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Amy Umble is health reporter for The Free Lance-Star

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Medical panel disciplines former ER worker at Spotsylvania Regional

The care provided by an ER worker at Spotsylvania Regional was the subject of a medical board hearing yesterday.

A state medical panel decided yesterday that one of the former physician assistants at the Spotsylvania Regional Medical Center violated state law in the way he cared for one of his patients.

A committee of the Virginia Board of Medicine disciplined William Carr for his treatment last year of Shirley Chaney, 73, of Ruther Glen.

Carr treated Chaney in the hospital’s emergency department and released her. Two days later, Chaney was admitted to Mary Washington Hospital. She died in its hospice unit.

Carr said several times during the hearing that Chaney was “stable” when she left the Spotsylvania hospital.

“Otherwise I would have kept her,” he said.

The disciplinary hearing focused on the events of June 20, 2010, about two weeks after the opening of the new hospital.

Chaney was seen in the emergency room with her family at about 11 a.m. She had been sick for about a week and was complaining of a severe headache, according to Carr’s testimony and hospital records. Leonard Chaney, her husband, told the disciplinary panel that his wife also had facial pain and was so sensitive to light that she had to keep one eye closed.

The family was concerned, Leonard Chaney said, given his wife’s medical history. Shirley Chaney had a lung transplant in 2001, suffered from kidney failure, and was taking medicines to suppress her immune system.

Carr said he has been a physician’s assistant for 21 years, including six years in emergency rooms in New Jersey and Maryland. At Spotsylvania Regional, he worked for Sheridan Healthcare, which had a contract to staff the ER. He said he works now in New Jersey.

Carr said he examined Chaney and ordered several tests, including a chest X-ray and CT of the head. He concluded that she had sinusitis. Chaney’s primary care physician had offered the same diagnosis when he saw her two days earlier.

Chaney and her family stayed at the hospital several hours. Her husband said that just before being discharged, his wife asked to talk with Carr again. She pointed out that she had sores on her forehead and asked about shingles, a herpes virus infection.

Carr said he noticed the lesions above her right eye before Chaney asked about them. He concluded that she did have shingles, and he gave her a prescription for a week’s worth of Valtrex, an anti-viral medication. He told her to take the one-gram pill three times a day.

Chaney went home that afternoon but her pain got worse. Two days later, her husband took her to Mary Washington Hospital, where she was admitted. She died there on July 4. On her death certificate, the cause of death is listed as herpes simplex encephalopathy.

After Chaney’s death, her family filed a complaint about Carr with the Virginia Board of Medicine. The board investigated and eventually summoned Carr to appear at this week’s informal conference committee hearing.

In the notice that the board sent Carr, it alleged that he had failed to note the lesions on Chaney’s face until six hours after she came to the emergency room, when they were brought to his attention.

It also alleged that:

*He did not consult with his supervising physician or with an infectious disease specialist or transplant specialist.

*He did not administer Valtrex immediately, but instead gave Chaney a prescription.

*He failed to adjust the dose of Valtrex in light of Chaney’s kidney failure.

The committee heard two hours of testimony and eventually ruled that Carr had violated state law when he failed to administer Valtrex immediately and did not adjust the dose. It cleared him of the other allegations.

The committee ordered Carr to attend five hours of continuing education classes. He has 30 days to appeal the decision before it takes effect.

Afterwards, Chaney described himself as “very unhappy” with the decision.

He said his wife might still be alive if Carr had treated her correctly.

“He did everything wrong,” Chaney said.

Carr declined to comment about the case, referring all questions to his attorney, Ramon Rodriguez, who also declined comment.