Prominent pathologist leaves Johns Hopkins after allegations

Prominent pathologist leaves Johns Hopkins after allegations

Internationally regarded pathologist Jonathan I. Epstein has resigned his post at Johns Hopkins Hospital, months after he was put on administrative leave amid misconduct allegations, the doctor and the hospital confirmed.

The resignation came before the hospital determined whether the allegations that he bullied or intimidated others in his department were founded, Hopkins spokeswoman Liz Vandendriessche said in an email. She did not say whether that inquiry would continue given his departure.

Epstein, who had been on paid leave since May, told The Washington Post in an email this month that Hopkins had “found no evidence of any professional misconduct (ie. no evidence of bullying).” Vandendriessche, however, said that The Post had been “misinformed” by Epstein and that his assertion that there was no evidence of misconduct was not true.

The disagreement punctuated a nearly four-decade relationship between Epstein and Johns Hopkins University, which he joined as a faculty member in 1985, developing a bustling consultation practice providing second opinions on pathology reports at the request of patients and other doctors.

Hospital officials do appear to have cleared Epstein of some issues related to his clinical care of patients, according to a statement Epstein said he and the Baltimore hospital agreed to in a legal document.

“Johns Hopkins Hospital conducted a review of Dr. Epstein’s clinical care and did not identify any areas of concern,” the statement said, according to Epstein. He declined to elaborate on the agreement, but he said the institution had committed to giving the statement to any prospective employers who call Hopkins to ask about him.

“Johns Hopkins University initiated an inquiry into allegations of professional misconduct,” the statement continued. “After seven months of inquiry, no determinations regarding professional misconduct had been made prior to Dr. Epstein’s resignation.”

The statement, the authenticity of which Vandendriessche did not confirm, went on to say that Epstein chose not to renew his clinical privileges at the hospital because of his decision to resign his faculty position at Johns Hopkins University, which Epstein said he did on Jan. 31. He had been the hospital’s director of surgical pathology.

Epstein told The Post he resigned because doctors who had made “anonymous false allegations” against him were still there, and he decided he “did not want to go back there to practice.”

A private accreditation report obtained by The Post last year detailed concerns under review by the Joint Commission, a nonprofit organization that accredits hospitals. The report, which did not name Epstein, referred to him when it pointed to “a department leader” as the subject of the complaints, according to people familiar with the situation who spoke to The Post on the condition of anonymity last year to discuss the then-ongoing review.

Epstein, according to the report, was accused by other doctors of pressuring them to change diagnoses and defer to his wishes over several years. In some cases, according to the people familiar with the accusations, doctors said they felt pressured to give second opinions that agreed with diagnoses made by Epstein’s wife, a pathologist at a urology center in Beltsville, Md. In one case, a misdiagnosis led to a patient’s bladder being removed, according to the report and the people.

The confidential Joint Commission report directed Hopkins to address long-standing concerns among physicians and others “regarding a culture of bullying and intimidation in the surgical pathology department,” which it said had left patients vulnerable to improper care. Accountability for safety in the hospital industry often relies on such private accreditation bodies, which make few, if any, of their findings public. Maureen Lyons, a Joint Commission spokeswoman, declined to comment beyond pointing to a website that lists Hopkins as accredited.

Experts say a proactive internal safety culture in which hospital staffers do not fear retaliation for speaking up is essential to ensuring good outcomes. Hopkins doctors and researchers have long pushed for safer medical institutions, efforts that have included the founding in 2017 of a Center for Diagnostic Excellence, which aims to eradicate misdiagnoses and the medical harm they cause.

This month, Epstein provided The Post a letter he received from the hospital, which said that a staff professionalism group conducted “an independent external review” of a sample of Epstein’s pathology cases and did not find significant clinical concerns. The hospital provided him the report, but Epstein said he could not share it because it included information about individual cases and was marked by Hopkins as confidential.

The hospital’s review, Epstein said, included the case involving the bladder. He said that an outside pathologist “agreed with my diagnosis and concluded that other pathologists would have arrived at the same diagnosis given the limited nature of the specimen, its morphology, and what clinical information I had at the time of the biopsy.”

The review, Epstein said, “concluded that all of these diagnoses were within good practice and what a reasonable pathologist would have diagnosed in the same situation.”

Vandendriessche said in an email that “some of the information provided to The Washington Post by Dr. Epstein was gathered pursuant to a confidential review process, which Dr. Epstein is not permitted to disclose.”

Epstein, recognized by urinary pathologists as a leader in his field, has written numerous papers on the detection of cancer and other diseases. He has steadfastly denied the allegations and told The Post last year that he was “profoundly distressed” by them. In a letter to colleagues last year, he wrote that he was “heartened by the outpouring of support from my pathologist friends and colleagues from all over the world in response to what they have termed a ‘hatchet job’ or a ‘smear campaign.’”