BEFORE THE NORTH CAROLINA MEDICAL BOARD In re: ) ) ORDER OF SUMMARY John David Hamel, M.D., ) SUSPENSION OF LICENSE ) (N.C. Gen. Stat. 150B-3(c)) Respondent. ) This matter is before the North Carolina Medical Board ( Board ) pursuant to N.C. Gen. Stat. 150B-3(c) and upon information that John David Hamel, M.D. ( Dr. Hamel ): (1) committed unprofessional conduct by violating his Consent Order with the Board prohibiting him from performing certain types of invasive elective surgeries; (2) performed surgeries in a manner below the standard of practice in North Carolina and resulting in harm to his patients and subjecting patients to dangerous and unnecessary risk; (3) falsified medical records to hide the fact that he was performing surgeries prohibited by his Consent Order; and (4) has a history of alcohol abuse and was recently arrested for Driving While Impaired. Information regarding Dr. Hamel s patient care was provided to the Board through three separate complaints from two physicians and a healthcare clinic all of whom addressed complications resulting from prohibited surgeries performed by Dr. Hamel and expressed concern that Dr. Hamel was endangering Order of Summary Suspension John David Hamel, M.D. Page 1 of 11
his patients. The Board also submitted the records of the three patients to a reviewing medical expert who concluded that Dr. Hamel s diagnosis, treatment and documentation of all three patients failed to conform to the standard of practice in North Carolina and expressed his own concerns regarding the risks and dangers that Dr. Hamel was exposing his patients to. In support of this Order of Summary Suspension of License, the Board finds the following: 1. During the times relevant herein, Dr. Hamel practiced medicine in and around Nebo, North Carolina. 2. In August 2014, the Board and Dr. Hamel entered into a Consent Order in which Dr. Hamel s medical license was restricted from performing surgery except in certain limited circumstances. That Consent Order resulted from findings by the Board that Dr. Hamel had performed cosmetic surgical procedures on five patients and that his care had failed to conform to the standards of acceptable and prevailing medical practice in North Carolina. 3. As a result of the Board s findings, the Board ordered that Dr. Hamel was restricted and prohibited from performing any elective surgical procedures which require more than topical anesthesia except for those cosmetic procedures listed in Appendix A to this consent order. However, Dr. Hamel may use a subcutaneous infiltrative local injection of not more than five Order of Summary Suspension John David Hamel, M.D. Page 2 of 11
(5) centiliters of one or two percent lidocaine solution for supplemental pain relief. 4. The Consent Order also provided that: If Dr. Hamel fails to comply with any of the terms of this Consent Order, that failure shall constitute unprofessional conduct within the meaning of N.C. Gen. Stat. 90-14(a)(6) and shall be grounds, after any required notice and hearing, for the Board to annul, suspend or revoke his license to practice medicine and surgery and to deny any application he might make in the future or then have pending for a license. PATIENT A 5. In May 2016, the Board received a complaint from Physician A regarding a patient ( Patient A ) that he had treated in the emergency room after Dr. Hamel had performed several cosmetic surgeries on her. One of those surgeries led to an abscess that required a hospital admission and surgical intervention by Physician A. According to Physician A, Dr. Hamel had allowed Patient A to insert a needle into her own thigh on multiple occasions to suck fluid out of the thigh. Physician A expressed concern that Dr. Hamel would eventually kill someone. 6. In September 2015, Patient A initially underwent a belt lipectomy. On the next day, Patient A underwent a bilateral thigh liposuction and thigh lift surgery. According Order of Summary Suspension John David Hamel, M.D. Page 3 of 11
to Patient A, Dr. Hamel performed the surgery on her right leg while another surgeon operated on her left leg. 7. Patient A also underwent a bilateral breast augmentation in October 2015. Again, Patient A reported to the Board that Dr. Hamel performed the operation on one side while the same second surgeon performed the surgery on the other side. 8. Patient A reported to the Board that, in March 2016, Dr. Hamel performed a scar revision on both of Patient A s thighs. The medical record reflects that another doctor performed the surgery. Patient A was awake for the surgery and insists that Dr. Hamel was the only physician in the room. 9. The Board also sent the medical records for Patient A to an independent expert reviewer. The reviewing expert concluded that the diagnosis, treatment and documentation of Patient A s care all failed to conform to the standards of acceptable and prevailing medical practice in North Carolina. 10. Specifically the reviewing expert commented regarding the September 2015 surgeries, By this point she has undergone 3 major surgeries in 6 days. This is highly unethical and exceedingly dangerous. The reviewing expert summarized his criticism of Patient A s care in the following manner: There was a lack of a proper pre[-] and postoperative evaluation by the operative surgeons, inadequate medical record documentation, poor surgical decision making and technique, mismanagement of Order of Summary Suspension John David Hamel, M.D. Page 4 of 11
multiple complications which were further compounded by additional surgeries that were not indicated, lidocaine overdose, and lack of informed consent. 11. The thigh lift surgery, the breast augmentation surgery, and the scar revision of the thighs are elective surgical procedures that require more than topical anesthesia and are not excluded from the Consent Order. Thus, Dr. Hamel violated the restriction of his practice contained in the Consent Order and such violation constitutes unprofessional conduct within the meaning of N.C. Gen. Stat. 90-14(a)(6). 12. In addition, Dr. Hamel fraudulently entered the name of another physician on the medical record to obscure the fact that he was violating his Consent Order. PATIENT B 13. In May 2016, the Board received information from Physician B who indicated that Patient B had been seen in his office after she had undergone an abdominoplasty performed by Dr. Hamel. Physician B requested a copy of the medical record for Patient B. The medical record indicated that another physician had performed the surgery. Patient B, however, insisted that Dr. Hamel was the only physician in the room during her surgery. Order of Summary Suspension John David Hamel, M.D. Page 5 of 11
14. Physician B indicated that he believed Dr. Hamel was in violation of his Consent Order and had engaged in falsifying the medical record. 15. During the Board s investigation, the Board interviewed Patient B who reported that she was conscious the entire time of her surgery and that Dr. Hamel was the only physician in the operating room and had performed her surgery. She also indicated she was surprised when she saw in the medical record that Dr. Hamel was not listed as her surgeon. 16. The Board submitted Patient B s medical records to an independent reviewing expert. The reviewing expert concluded that the diagnosis, treatment and documentation of Patient B s care all failed to conform to the standards of acceptable and prevailing medical practice in North Carolina. 17. Specifically, the reviewing expert opined that [t]he preoperative history and physical exam is completely inadequate and [n]o preoperative lab work was done to ensure the patient was safe to undergo the procedure. The expert also criticized the lack of postoperative monitoring and the high dosage of 50mg/kg of lidocaine used as beyond the standard of care for tumescent liposuction. The expert commented that It is pure luck that she did not have an adverse event. 18. The expert also noted that Dr. Hamel did not have hospital privileges. As the reviewing expert explained, For Order of Summary Suspension John David Hamel, M.D. Page 6 of 11
major surgeries such as abdominoplasty and liposuction done in an outpatient facility, full operative privileges at a nearby hospital is essential for patient safety. The reviewing expert opined that it violates the standard of care to not have the ability to care for surgical complications that require inpatient hospitalization. 19. The reviewing expert summarized Dr. Hamel s care of Patient B as follows: The standard of care was violated... in the lack of pre- and postoperative evaluation, poor documentation throughout the chart..., poor surgical technique with a high abdominoplasty scar and lack of rectus plication, lidocaine overdose, and lack of documentation of informed consent. 20. The abdominoplasty procedure performed on Patient B is an elective surgical procedure that require more than topical anesthesia and is not excluded from the Consent Order. Thus, Dr. Hamel violated the restriction of his practice contained in the Consent Order and such violation constitutes unprofessional conduct within the meaning of N.C. Gen. Stat. 90-14(a)(6). 21. In addition, Dr. Hamel fraudulently entered the name of another physician in the medical record to obscure the fact that he was violating his Consent Order. Order of Summary Suspension John David Hamel, M.D. Page 7 of 11
PATIENT C 22. The Board also received information from Catawba County Public Health for Women s Health Services ( Catawba Women s Clinic ) reporting that they were seeing a number of patients from Dr. Hamel s clinics that were experiencing complications from surgeries being performed by Dr. Hamel. The Catawba Women s Clinic specifically identified Patient C as a patient that had experienced such complications. 23. The Board ordered Dr. Hamel to produce the medical records for Patient C. 24. The first surgery Patient C underwent at Dr. Hamel s clinic included liposuction of the abdomen, flanks, and back followed by an abdominoplasty and fat grafting of the buttocks. The medical record for Patient C reflects that a second surgeon ( Physician C ) was the lead surgeon and Dr. Hamel assisted the surgery. However, Physician C has indicated that Dr. Hamel performed all the liposuction and tumescence on the patient as well as the fat transfer. He also made the incision around the umbilicus and sewed the umbilicus in and half of the abdominal incision. 25. Although Dr. Hamel s Consent Order allowed him to perform liposuction and fat transfer, he is not permitted to perform the abdominoplasty as described above by Physician C. Order of Summary Suspension John David Hamel, M.D. Page 8 of 11
26. After the procedures described above were performed, Patient C began to experience complications. As a result, Dr. Hamel performed two additional surgical procedures requiring more than topical anesthesia that were in violation of his Consent Order. 27. The Board provided Patient C s medical records to the Board s independent expert reviewer. The reviewing expert concluded that the diagnosis, treatment and documentation of Patient C s care all failed to conform to the standards of acceptable and prevailing medical practice in North Carolina. 28. The reviewing expert summarized his criticism of Dr. Hamel and the second surgeon s care of Patient C in the following manner: There was a lack of a proper pre and postoperative evaluation, poor patient selection, lack of confirmation of quitting smoking, the poor judgment involved in repeat operations that were doomed to failure, improper selection of operations, poor documentation throughout the chart with lack of documentation of proper physical examination on multiple occasions and lack of documentation of informed consent. This patient should have never undergone the initial procedures that were performed, nor should she have undergone either of the subsequent operations to fix the problems as a result of poor patient selection. Order of Summary Suspension John David Hamel, M.D. Page 9 of 11
DR. HAMEL S DWI AND ALCOHOL ABUSE 29. On July 2, 2016, Dr. Hamel was charged with Driving While Impaired Motor Boat Vessel. Dr. Hamel refused during his arrest to a chemical analysis to determine the alcohol concentration or presence of an impairing substance. According to Dr. Hamel, he had consumed four beers and three liquor drinks on the evening of July 1, 2016. 30. At the time that he was stopped, Dr. Hamel was operating the boat with seven passengers on board. 31. During the Board s investigation, it was learned that Dr. Hamel has abused alcohol in the past. 32. From 2006 to 2013, Dr. Hamel was monitored by the North Carolina Physicians Health Program for issues related to his abuse of alcohol. 33. Dr. Hamel s history of alcohol abuse and recent alcohol related arrest are an indication that Dr. Hamel may be unable to practice medicine with reasonable skill and safety to patients by reason of illness, drunkenness, excessive use of alcohol, drugs, chemicals, or any other type of material or by reason of any physical or mental abnormality within the meaning of N.C. Gen. Stat. 90-14(a)(5). Order of Summary Suspension John David Hamel, M.D. Page 10 of 11
For the foregoing reasons, the North Carolina Medical Board finds and concludes that the public health, safety, or welfare requires emergency action. The Board therefore ORDERS, pursuant to N.C. Gen. Stat. 150B-3(c), that Dr. Hamel s license to practice be SUMMARILY SUSPENDED effective immediately. This the 10 th day of October, 2016. NORTH CAROLINA MEDICAL BOARD By: Pascal O. Udekwu, M.D. President Order of Summary Suspension John David Hamel, M.D. Page 11 of 11