Sept. 13, 2002 – Dr. Walter H. Gardiner is a St. Croix internist and nephrologist — a medical doctor specializing in diagnosing and treating kidney diseases — whose work in the Juan F. Luis Hospital hemodialysis unit has become the subject of acrimonious debate and threatened job actions.
On Wednesday, Gardiner called a press conference and distributed a statement in which he took issue with information about dialysis centers he formerly operated in Tennessee that was faxed to news media on Tuesday by Raymond "Usie" Richards, a member of Sen. Adelbert M. Bryan's staff who also is running for the Senate himself.
The four-page document stated that some of the four centers were found by Tennessee state authorities to have deficiencies that led to their being disqualified as a supplier of dialysis services and as a Medicaid participant.
Richards' document says the information was taken from testimony at a Dec. 22, 1995, meeting of the Senate Health and Government Operations Committee, chaired by Bryan. Richards said he was distributing the material "in response to the continued disruption of service rendered at the hemodialysis unit" at the hospital "and the disregard and lack of respect exhibited by the members of the governing board and administration of this facility."
At the press conference, Gardiner said he was brought on board the hospital staff in 1995 by then-chief executive officer George McCoy to upgrade dialysis unit services so as to meet Medicare compliance and obtain certification. Under his direction, he said, the unit was fully certified within the year.
Although the hospital board voted to remove him from the dialysis unit in 1997 amid complaints from patients and staff of his bedside manner and treatment of patients, he said, he has continued to treat patients at the hospital over the years. He said he chooses to "take his licks" in order to ensure that requests for quality patient care are met.
He said the hospital board recently voted to reinstate him to the unit, but protests have threatened to jeopardize patient care.
Last Friday and again on Monday, after the unit staff was notified by the hospital administration that Gardiner had been reinstated to the unit, employee and patient protests forced the hospital to halt dialysis services.
On Monday afternoon, at the request of the hospital board, the staff returned to work with the promise that Gardiner's return to the unit would be on hold until a meeting scheduled for Sept. 25.
Gardiner, a native of Tobago, said there have been no charges of incompetence or malpractice levied against him at the hospital but that rumors are being circulated by dialysis unit staff and a handful of patients about his "callous" treatment of patients.
He declined to respond to questions concerning staff competence, other than to say that during his leadership, unit head nurse Lorna Davis was resistant to the changes he wanted to implement. He said the issues were not about "change" but about "doing things the right way."
Gardiner also said, answering an issue raised by Richards, that he had, indeed, invited a registered nurse in Tennessee to come to the Virgin Islands as part of a contingency plan amid rumors that Davis would resign if he returned to the unit. The stateside RN has more than 15 years of dialysis experience, he said.
"I invited her to come here when I learned that Ms. Davis had resigned and that a job action by the other RN's was being contemplated," he said.
"These patients can't go for days without treatment," he said.
Patients who have experienced kidney failure rely on hemodialysis machines to filter waste impurities from their blood. The approximately 70 patients on St. Croix are scheduled for treatments of two to three hours that are literally a matter of life and death. Six days a week, the unit operates three dialysis shifts between 7 a.m. and 9 p.m. utilizing some 16 hemodialysis machines.
The hospital board did not accept Davis's resignation, and on Wednesday afternoon, she was back on the job.
Gardiner said he has chosen over the years not to respond to rumors but that Richards has attacked his credentials and career performance. "Until today, I have remained silent, willing to let the issues sort themselves out," he said in the statement he handed out to the media. "However, yesterday the attacks took a personal twist with sinister implications."
Gardiner said Medicaid authorities had inspected all of his Tennessee facilities over the years and only one location was temporarily closed until deficiencies were corrected.
On St. Croix, under his guidance, he said, the number of patients being treated at the dialysis unit increased from 25 to 55 in two years and has since grown to 70. He said he has treated about 10 of the current patients.
"I'’m not looking for a difficult situation or being a glutton for punishment," Gardiner said. "There are patients I have been treating for years who should have the right to choose their own physician."
Gardiner said there is a great need for preventive care and he specializes in diseases related to high blood pressure. "There's only one thing I am asking for here," he said. "Patients ought to have the right to choose. That's the bottom line."
He said 10 of what were then 55 patients testified at a February 1997 hospital board meeting which led to his removal from the dialysis unit.
Despite the protests again his return to the unit now, Gardiner said, his colleagues have been supportive of his efforts to upgrade the quality of service provided. "What Mr. Richards did not tell or did not know was that it was experiences like this that prompted the JFL Hospital to recruit me," he said.
Richards' material ends with the comments: "This fact sheet is the first in a series of facts that will be shared with the administration of the hospital, the governing board, staff and patients of the unit and the public via the press. Coming soon a historical account of patients and staff in the Virgin Islands who have been in contact with Dr. Gardiner."
Gardiner said, referring to the 1995 Senate committee hearing, that Richards had "not uncovered anything then of substance and will not find anything now … If he thinks he is going to become a senator riding on my back, I've got news for him. I'm choosing not to throw kerosene on fire."
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