Janae Pierre: Welcome to NYC Now. I'm Janae Pierre. Happy Saturday. We're back with another weekend special, and this one is a big one. It's the first episode out of five that we've produced in partnership with the Pulitzer Center. New episodes will be released every Saturday morning for the next five weeks. Here's episode one of Imminent Danger: One Doctor and a Trail of Injured Women.

Karen Shakerdge: I need to start this whole thing with telling you about a woman I've never met and what I've learned about her life before it took a tragic turn. This woman's name was Wai Chi Lam, but she went by Amy. She lived in Harlem. She was from Hong Kong and she was a journalist. She moved to New York specifically to study journalism at Columbia University. I have a bunch of videos that her husband shared with me, just a collection of everyday moments of her and her family. They're lovely, but also, ever since I first watched them, in many ways, they've haunted me.

They're singing songs, walking around the park on a nice sunny day, doing bath time. There's just a lot of laughter and joy in the most simple and beautiful of ways. This is not a story about those moments. It's a story about what happened to Amy after she gave birth to her second child, and about the track record of one doctor that stretches way back to well before he treated her at a hospital in New York City.

Back in the early '90s, New York State found that doctor, an OB-GYN named Thomas Byrne to be dangerous, negligent, and fraudulent. They even took away his medical license. Then decades later gave it back to him. They said he was rehabilitated, fit to practice, but I've obtained over 4,000 pages of public records, and what I've discovered is that since he first lost his license in New York, former patients and their family members across multiple states have continued to file lawsuits that allege he was negligent while providing medical care, which they claim caused injuries or death, and yet he's still practicing today.

Over the years as a health reporter, I've seen how varied the quality of medical care can be for patients. I think we'd all like to believe that as we sit across from doctors, we can and should trust them, that there's no reason to question them. Most of the time, that's absolutely true. Doctors do take care of us when we're at our most vulnerable, but other times, what unfolds in the space between patients and doctors can be fraught, like just walking into a hospital is taking a risk. I've decided to figure out how doctors in our country are supposed to be vetted and how patients are supposed to be protected.

Christopher Werth: This is Imminent Danger. An investigation by Karen Shakerdge into the career of one doctor. What she uncovers reveals a complex web of shortcomings on the part of hospitals, the state, and federal systems used to track and discipline doctors, and how New York backgrounds the physicians it approves to practice. I'm Christopher Werth. I'm the investigative editor at WNYC in Gothamist. This is episode one, Wrongful Death. A quick heads up. This story is a difficult one. It deals with detailed accounts of medical injury, loss, and grief. Karen, what exactly happened to this woman, Amy Lam, whose case you've been looking into?

Karen Shakerdge: In 2016, she was pregnant with her second child when the plan she had for the birth got completely derailed.

Susan Karten: My cases will have an effect on me, but this one particularly because my daughter just gave birth, and for a few months, I couldn't even open the pages of the case because gave me such a bad feeling.

Karen Shakerdge: I spoke with Susan Karten. She's an attorney in New York who specializes in medical malpractice cases, and she represented Amy's family in a lawsuit. She explained to me that Amy really wanted to stay in New York so she could have her second kid here.

Susan Karten: Because it was her belief that the medical care was better in New York City than anywhere.

Christopher Werth: Where in New York was Amy supposed to have her baby?

Karen Shakerdge: She was supposed to go to Beth Israel downtown in the city. She goes there when she feels like she's in labor, but they tell her that she's not far along enough, and she heads back to her apartment, but then things moved pretty quickly.

Susan Karten: Now all of a sudden, she felt the baby coming.

Karen Shakerdge: And she ended up giving birth at home.

Susan Karten: She got on the floor of the bathroom, and she delivered this child. The neighbor came in, the neighbor helped, and thank God, everything was fine. The baby came out, Amy was fine. However, they wanted somebody to cut the umbilical cord, so her husband called EMS. EMS showed up pretty quickly. They wrote down in all their records that she was alert in what we call alert x3. She was talking, she was smiling, she was taking pictures of the baby. She had done a selfie with her husband.

Karen Shakerdge: The only issue was that the placenta hadn't come out, so EMS asked her husband what turned out to be a pivotal question.

Susan Karten: EMS said, "We can take you to two hospitals. We can take you either to Colombia or we can take you to Harlem." Her husband said, "Which one is closer?" and they said "Harlem," so that's where they ended up.

Christopher Werth: What happened when Amy got to Harlem Hospital?

Karen Shakerdge: The doctors there do eventually get the placenta out, but at some point around 2:00 PM, her blood pressure started to drop.

Susan Karten: There were red flags going off. Her blood pressure was dropping, her heart rate was increasing, and she was getting weaker and weaker.

Karen Shakerdge: Sue says it should have been very clear to the physicians there that they were not dealing with a typical or expected amount of bleeding.

Susan Karten: There should have been an immediate recognition that there was a real problem and that she was bleeding internally.

Karen Shakerdge: Over the next several hours, Amy was monitored and given what medical records described as massive blood transfusions.

Susan Karten: What they've continued to say is, "We were giving her transfusions." Well, the transfusions weren't working. It's like pouring blood into somebody, but you're not finding out what's causing the bleeding.

Karen Shakerdge: What happens next is a cascade of procedures. According to Amy's medical records, Dr. Byrne, the OB-GYN I mentioned earlier does an ultrasound and prescribes a medication that's supposed to stop bleeding in the uterus, but it doesn't help. Around 8:00 PM, which was about five hours after she initially started showing signs of distress, Amy gets moved to an operating room. Another doctor who was there opens up her abdomen where they find severe internal bleeding. Byrne then does a hysterectomy. He removes her uterus and at least one of her ovaries. A vascular surgeon then arrives and continues to operate on Amy, but ultimately, they don't stop the bleeding in time.

Susan Karten: And Amy died.

Karen Shakerdge: It was 10:37 PM, just about 11 or so hours after she had given birth in her apartment. The New York Medical Examiner's Office later concluded that the cause of her death was that her aorta which is the main artery in the body that carries blood had ruptured in the operating room. Medical records show that, at the time of her death, she had lost her entire blood volume.

Christopher Werth: Do we know why her aorta ruptured in the way that it did?

Karen Shakerdge: The autopsy report says it was unclear whether it was a result of the medical care she received or if it's something that just happened naturally. Attorneys for the hospital said it was a rare and unforeseeable event, but Sue and her medical experts argue that Amy's life could have been saved if the doctors had done things differently and tried to stop the bleeding sooner.

Catherine King: It was really difficult to say goodbye to Amy.

Karen Shakerdge: I spoke with a friend of Amy's, Catherine King. She went to journalism school with her and attended her funeral which was in Chinatown in Manhattan.

Catherine King: It was difficult to see Amy in a casket. She shouldn't have been there. She should have been alive enjoying her newborn. I really don't think of her the way I last saw her. I think of her sitting in class laughing, playing with her son on the sidewalk, and talking about Hong Kong, her life in Harlem, and her dreams for the future.

[music]

Karen Shakerdge: When Sue Karten, Amy's family's attorney started looking into the doctors who treated Amy that night, she found some pretty troubling information about Dr. Byrne.

Susan Karten: There was notations in his record from New York State that this man was an imminent danger to patients.

Christopher Werth: That's coming up.

[music]

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Male Speaker 1: We are all gathered to experience the magic of great human voices, beautiful staging, and big human drama.

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Christopher Werth: Karen, we know that Amy's family sued the hospital, they sued the doctors who were involved here, including the OB-GYN you've been reporting, on Dr. Thomas Byrne. What did her family's attorney find when she talked to him?

Karen Shakerdge: First, just to be clear, there were five physicians named in the lawsuit for Amy's death, but when Sue Karten deposed them, she said Dr. Byrne really stood out to her.

Susan Karten: I felt there was something about this man, his background, from the way he was testifying, and so I asked him. I said, "Do you have a license in New York?" He said, "Yes." I said, "Have you continuously been licensed in New York?" and he said, "No."

Karen Shakerdge: Just to give you a little background on Dr. Byrne, he's a maternal-fetal medicine specialist, which is a specialty within obstetrics and gynecology for high-risk patients and just more complicated cases. He grew up in Illinois and went to medical school at Loyola University there. He did his internship at what was then called Cook County Hospital on the west side of Chicago. He did his OB-GYN residencies in North Carolina and then in New York. Over the years, he's moved around a lot, often working in underserved areas.

Susan Karten: I started to question with great detail is, "What was your background?" It came out that he had lost his license. It had been revoked, which is very serious, very serious in New York.

Karen Shakerdge: According to public records from New York state's health department, back in the early '90s, the state investigated Dr. Byrne and found him guilty of things like gross negligence, gross incompetence, negligence on more than one occasion, incompetence in more than one occasion, obtaining a license fraudulently, and practicing the profession fraudulently. That last one is a reference to making a false statement in a patient's medical record.

Susan Karten: There was notations in his record from New York State that this man was an imminent danger to patients.

Christopher Werth: An imminent danger to patients, that's what the record says.

Karen Shakerdge: Yes. In 1990, the health commissioner used emergency powers to immediately suspend his license. One of the criteria for being able to do that is the health department finds that the physician poses an immediate danger to the health of the people of the state, just to be able to get him to stop practicing immediately.

Susan Karten: To be honest with you, I was shocked, and I don't shock easily because I've seen a lot.

Karen Shakerdge: The state later fully revoked his license, it was about a year later, which meant at that time he was no longer able to practice medicine anywhere in New York State. What Sue realized, and what I've found is that, despite that troubling track record, Dr. Byrne not only managed to get his license back in New York several years later, but he's managed to go from state to state and hospital to hospital within other states practicing medicine and leaving some really bad outcomes behind. He's been doing that for over 30 years.

Susan Karten: He went to Oklahoma and he went to New Mexico, and lawsuits followed him to every state.

Christopher Werth: How many lawsuits are we talking here?

Karen Shakerdge: What I found is that he's been sued for malpractice at least 23 times. That's the number of lawsuits I've been able to confirm, but I did see references to other claims.

Christopher Werth: Okay. Put that into context for us. Is that a lot?

Karen Shakerdge: Well, OB-GYNs are some of the most sued doctors compared to other kinds of doctors. It's hard to compare physicians for one thing. The longer you practice, the more likely you are to have racked up more malpractice claims. Byrne started his residency in 1980, so he's been practicing for a while, but I found two studies, one from the American Medical Association, another from the American Congress of Obstetricians and Gynecologists that found all the OB-GYNs they surveyed had been sued on average about one to three times in their careers so far.

Christopher Werth: Byrne has been sued nearly two dozen times.

Karen Shakerdge: That's right. I'll say that the number of malpractice lawsuits is not the only indicator of a doctor's quality of care, but still, several OB-GYNs I've spoken with were pretty shocked by this number, even with the amount of years Byrne has been practicing.

Christopher Werth: What has Byrne himself had to say about all this? Have you spoken with him?

Karen Shakerdge: I have reached out to Dr. Byrne many, many times. For about a year now, I've been trying really hard to get an interview with him. I've left messages for him at clinics and hospitals he's worked at. I've emailed him many times. I've sent him a list of very detailed questions by certified mail, but unfortunately, I haven't gotten any response. I did manage to reach him by phone once.

[phone ringing] [phone conversation]

Hi, Dr. Byrne. Is this Dr. Thomas Byrne?

I introduced myself. He confirmed he was Dr. Thomas Byrne. I explained why I was calling.

[phone conversation]

Just wondering, have you gotten any of my emails or messages?

But then the call ended abruptly.

[phone disconnected]

Okay. Hang up.

Voicemail: Call has been forwarded to an automated message.

Karen Shakerdge: I called several more times after that and left messages.

[phone conversation]

Hi, Dr. Byrne, this is Karen Shakerdge calling again, the reporter who left you voicemails and just wanted to follow.

But as we speak, I still have not heard back from him. I did speak with some former and current colleagues of his, doctors he's worked with. Unfortunately, none of them agreed to be interviewed, but they generally told me that he was a great doctor. I was also able to read about a dozen recommendation letters other doctors wrote for him that were part of some medical board files I got, and all the letters were very positive about Dr. Byrne and his skills.

Christopher Werth: What has Harlem Hospital had to say about Dr. Byrne?

Karen Shakerdge: I did reach out to New York City Health and Hospitals, which runs Harlem Hospital, and they confirmed he's no longer working there. I have learned that he's still practicing in the city elsewhere at St. Barnabas in the Bronx, and he's also working in Texas, in Amarillo.

Christopher Werth: Whatever happened with Amy's family and their lawsuit?

Karen Shakerdge: The lawsuit settled in 2020 as a wrongful death case. Amy's husband, Gilbert, and their two children recently moved to Scotland. I was in touch with him for this story to learn more about Amy and how he's handled everything. It has been seven years now since Amy died, and their second child Zachary was born. Gilbert told me he still to this day has a lot of what-ifs that he sits with. What if things unfolded differently at the hospital that day? What if he asked more questions? What if she was still alive today? What would their lives look like?

Gilbert: Happy birthday to you.

Karen Shakerdge: Gilbert and the kids were recently back in New York for a visit this past summer and they celebrated Zachary's birthday [singing birthday song] in Harlem with their old neighbor, the one who came in and helped Amy when she found herself unexpectedly giving birth at home.

Gilbert: You're going to blow? Make a wish. Make a wish, Zach. Oh my God, look, I wasn't recording. Oh my God. Happy birthday to you.

Male Speaker 2: Yes, all yours.

[cheers]

Gilbert: Yay.

Male Speaker 2: Yay.

[music]

Christopher Werth: Karen, I think that many people will be surprised to learn that a doctor can have their license revoked for malpractice in one state, be labeled an imminent danger in that state, and then go on to practice elsewhere I think pretty quickly, and then get their license back in the state that they lost it in. How does something like that happen?

Karen Shakerdge: This was also very surprising to me when I first started looking into all of it, especially because there are systems that are in place to prevent doctors with questionable track records from practicing. Yet, I've spoken with over a dozen former patients of Dr. Byrne's, or their family members who've told me about some really harrowing experiences. What I've done is collected thousands of pages of records on Byrne and other doctors from state medical boards, patients, courts all over the country to try and answer that question, how did this happen, how is he still practicing, and who exactly is supposed to prevent this kind of thing from happening in the first place?

[music]

Christopher Werth: Coming up on Imminent Danger.

Female Speaker 1: I Remember saying to the nurses who were there, my peers, "Do you all understand that this did not have to happen? This was preventable."

Male Speaker 3: Practicing physicians are expected to be infallible and make zero mistakes 100% of the time.

Female Speaker 2: I just remember being told that they were watching this guy considering what he did to my daughter and other children.

Male Speaker 4: I think everybody that was involved in that case was lied to.

Christopher Werth: Imminent Danger: One Doctor and a Trail of Injured Women was reported by Karen Shakerdge and edited by me, Christopher Werth. It was produced in partnership with the Pulitzer Center. Our executive producer is Ave Carrillo. We had additional editing by Nsikan Akpan, Stephanie Clary, and Sean Bowditch. Ethan Corey is our researcher and fact-checker. Jared Paul is our sound engineer. He also wrote our theme music.

We had additional reporting and producing from Owen Agnew and Catherine Roberts. Lauren Cooperman is our legal counsel. Special thanks in this episode go to Dr. Alan Braverman, Jackie Fay, Karen Frillmann, Gilbert Kwok, Dr. Katherine Kula, Dr. Benedict Landgren, Jessica DiNapoli, Rob Norton, Wayne Schulmeister, and Gina Vosti.

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Janae Pierre: Thanks for listening. Be sure to check out NYC NOW every Saturday morning for the next five weeks. I'm Janae Pierre. Until then, have a great weekend.

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