What she found was worse than I’d imagined. Over his 15-ear career, Vance had been involved in at least 12 cases of misdiagnosis or inadequate care that resulted in patient harm. Most had been settled quietly. A few had resulted in medical board complaints that were dismissed due to lack of evidence or closed after Vance agreed to additional training. Christine’s article ran in the city’s major newspaper with the headline, “Pattern of neglect. how one ER doctor’s bias put patients at risk.
It detailed Ethan’s case alongside four other cases where young patients had been dismissed by Vance as drug seekers or hypochondriacs only to have serious medical conditions that required emergency intervention. The public response was immediate and fierce. Patient advocacy groups called for Vance’s license to be suspended. Other patients who’d been treated by Vance came forward with their own stories of dismissive care and missed diagnosis. The hospital’s patient relations office was flooded with complaints. Mercy General’s administration, facing a public relations nightmare, announced they were conducting a comprehensive review of their emergency department protocols and had terminated Dr.
Vance’s employment effective immediately. But termination from one hospital didn’t mean he couldn’t practice elsewhere. And it didn’t address the fundamental problem of a physician whose biases made him dangerous to patients. The medical board hearing took place on a cold morning in November, 4 months after Ethan’s ruptured appendix. The hearing room was formal and intimidating with a long table where the medical board members sat and witnessed chairs positioned in front. The board consisted of five physicians and two public members, all appointed by the governor to review physician misconduct cases.
Ethan testified first. He was nervous, his voice shaking slightly as he described his symptoms, his attempts to get treatment, and Vance’s dismissive attitude. He looked at me like I was trash, Ethan said quietly, like I wasn’t worth his time. I kept trying to explain that something was really wrong, but he’d already decided I was lying. Vance’s attorney cross-examined him, trying to poke holes in his timeline and suggest that Ethan had understated his symptoms or failed to communicate effectively, but Ethan held firm, his answers clear and consistent.
The nurses testified next. Carol Brennan was particularly effective, describing how she’d raised concerns about Ethan’s condition multiple times and been dismissed by Vance. “In my 26 years as an ER nurse, I’ve learned to trust my instincts about patients.” She said, “Mr. Mills was genuinely ill. His vital signs, his appearance, his pain level, everything indicated a serious medical condition. Dr. Vance refused to listen. Doctor Kowalsski’s testimony was clinical and devastating. He walked the board through the surgical findings, the evidence of recent perforation, and the timeline showing that the rupture occurred during the hours Ethan was in the ER without treatment.
In my professional opinion, if Mr. Mills had been properly assessed when he first presented to the emergency department, his appendix could have been removed laparoscopically before perforation occurred. The delay in diagnosis and treatment directly caused the rupture and the subsequent complications, including peritonitis, and the need for open surgery, extended hospitalization, and prolonged recovery. Dr. Torres presented his investigative findings, including the pattern of similar incidents in Vance’s practice history. He’d identified 18 cases over 5 years where Vance had made snap judgments about patients that resulted in missed diagnoses or delayed care.
