Shooting Blanks?

[January 25th, 2006] If you're looking for Dr. Joseph Livingston, try Saipan.

The 37-year-old children's doctor is now working 5,500 miles away in the tiny Pacific capital of the Northern Mariana Islands after he was fired in April 2004 from Metropolitan Pediatrics' office in Beaverton.

Livingston claims in a whistle-blower lawsuit filed Jan. 13 in Multnomah County Circuit Court that he was fired for making a stink with Metropolitan about how it dealt with its vaccination problem. He contends the fear of bad publicity and high costs drove the clinic to not revaccinate thousands of children after state inspectors ruled the refrigerator where the clinic's inoculations were stored was too cold, destroying the effectiveness of potentially thousands of vaccinations.

The clinic did recommend revaccination for 3,000 tots, but Livingston's lawsuit alleges Metropolitan's investigation to determine which shots were compromised was botched, possibly putting more children at risk for diseases like polio, hepatitis and meningitis.

The problems began at Metropolitan Pediatrics, a 21-doctor practice with four offices in and around Portland, in November 2003. A state inspector found the thermometer for the clinic's refrigerator registered 32.9 degrees Fahrenheit when the inspector's thermometer showed it was actually freezing.

That same reviewer noted that when the clinic logged temps out of the acceptable range, it did not respond by adjusting the thermostat, double-checking the reading with a different thermometer, moving the vaccine or calling immunization officials for help.

In February 2004, Metropolitan announced plans to recommend revaccination for about 3,000 children who had received the single vaccine covering diphtheria, tetanus and whooping cough.

Metropolitan agreed to conduct its own investigation. It found that only that vaccine, which was kept on the top shelf near the cold-air blower, was affected, even though other kinds of vaccines were stored in the same fridge.

Mitra Shahri, Livingston's attorney, says it doesn't make sense to put clinics and hospitals in charge of investigating their own failures. "You don't left the wolf guard the chicken," she says.

State immunization officials said last week that they and officials from the federal Centers for Disease Control and Prevention had worked with the clinic to determine which vaccines might no longer be effective.

Dr. Livingston's lawsuit says Metropolitan couldn't have determined how long the problem had been going on nor confirm which refrigerator shelves were affected "since different batches of vaccines may have moved as more or different vaccines were used or stored.... There were also no records ever created, or kept by anyone, regarding the position of the vaccines."

Oregon Department of Human Services immunization manager Lorraine Duncan says no illnesses had been linked to vaccine storage problems.

And state records show Metropolitan Pediatrics told the state Bureau of Labor and Industries last April that Livingston was fired for poor patient care and communication that started long before the vaccine flap.

On Tuesday, the clinic declined to comment on the suit but pointed to its earlier statement to the state labor bureau that said Livingston's allegations were "insulting, inaccurate, incomplete and incorrect."