Janae Pierre: Good morning, and welcome to NYC NOW. I'm Janae Pierre. This is the fifth and final episode of Imminent Danger: One Doctor and a Trail of Injured Women, produced in partnership with the Pulitzer Center. Here's Christopher Werth, investigative editor at WNYC and Gothamist.

Christopher Werth: Throughout this series, we've heard how the systems in place to vet doctors are not always protective of patients.

Karen Shakerdge: I think the public needs to recognize that the medical industry is an industry just like any other, which may sometimes come at the expense of patients and the general public.

Susan Karten: I just wanted him stopped. I wanted him to lose his license and not be able to practice, which apparently didn't happen.

Christopher Werth: In this episode, New York again, we turn back to a question we asked at the start of this series, why did New York give an OB-GYN named Thomas J. Byrne his medical license back after the state's own investigation found him to be "an imminent danger to patients." Just a quick warning, the start of this episode includes a detailed telling of loss and the death of a child. Here's our reporter, Karen Shakerdge.

Karen Shakerdge: In our last episode, I want to tell you about some findings, discoveries, really, that we've made along the way that may help explain how Byrne has managed to continue practicing all of these years. First, there's a guy I went to go see last summer, John Henries. I visited him at his home in Penn Yan, which is a village that's right at the top of one of the Finger Lakes in Upstate New York, who, I think, really helped me see why New York giving Dr. Byrne his license back was such a big deal.

Dr. Byrne delivered John's son, Matthew Henries, back in 1989. I sat down with John at his kitchen table and we talked for hours.

John Henries: I tried to do research on Dr. Byrne, I really can't find nothing on him. He's like a ghost. He disappears and then pops up.

Karen Shakerdge: He explained to me that his life started to unravel after what happened to Matthew.

John Henries: I went down a long, hard road, and a lot of it was not good. I just didn't know how to process. I pushed people out of my life. I pushed my parents out of my life. It was just like you take a snowball at the top of the mountain and let it roll down, and it gets bigger and bigger and bigger and bigger.

Christopher Werth: Matthew was one of the babies in New York's investigation before Byrne ultimately lost his medical license.

Karen Shakerdge: Yes, he was one of the five babies that I told you about earlier in this series. You were saying this before, why had I reached out to you out of the blue for something that happened so many years ago? Dr. Byrne applied to get his license restored in New York State in 2010. It sounds like you didn't know that.

John Henries: No.

Karen Shakerdge: His license was restored and he moved back to New York and started working at two hospitals in New York City as an OB-GYN.

John Henries: That's wrong because I was lied to. I think everybody that was involved in that case was lied to when they even said he'll never practice medicine again in New York State. That's a lie. It just makes me mad that he could do that and get away with it. This ain't right. That's the way I feel.

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Karen Shakerdge: Many of the people that I've spoken with from Byrne's time in Upstate New York have reacted like this, something like this. I think for them, Dr. Byrne losing his license provided some level of what felt like justice. When they hear that the state restored his license, it's almost like that justice has been taken away from them.

Christopher Werth: What exactly happened to John's son, Matthew?

Karen Shakerdge: Matthew was born just a few days before Christmas in 1989. During his birth, according to public records from the health department, Dr. Byrne used a vacuum extractor 15 times while delivering him. An expert consulted for the state's investigation testified that was "excessive and inappropriate." Matthew developed bleeding around his skull and was taken to an advanced neonatal intensive care unit about 40 miles away.

That NICU was actually at a hospital that all five of the babies included in the state's investigation were ultimately taken to after Byrne delivered them.

John Henries: When we got there, they were asking me a lot of questions about the birth, what exactly happened, and I kept on telling them the same story. The one doctor said, "Whatever happens, we advise you to go see a lawyer." I said, "May I ask why?" The one doctor looked and he said, "I'll be straight upfront with you," he says, "I am sick and tired of seeing Dr. Byrne's 'mistakes' coming in here."

Karen Shakerdge: The record also lays out that Matthew developed a very severe seizure disorder and that at the age of one, he was functioning as a one-month-old.

John Henries: The seizures were caused by traumatic brain injury. He had a diagnosis of cerebral palsy. He didn't talk. Really, he would communicate through his eyes and stuff like that.

Karen Shakerdge: John and Matthew's mother relocated to Vermont. John texted me some photos of Matthew from that time, one where he's reclined on a bright red chair.

John Henries: The picture that I sent you, he was in a red, foamy chair. He loved to sit in that and watch MTV, [chuckles] so I would have it on. I was watching him one afternoon, and I was out fixing him something to eat, and I came in and he was leaned over on his head looking at the TV and laughing out loud. I was going, "You got to be kidding me."

Karen Shakerdge: John told me Matthew continued to have all kinds of serious health issues and that right before he turned three years old, he was back in the hospital again.

John Henries: The day of his birthday, December 21st, we had a cake and presents and locked into his room, and soon, a nurse holding him and the pager was going off. She said that he was in distress breathing. On December 22nd, we made the decision if Matthew heart stopped, don't do nothing, just let him go but keep him on the ventilator, and then if he does pass, then don't do nothing. Then he passed away on December 23rd of '92.

Karen Shakerdge: Two days after his birthday.

John Henries: Yes, two days before Christmas. I didn't want to go up. My dad told me that I needed to go up, I needed to hold my son. I went up there, and I'm glad I did because I sat there and rocked Matthew for about an hour.

Karen Shakerdge: John told me that after Matthew died, his relationship with his wife at the time really suffered.

John Henries: She asked me why I keep going to the cemetery, and I couldn't even tell her why. I just felt like I was abandoning him up there, that he was there all alone and just crazy, just the thoughts. After my divorce, I went down the wrong road, took me to some places that I didn't want to be. So now, 30 years later, "Sure, let's give you your license back." When are they going to say enough is enough? Or don't they ever say that? Oh, it's wrong, totally wrong.

Karen Shakerdge: John died four months after I went to go speak with him. He told me that day that he hoped to one day get a law passed called Matthew's Law that would make it impossible for doctors who've been found guilty of negligence to practice medicine again.

Christopher Werth: Coming up, we take a close look at Byrne's applications for medical licenses in other states and what we know about New York's decision to restore his license here.

Dr. Roger Oskvig: In New York State, the education department and the health department protect our citizens.

Susan Karten: There were so many red flags that the state should have been aware of and should have investigated and should have denied this man his license to come back into New York.

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Christopher Werth: Can I ask you a question? I'm curious about what exactly does someone have to do to get a license back after they've lost it. How does that work in New York specifically?

Karen Shakerdge: A doctor who loses a medical license can petition the state to restore it after three years have passed. They apply with the education department. Most states have one entity that both investigates doctors and licenses them, but in New York, it's the health department that investigates complaints and doctors and the education department that handles professional licensing.

Dr. Roger Oskvig: It's a good process. I think it's one of the best in the country. It's made up of people who sometimes could do better and sometimes do things amazingly better than we ever thought could be.

Karen Shakerdge: Dr. Roger Oskvig is a professor of clinical medicine at the University of Rochester Medical Center. He's also been doing work related to physician licensing and discipline for almost 50 years, and he's currently part of what the education department calls its extended board of medicine. Just to be clear, he was not speaking for them during our conversation. That was a condition of the interview. How common is it for a physician who has gotten to the point of a revocation getting their license back?

Dr. Roger Oskvig: The general response is it's uncommon to have a license restored.

Christopher Werth: If it's so uncommon, who are the people, the actual human beings who even make that decision?

Karen Shakerdge: There's a group of people called the Board of Regents. There are 17 people that the state legislature elects. The Regents ultimately hold the decision-making power on whether to grant or deny a petition, but there are several committees that review a doctor's application before it gets to them, and it's a very involved process. Officials at the education department told me that among other things, five people have to submit affidavits on the applicant's behalf. Three of those five people have to be doctors. The department also gathers information it finds relevant about the doctor for the committees to review.

Dr. Roger Oskvig: From the time the license was revoked, what has the applicant been doing? It's the burden of the applicant to prove, you had some reason to lose your license. Demonstrate to us how that could never happen again.

Christopher Werth: The documents you were able to get your hands on, what do those show about how Byrne went about demonstrating that?

Karen Shakerdge: What I got through a public records request is a 20-page document that summarizes Byrne's application and conversations he had with various committees, and it lays out on what basis the education department decided to restore his license. I did also ask for his full application, but the education department told me that restoration applications are not part of the public documents that are subject to freedom of information law.

The first thing I noticed is that it seems the issues Byrne had in Oklahoma and New Mexico after losing his license in New York, everything I've laid out over previous episodes is just not referenced or even hinted at. The restoration record says, "When asked why the members of the New York State Board for Medicine and other committee members should grant him the reinstatement of his license after all these years," the applicant responded by saying, "I am a knowledgeable physician who specializes in a high-risk field. Since 1992, I have practiced medicine in other states with a valid license without incident."

Christopher Werth: What do you make of that "without incident"?

Karen Shakerdge: I've thought about the use of the word incident a lot. He wasn't disciplined by any medical board as far as I know in the intervening years. That's accurate, but I have seen the application form doctors fill out to get their licenses restored and Dr. Byrne would've had to disclose a number of things that happened since he lost his license according to this application form, including 11 lawsuits he was named in for incidents that happened from the time he lost his license in New York to filling out the restoration application.

There were three more lawsuits filed against him after he submitted the application but before New York made its decision to restore his license. He also would've had to disclose that one hospital temporarily suspended his privileges and that one medical board, Oklahoma, denied him a medical license.

Christopher Werth: We don't know what he disclosed because we don't have his full application.

Karen Shakerdge: Yes, that's right. All we have is this summary. In the summary, the committees also know that Byrne cared for patients in underserved areas and they conclude the document by recommending that the Board of Regents restore his license. It says, "The fact that Dr. Byrne has practiced in his field of obstetrics and gynecology successfully in Oklahoma and New Mexico for the last 20 years or more without having any professional discipline charges made against him is proof of his rehabilitation."

Susan Karten: I think that somebody that is put in charge of investigating a doctor who had his license previously removed should be turning over every stone to find out what he's been doing for the last 10, 15 years and what happened during those years. It seems basic.

Karen Shakerdge: This is Sue Karten again. She's the attorney who represented Amy Lam's family in a lawsuit filed against Dr. Byrne, four other doctors in Harlem Hospital for Amy's death in 2016, who I told you about at the start of the series.

Susan Karten: You cannot escape the decision that something happened here that shouldn't have happened or it wasn't given the attention that it should have in this case. There were so many red flags that the state should have been aware of and should have investigated and should have denied this man his license to come back into New York. Why that didn't happen, I don't know.

Christopher Werth: Karen, do you have any indication as to whether the education department at least knew about all the things that you've told us about in Byrne's record?

Karen Shakerdge: I really wanted to find that out, but the education department said they were unable to disclose any information about Dr. Byrne's application to get his license restored. I asked Dr. Roger Oskvig if it's possible the education department could just miss stuff.

Dr. Roger Oskvig: Not likely. My personal experience is we get hundreds and hundreds of pages of documents. It's not lack of information that we deal with. If an individual is restored that has a lot of historical information, it's because the restoration committee has concluded that that's not a risk to public based on the information provided at that hearing.

Karen Shakerdge: Is it the responsibility of the applicant who wants their license to be restored to show a clean record, or is that the responsibility of the department to find any relevant information on that front?

Dr. Roger Oskvig: New York State law is clear. It's actually in the language. It's the burden of the applicant to prove their qualifications; qualified, competent, good moral character, the burden of the applicant.

Karen Shakerdge: When you say burden of the applicant, do you mean it is up to them to tell New York State everything that is in their history?

Dr. Roger Oskvig: The applications have to be truthful and complete. Every application at the bottom, "I attest that everything I've said is complete and true." New York State like all 70 jurisdictions I know of say, "If I have intentionally not put something in my application, it can be inferred that this is application fraud," the penalty for which is no license or no membership on the medical staff. If we can't trust you to be truthful about who you are, how can we trust what's in the medical record to be truthful?

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Karen Shakerdge: I was really stuck on these questions; what doctors have to disclose and what happens if they don't, because I obtained Byrne's public files from medical boards, over 600 pages of records, which included his applications for licenses and renewals in multiple states; Oklahoma, North Carolina, New Mexico. We did a deep analysis by comparing them with public court records and New York State's own investigation into Byrne from the '90s. What we found is that since 1983, Byrne has made statements that appear to be inaccurate 16 times.

Christopher Werth: What do you mean specifically by inaccurate?

Karen Shakerdge: Well, most are statements where responses to questions are just not true. Many were instances where Byrne was asked to disclose malpractice lawsuits or payments or suspension of hospital privileges that had happened since the last time he'd renewed a license and he didn't disclose that information even though records show he had been sued or he had made payments or he did have his privileges suspended, as was the case at a hospital in Oklahoma.

For example, on one licensed renewal application in Oklahoma in 2004, he was asked whether he'd withdrawn an application for privileges since his last renewal. Byrne answered no, but I obtained a letter from an attorney who'd written to a hospital on Byrne's behalf about five months earlier requesting that Byrne's application for privileges be withdrawn. Then there are also times where Byrne's application misrepresents details about specific patient cases that don't match up with New York State's findings.

Christopher Werth: How so?

Karen Shakerdge: In an application to have his license reinstated in North Carolina, North Carolina actually had taken away his license after he lost the license in New York originally, there's a description of what happened to Matthew, John's son, that omits what seemed like key details. For example, Byrne states that Matthew's delivery was vacuum extraction assisted but does not note what New York State found that the vacuum extractor was used excessively in a way that caused or contributed to Matthew's injuries at birth. He also says that a CT scan that was done was "normal."

Christopher Werth: Didn't you say that the state's investigation found Matthew had bleeding around his skull?

Karen Shakerdge: Yes. Actually, Byrne also misstates the reasons why his New York medical license was revoked in the first place. He states that "New York revoked my license in 1991 for their words, fraudulently applying for a license after reviewing my application for licensing six years earlier." As I've noted, according to public records from New York State's Health Department, he was also found guilty of gross negligence, gross incompetence, negligence on more than one occasion, incompetence on more than one occasion, and practicing the profession fraudulently.

I've really hoped to speak with Dr. Byrne directly about everything that I've found and reported and that we've put into this series. We haven't taken it lightly that I haven't been able to include his response to any of this. We've made several attempts to reach Dr. Byrne several weeks ago. WNYC's deputy editor, Stephanie Clary, traveled out to Amarillo, Texas. Byrne practices there as an OB-GYN at a clinic affiliated with Texas Tech University Health Sciences Center-

Stephanie Clary: I'm looking for Dr. Thomas Byrne. Do you know if he's [unintelligible 00:27:34]?

Karen Shakerdge: -but a police officer asked her to leave.

Police Officer: I would appreciate if you guys [unintelligible 00:27:40] and leave.

Stephanie Clary: Okay. We're outside of Texas Tech Physicians where Dr. Byrne works. We found out that he was inside the building, but he did not want to see us. We tried to wait around for him, but we did deliver him another copy of the list of questions we've been trying to get to him, so hopefully he has that now.

Karen Shakerdge: When I spoke with Dr. Roger Oskvig, there was something he said that made me think that there could be even more going on here. I wonder if it might help for me to just tell you in very general terms what has set me off on this whole endeavor of trying to understand all these systems, which is that there was a physician who lost his license in the early '90s in New York State. There were several counts of medical negligence. It made quite a bit of news at the time. His license was taken away after hearings were held.

He then went on to practice in other places; New Mexico, Oklahoma. Then about 10 years ago, he asked New York State to restore his license and it was granted. Now, while he was away not practicing in New York, there were several cases of medical negligence, and more recently in New York, he was involved in a wrongful death case in New York City and now he's practicing in Texas. I'm not sure what to make of all of that.

Dr. Roger Oskvig: Don't we both wish you had more information?

Karen Shakerdge: I'd love to have more information.

Dr. Roger Oskvig: Yes, because as you're inferring there, there seems to be more to the story than the story that we're able to read so far. You have the Reader's Digest version but not the deep version.

Karen Shakerdge: You want me to shut this off? I had to stop recording then, and just to be clear, it was a condition of our interview that we wouldn't discuss any specific doctors or cases. Roger explained to me that he's bound to confidentiality to protect the privacy of doctors and patients.

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Christopher Werth: What was he referring to exactly by the deep version? He certainly seemed to be hinting that he knew more than he was willing to tell.

Karen Shakerdge: Yes. I've spent a lot of time trying to figure out what he may have been talking about. While I have spoken with people who have knowledge about Dr. Byrne, there's a lot of people, specifically other doctors, who did not want to talk with me on the record. What I do know at this point is that it's hard to imagine that the state didn't at least have some hint that concerns were raised about Byrne's practice since his New York license was revoked.

Susan Karten: I don't know what he gave to the state. I remember there were some glowing letters about him that were submitted by people that worked with him, and that's part of the problem too. It's like [unintelligible 00:31:31] police brutality cases and we call that the blue wall of silence. Well, here's the same thing, basically doctors covering for doctors.

Christopher Werth: You mentioned there was another malpractice case while Byrne was at Harlem Hospital where Amy Lam died. Tell us about that.

Karen Shakerdge: Yes. I found another lawsuit that was filed in 2021 against Dr. Byrne in Harlem Hospital regarding the delivery of a newborn. According to the complaint, the parents alleged that Byrne injured their baby while doing a C-section, specifically that he didn't use surgical instruments correctly, that he didn't identify the position of the baby correctly, and that he lacerated the baby's lower back and buttocks causing permanent injuries.

The lawsuit is still unfolding in court, so we don't know the outcome of it yet and I haven't been able to interview anyone involved in the case. One thing that I did learn is that Amy Lam's husband, Gilbert Kwok, filed an official complaint with the New York State Health Department about what happened to Amy. Three complaints actually for three doctors, including Byrne.

Susan Karten: He wanted to basically stop this from happening to anybody else in New York State, and he wanted the state to know what happened to his wife. Why he's doing this is to get some answers. The lawsuit gave us the picture, but it really didn't give us the answer of why he was practicing on that day at Harlem Hospital. There's a backstory here we don't know.

Karen Shakerdge: Those complaints are now with the Office of Professional Medical Conduct, which is responsible for investigating doctors in New York.

Susan Karten: There is no closure here. There's really been no closure, I should say, for the family and for me. I could have said you got your money and move on, but I don't believe that's what should happen here. I think the board has to answer for what happened here and I hope that there is a vigorous investigation with some answers.

Karen Shakerdge: I was able to see a letter that the OPMC sent in response, and it explained that an investigator was assigned to look into the information submitted, which means that essentially the very same agency that investigated Dr. Byrne back in the early '90s may be investigating him once again.

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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. Thanks to our researcher and fact-checker Ethan Corey and to Jaclyn Jeffrey-Wilensky for their detailed reporting in this episode. Jean Rostkowski and Wayne Schulmeister were our sound engineers on this episode. Jared Paul wrote our theme music.

Lauren Cooperman is our legal counsel. We had additional reporting and producing from Owen Agnew and Catherine Roberts. A special thanks to Meral Agish, Julia Barton, Amber Bruce, Rob Christensen, John Durkee, Maura Ewing, Dr. Benedict Landry, Sarah Lumbard, Maggie Stapleton, Marshall Allen, and the 2015 investigative health reporting class at the Craig Newmark Graduate School of Journalism at CUNY.

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Janae Pierre: Thanks for listening. We've reached the end of Imminent Danger, but more in-depth reporting will be appearing Saturdays on our feed. I'm Janae Pierre, and we'll be back with the local news and headlines first thing Monday morning. Until then, have a great weekend.

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