By Melanie Lefkowitz, Newsday, Melville, N.Y.
Dec. 17–Joan Grochowsky, a 52-year-old Roslyn Heights woman hobbled by searing and mysterious back pain, drove with her husband in the summer of 1999 to the busy Plainview clinic of a doctor named Harvey Finkelstein.
Visibly concerned by her condition, Finkelstein directed her to go straight to the hospital so he could begin epidural injections. He didn’t even want her to get back in the car. An employee pushed her in a wheelchair to Plainview Hospital across the street, recalled her husband, Gerald Grochowsky.
“I guess maybe I formed my opinion then — ‘Gee, he seems to be a nice guy,’ and my wife felt the same way,” Grochowsky said. “Little did we know where it would lead us.”
Thirteen months later Joan Grochowsky was dead, killed by the aggressive lymphoma that her husband now believes could have been the cause of that terrible back pain. And seven years after that, Finkelstein, accused in a lawsuit of disregarding a sonogram that should have raised alarms about Joan’s cancer, settled with her estate for $925,000.
The suit settled in May, six months before the state Health Department would reveal that Finkelstein may have exposed thousands to hepatitis C and other bloodborne diseases by reusing syringes from multi-dose medicine vials. The Nassau County district attorney is conducting a criminal probe in the case, and the state health department has pledged to more closely track physicians who, like Finkelstein, are forced into the state’s insurance plan for doctors with extensive malpractice histories. Gov. Eliot Spitzer said the system moved too slowly to notify the public and state health commissioner Dr. Richard Daines has said the doctor-disciplinary system needs changes.
A review of courthouse records stretching back 12 years, along with interviews with former colleagues and attorneys who have sued Finkelstein, yields a portrait of contradictions. The 52-year-old Dix Hills father of three has deep roots on Long Island and many describe him as deeply caring, the kind of doctor to whom they would refer their mother.
At the same time, however, Finkelstein has far more malpractice settlements than other pain-management specialists listed by the state medical society on Long Island, and he’s among 0.5 percent of physicians statewide who are enrolled in the malpractice pool set up by the state for doctors who can’t otherwise get insurance. Many patients say he was all business, typical of today’s harried health-care provider feeling the financial pressure exacted by managed care. And all agreed that his clinics seemed increasingly and unusually busy.
“I’ve never seen or dealt with a doctor who was just so overwhelmed with patients,” said Brendan Becker, 33, who said that during one of his seven visits to Finkelstein the doctor left the examination room to run across the street to the hospital while Becker waited 15 minutes for him to return. Becker said he now sees another doctor to treat his facial palsy. “He definitely seemed concerned with my pain, but he was always so rushed,” he said.
Last week, the state said it was adding 8,500 people to the list of patients from 2000 to 2005 who were notified that Finkelstein potentially put them at risk with his improper infectious-disease control procedures. So far, about 11,000 from that time period have been identified.
Amid the statewide storm around his case, Finkelstein has declined to comment on the syringe scandal and his malpractice history. No one answers the door at his home and people who answer the telephone say they will not speak to reporters. His spokesman, Andy Kraus, agreed last week to accept written questions for Finkelstein, but then said the doctor would not respond. Finkelstein has not spoken out publicly since releasing two prepared statements in November.
“First and foremost, I am a compassionate healer,” one statement reads. “I have worked tirelessly, putting in 12- and 16-hour days on my patients’ behalf.”
A ‘feel-good place’
Some patients and colleagues described Finkelstein’s clinic, Pain Care of Long Island, as a warm, welcoming place where they were ushered right in to see a doctor who was available to them 24 hours a day, seven days a week. Lonnie Javurek of Lindenhurst, who is on permanent disability from her ailments, including a nerve problem in her foot, and has been seeing Finkelstein for the past 15 years, called his office a “feel-good place.”
“He is the kindest, most compassionate man that walks on this Earth,” she said. “He is like a big teddy bear. He cares so much for his patients, I owe my life to Dr. Finkelstein. If it weren’t for him I literally would be bedridden and not functioning at all.”
Tricia Astraus of Commack, who worked in Finkelstein’s office from 1999 to 2004, said the long days and sea of patients stemmed from the doctor’s tireless dedication.
“Without a doubt he had an enormous size practice. He would work 15 to 16 hours a day. He would go to the nursing homes. We were right there at all the funerals,” she said. “He does not know how to stop. He doesn’t know how to say no. He has gone to people’s houses if they don’t drive. If they don’t have insurance, he would treat them anyway. You don’t find many doctors who are like that.”
Harvey Saul Finkelstein comes from a family distinguished for its leadership in Long Island’s Jewish community. His father, Rabbi Ezra Finkelstein, led the Midway Jewish Center in Syosset for more than 20 years, and his grandfather headed the Jewish Theological Seminary from 1940 to 1973. His brother is a rabbi at a New Jersey synagogue.
He and his wife, Miriam, who also works in his Plainview clinic, are active members of the Dix Hills Jewish Center. In 2005, Finkelstein told a reporter that he attends religious services twice a day, in part for “the sense that you were starting the day with a purpose — it gave more meaning to the day.”
“I am close to my God and dedicated to my religion,” Finkelstein said in his Nov. 18 statement. “I have asked for God’s grace and strength during this difficult time.”
He majored in biochemistry at Clark University in Worcester, Mass., and graduated in 1981 from the Sackler School of Medicine in Tel Aviv, spokeswomen at those institutions said. After two years of surgical residency at Long Island Jewish Hospital, he did a residency at Stony Brook University Medical Center from 1983 to 1986, according to a spokeswoman there.
Background discrepancies
Under the heading “Fellowships” on the resume posted on his clinic’s Web site — now offline — Finkelstein was described as a 1985 fellow in pediatric and cardiac anesthesia, and a 1986 fellow in pain management. The Stony Brook hospital spokeswoman, Lauren Sheprow, said Stony Brook was not accredited to offer fellowships in pain management until 1994, in pediatric anesthesia until recently, and is not accredited in cardiac anesthesia. She said such training existed — even if the fellowship title did not — but said she could not legally confirm whether Finkelstein had enrolled in it.
“Medical training has evolved over the years and not all programs that are accredited now were accredited back in the ’80s,” Sheprow said.
In July 1988, Finkelstein joined the anesthesia department of Central General Hospital (now Plainview Hospital), where he served as director of anesthesia from August 1992 to October 1999. According to court papers, he opened a part-time practice in 1990 and state documents show that he incorporated Plainview Anesthesiologists, P.C., as president with four other shareholders, in 1994. His current clinic, Pain Care of Long Island, was incorporated in 2000 at the same address, and Plainview Anesthesiologists was dissolved in 2002, records show.
Undeterred by waits of up to three hours, streams of patients found their way to his office, referred by the doctors who could not cure or lessen their stubborn, chronic pain.
“You try everything, acupuncture this, chiropractic that,” said Susan, a Massapequa single mother of three who spoke to Newsday on condition her last name not be used. She said Finkelstein’s treatment for her pelvic pain helped at first. “He was nice enough in the beginning, ‘How you doing, come on in.’ You sat there for hours in his office and waited for him, but you were waiting for your genie in a bottle. That’s what it comes down to for a pain-management patient.”
Over the years, as Finkelstein’s practice steadily grew, so did the number of lawsuits filed against him. Starting in 1995, he was sued, on average, once or twice each year.
In 2001, Finkelstein signed up for the Medical Malpractice Insurance Plan “after being declined coverage by regular commercial malpractice insurance carriers,” Daines said earlier this month at a state senate health-committee hearing. The plan covers physicians in the state who can’t otherwise get insurance. It costs up to three times as much as regular insurance, according to the state insurance department. Finkelstein also is among the 475 of the state’s 80,681 physicians — 0.5 percent — in the plan.
Although trained and board certified as an anesthesiologist, Finkelstein is insured not as an anesthesiologist but as pain management specialist. Pain management is considered a lower risk specialty than anesthesiology, and it’s also less expensive to be insured. While his insurance within the high-risk pool as an anesthesiologist would cost about $97,000, his base rate as a pain management specialist is $65,000. Surcharges, which are calculated on doctors’ malpractice history, can triple the premiums, said Martin Schwartzman of the state Insurance Department.
All but two of the 17 lawsuits filed in Nassau and Suffolk against Finkelstein concern epidural injections, a procedure in which anti-inflammatory medicine is injected into the space around the spinal cord. Finkelstein began performing these injections in his clinic in February 2004. That’s when he invested in a fluoroscopy machine to help guide the injections, according to court records. Previously, he performed them at the hospitals where he had privileges.
An examination of court records in Finkelstein’s lawsuits shows that seven plaintiffs said their epidurals caused nerve damage or paralysis; two allegedly caused meningitis; three others resulted in serious infections; and three concerned the reused syringes, one of which was filed since coverage of Finkelstein began.
Severe cases
The Grochowskys’ suit said Finkelstein assured them a result on her abdominal scan was “benign” though other doctors called it a prime indicator for lymphoma; and another lawsuit, from a Baldwin woman, said in court papers that stopping her blood pressure medication so she could receive injections — which her cardiologist approved, court papers say — caused her to have a stroke.
At least 10 of Finkelstein’s malpractice lawsuits have led to settlements. None of the other 11 pain-management specialists from Long Island listed in the state medical society’s 2007 directory and found on the state’s physician profile database had more than one settlement. Nine had none.
Vicki Rawson, of Massapequa, who settled a lawsuit against Finkelstein in April, said her improperly administered epidural injection in June 2003 was so painful she awoke despite being anesthetized. She said that afterward, Finkelstein told her and her husband she was fine to go home, but other doctors her husband called said she should go straight to the hospital. There, she said, she learned her spinal fluid was leaking. She remained hospitalized for eight days and still feels the effects of the damage four years later when her left side occasionally “goes out,” she said.
“I’m not independent anymore, I haven’t worked, I haven’t driven in four years,” she said. “My life as I knew it before is not the same.”
A more recent lawsuit, involving a 2004 incident centering on Finkelstein’s treatment of a Syosset man, serves to connect his largely unknown lawsuit history with the ongoing probe sparked by his improper infectious-disease control methods.
The man visited the Pain Care center three times a year for epidural injections for a chronic back condition. On one of those visits, at 1 p.m. on July 15, 2004, he received epidural injections immediately after a patient with hepatitis C underwent the same procedure and contracted the disease from Finkelstein’s syringe, court records and state Health Department documents indicate.
The 66-year-old man, whose name is being withheld by Newsday at his request, tested positive for hepatitis C in December 2004. Around that time, a Nassau County nurse discovered two other hepatitis victims who were also treated by Finkelstein. The state then began investigating Finkelstein’s practice and eventually notified 98 patients in May 2005.
One of those notified was the 66-year-old Syosset man. He, like many patients, also got a call from Finkelstein telling him that he would receive the notification letter. The man informed him he already had hepatitis C, according to court records.
“He knew that he had hepatitis C, but he didn’t know from where,” said his lawyer, Michael Glass of Hauppauge. “Then he got the letter, and that’s how he put two and two together.” The Syosset man sued Finkelstein in January 2006.
Still, supporters
Several patients and colleagues maintained that the lawsuits and press coverage paint an inaccurate portrait of an able doctor and a compassionate man. “I’d send my mother to him,” said Ted Kalyvas, a salesperson and technical specialist for a medical implant company who works closely with Finkelstein and other doctors on Long Island. “This is a guy who did a great job his whole life, really was there to serve his patients.”
Kalyvas said the difficulty of pain management cases must be taken into account when assessing Finkelstein’s legal record. “They often inherit patients who’ve failed traditional routes.” But Jeff Korek, president of the New York State Trial Lawyers Association, said it is “very rare” for a pain management doctor to be sued. “I think if you have somebody with as many suits as Finkelstein it should raise all kinds of red flags.”
While Finkelstein has remained publicly silent, he has communicated through his profile on the physician Web site run by the state health department. Last week, he updated his entry. He reported that he does charity work for the Yemin Orde Orphanage, and Nirim, a school for underprivileged youths, both in Israel.
Another update announced that he took a leave of absence from Plainview Hospital and New Island Hospital.
Staff writer Ridgely Ochs contributed to this story.
Two case studies
JOAN GROCHOWSKY
Roslyn Heights
Treated by Finkelstein for back pain.
Died of cancer.
Her family accused Finkelstein of disregarding a sonogram that should have raised alarms about Joan’s cancer, settled with her estate for $925,000.
VICKI RAWSON
Massapequa
Given epidural injection that was so painful she awoke despite being anesthetized.
She says Finkelstein told her and her husband she was fine to go home, but other doctors her husband called said she should go straight to the hospital. There, she said, she learned her spinal fluid was leaking. She remained hospitalized for eight days and still feels the effects of the damage four years later.
Settled lawsuit against Finkelstein in April.
“He is the kindest, most compassionate man that walks on this Earth. He is like a big teddy bear. He cares so much for his patients, I owe my life to Dr. Finkelstein. If it weren’t for him I literally would be bedridden and not functioning at all.” — Patient Lonnie Javurek of Lindenhurst
I’m not independent anymore, I haven’t worked, I haven’t driven in four years. My life as I knew it before is not the same.”- Patient Vicki Rawson of Mass
“He does not know how to stop. He doesn’t know how to say no. He has gone to people’s houses if they don’t drive. If they don’t have insurance, he would treat them anyway. You don’t find many doctors who are like that.” — Tricia Astraus of Commack, who worked in Finkelstein’s office from 1999 to 2004
“I think if you have somebody with as many suits as Finkelstein it should raise all kinds of red flags.” — Jeff Korek, president of the New York State Trial Lawyers Association, adding it is “very rare” for a pain management doctor to be sued
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