State had concerns over accused doctor for years

By Carol Ostrom and Mike Carter
Seattle Times staff reporters

Dr. Charles Momah pleaded not guilty.

E-mail this article Print this article Search archive Most read articles Most e-mailed articles

The state suspended Dr. Charles Momah's license a year ago, after a rape accusation, but had already logged several unrelated complaints about the obstetrician-gynecologist.

Doctors, nurses, hospital administrators and state investigators questioned Momah's medical skills and practices. Investigators generated dozens of reports detailing Momah's behavior: yelling at patients and nurses, ignoring pages and making suspect medical decisions.

Complaints began in 1998. Since then, 50 patients have reported Momah to the state and 47 women have sued — most since the first rape allegation. The Department of Health is pursuing 18 separate disciplinary charges against Momah and investigating 29 more complaints, said Donn Moyer, department spokesman.

Wednesday, Momah, 49, was charged with two counts of rape, two counts of taking indecent liberties and three counts of insurance fraud. He pleaded not guilty to the charges yesterday at the Kent Regional Justice Center. Momah has denied any unprofessional conduct.

Prosecutors say other sex-related charges weren't filed because a three-year statute of limitations had passed.

The lawyer who has filed almost all of the lawsuits against Momah, Harish Bharti, has also filed a $10 million negligence claim against the state on behalf of some of the women.

Health Department investigators knew of at least one instance in which a patient complained, in 2001, that Momah touched and kissed her.

Despite that complaint, Moyer said regulators had no evidence of "sexual boundary issues" with Momah until a woman accused him of rape in August 2003.

Once that report was filed, "In three weeks, we had that guy out of practice," Moyer said.

Moyer acknowledged that the state could have acted more quickly against Momah for questionable professional and medical conduct. It is unlikely that any disciplinary action by the state before the rape allegation would have resulted in Momah immediately losing his license, Moyer said.
 
"I'm not going to candy-coat it," he said. "I'm not going to hide this from you — there is culpability on our part."

Part of the problem was that lawyers for the state repeatedly delayed filing disciplinary charges alleging unprofessional conduct, Moyer said. The reason, he said, was that new complaints kept coming in.

"They wanted to build the strongest case possible," Moyer said. "So they'd have the investigators chasing down the new complaints to add them to the charge. And that took time. I think we could have acted sooner."

As a result, the first complaint against Momah — alleging a variety of unprofessional acts — wasn't filed by the state's Medical Quality Assurance Commission until June 2003, two months before the rape allegation surfaced and nearly three years after the commission had opened its investigation. The commission licenses doctors and investigates complaints against them.

During the spring and summer of 2001, state investigators generated more than 30 Momah-related memos. Several dealt with complaints that he was frequently unavailable when emergencies arose at the hospitals where he practiced — Auburn Regional Medical Center and Highline Community Hospital in Burien. Both eventually revoked his privileges.

In one instance, in May 2001, nurses repeatedly and desperately paged Momah while one of his surgical patients bled uncontrollably, reports say. A passing orthopedic surgeon and an emergency-room physician stepped in to treat the woman as her blood pressure dropped and doctors pumped six units of blood into her, according to reports of the incident.

When Momah finally called in, he told a nurse to call him back "in an hour if there was a change."

"What are you talking about, there is no other hour," the nurse told him.

Nurses on duty at the time, and later the patient herself, alleged Momah destroyed and altered records about the incident.

State investigators also were concerned that Momah appeared to be performing major abdominal surgeries in his small suite of offices in Federal Way without certification as an outpatient surgical center. They learned about it after Momah brought tubs of "heavy duty" surgical instruments to Highline hospital for sterilization, reports show.

"The instruments were not clean," one memo noted. "Organic material was still clinging."

An investigator wrote after an inspection of Momah's office in 2002 that it "made us real nervous about him opening bellies in this kind of setting."

It was particularly troubling because by then, Momah had lost privileges at local hospitals and had nowhere to send patients in an emergency where he could care for them.

Earlier trouble in N.Y.

To David Allen, Momah's attorney, "It's been a nightmare. Civil attorneys have been saying untruths and slurring him."

Momah has not had a hearing in front of state licensing authorities. He has filed papers denying the allegations of unprofessional conduct.

Washington's investigation is not the first Momah has faced. While a doctor in New York, where he began a practice in 1987, he was reprimanded and censured for negligent care.

He also was indicted in 1997 on 23 counts of billing fraud, by the New York Attorney General's Medicaid Fraud Control Unit. He was acquitted of the criminal charges, but ordered to pay $500,000 in overbillings in a civil case. He paid $350,000 cash and promised the remainder within a year.

Three of the felony counts filed against him here this week allege double billing and billing for procedures he did not do.

Washington officials knew about the New York reprimand and fraud cases, state records show. But because New York did not restrict his license, Momah was able to practice medicine in Washington when he moved here in 1993.

In 1998, the Health Department received its first complaints about Momah when two women reported anonymously that he had refused to turn over their medical files and, when they persisted, he yelled at them and threatened to sue.

Investigators were unable to track down the women, so they closed the file, records show. During an e-mail exchange between investigators and staff lawyers, Health Department attorney Rosemary Irvin wrote that Momah "lies a lot and goes around claiming discrimination — not to mention he is just a bad doctor."

Throughout 2000 and 2001, nurses, patients and hospital officials complained to state investigators that Momah was verbally abusive, neglected to provide prenatal records for patients and didn't answer pages.

One patient said he kissed and touched her, and then refused to forward her medical records when she switched to another doctor unless she agreed to see him again.

In late 2000, Auburn Regional Medical Center told the state that it had denied Momah admitting privileges, an "adverse action" the hospital is required to report. That meant Momah could not practice medicine at the hospital. Less than a year later, after the incident with the bleeding surgical patient, Highline Community Hospital did the same. Momah fought Highline's action, but the hospital prevailed.

The surgical patient sued Momah and Highline, and they settled for an undisclosed sum, said her attorney, Jeff Herman.

"Dr. Momah is one of those always skating near the edge," one investigator, quoting a Highline hospital official, said in a May 2, 2001, memo. "He has a very aggressive attorney fighting for him as well."

From the state's point of view, the suspension of Momah's hospital privileges meant the public was being protected and so there was no need for further actions, Moyer said.

"We believed the public threat was removed because he should not be providing the kind of services that he was accused of providing below standard," Moyer said.

But in early 2002, Health Department investigators and inspectors voiced grave concern over Momah continuing to do surgery in his office.

"He does not have an agreement with any hospital regarding transfer of patients should they get into trouble," one investigator wrote.

Still, the outpatient surgeries continued.

"I have been asked to ask your client if he would be willing to stop performing surgeries in his office," one Health Department inspector wrote to Momah's attorney Bob Meals in August 2002. "Specifically those procedures where he enters the abdominal or pelvic cavity ... until the suite is certified and he has privileges at a hospital so that he could have a smooth transfer of a patient should there be a crisis."

The Health Department records are salted with the concerns of other health-care professionals. But Moyer said "gut feelings" and worries aren't enough to take action against a physician's license.

"We have to have a violation, and evidence, and then we have to prove it," he said. The question in this case is whether there was sufficient proof earlier than when the state eventually acted. The answer is yes, Moyer said.

Momah routinely yelled at hospital staff when they questioned him about his work and blamed others for mistakes, records indicate. As a black man from Nigeria, he accused critics of discriminating against him, according to the documents.

Moyer said there was nothing in the investigative reports to indicate Momah would rape or assault patients.

"You can't draw a straight line from using dirty instruments and talking nasty to rape," Moyer said.

Some who accused Momah were addicted to drugs. One had trouble finding doctors who would accept her Medicaid coupons, state records show. Another returned to his practice after he allegedly assaulted her because she was desperate to have a baby and Momah said he could help her conceive. He never did, according to the criminal charges against him.

One woman who accused Momah of rape said he molested her and propositioned her repeatedly, but, she told investigators, she kept going back because she was a drug addict and he would give her narcotics. Eventually, she told investigators, he forced her to have sex with him and she went to the police.

Other women who complained about Momah told investigators they didn't come forward earlier because he intimidated them.

"He said, 'Who's going to believe you? You're nobody. I'm a doctor — I have certificates. You're prejudiced, that's why you're doing that,' " recalled MiKell Bannach, a former patient who is suing Momah, alleging medical and sexual wrongdoing.

"He was always very nice"

Momah has supporters. Former patient Misty Jones, a 26-year-old Des Moines resident, describes him as a compassionate, dedicated doctor who treated patients respectfully.

Jones is convinced Momah saved her life in 1994, when a raging abdominal infection landed her in the hospital. He videotaped his surgery on her, and showed it to her, she said. She began seeing him regularly at his Burien clinic.

"He was always very nice, willing to go the extra mile, whatever I needed," she said. "He always had a nurse in the room, always very gentle, always explained everything, what he was doing."

She knows other women have alleged Momah performed unnecessary surgeries, but Jones said that when she went to him asking for a hysterectomy, he recommended against it.

Momah saw her even after he knew she had no insurance and couldn't pay, said Jones, who continued as his patient until two years ago, when she became embarrassed that she couldn't pay.

Momah was released yesterday afternoon after posting a $200,000 bond. He is scheduled to appear before a King County Superior Court judge Sept. 30. No trial date has been set.

Mike Carter: 206-464-3706 or mcarter@seattletimes.com

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com