*****UPDATE:Click here to read the November 2012 ruling from the Florida Board of Medicine determination that "probable cause did not exist"*****

** Please note - all identifying information has been removed, for patient privacy **

Emails from the Risk Manager show reviews were being initiated as early as Spring of 2011:

The original 'precautionary' suspension letter and responses from Dr. Dinsmore and her attorney

  • If the decision "does not imply any final finding of responsibility for the situation(s) that caused such suspension" then how was it determined that an immediate suspension was "required for patient safety," or that Dr. Dinsmore was even the responsible party?
  • Also notable is that corrective measures of a less-drastic measure were never considered, and that these "problems" only appear to be uncovered during the recredentialing process.

These correspondances relate to the timing of when charts were reviewed, and by whom:

  • HEMH Risk Manager's request of July 29, 2011 for medical records
    • Patient #2 from April not included; deliveries for patients #12 and 13 had not yet occurred
  • HEMH Notification of Review from September 6, 2011 indicating which deliveries were being reviewed
    • Interesting that only 4 charts appear to have been sent to an outside reviewer - the final 3 deliveries, plus the second delivery from April.
    • Were any of the other 9 charts ever reviewed by anyone outside of HEMH?

*** These are the actual reviews of the pertinent deliveries: ***

  • Dr. Dinsmore's response to the outside reviewer's allegations (arranged chronologically)
  • Supporting reviewer's response to the allegations (arranged chronologically)
  • The original "Exhibit A" of allegations as summarized by the hospital, supposedly by the outside reviewer (in the order presented by the hospital).
    • The order is interesting, as the first 4 match the charts from the HEMH Notification of September 6, but the remaining charts appear to be listed in random order
    • Since the full review has never been made available for inspection, the question remains - do all the opinions belong to the outside reviewer, or were the other 9 simply added to imply that?

The Notice of Adverse Recommendation from HEMH to Dr. Dinsmore issued October 10, 2011

  • The statement "13 cases reviewed by an external obstetrics expert" seems to conflict with the number from the Notification of Review - who actually knows how many went where?
  • Now there is also a concern about lack of informed consent for Cesarean Section deliveries in addition to VBAC's - did that appear out of nowhere?
  • It is interesting that, although much attention is given to specifically quoting parts of the bylaws, not once is there a direct quote of what documentation rules, exactly, were supposedly violated - shouldn't a copy of those "rules" been presented somewhere throughout this process for reference?

Additional documents referenced in the timeline:

HEMH 2010 Physician Quality Report and Ongoing Professional Practice Evaluation issued April 11, 2011

  • Very favorable toward Dr. Dinsmore. Of interest, the statement "This evaluation is done at least every 6 months." Is there a similar evaluation for the 6 months ending June 30, 2011?
  • The renewal date for Dr. Dinsmore's privileges was June 30, 2011. Would not the "required activity" of gathering information have revealed any serious deficiencies prior to that date?
  • Despite being "welcome to view (the quality) file at any time", inquiries have been diverted to the Risk Manager (who, by all accounts, is apparently not very well-suited for discussions with the public).

Proposed Criteria For VBAC Candidates issued by HEMH on April 13, 2011 - A (very) brief summary of ACOG Practice Bulletin 115

HEMH OB Committee Meeting Minutes:

  • January 10, 2011
    • Dr. Dinsmore had been delivering at HEMH since mid-July2010, and mention was made that total deliveries had increased in the last quarter of 2010. However, the claim was made that "OB volumes for the year have not actually increased." It is interesting to note that while the meeting was held at the beginning of 2011, the comparison was to 2004. Was that year chosen in order to avoid acknowledging a positive impact by Dr. Dinsmore over more recent years' totals? Why, then, the need to discuss "adequate staffing for increased volume?"
    • The need for VBAC criteria was initiated, with discussion deferred to a later date.
  • May 5, 2011
    • VBAC criteria discussion again deferred to the next meeting, due to "ACOG practice guidelines not being available," in spite of a reminder from the Medical Staff office a month in advance.
    • Interesting that results were not completed almost a month after the Perinatal Risk Assessment - can it be assumed that no urgent problems were discovered?
    • Also interesting that apparently there had not previously been across-the-board training with the hospital's Labor & Delivery staff, with regard to ACOG practices and documentation, even after concerns were expressed at tha January meeting.
  • July 11, 2011
    • A full set of minutes were not provided, but the statistics alone are interesting.