the surgery and the multiple heart valves that the surgeon had planned to replace. The surgeon also allegedly told the patient that they would be “walking out the door just one week after surgery.”  

Tener learned of the situation with the surgeon and the patient and reported it to the ethics committee, who allegedly told Tener’s supervisor of the complaint. The committee also told the surgeon of the complaint and the surgeon “demanded” to know who had reported them.  

The lawsuit alleged that the committee broke policy by telling the surgeon that Tener had reported him, and then the committee joined the surgeon to obtain proper informed consent from the patient regarding the planned surgery.  

As a result of telling the surgeon who reported them, the surgeon left angry voicemails on Tener’s phone demanding a meeting. During the meeting in the surgeon’s office, they allegedly screamed at her and stated that she should not have filed the report. The surgeon yelled at Tener within five inches of her face, stating that she was “nothing but a nurse.”  

Tener allegedly reported the behavior to her supervisor, and she claimed that she did not feel the supervisor was handling the surgeons’ malpractices appropriately. The lawsuit stated that her supervisor allegedly told her that she needed to work on building a relationship with the surgeon.  

Tener discovered that MercyOne physicians in Iowa were reading results for cardiac tests conducted in Nebraska and South Dakota, despite not being properly licensed in those states. The lawsuit alleged that MercyOne and the other Defendants billed Medicare for the reading and interpretation of the results. The suit filings specified that the actions of the unlicensed physicians went against the Medicare billing rules and were unlawful. Tener reported this to her supervisor, who allegedly responded with “I know it’s a problem.”  

The lawsuit indicated that in October 2021, two nurses allegedly filed a complaint against the Surgeon after they documented providing an anesthetic to a patient during a debridement (the removal of infected tissue or a foreign object) operation. The nurses alleged that the surgeon also did not get informed consent from the patient until after the procedure was completed.  

The surgeon allegedly told Tener’s supervisor that she had influenced the nurses by telling them to file the complaints. Her supervisor allegedly told the surgeon that it was “no big deal” because when the supervisor receives complaints they mark them as unfounded.  

The lawsuit alleges that Tener played no role in the complaints filed by the nurses, and less than two weeks later on November 3, 2021, Tener was summoned to meet with her supervisor and a member of their human resources department. During the meeting, Tener was asked to describe her job duties and her leadership style. The member of human resources told Tener that they had received complaints about her, stating that she had created a “toxic work environment” and the allegations needed to be investigated.  

The lawsuit alleges that Tener was subsequently placed on suspension during the investigation and then she was fired on November 9, 2021. Tener’s supervisor allegedly told her that she was fired because she had created the toxic environment she was accused of, and her staff did not feel comfortable coming to her with their concerns. Her supervisor allegedly did not provide any information regarding the nature of the complaints and refused to reconsider despite no prior disciplinary action being taken against Tener.  

The lawsuit stated that Tener requested a trial by jury.