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The Spine Turf Wars-Was the New Jersey media willfully blind to the facts and science of spine surge

An article published in the New Jersey rag, the Star Ledger, on February 15th 2014 by Brent Johnson and by Jon Swaine in the London Guardian, describes the long and complicated legal battle that preceded the decision medical board, which has since been replaced by Governor Christie due to the fact it was illegally constituted, to improperly revoke the medical license of minimally invasive pioneer Dr. Richard Kaul. The absurdities and overtly political nature of this case demonstrate a complete lack of knowledge of the accepted complication rate of spine surgery which as the medical literature supports is between 10-15%. These numbers are of critical importance as when compared to the actual statistics reflective of the spine practice of Dr. Richard Kaul would actually prove that he is an accomplished and competent surgeon. However it is of no surprise that the media omitted these balancing details from their sensationalist piece of propaganda.

The main thrust of the argument to revoke the license of Dr. Richard Kaul was the purported lack of training in spine surgery left a few patients with some minor post operative complications and as hysterically described by Swaine ‘injured’. What he failed to report was that all of these patients has severe pre-existing disabilities before the surgery which is why they sought my services. However this argument immediately falls flat on its face due to the facts that:

  • Dr. Kaul did over a period of ten years train extensively in both the fellowship and over seventy hands on cadaver spine training courses which was the exact same mechanism the neurosurgical expert for the state admitted to upon cross examination.

  • The field of minimally invasive spine surgery is relatively new and the majority, if not all, current clinical practitioners in the same age bracket as Dr. Kaul obtained their training the exact same way.

  • Dr. Kaul in his ten year career has performed the following number of cases:

  • 800 minimally invasive discectomies and fusions

  • 6000 spinal intervention procedures

  • a complication rate of 0,1% which is well below the accepted number for any type of spine surgery

  • a patient outcome that includes a 90-95% good to very good outcome as measured with the accepted evaluation tools of the post surgical patient

The medical board expert utilized the term ‘gross negligence’ which is somewhat meaningless but has a sting like prosecutorial tone to it, and was clearly intended to paint Dr. Kaul in the worst possible light. It would have been reasonably sufficient to describe the alleged deviations as just that without using the inflammatory term ‘gross’. In addition the ten years that Dr. Kaul had been successfully practising minimally invasive spine surgery were of no secret to the medical board when one considers that in his multiple renewal applications he indicated the nature of his practice. The description by the journalist of Dr. Kaul as being dishonest is a significant mischaracterization that is belied by the voluminous documents and actual testimony provided by his attorney, Jeff Randolph, testifying to the fact that numerous communications were made with the medical board before Dr. Kaul commenced performing minimally invasive spine surgery. In addition to this it was made clear that at every institution he practiced he was properly credentialed and authorized to carry out these procedures.

An bizarrely included detail in the story by Swaine related to the fact that I was a multimillionaire. It is incredulous that he would have the naivety and some have said stupidity to make such a statement without having properly researched my fiscal position. The unfortunate death of the patient in the UK was highly contested by at least eight eminent experts during the case in the UK and what Swaine conveniently omits from his article is the fact that the jury could not reach a unanimous verdict and were ultimately instructed by a judge under political pressure to accept a majority verdict. This type of judicial miscarriage would never have occurred in the US with its fairer and more transparent system of justice.

Swaine continues to mischaracterize my relocation from the UK to the US and deceitfully omits the fact that it was eight months between the completion of the UK case and my return to the US. I must admit that I would find it almost impossible to find any fair minded individual who would consider this an act of fleeing. The use of the word ‘fled’ is clearly intended to disparage my character but more disappointingly is a tragic indictment of the complete failure of any moral compass Swaine might possess.

The constant use of the term ‘manslaughter’ is prejudicial and intentionally inflammatory. The use of this antiquated charge in Britain is under attack from the British Medical Association which considers it a example of overzealous prosecutorial misconduct which serves no purpose than that of being purely punitive.

Jon Swaine, Lindy Washburn and Brent Johnson made much noise over the lawsuit that Geico had filed against my corporations. Well they will be pleased to know the action was dismissed by the US Federal court last week on the grounds that it was frivolous and without provable merit. I wait with baited breath for their story describing this significant event but am quite sure they will not report should they risk the possibility that the facts would get in the way of their fictions.

The journalist irrelevantly points to a case that occurred over a decade ago in a foreign jurisdiction with an entirely different legal system in which Dr. Kaul was ‘struck off ‘ the medical register and in which physicians are regularly prosecuted with the uniquely British charge of ‘medical manslaughter’ of which no equivalent exists in the US. Of even more troubling concern is that the journalist, Brent Johnson, omitted to tell his reading public all the facts about that case with the most important being that the conviction was based not on an unanimous verdict but simply on a majority decision. Again this sort of injustice would ]never have occurred in the much more balanced system of US jurisprudence.

There has been an abnormally extensive coverage of the case with a large part of it negligently reported, which begs the question as to whether journalists should be licensed, before they are allowed to write articles ostensibly designed for both public consumption and increased media sales. This was never the intention of professionally minded writers of the past who understood the societal privilege they had been given and responded with well reasoned and researched articles.

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