Roanoke jury rules ER doc wasn’t fired for whistleblowing

A jury ruled Friday that a Roanoke Valley emergency room doctor was not fired for complaining that HCA Healthcare‘s emphasis on short wait times at LewisGale Medical Center and its Cave Spring ER had a negative impact on patient safety.

Dr. Thomas Bolton sought $20 million in his lawsuit against his former employer, Lake Spring Emergency Group, a Glen Allen staffing and management services company that provides physician staffing for LewisGale Medical Center in Salem and the freestanding LewisGale Cave Spring ER in Roanoke County.

The case is believed to be the first brought to trial under Virginia’s relatively new whistleblower law.

On Friday, the Roanoke County Circuit Court jury ruled that Bolton believed he was reporting a violation of federal or state law or regulations to a supervisor. However, jurors were not convinced that’s why Bolton lost his job.

In Bolton’s initial lawsuit, filed in 2023, LewisGale Medical Center, LewisGale Hospital and HCA Management Services were also listed as defendant, but Roanoke County Circuit Court Judge James R. Swanson dismissed parties other than Lake Spring Emergency Group from the suit. One of the nation’s largest for-profit hospital chains, Tennessee-based HCA Healthcare owns and operates about 2,400 hospitals and clinics, including the LewisGale facilities in the Roanoke area.

HCA Healthcare, Bolton’s attorneys and the attorneys representing Lake Spring Emergency Group did not respond to  requests for comment.

In Bolton’s 2023 complaint, he stated that doctors at the two LewisGale facilities receive alerts when management feels ER wait times are too long. Both facilities also have large digital signs that display the average length of time patients can anticipate waiting before being seen by emergency medical staff .

Bolton, who was hired by Lake Spring Emergency Group in 2018 to work at the LewisGale facilities in Salem and Cave Spring, repeatedly complained to management about the alerts and their impact on patient care. He also reported other concerns to management, including that patients who needed to be admitted to the hospital were being left in the emergency room and that there were slow responses for transporting critically ill patients in need of “emergent surgical intervention,” as well as inadequate numbers of medical staff.

Lake Spring Emergency Group denied the allegations in court documents.

In August 2021, management placed Bolton on a performance improvement plan. Bolton considered the PIP retaliatory, according to his complaint. Lake Spring Emergency Group, however, stated in court documents that the performance plan was implemented due to “among other things, clinical efficiency, timely communication and punctuality.”

In January 2023, Bolton complained to management that an 800-pound man had been at LewisGale Medical Center’s emergency room for 45 hours without any lab work being ordered. Bolton called an administrator at night to stress that the patient needed to be admitted to the hospital.

A month later, Bolton learned his physician agreement had been terminated and he would not be scheduled to work at either LewisGale facility beyond May 2, 2023.

Over the course of the four-day trial, numerous emails and texts were presented as evidence. Several of the emails are from employees of SCP Health, an Atlanta-based health care solutions company. Lake Spring Emergency Group shares a principal address with SCP Health in a Virginia State Corporation Commission filing.

In a May 2021 email presented in court, a SCP employee noted Bolton “consistently remains about 60 charts behind.” In a June 4, 2021, response, Bolton wrote that he took “complete ownership” of “charting delinquencies,” adding that his charts were “very thorough and detailed.”

In an Oct. 24, 2022, email, Bolton wrote to Puneet Chopra, regional medical officer for SCP Health, about concerns regarding patient care, writing, “I do not have trust in you, SCP and HCA administration that the concerns below won’t be disregarded due to chart delinquencies or other targeted issues and [I] do feel, have felt and I strongly believe that … in general none of the parties above ‘have my back.’”