Wednesday, May 14, 2003

Coroner program suspended

Won't be allowed to train medical student this year

By Dan Horn
The Cincinnati Enquirer

The Hamilton County Coroner's office will not be permitted to offer a one-year training fellowship to a medical student this year because of the way county officials handled the morgue photo case last year.

A national review board has suspended the county's pathology training program after concluding that morgue officials did not adequately supervise Jonathan Tobias, the young pathologist who was accused of helping photographer Thomas Condon take unauthorized photos of bodies at the morgue.

Tobias was fired and charged with gross abuse of a corpse, but an appeals court overturned his conviction last week.

The review board withdrew its accreditation of the county's training program last year after concluding that there was poor oversight at the coroner's office.

"We felt the system they had in place didn't work," said Steven Nestler, who heads the pathology review board for the Accreditation Council for Graduate Medical Education.

Although some local medical students can still take part in limited training, the suspension increases the workload for the full-time pathologists at the coroner's office, who now must perform the 250 autopsies that are usually done each year by the student. The office also handles some work for surrounding counties.

The national board, which oversees about 8,000 medical training programs across the country, reviewed Hamilton County's accreditation after learning Tobias had been implicated in the photo case.

Nestler said suspending a program is rare - it only happens in about 1 percent of cases each year - but the board felt the action was needed to spur changes at the coroner's office.

The board determined that those changes should include a revision of disciplinary policies and new rules that would improve supervision of the students, who typically work at the morgue as part of a one-year fellowship.

"We felt it was inappropriate for the office to have a fellowship program until they make some structural changes," Nestler said. "The committee here felt that had the coroner's office had different procedures in place, (Tobias) would not have been charged with a crime."

Tobias was accused of helping Condon get access to bodies, which Condon then photographed with seashells, toys and other props. Condon said the photos were part of "an artistic endeavor.''

Families of those photographed have sued the county, claiming that the county was neglectful in allowing Condon access to the bodies. On Tuesday, a federal judge ruled their lawsuit could go forward as a class-action complaint.

Tobias' attorneys say he was singled out for prosecution to protect higher-ranking supervisors from embarrassment and possible criminal charges.

The county's chief deputy coroner, Robert Pfalzgraf, said Tuesday he disagrees with the decision to withdraw accreditation for the training program. But he also says Tobias should not have been charged with a crime.

Pfalzgraf said he and other pathologists at the morgue thought Condon had permission to be there as part of a project to produce a training video. County lawyers, however, have said the video project was soon abandoned and Condon should not have been allowed in the morgue.

"Dr. Tobias didn't know (Condon) wasn't supposed to be here. None of us knew," Pfalzgraf said. "We all assumed he had clearance ... I'm the chief deputy and nobody told me he wasn't supposed to be here."

Pfalzgraf said he expects to apply for reinstatement sometime this year, but he does not foresee resuming the program until 2004 or possibly 2005. Until then, he said, "we can't train anybody."

Tobias' attorney, Marc Mezibov, said the review board's decision supports his client's assertion that he didn't break any rules.

"That office, with respect to its supervision of Dr. Tobias, failed in its responsibilities," Mezibov said.

Pfalzgraf said the office was stung by the loss of its accreditation and deserves to have it reinstated. "I thought and still think we had one of the best training programs in the country," he said. "I think the ACGME was sort of punishing us."

Nestler said the review board would consider reinstatement as soon as the county applies for accreditation. "They're going to have to convince us that they have done the things we think they need to do," he said.


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