Texas politicians have a nasty habit of interfering with medical board investigations. They need to butt out.

My pick for worst bill passed was the one removing corruption prosecution of public officials and state employees from the Travis County Public Integrity Unit to the home counties of those being investigated, with the Texas Rangers doing the official’s initial investigation. All of us know that good-ol’-boy clubs are as emblematic of Texas as cowboys and oil wells; doesn’t the Legislature?

Anne Mitchell (foreground) and Vickilyn Galle

You have to look no further than the Winkler County whistleblower imbroglio to see how local prosecutions can go bad and why this law stinks. But you have to look pretty far west; it’s located in the dusty Permian Basin practically on the border with New Mexico.

Here’s how the story goes: Kermit (population 5,000) desperately needed a doctor. An affable Rolando Arafiles rode into town. The town’s prominent good ol’ boys all liked the smiling doctor. So, despite having a stipulation on his medical license for corruption in Corpus Christi, the hospital hired him in 2007.

By the following year, a doctor, a nurse practitioner and two quality assurance nurses employed by Winkler County Memorial Hospital, separately reported Arafiles to the Texas Medical Board for substandard care. After the medical board sent Arafiles the reports with names redacted, he complained of harassment to his golfing buddy, the sheriff.

Sheriff Robert Roberts

Through nefarious means, the sheriff found the nurses’ report to the board on one of the nurse’s computers. The hospital administrator immediately fired the nurses, and the county attorney charged the nurses with misuse of official information, a third-degree felony punishable by up to a $10,000 fine and 10 years in prison.

No nurse ever had been criminally prosecuted for reporting a doctor, and national headlines were made. One of the nurses chose to retire early, and charges against her were dropped. But the case against the other nurse, Anne Mitchell, went to trial. After four days of a trial attended by nurses from across the state and a reporter and photographer from the New York Times, Mitchell was acquitted in less that an hour.

Smelling rot, in an anomalous 180-degree judicial turnaround the attorney general’s office investigated and charged all members of the good-ol’-boys club — the doctor, sheriff, hospital administrator and county attorney — with two counts each of two felonies: retaliation and misuse of official information.

All were found guilty, resigned their positions, were fined and served time behind bars. The doctor, sheriff and county attorney all lost their professional licenses. Justice was served, but not for the two nurses whose brilliant careers were ended for exercising their ethical duty to protect the public. And not for Kermit, the previously peaceful town that was, and remains, torn apart.

Judge David Glicler (former assistant attorney general) brought justice to the corrupt local officials.

David Glickler, a Hays County judge and former assistant attorney general who so brilliantly prosecuted the case against the local officials, told me he believes the Winkler County case was a prosecutorial aberration. But Sen. Kirk Watson (D-Austin) believes the bill in effect leaves “legislators proclaiming themselves and statewide elected officials as a privileged class with benefits their constituents don’t have.” Amen.

It took a statewide prosecution to right the wrongs of a local prosecution. Gov. Greg Abbott has refused comment on the bill, but we’ll know within a week if he allows it to become law without his signature. As former attorney general, he above anyone should know that this bill doesn’t pass the sniff test and that corruption cases of state officials should be prosecuted by a statewide entity, like say, the attorney general’s office. The Texas Rangers already investigate most of their cases anyway.

It’s only because the nurses’ case received national media attention that the local villains came to justice. It’s hard to shine the light of day on all 254 Texas counties in this huge state with vast rural and frontier areas — and lots of small good-ol’-boy clubs made up of the counties’ prominent citizens who have personal and business relationships with each other.

For defending a nurse’s right to act as patient advocate, Assistant Attorneys General David Glickler and Shane Attaway and investigator Randy Muenzler recently received the Texas Nurses Association’s highest honor, the President’s Award.

You might remember the characters in this sordid tale of abuse of power:

■ The victims/heroes: Nurses Anne Mitchell and Vickilyn Galle, who anonymously reported a doctor for poor and unsafe care to the Texas Medical Board in 2009, while the nurses were in charge of quality assurance and risk management at Winkler County Memorial Hospital in Kermit. They, too, were doing their jobs.

■ The villains: Four prominent Winkler County buddies — Rolando Arafiles, the doctor; Scott Tidwell, the county attorney; Robert Roberts, the sheriff; and Stan Wiley, the hospital administrator.

When the medical board notified Arafiles of the complaint, he asked his golf buddy, the sheriff, to find out who reported him. The sheriff sent a letter to the board stating he was conducting a criminal investigation and needed a copy of the complaint.

The board sent him a copy and noted that the information in the complaint was confidential.

The complaint letter said, “Due to the ‘economic climate,’ the fact that I am over 50, female and have been employed by this facility since the 1980s, I am hesitant to place a signature on this information.”

Bingo. That narrowed his search to two nurses who fit the description: Mitchell and Galle. The sheriff seized their work computers and found a copy of the letter to the medical board.

The hospital administrator fired the nurses, and the county attorney charged them with “misuse of official information,” a third-degree felony punishable by up to 10 years in prison and a $10,000 fine.

Mitchell and Galle endured an excruciating, eight-month wait for the criminal trial. Charges were dropped against Galle at the last minute, and the jury acquitted Mitchell in less than an hour.

After the medical board complained to the Texas attorney general’s office that the nurses had been illegally prosecuted, the case was opened.

At the end of an investigation by Glickler and Muenzler, all four good ol’ boys lost their jobs, were sentenced to jail and paid fines. The hospital administrator and the doctor pleaded guilty. Juries found the sheriff and county attorney guilty. The doctor, sheriff and county attorney lost their professional licenses.

Muenzler had a special sensitivity in this case. He is married to a nurse who was offended by what happened in Winkler County and was aware of the ramifications of reporting.

“I was struck by the oppressive and heavy-handed manner in which they came down on those nurses,” he said. “None of this should have happened.”

Attaway was equally moved.

“This is one of those cases that makes you feel good about being a prosecutor,” he said. “Those nurses were so wronged; they must have thought there’s no one who can help them.”

Glickler said: “In 11 years at the AG’s office, this is by far the most bizarre case we’ve been faced with. We’re used to dealing with cases where public officials have enriched themselves at the expense of the office and the public trust, like bribery and theft. But there was no financial benefit to the bad actors in this case.”

“I’m humbled to have had a role in a case that will so largely impact nursing, law enforcement, too-proud prosecutors and small-town politics. You can’t push people around,” he added.

Where are key figures in the story now?

Ex-hospital administrator Wiley went back to Lubbock. Ex-doctor Arafiles returned to Kermit and is tossing pizzas at the Pizza Hut. Ex-county attorney Tidwell is appealing his license revocation.

Nurse Galle retired early, and Mitchell accepted a position working with the developmentally disabled in a small town in New Mexico.

Muentzler, Glickler and Attaway still work for the attorney general’s office.

Glickler is running for judge in the 22nd District Court, covering Caldwell, Comal and Hays counties.

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.

One by one, the Winkler County sheriff, county attorney and hospital administrator all lost their jobs and have been sentenced for their roles in retaliating against the nurses who registered an anonymous complaint of dangerous practice with the Texas Medical Board against the town doctor. Though the doctor has been disciplined by the medical board and could be disciplined further, he also faces criminal charges arising from the scandal.

In June 2009, these four prominent Winkler County good ol’ boys orchestrated the prosecution of Anne Mitchell and Vickilyn Galle, who were fired from their jobs and indicted on third-degree felony charges of misuse of official information, each nurse facing a possible 10 years in prison and $10,000 fine.

Responding to their report, the medical board publicly reprimanded Arafiles, fined him, and required classes and supervision.

Charges against Galle were dropped, but Mitchell stood trial and was acquitted in less than an hour. For exercising their ethical duty to protect patients, their careers were destroyed. The Texas attorney general opened an investigation and prosecuted the four men.

Arafiles is the last of the four to have his day in court. The other three have all served jail time.

The first of the four, hospital administrator Stan Wiley, was indicted on two felony charges of retaliation. He pleaded guilty to the lesser charge in exchange for his cooperation. He also spent 30 days in jail and was fined $2,000.

The second, Sheriff Robert Roberts, was convicted in less than two hours of all six charges — two counts each of retaliation, misuse of official information and official oppression. Roberts was removed from office, fined $6,000, received four years of felony probation and was sentenced to 100 days behind the bars of the jail he ran for 20 years. He will retire from the county with full benefits.

The third, County Attorney Scott Tidwell, was convicted Oct. 4 on all charges — four felonies and two misdemeanors.

Against the advice of the executive director of the Texas Medical Board and the Andrews County attorney, Tidwell prosecuted the case against the nurses, acting as district attorney, even though he was county attorney.

The prosecuting attorney in Tidwell’s case told the jury that Tidwell’s motive to prosecute the nurses was that Arafiles was a “cash cow” for the hospital, ordering expensive (and well reimbursed) tests and admitting patients, which Mitchell and Galle reported as unnecessary.

Tidwell opted for the judge to assess his sentencing. The defendant’s character and criminal past is normally part of sentencing considerations. During the sentencing phase, Tidwell’s past contact with prostitutes surfaced. Tidwell pleaded guilty to charges of hiring a prostitute in 2004.

Judge Robert Moore sentenced Tidwell to 120 days in jail, 10 years of probation and a $6,000 fine. He is appealing, but the judge already had removed him from office.

The judge said, “Lives have been altered and changed in a way that there is no undoing … The ones most profoundly and permanently affected are, of course, Anne Mitchell and Vicki Galle.” After trial, it was reported he approached Tidwell and asked in hushed tones, “What were you thinking?”

It’s a tragedy that the careers of these brave women ended for doing the right thing by exercising their ethical — and in some cases — legal duty to report unsafe practice. The medical board depends on the eyes and ears of nurses and others on the health care team to report subpar practice to achieve its mission — protecting patients, the same duty nurses have.

Criminal prosecution of nurses for reporting a doctor is unprecedented, and to help it from happening again, the Legislature passed a bill this year increasing medical whistle-blowers protections as well as fines for nurse retaliation.

Eyes have been opened about nurses’ important duty to protect patients against harmful medical providers.

Alternate juror James Fair’s eyes were opened. Knowing nothing of the case before he was picked, he said, “It just goes to show you how people with power can abuse it.” Though he was not part of jury deliberations, he said he would have handed down the same verdict and that he sees the role of the nurses and patient care standards with a whole new appreciation.

“As time went on,” Fair continued, “it became more and more clear exactly what was going on and in my opinion, there was no defense. They should have never even went to trial. The whole thing was ridiculous.”

It has an all-star cast. Winkler County nurses Anne Mitchell and Vickilyn Galle; town doctor Rolando G. Arafiles Jr.; hospital administrator Stan Wiley; former Winkler County Sheriff Robert L. Roberts; Winkler County Attorney Scott M. Tidwell; Attorney General Greg Abbott; state Sen. Jane Nelson, R-Flower Mound; and state Rep. Donna Howard, D-Austin.

Anne Mitchell, foreground, and Vickilyn Galle

A good setting: A dusty, isolated West Texas town, Kermit in Winkler County. Thick good-ol’-boy culture. Squat courthouse. Twenty-five bed community hospital.

Plot: It’s 2007, and the small town is desperate for a doctor. Arafiles rides into town. He’s an affable guy hired despite the red flag of a stipulation on his Texas medical license. The town sheriff quickly befriends the doctor, and they become golfing buddies.

According to published reports, the doctor’s colleagues become increasingly uncomfortable with his standards of practice. The doctor sells a dubious nutrition supplement called Zrii to his patients as a sideline, following up with emails. They question his examining and billing for genitalia exams of people coming to the ER with maladies such as sore throats and headaches.

By 2009, the doctor’s fellow practitioners have had enough. They report him to the Texas Medical Board. Two who anonymously report him were the no-nonsense hospital quality assurance nurses, Mitchell and Galle, who between them had 46 years of experience at the hospital and immense respect.

When notified of the report, the doctor becomes outraged and enlists his buddy the sheriff to find out who made the report. The sheriff obtains confidential information from the medical board through fraudulent means, and the reports are traced down to the two nurses. The hospital administrator, Wiley, instantly fires the nurses.

The story gets really weird here. What transpired next is something that has not happened in any state. In a stunning display of prosecutorial might, the nurses are indicted on felony charges of misuse of official information. If convicted, they face a maximum of 10 years in prison and/or a $10,000 fine. The case makes national headlines.

The two nurses and their families wait nearly a year for their trial. They have lost their jobs and incomes. Galle retires early. Mitchell, who is 15 years shy of retirement age, finds another county job, but not as a nurse. She takes a $35,000 annual pay cut, just as her son enters college.

The criminal charges against Galle are dropped, but Mitchell endures a four-day trail before the jury acquits her after less than an hour of deliberations. Once again, the case makes national headlines.

After Mitchell’s acquittal, Abbott opens an investigation into the case. In January, the doctor, sheriff, county attorney and hospital administrator are indicted on charge of retaliation against the nurses.

Roberts, the former sheriff, and Tidwell, the county attorney, each face six counts — two counts each of misuse of official information and retaliation (third-degree felonies) and official oppression (class A misdemeanor).

Wiley, the hospital administrator who hired Arafiles and fired the nurses, is indicted on two charges of retaliation. In March, he pleads guilty to abuse of official capacity for his role in the firing of the two nurses and promises to cooperate with the prosecution.

Last week, after a seven-day criminal trial and less than two hours deliberation, a Midland County jury convicted Roberts on all charges. He was sentenced — and unable to appeal — to four years of felony probation, $6,000 in fines and 100 days behind the bars of the same jail he ran for 20 years. He will be removed from office and must surrender his peace officer’s license. He will also retire from the county — with full benefits. Wiley testified during Roberts’ trial.

Two defendants await trial: Tidwell and the doctor. Arafiles continues his $200,000 job at the hospital even after the indictments. His contract is not renewed, and he now practices in Grand Saline. If convicted of a felony, he will lose his medical license.

Despite the legal vindication, the nurses have lost their careers, half of their incomes and their quality of life. Why? For doing the right thing to protect patients.

The case prompted legislative action to protect nurses from criminal prosecution for patient advocacy. Howard and Nelson co-sponsored successful legislation to keep this nightmare from happening again. The governor should sign this bill.

Oh, if only this were all a movie script and not real life.

No state needs primary care providers more than Texas, which has a severe shortage. Texas ranks last in access to health care and in the percentage of residents without health insurance. Of Texas’ 254 counties, 188 are designated by the federal government as having acute shortages of primary care physicians. Of that number, 16 counties have one and 23 have zero.

If every nurse practitioner and family doctor were deployed, we still couldn’t meet the need. Texans are desperate for health care.

Doing the math and to help meet the need, the Legislative Budget Board recommended autonomous practice of advanced practice nurses after a preceptorship.

In Texas, our Legislature — session after session — keeps the most restrictive laws in the country. Nurse practitioners don’t want to perform brain surgery. They just want to provide primary care and are quick to refer cases to a doctor when necessary.

Most states with far less need do not legislate practice barriers to nurse practitioners. Given the severity of our problem, shouldn’t we at least bring ourselves in line with those other states?

Texas has a large cadre of licensed, competent and qualified nurse professionals supremely educated, trained and eager to provide primary care. Hundreds of studies have shown their safety records to be equal to those of doctors —with the exception of their communication skills, which rank higher.

Superior communication skills are exemplified by nurse practitioner Naomi Warren from Winkler County in far West Texas, now famous for the whistle-blower/retaliation case. Having practiced in Winkler for more than a decade, she knew her patients well. They trusted her and were devoted to her.

When she quit her job in Winkler County rather than work alongside the doctor she and many others viewed as incompetent and dangerous, she moved her practice to neighboring Monahans Clinic. Even though they had to drive 50 miles round-trip to see her, 600 of her patients followed her.

The main legislative hurdle, or sticking point, is physician delegation. For example, a nurse cannot diagnose and treat the medical conditions of a patient without a physician willing to leave his or her practice, travel to a nurse practitioner’s site and sign charts for care that had already been provided.

Medically underserved areas are lucky to have one provider, much less two, necessitated by the delegation rule. In addition, the number of patients a doctor can see in a day is diminished. This rule significantly exacerbates Texas’ severe access problem. But physician delegation is embodied in Texas law, not federal law, so it’s amenable to legislative reform.

Hungry to have the human resources to meet the health care needs of their constituents, a wide variety of interest groups support nursing’s bills. Stakeholders include the Texas Association of Business; AARP Texas; the Texas Rural Health Association; insurance companies such as United HealthCare Texas, AmeriGroup and WellPoint; and many affected individual physicians and others.

As in years past, the only organized opposition comes from physician groups. Their opposition is vehement, and they make large campaign contributions. But why bother? It’s not as if primary care doctors could even remotely fill the need, and they won’t in the foreseeable future.

Older physicians saw the long, on-call hours of practicing primary care as an honorable profession. In turn, they were greatly respected by the people in the community with whom they developed strong relationships over the years. They were often paid in kind. But their numbers are dwindling; many are retiring.

Seeing poor reimbursement rates, few doctors in training choose primary care, where they will make two to 10 times less than their colleagues.

Organized medicine’s powerful opposition is not in the best interest of Texans with no health care. Is it about control? Is it about money? Perhaps they see autonomous advanced nurse practice as an encroachment on their territory. I don’t know why.

But I do know that given the economy, the state budget deficit, the severity of the access problem and the longevity of medicine’s success in killing nursing bills, that turning the tide will be difficult. But it will be historic, a victory for those desperate for health care.

For that to happen, legislators will need to recognize and resist the inherent conflict of interest of deep-pocketed organized medicine. It will take compassion and courage on their part. But they can be proud of their votes because it’s the right thing to do.

Anne Mitchell (left) and Vickilyn Galle after their indictment in 2009

Facing a $27 billion budget shortfall, Gov. Rick Perry has revived a failed and tired idea from past legislative sessions. To save a paltry $7 million, he proposes to combine under one umbrella some of the most essential agencies in state government — the boards regulating doctors, nurses, dentists, chiropractors, podiatrists, optometrists, pharmacists, psychologists and physical and occupational therapists.

The health professions boards were created to protect the public from harm. Although sluggish from recent years’ budget cuts, they are effective in protecting us because they are separate agencies with investigators trained specifically for each respective health discipline. They make you, me and every Texan a lot safer when we seek health care.

From the economic and public safety standpoints, the governor’s one-size-fits-all gesture makes no sense at all.

It costs the state $29 million to run these boards, but through licensing fees and disciplinary fines they collectively bring in $79 million for the state’s general fund (numbers courtesy of the Legislative Budget Board and the Texas comptroller’s office).

For example, the Texas Medical Board, which oversees doctors, had a budget of $9.4 million for fiscal year 2010 but brought in $35.7 million to state coffers.

The separate regulatory boards are cash cows for the state. It makes me wonder if the governor can count.

The professions are exceedingly different, with vocation-specific investigators. Nursing experts know nothing about regulating dentistry and vice versa.

The complex Winkler County case demonstrates the importance of a separate health board to protect the public.

The medical board first investigated Dr. Rolando G. Arafiles Jr. in 2007. It found that among other unprofessional and unethical offenses, he failed to keep adequate medical records in supervising a physician assistant who was prescribing nontherapeutic drugs at a weight loss clinic. His penalty was a $1,000 fine and a three-year stipulation on his license.

The doctor relocated, and in 2009, nurses Anne Mitchell and Vickilyn Galle of Winkler County reported the doctor to the board citing numerous cases of improper care, one of which was examining the genitalia of patients in the rural emergency room whose symptoms included stomach distress, headache and sinus pain, and blood pressure and jaw problems.

When the board notified Arafiles of the complaint, he enlisted his golfing buddy, the county sheriff, to find out who reported him. After identifying the nurses through spurious means, the hospital administrator immediately fired them, and the county and district attorneys charged the nurses with misuse of official information — a third-degree felony punishable by 10 years in prison and/or a $10,000 fine.

The medical board sent a letter to the prosecuting attorneys stating that it is improper to criminally prosecute people for raising complaints with the board — that the board depends on the eyes and ears of health care professionals to carry out its duty to protect the public from improper practitioners.

After the nurses’ report, the board investigated Arafiles and charged him with poor medical judgment, nontherapeutic prescribing, failure to maintain adequate records, overbilling, witness intimidation and other violations.

Mitchell and her family endured a torturous eight months waiting for the criminal trial to determine if she would go to prison or be fined an amount she could not pay. In 2010, Mitchell was acquitted in less than an hour, making national headlines and prompting a Texas attorney general investigation into the doctor and Winkler County officials.

The medical board subsequently issued a public reprimand of Arafiles, ordering physician monitoring of his practice and a $5,000 fine. He also was ordered to complete a rigorous course followed by assessments of his competence and medical jurisprudence.

Soon thereafter, the doctor, sheriff, county attorney and hospital administrator were indicted on charges of retaliation against the nurses. They await trial.

The Winkler County case demonstrates the crucial role of a board in protecting the public. The complexity of this case likely would not have been handled effectively by an umbrella agency. Functioning as a single agency would only dilute and weaken the power to protect the public’s safety.

Back in April 2009, Anne Mitchell and Vickilyn Galle, nurses in dusty Winkler County in the Permian Basin, and others reported to the board that Dr. Rolando Arafiles Jr. delivered the inept care described above. The board investigated the reports and issued formal charges against the doctor.

Upon receiving notification of the complaint, the doctor turned to a friend, the sheriff. Winkler County Sheriff Robert L. Roberts Jr. launched an investigation aimed at finding who had reported his buddy, the doctor, to the medical board. The administrator of the Winkler County Memorial Hospital in Kermit fired the nurses. That was only the beginning of their troubles.

In June 2009, the nurses were indicted on charges of misusing official information — a third-degree felony punishable by up to 10 years in prison and a $10,000 fine.

Mitchell and Galle filed a federal civil lawsuit in August 2009 against the hospital administrator, physician, sheriff, county attorney, District Attorney Mike Fostel as well as the hospital and the county. They charged that their constitutional right to free speech and due process was violated. They further accused the defendants of violating laws intended to protect whistle-blowers.

A year later, the civil suit was settled when Winkler County officials agreed to pay them $750,000 for past and future earnings, an amount they will share with their attorneys. Taxpayers are responsible for the bill.

The criminal charges against Galle were dropped. National headlines were made when a jury acquitted Mitchell in less than an hour in February 2010.

Last month, Arafiles was arrested and charged but continued his $200,000 job at the hospital.

After Mitchell’s acquittal, Attorney General Greg Abbott opened an investigation of the case. Lawyers from the attorney general’s office presented their case to a grand jury, which on Jan. 13 returned indictments against the doctor, sheriff, county attorney and hospital administrator on charges of retaliation against the nurses.

Roberts and County Attorney Scott M. Tidwell each face six counts — two counts each of misuse of official information and retaliation (third-degree felonies) and official oppression (class A misdemeanor).

Stan Wiley, the hospital administrator who hired Arafiles and fired the nurses, was indicted on two counts of retaliation. He has since resigned.

Arafiles faces two counts each of misuse of official information and retaliation against the nurses. How rich an irony that those involved were indicted on the same charge as the nurses — misuse of official information.

Two brilliant nursing careers were ended; the county became divided as its reputation suffered. The rural hospital was left in turmoil, and medical providers left, leaving people with few options for care — a burden disproportionately shared by the elderly.

Ultimately, after the medical board’s official charges were challenged by Arafiles, the case went to an administrative law judge.

Arafiles and medical board staff reached an agreed settlement. The terms have not been disclosed. The medical board has final say on the agreement and is scheduled to consider it at its February meeting.

The whole tawdry affair was unnecessary and should send a message that stunning displays of good ol’ boy idiocy and abuse of prosecutorial discretion in a small, far-off county will not be tolerated.

Turning a case around 180 degrees and prosecuting the prosecutors is a judicial anomaly. The judicial system functioned as it should.

We await the final disposition of the case, when the doctor and officials might or might not be convicted. Like the nurses before them, they are presumed innocent. But their indictments alone prove that justice was served, at least so far.

Inglis is a neonatal intensive care nurse at the Seton Family of Hospitals and editor of ‘Seton Nursing News.’

You get harmed patients, two brilliant nurses fired, an excruciating criminal trial, the departure of the county’s only nurse practitioner, a $750,000 bill to taxpayers and an indictment for the doctor.

On Dec. 21, Texas attorney general officers arrested the physician in question, Dr. Rolando G. Arafiles Jr., and charged him with two third-degree felonies: misuse of official information and retaliation against the nurses who turned him in to the Texas Medical Board for subpar care. Arafiles, who’s from the Philippines, also had his passport seized.

It all started in 2008, when the physician was hired with promises of producing revenue for Winkler County Memorial Hospital in Kermit by ordering a lot of tests and admitting a lot of patients. The hire was made despite the fact that in 2007, the medical board had fined Arafiles $1,000 and placed a three-year restriction on his license for a variety of unprofessional and unethical offenses.

Within a few months, Vickilyn Galle and Anne Mitchell, nurse administrators responsible for quality of care at the 25-bed hospital, and nurse practitioner Naomi Warren, exercised their professional ethical duty to advocate for patient safety by reporting the physician. The reports were made anonymously, using only patient medical record numbers.

When Arafiles received notice from of the complaint, he urged his golfing buddy, Winkler County Sheriff Robert Roberts, to find out who made the anonymous reports.

The sheriff traced the letter to Mitchell and Galle, who were then indicted on charges of misusing official information, a third-degree felony, and fired from their jobs.

Publicity of the indictment and firing caused state and national nursing and watchdog communities to feel that the whistle-blower safety net had been whisked away.

The Texas Medical Board sent a letter to the prosecuting attorneys stating that it is improper to criminally prosecute people for raising complaints and that the board depends on reports from health care professionals to carry out its duty of protecting the public from improper practitioners.

Mitchell and Galle filed a federal civil rights suit against hospital and county officials, accusing them of malicious prosecution, violating their free speech rights and violating the state whistle-blower law.

The county prosecutor dropped the criminal charge against Galle but took the case against Mitchell to trial. During the trial, Arafiles offered excuses for his care, but no denial of the facts. The jury took less than an hour to acquit Mitchell.

Subsequently, the medical board charged Arafiles with poor medical judgment, nontherapeutic prescribing, failure to maintain adequate records, overbilling, witness intimidation and other violations.

In August, Mitchell and Galle’s federal lawsuit was settled when Winkler County officials agreed to pay them $750,000 for past and future earnings, an amount they will share with their attorneys.

Though the exoneration is comforting, Mitchell and Galle’s nursing careers are over, as employment opportunities are scarce in rural areas. Despite job offers from urban areas, the drive from their homes is financially unfeasible, and they don’t want to move.

Criminal prosecution against nurses is rare and unprecedented. There’s so much wrong here: abuse of prosecutorial discretion, arrogance, vindictiveness, good-ol’-boy idiocy. It staggers the imagination that such proceedings can occur in full view, even in Texas.

Inglis is a neonatal intensive care nurse at the Seton Family of Hospitals and editor of ‘Seton Nursing News.’