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UCLA surgeon backs LIJ’s Chiari Institute

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A neurosurgeon from UCLA Medical Center wrote a report in defense of an embattled institute run by the North Shore-Long Island Jewish Health System that treats a rare brain condition known as Chiari malformation. The hospital, which asked for the review, said it would expand the center based on the findings.

Chiari malformation is diagnosed when excess brain tissue pushes against the cerebellum and the spinal cord.

North Shore-LIJ opened The Chiari Institute in 2001 under its director, Dr. Thomas Milhorat. Milhorat and Dr. Paolo Bolognese came under fire in May 2009 after Milhorat reportedly refused to perform a brain operation on a woman who had been anesthetized for surgery because she was not his patient.

Bolognese was scheduled to perform the surgery, but he could not be reached by the hospital and the hospital could not find another surgeon to perform the surgery.

The patient, identified by Newsday as Pennsylvania resident Jennifer Ronca, was prepped for surgery, including having her head shaved, but she had to be awakened from the anesthesia and was told the operation had never taken place.

North Shore-LIJ spokesman Terry Lynam said the surgery was eventually performed and it was a success.

Manhattan lawyer Lee Goldsmith is representing 11 patients in a case against Milhorat and Bolognese, including a $60 million claim filed on behalf of a 7-year-old Idaho girl who he said was used as a “human research subject” because the institute performed “experimental” surgery” on the girl.

“Over the past year, the North Shore-LIJ Health System’s Chiari Institute has been the focus of considerable scrutiny, most of it fueled by lawsuits initiated by a single attorney representing patients — many of whom had undergone previous surgeries at other hospitals — who say they did not benefit from surgeries performed at North Shore University Hospital,” said North Shore-LIJ Chief Medical Officer Dr. Lawrwence Smith. “Based on the [report’s] findings, the North Shore-LIJ Health System reaffirms its support of The Chiari Institute and plans to continue and expand the program under the existing model.”

Milhorat retired after the cases were made public last year, but Smith said the neurosurgeon’s retirement had been in the works for months because of his age — 73.

Bolognese’s clinical practice privileges were on hold following the allegations. It was unclear whether he has resumed those privileges.

Dr. James I. Ausman, a neurosurgeon and professor of neurosurgery at the University of California, Los Angeles, wrote a report released Tuesday by the health system that called The Chiari Institute “a jewel for New York state and the New York metropolitan area.”

“It is the finest center of its kind in the world treating Chiari deformities consistent with the high standards of the arts and sciences exemplified by New York,” Ausman wrote.

He said more than 80 percent of patients seen at the institute leave the center in an improved condition.

“One cannot reasonably expect that a treatment of any medical condition has a 100 percent good outcome, particularly the Chiari malformation family of disorders in which the diagnosis and treatment are so complex and variable,” Ausman said. “It is remarkable that 50 percent of those patients are seen at TCI, who have failed previous therapy, are improved after treatment there.”

Ausman also found that allegations that the institute was performing unnecessary surgeries so the center can make money were unfounded, saying only 21 percent to 30 percent of patients at the institute are actually operated on.

“Thus, it would be totally incorrect to believe that TCI doctors are performing work for the purpose of financial gain,” he said.

State Health Commissioner Dr. Richard Daines applauded the health system for initiating the review.

“The Chiari Institute is highly respected in the medical community and provides valued treatment to patients who seek assistance there,” he said in a statement.

Reach reporter Howard Koplowitz by e-mail at hkoplowitz@cnglocal.com or by phone at 718-260-4573.

Updated 5:48 pm, October 10, 2011
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Reader feedback

robert from ohio says:
They did un-needes surgery on my sister and this was verified by several Nero surgeon. Sound like this reporter got paid off. This institute is a jooke.
March 10, 2014, 6:50 pm
Kathy from Pa says:
If u could see the condition my mother is in due to the surgeries performed by these two specific doctors, you would be appalled. I can't begin to tell u how many surgeons have been in complete shock over what was done to her. She has lifelong serious complications due to surgeries that were completely unnessesary!!! She has been proven to have never had a couple of the conditions they told her she did and needed surgery for. This article is written by someone who has no clue what they are talking about. They need to interview the ones that havr their entire life changed by these doctors actions.
March 23, 2014, 9:25 am
Kathy from Pa says:
One other note...she went through all treatment ect with one doctor amd was under the impression that he performed the last surgery. Wasnt until court ordered surgical notes came out that she found out a completey dif doctor, one never having had treated her is who operated on her. She had no idea. Her copy of sugical notes say dif. But the copy given to courts and attorneys say what she would have never known. Defend them all u want, without real facts, ur a joke.
March 23, 2014, 9:37 am
Jessica says:
These two doctors saved my life!
I was in horrible shape before being told by my Doctor in California that they had done all they could for me and if anyone could offer me hope it would be the doctors in N.Y. I am so thankful I went there and greatful to these doctors.
June 17, 2014, 12:11 pm
Jennifer from LI, NY says:
These extremely brilliant surgeons saved my child's life. They are pioneers in a sub-specialty of neurosurgery that few surgeons bother to learn even a little about- in spite of the lifelong horrific suffering people with Chiari and its sister syndrome endure.....and in spite of the growing number of people being diagnosed with this "rare" condition. This article has nothing to do with the "reporter"... it's about the impartial PEER review about this Institute and these two doctors from the University of California. I'm sorry that people here have experienced failed surgery, but Chiari is an extremely complex condition, with no guarantee of positive outcomes.
June 18, 2014, 1:39 pm
Nella from From Ct says:
I have nothing but praise for these doctors, my daughter and I both have this RARE brain condition.only my daughter had SIRINGO and I had Chiari,my daughter had surgery 17 yrs ago, I had surgery 4 yrs ago.my daughter had concerns because of numbness in her arm,her doctor in Ct had her do a new MRI and told her that they thought the siring was back, I had Chiari surgery done in 2011 at a very reputable hospital in Boston Mas,but all my condition were back after a few months.we both went to see 2 differnt doctorsat the Chiari Institute ,my daughter was told that her condition was NOT back,she did not need a new surgery, that the numbness was due to her picking up and holding her children always on one side,the MRI was clear and was miss read by surgents here in Ct that told her she did need a new surger. I instead saw another doctor in the same institutue, he said that I needed new surgery and he had said that also had another issue that added to my condition, and he showed me on the MRI the clear image of what he was talking about. He did tell me go go home and think about it, I didn't need it immediately,but as time goes on my health would deteriorate,and he was rite!! It tookme 9 month to fight with insurance company( because they think they rule the world) and in the mean time he was rite I was home bound for several months,and now thanks to this doctor, I have my life back, living a normal life and I am able to work again!!!!
March 24, 2015, 3:44 pm

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