PRIVATE CONTRACTORS Questionable Doctors Hired * Short on doctors of its own, the military must hire civilian physicians, a practice that can attract doctors with problems

Although Brian E. Bolin remains in the Navy, he says he only goes to civilian medical facilities after Dr. James J. Kwee, working as a contract physician for the Navy, failed to diagnose his wife's cancer and instead treated her for a hormone imbalance. SKIP PETERSON / DAYTON DAILY NEWS

Brian E. Bolin helped his country fight in Operation Desert Storm, trusting the Navy to care for the sick wife he left behind.

Bolin returned safe, with ribbons to pin to his uniform. His wife, Rita, didn't survive the Navy hospital in Oakland, Calif.

For months, doctors working for the Navy treated her for a hormone imbalance, Bolin said. Then Rita Bolin collapsed in a shower - the cancer in her body so advanced that her blood covered a shower stall. She went to a civilian hospital, where her cancer was diagnosed in minutes.

"If it was caught earlier, she'd be alive today," said Bolin, now stationed at the Whidbey Island Naval Air Station in Washington. "The only thing I could think was: Why didn't they (the military) do this before?"

The doctor in charge of Rita Bolin's care didn't wear a uniform. He was a civilian doctor, one of hundreds the services employ to run emergency rooms, perform surgeries and deliver babies at military hospitals and clinics across the world.

"The reason the military hires them is the military is understaffed. ... They don't have the money to provide the quality of care and level of care they need to provide for all their military personnel and dependents, so they've had to hire outside doctors," said Robert I. Deutscher, a former Army attorney now specializing in suing the military for medical malpractice.

This practice can attract doctors with problems.

"The United States government has always been known to contract not for quality but for price," said John Caldwell, former special assistant U.S. attorney and chief of the western United States torts branch for the Army Claims Service. "With the lowest bidder, you limit yourself to those doctors who cannot practice elsewhere."

Dr. Kwee now practices at a Navajo reservation hospital in Tuba City, Ariz. JAKE BACON / FOR THE DAYTON DAILY NEWS

Rita Bolin's doctor was James J. Kwee. In seven years, he completed college and medical school at the University of Airlangga in Indonesia, where he earned his first medical license. He came to the United States and completed a residency at Baptist Hospital in Little Rock, Ark., in 1975.

In 1979, the complaints started - and never stopped for more than 15 years.

The first lawsuit in Arkansas came from a woman who claimed she underwent a "complete castration" even though she never gave her consent for the surgery. Three years after that suit was filed, a pregnant woman claimed she went to Kwee's clinic with a high insulin level.

"There were never any tests done during the pregnancy until she went into shock for diabetes," said Janet L. Pulliam, the attorney who represented Ceasar and Dorothy Alexander in a lawsuit against Kwee and other doctors.

Ceasar Alexander, now living with his wife in Nebraska, cried recalling the day 15 years ago when he rushed his wife to the hospital to give birth, only to learn their unborn daughter wouldn't survive.

"I carried that baby from the room down to the morgue and laid it on the table down there," Alexander said. "We wanted a little girl. She was beautiful."

The case was settled for an undisclosed amount.

In all, six lawsuits were filed against Kwee in Little Rock, two by the same woman. All except the Alexanders' were dismissed for various reasons.

In late 1988, Kwee moved to California, where he was sued six more times. One case, settled for $200,000, was filed by the mother of a 32-year-old woman who died.

But lawsuits weren't his only problem in California.

In February 1996, the medical board accused Kwee of "gross negligence, repeated acts of negligence and incompetence" involving his care to three patients.

Two of the patients were young women who died, and the third was a baby born with severe cerebral palsy. While the baby was in the womb, Kwee tried to reposition the head with a vacuum extractor, an action the board called "a significant departure from the standard of care."

Kwee was put on probation for five years, and he was given 15 days to tell his employers about the probation. He also was ordered to get 40 hours of additional training every year during his probation, undergo a clinical examination in obstetrics administered by the California medical board and have another doctor monitor his practice, providing the board with periodic reports on his progress.

Robert I. Deutscher, a former Army attorney now specializing in suing the military for medical malpractice, says contract doctors fill gaps in the military medical system. "The reason the military hires them is the military is understaffed." SKIP PETERSON / DAYTON DAILY NEWS

Last month, shortly before Kwee was scheduled to undergo a compentency examination as part of his probation, he surrendered his California license. Kwee, who used the name James-Yen T. Kwee on his California license, still holds a valid license from Arkansas.

Kwee now works at the Tuba City Indian Medical Center on the Navajo reservation in Tuba City, Ariz. Like the military, Indian tribes do not require doctors to have malpractice insurance.

Kwee acknowledged he made mistakes but said he has also helped many patients.

Dressed in a wrinkled white shirt and what appeared to be a pair of white painter's pants, Kwee said he has no medical malpractice insurance. Although he could get insurance, he said, the cost would be "very expensive" because of his litigation history.

Deutscher, the attorney representing the Bolins, blamed the military medical system more than Kwee. The initial tests requested by Kwee were never done, he said, and the military never properly notified Rita Bolin of the abnormal results of subsequent tests.

The Bolins sued the U.S. government and the company that employed Kwee. The government settled for $100,000, and the company that employed Kwee contributed an additional $15,000.

Brian Bolin remains in the Navy, but he said he goes to civilian clinics.

"I don't use military (medical) facilities any more."