Delaware Tightens Oversight of Physicians

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Legislation follows arrest of pediatrician on sexual abuse charges.

By Grena Porto, RN, MS, ARM, CPRHM

In July, Delaware Governor Markell signed a set of nine bills that tighten oversight of physicians and increase protection of children in medical care. Known collectively as The Bradley Bills, Delaware’s new legislation is the most comprehensive of its kind in the country and is named after a physician pedophile who got away with sexual abuse or rape of more than 100 children over the course of 10 years, while fellow physicians, hospitals, government agencies, and others looked the other way. Complaints from parents and nurses were ignored. The story has vast implications for peer review, physician autonomy, medical staff governance, the role of hospitals in medical staff oversight, the limitations of “small government,” the role of the press in exposing system failures, the need for transparency, and a host of other hot topics. I’ll let you draw your own conclusions, so here is the story:

Pediatrician Earl Bradley came to Delaware in 1994, and over the course of the next 10 years was investigated five times for allegations of sexual abuse of children. Each of those investigations went nowhere and each of the agencies did not inform one another, let alone the public, of the allegations or the investigations. Indeed, it was only after The News Journal subpoenaed documents and revealed the extent of the allegations and mishandling of the investigations that Delaware’s Attorney General, Beau Biden, initiated an investigation that ultimately led to the new laws. Here are some of the many faux pas in the various investigations:

Bradley was investigated by police on at least two occasions for inappropriate touching of patients and molestations, complaints that were instigated by mothers of patients. These went nowhere for “lack of evidence,” and the Delaware medical board was never notified.

The hospital where Bradley had privileges knew of at least one of these criminal complaints but took no action. This despite the fact that the hospital had previously received a complaint from one of its own nurses about how Bradley positioned girls for genital exams, how he performed excessive catheterizations, how he engaged in excessive kissing of patients and also how he made sexist remarks regarding mothers. The hospital had cleared Bradley of any wrongdoing after the nurse’s complaint.

Bradley’s own sister tried to warn the Medical Society of Delaware in 2004 about the allegations of improper touching and also his deteriorating behavior, only to be told that this was a “family matter.” The Medical Society did not notify the state medical board of the sister’s report.

Fellow physicians had concerns about how Bradley performed genital and vaginal exams on young patients but took no action, including making a report to the medical board, as required by law. One fellow doctor even routinely referred to Bradley as a “pedophile” but took no action.

The Attorney General’s office received three complaints of improper exams in 2008 but took no action and did not report these to the medical board – until The News Journal published its findings in 2009.

The Delaware medical board did find out about an investigation by Philadelphia police in 1994 when a mother complaint of inappropriate touching of her 21-month-old daughter by Bradley, but did nothing, even though they had just licensed Bradley in DE.

Here are the main components of the new law, as summarized in The News Journal July 5, 2010:

  • Physicians seeking to obtain or renew a license must disclose all previous investigations into their behavior.
  • The medical disciplinary board can force hospitals and other healthcare institutions to release records of previous investigations.
  • All hearings of the medical board involving alleged misconduct must be held in public.
  • Doctors accused of improper behavior won’t be able to learn the identity of the person(s) making the complaint.
  • The medical board can expedite suspensions when there is a threat to the public.
  • Every doctor must be fingerprinted, and the medical board must conduct a criminal background check every 6 months.
  • A chaperone must be present when a child under 15 is at least partially disrobed for an exam. Parents and caretakers must be informed of this requirement.
  • The medical board can suspend or revoke a physician’s license for failing to report suspected misconduct by a colleague.
  • The medical board can receive verbal complaints as well as written complaints.
  • Physicians, police and prosecutors must take have training in recognizing and reporting child abuse.
  • The medical board’s 7 (out of 16) non-physician members may have a healthcare background.
  • A healthcare provider can be sued for healthcare abuse of a child any time after the act, instead of the current 2-year statute of limitations.


Here is an amusing part of this story. The Medical Society of Delaware said that the 1,200 physicians of DE are opposed to #11 above. Proponents of this change argued that nurses and others are able to “understand the medical ‘mumbo-jumbo’ that doctors use to talk over the heads of others.” But Mark Meister, executive director of the Medical Society, said “It’s silly to draw the conclusion that physicians would try to buffalo people with medical terms.” This of course overlooks the true importance of this – that nurses are often the ones who report misconduct, yet are often ignored or marginalized, if not persecuted and fired.

Grena Porto is founder and principal of QRS Consulting, LLC, in Delaware. She has served as senior vice president at Marsh USA, senior director of clinical consulting and director of clinical risk management at VHA, and was president of American Society of Healthcare Risk Management in 1999. She also served on the Board of Directors of the National Patient Safety Foundation from 1998 to 2001. She currently serves on the Editorial Advisory Board for Patient Safety & Quality Healthcare and on the Joint Commission’s Sentinel Event Advisory Group, where she was instrumental in writing Sentinel Event Alert #40 on disruptive clinician behavior. Porto may be contacted at gporto@qrshealthcare.com.

See also, Grena Porto’s articles in PSQH:
Disruptive Clinician Behavior: A Persistent Threat to Patient Safety

Drawing the Line:?Effective Management Strategies for Disruptive Behavior

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