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The Winkler County nurse whistleblower case was a series of legal proceedings in West Texas that centered on the retaliation upon two nurses who submitted an anonymous state medical board complaint against a physician in 2009. The case attracted national attention for its implications on whistleblowing by nurses. After witnessing what they believed to be unsafe medical care, nurses Anne Mitchell and Vicki Galle submitted an anonymous complaint against Dr. Rolando Arafiles to the Texas Medical Board (TMB). When he learned of the complaint, Arafiles spoke with the sheriff of Winkler County, who was his friend and one of his patients. Arafiles alleged that the nurses' reports to the medical board constituted harassment. The sheriff investigated and obtained the TMB complaint, which provided enough information about Mitchell and Galle to make them identifiable. Galle and Mitchell were terminated from the hospital and faced criminal charges of misuse of official information. Galle's charges were dropped before trial and Mitchell was acquitted by a jury. In the aftermath of Mitchell's trial, Arafiles, several county officials and a hospital administrator all faced jail time for their roles in the retaliation against the nurses. The case raised questions about the extent of whistleblower protection for healthcare providers who report patient care concerns to licensing authorities. Texas law included remedies against retaliation for whistleblowers, but no known U.S. state had whistleblower laws that addressed appropriate prosecutorial conduct. According to the Texas Nurses Association, "No one ever imagined that a nurse would be criminally prosecuted for reporting a patient care concern to a licensing agency."〔 After the Mitchell case, protection from prosecution was incorporated into Texas whistleblower laws. The TMB stopped investigating anonymous complaints about physicians in September 2011. ==Background== The case originated at Winkler County Memorial Hospital (WCMH), a 15-bed hospital in Kermit, Texas. Mitchell and Galle were registered nurses at WCMH. The two nurses held multiple roles at the hospital and both were employed there for more than 20 years. Galle headed quality improvement and utilization management for the hospital, while Mitchell served as its compliance officer. Galle and Mitchell also split the responsibilities of the medical staff coordinator position. Mitchell held a part-time role as the county's emergency management coordinator.〔 She also had experience as a travel nurse and as an instructor and director in a licensed vocational nursing program.〔 In April 2008, Arafiles arrived at WCMH.〔 He had attended medical school in the Philippines and had come to the United States to train in Baltimore and Buffalo. Texas issued a medical license to him in 1998. The year before Arafiles came to Winkler County, the TMB restricted his ability to supervise nurse practitioners and physician assistants for three years and fined him $1,000. In that case, Arafiles allegedly failed to adequately supervise a physician assistant at a weight loss clinic and failed to exercise independent medical judgement when applying protocols written by the clinic's owner. Mitchell and Galle had concerns about Arafiles's care soon after he arrived at WCMH.〔 The doctor's practice in Kermit included the use of alternative medicine therapies such as herbal remedies. Witnesses later said that Mitchell made comments at work which characterized Arafiles as a "witch doctor".〔 Other coworkers said that Mitchell had legitimate concerns about the quality of the physician's patient care; they said that Mitchell first raised the issues with the hospital's administration, but that her concerns were not addressed. In one incident, Arafiles was alleged to have performed a skin graft on an emergency room patient even though he was not credentialed to perform surgery at the facility. Another patient came to the hospital with a crushed finger and Arafiles allegedly took a rubber tip off of a pair of medical scissors and stitched it onto the patient's finger. Mitchell and Galle sent an anonymous complaint to the TMB detailing their concerns with Arafiles's care of nine patients in 2008 and 2009. The letter said that the nurses feared losing their jobs if their identities were revealed in connection with the complaint. Arafiles became aware of the complaint and spoke to Winkler County Sheriff Robert Roberts, alleging that the complaint amounted to harassment. The TMB issued a copy of the complaint to Roberts with the understanding that it would only be used to investigate criminal activity by Arafiles. Roberts sent the complaint to Arafiles and to WCMH administrator Stan Wiley. As WCMH was a small hospital, details from the letter identified Mitchell and Galle as the sources of the complaint.〔(【引用サイトリンク】url=http://www.kwtx.com/home/headlines/123842324.html )〕 Roberts obtained warrants to search the nurses' computers and he found the letter to the TMB. The sheriff was friends with Arafiles. The doctor had treated Roberts in the emergency room for a heart attack. Roberts credited Arafiles with saving his life. He referred to the doctor as "the most sincerely caring person I have ever met." Roberts later commented on the board report, saying, "If it’s made to destroy somebody’s reputation or forcing them to leave town, then I don’t believe it is good faith."〔 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Winkler County nurse whistleblower case」の詳細全文を読む スポンサード リンク
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