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Doctor's reprimand called unjustified

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By Sarah Trotto

SCOTTSDALE — University of Arizona team physician Don Porter has been found to have committed unprofessional conduct in connection with the death of basketball player Shawntinice Polk.

The Arizona Medical Board voted 4-2 Thursday to issue a letter of reprimand to Porter for failing to consider and pursue a diagnosis of a lung blood clot and failing to perform an adequate exam on Polk, who was complaining of respiratory symptoms. Polk died Sept. 26, 2005, from a blood clot that traveled from her leg to her lung.

Porter, a 1979 graduate of the UA medical school, will have 35 days to appeal the motion. If upheld, the letter of reprimand will appear on his online profile, allowing the public to see the disciplinary action. Porter has no prior complaints filed against him. He has been the UA team physician for 20 years. As of October 2006, his salary was $112,398, according to university records.

"I still agonize today asking myself what I could have done differently," Porter, 54, told the board in the interview that lasted nearly an hour.

Polk, 22 when she died, became Porter's patient in 2002 and collapsed at McKale Center over two years ago. Called "Polkey" by fans and teammates, she was among the best players in program history.

The clot was a "very, very rare" occurrence for a healthy woman of Polk's age, a Pima County medical examiner told the Star the day Polk died.

Porter and his attorney, Paul Giancola, declined to comment after the meeting.

When asked if the UA will take action because of the board's ruling, athletic director Jim Livengood said: "We review everything. At this time, we're aware of the board meeting and the decision. We have great confidence in our medical staff and what we do with our athletes."

Board member Dr. Paul Petelin, who voted to discipline, asked Porter during the formal interview why he did not recognize Polk's symptoms as signs of a lung blood clot. Porter, whose patients are typically young, said he had not seen a case of pulmonary embolus before Polk's.

Porter said he was aware that Polk, who was 6 feet 5 inches tall and about 248 pounds, had been overweight and was taking oral contraceptives, which can increase the risk of blood clots. Porter said Polk had not expressed to him that she was experiencing leg pain.

The blood clot had traveled from Polk's leg. She underwent knee surgery five months before her death, so the possibility of the surgery causing her symptoms seemed "remote," Porter said.

"This is not something mysterious that happens once in a while. (A deep-vein blood clot) and the possibility of P.E. is a real entity and it's common," Petelin said. "The fact that the doctors that cared for this young lady had some degree of tunnel vision and didn't entertain that diagnosis is very disconcerting to me."

Polk's mother, Johnny Little, brought the case to the attention of the board. She could not be reached for comment Thursday.

Porter said Polk described her shortness of breath as similar to her asthma.

"I think I focused on the asthma," Porter said.

Board members Patricia Griffen, Dr. Ram Krishna, Petelin and Dr. Amy Schneider voted in favor of the letter of reprimand. Board secretary Dona Pardo and Dr. Lorraine Mackstaller voted no. Dr. Todd Lefkowitz and chair Dr. William Martin III abstained. Vice chair Dr. Douglas Lee and Dr. Robert Goldfarb recused themselves from the interview. Before the vote, the board approved that Porter had committed unprofessional conduct.

Krishna, who motioned for the letter of reprimand, said Porter comes across as a "caring, compassionate physician," but noted Porter saw Polk more than once before her death so he could have more properly diagnosed her.

Porter told the board in retrospect he would have conducted a more extensive exam. He said he will try to get more historical information from a patient experiencing similar symptoms and pay closer attention to vital signs. He has asked the UA medical staff to report anything suspicious about athletes and to send him injury reports.

Porter saw Polk on Sept. 19, 2005, when she had been coughing up blood and was dehydrated, according to the case. Porter said coughing up blood can be a sign of an upper-respiratory illness, so he ordered a chest X-ray and ran tests that ruled out pneumonia and valley fever. Porter told her to return if the symptoms worsened.

Polk saw another doctor Sept. 22 and had shortness of breath. She was told not to practice basketball and prescribed Prednisone, a drug used for various inflammatory diseases, including asthma.

Polk saw Porter again Sept. 23 — three days before her death — after experiencing shortness of breath during a morning workout, according to the case. Porter said she did not appear in distress and seemed to be doing better.

"I think it was also presented by the outside medical examiner that it's a low probability in this type of patient, and it's not something I've seen before," Porter said of a lung blood clot. "It just didn't come across my radar."

Porter did not see Polk again until Sept. 26, when emergency medical staff worked on her after she collapsed at McKale Center. She had been short of breath and experiencing chest pain. She was taken to University Medical Center, where she later died.