The founder of the University of Washington's heart-transplant program, Dr. Margaret Allen, has settled a sex-discrimination lawsuit with the university for $750,000 and resigned from her position.
Attorneys for the UW School of Medicine and Allen, a nationally prominent surgeon and the first female heart-transplant surgeon in the world, reached the settlement after a long, difficult mediation and binding arbitration.
Allen's resignation, effective a week ago, was one of the terms of the settlement.
Allen, who was at the UW for 15 years, says she plans to stay in Seattle and hopes to continue research on several projects. But she contends the settlement may prevent much of her work.
The agreement prohibits Allen from conducting research that has any legal tie to the UW School of Medicine. This precludes Allen from directing research that involves grants to the school or any of its scientists or staff members. It would not include projects in which she is not the director.
"For the sum we're paying ($750,000), we're buying a complete divorce. We're not having any shared custody," said Michael Madden, an attorney for the UW. He and other UW officials say Allen can still conduct research under the provision.
Dr. Edward Verrier, chief of the UW division of cardiothoracic surgery, became director of the heart-transplant program several years ago.
"We're really sorry to see this (Allen's departure) happen. I feel strongly that Dr. Allen has been very productive and added greatly to the school of medicine and to the care we provide patients in the Northwest," said Dr. John Coombs, associate dean of the school.
"It's frustrating that we couldn't work back into a productive relationship. . . . There is a sense of loss."
Mediation documents show the lawsuit came after years of a deteriorating relationship between Allen, 51, and UW Surgery Department administrators.
The UW engaged "in a vicious, unabated campaign to end Dr. Allen's distinguished clinical and research career," Allen's attorney Judith Lonnquist charged in the mediation statement. UW officials claim Allen was inconsiderate of others, too slow in the operating room and indecisive in surgical crises.
During her years with the UW, Allen was director of the heart-transplant programs at the university and Children's Hospital & Regional Medical Center, programs she founded soon after her arrival. She is past president of the United Network for Organ Sharing, the organization responsible for distribution of organs nationwide, and past president of a regional transplant society.
She started at the UW after completing her last residency at Stanford University in 1985 and was one of the first female heart surgeons in the country.
Allen said in mediation documents that discrimination against her, because is a woman, began about 1988, when several anesthesiologists portrayed her as insecure, difficult and indecisive, though she said they had not regularly worked with her.
Dr. Thomas Hornbein, professor of anesthesiology and one of the critics, noted in a 1990 internal memorandum filed with mediation documents that Allen had come directly from surgical training to her high-profile position and wasn't given much direction.
"Guidance, mentoring and clearly stated expectations appeared to be largely lacking, both in relation to her political/administrative function and in regard to her clinical action and interaction," he said in the memo, which opposed Allen's promotion from assistant to associate professor.
Allen's relationship with her supervisors began crumbling in 1989, when Verrier was appointed the new chief of cardiac surgery. UW officials say Allen "vociferously opposed" the appointment, but Allen denies it. She said Verrier soon began haranguing her about her performance in sessions that lasted more than an hour.
Allen said Verrier in January 1996 removed her as heart-transplant director at the UW and Children's without explanation. She said Verrier would not discuss the action for "a protracted period" and that, meanwhile, the surgery department director, Dr. Carlos Pellegrini, asked her when she would be leaving the department. Despite repeated tries, Pellegrini could not be reached for comment.
Later, Allen said, her supervisors falsely claimed the number of transplants had decreased during 1994 and that was a reason for her removal. She said officials ascribed increased transplant mortalities during 1996 to her, when she no longer was performing the procedures.
At one point, she said, the acting director of the department of surgery, Dr. David Ashbaugh, told her she would never be promoted to full professor because it was like an "old boys' club." Ashbaugh denies saying that and said he did all he could to help Allen be promoted.
Allen's attorney concluded in her mediation statement: "Dr. Verrier and others have engaged in a continuous and relentless pattern of animosity, disrespect and discrimination toward Dr. Allen."
Verrier declined to be interviewed regarding Allen's charges. He released a brief, written statement:
"As the surgeon who performed the Northwest's first heart transplant, Dr. Allen was a pioneer in establishing an outstanding clinical program at the UW. Some time ago, Dr. Allen intensified her research interests. I wish her nothing but the best as she now pursues her biomedical research activities."
UW officials said Allen alienated anesthesiologists and others in the operating room. She was too slow and "had a reputation for changing direction, and surgical schedules, at the last minute, frequently causing the OR staff to wait many hours for her to begin surgery, or before learning that it had been canceled," Madden, a UW attorney, said in a mediation document.
Allen denied being slow, saying her average surgery times were within one minute of those of the other surgeons in the department. She said her operating schedules were sometimes inconvenient because the surgical team had to wait for organs to arrive from other hospitals. At other times, she said, she had to operate late at night because she was given low priority for operating-room times.
Officials also said Allen was indecisive in surgical crises, but Allen strongly denied it.
"I've dealt with a lot of crises, and I have a very good clinical record," she said. "I feel I can get any patient through any operation. . . . I frequently was referred the more difficult cases."
Allen contended that Verrier, as part of his discrimination against her, had diverted her patient referrals. UW officials deny that, saying Allen started making herself less available for cases in the early 1990s because her enthusiasm for surgery was waning.
But Allen said she has always been very enthusiastic about surgery. Even as she pursues research interests, several of her projects focus on surgery, she said.
Allen's salary and surgical fees steadily declined through the years from about $265,000 to less than half of that. Allen said that was because of discrimination, reduced referrals and because she was forced to rely on research grants.
UW officials said it was because she brought in fewer patient fees and because in some years the hospital needed money for salaries to attract new surgeons. They said her pay was later increased, though like all researchers, she had to rely on grants when she switched to research full time in 1997.
Allen said she never wanted to file a lawsuit. For years, she said, she tried to resolve her discrimination claims with various officials of the medical school and university.
"This is incredibly discouraging to me," she said. "I feel like I've devoted a good portion of my life to the university."
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