West Texas doctor done in by his own bizarre choices

Austin American-Statesman, November 9, 2011

Read this article online...

Arafiles' bizarre decision to represent himself in court against such serious charges mimics his reckless and bizarre medical practice, which got him reported in the first place.

In this country, a person has a right to legal representation. If you choose instead to represent yourself in court, you must sign a waiver stating you give up your right to legal counsel. If convicted of a felony of the third degree, you stand to spend 10 years in prison and pay $10,000. At a pre-trial hearing in October for two such serious felonies, Dr. Rolando Arafiles signed the waiver to defend himself, against the advice of the judge.

The legal community has a saying for it: “A person who chooses to represent himself in court has a fool for a client.”

Here’s the background: More than two years ago, two Winkler County nurses anonymously reported a doctor to the Texas Medical Board. The board notified the doctor that he was being investigated. The doctor elicited help from the sheriff to find out who made the report. The hospital administrator fired the two nurses and the county attorney charged them with misuse of official information, a felony. Charges against one nurse were dropped, and the other, Anne Mitchell, endured a criminal trial in which she was acquitted in less than an hour. The attorney general’s office jumped in and charged the four good ol’ boys with retaliation and misuse of official information, all felonies. The hospital administrator, sheriff and county attorney all lost their jobs and were sentenced to jail time. Now it’s the doctor’s turn.

As it turns out, Arafiles didn’t come off too badly in court. In a plea bargain Monday, he pleaded guilty to both felonies — retaliation and misuse of official information. He was sentenced to 60 days in jail, five years probation, a $5,000 fine and, in a triumph for patient safety, had to surrender his license to practice medicine.

Arafiles’ bizarre decision to represent himself in court against such serious charges mimics his reckless and bizarre medical practice, which got him reported in the first place.

The guy sold herbal remedies and prescribed non-FDA approved “ozonated” olive oil to his patients, sewed a rubber packaging tip onto the end of a guy’s crushed finger, rammed a needle into a woman’s crushed toe over ER nurses’ objections and sent home a 10-year-old boy with severe lower abdominal pain and nausea after giving him three enemas — the most dangerous thing you can do with acute appendicitis.

And let’s not forget a failed skin graft, what he called his “masterpiece.” In a non-sterile environment and without surgical privileges, Arafiles removed skin from a 74-year-old diabetic’s abdomen and sewed it onto his injured hand. In Anne Mitchell’s criminal trial, he testified under oath that he did not remove the man’s skin, but when asked to look at the chart, he admitted he did cut it off.

When he testified that diabetics “heal as well as anybody else,” the response in the courtroom was so intense that the judge called for order and warned that he could have people removed.

Also in Anne Mitchell’s trial, the doctor was asked under oath if he knew how the sheriff came to possess patient contact information in the cases reported to the medical board.

He answered, “I don’t know, sir.”

An Andrews County grand jury found reason to believe Arafiles himself gave that information to the sheriff, who contacted the patients to determine who had made the unsigned complaint. He was charged with aggravated perjury (“aggravated” because it was material to Mitchell’s case), but that charge was dismissed as part of the plea agreement.

Had he chosen legal representation, he would have maximized his chances of a lighter sentence.

Patients worse off than before they saw him, six careers ended, a dusty West Texas town shaken and divided, multiple extensive and expensive investigations and trials. What a guy.

At least he can’t hurt anyone else as a doctor — thanks to the nurses who reported him.

Toni Inglis, MSN, RN, CNS, FAAN, is a lifelong Austin resident and retired editor and neonatal intensive care nurse. She writes a monthly opinion column for the Austin American-Statesman editorial page.