WASHINGTON — Investigating complaints into doctors can take months or years, a KIRO 7 investigation found, allowing them to continue operating on patients in the meantime.
In some cases, these doctors can move states, and it can take months before a new state’s medical board recognizes another state’s disciplinary action with its own action.
“I didn’t know if I was going to live or die,” said Desiree Knight, who told KIRO 7 she was left feeling deformed after a routine breast reduction surgery in 2021.
Knight says her primary care doctor recommended certified plastic surgeon Dr. Sarah Crandall, who was then working out of St. Clare Hospital in Lakewood.
“She was very friendly,” Knight said. “She agreed to everything that I wanted done.”
Knight said her surgery initially appeared to go well. She came home the same day and went to lie down in anticipation of feeling better.
It didn’t happen, she says.
Instead, Knight landed in the emergency room twice after her surgery.
“I knew something was wrong,” she said. “They came in and (were) like, ‘You have a liter and a half of fluid on one side and a liter on the other side and we have to take you in for an emergency surgery.’”
As she healed, Knight said her breasts felt “deformed.”
“I didn’t want my husband to look at me or people to look me,” Knight said. “You feel like a monster.”
She ultimately filed a complaint with the hospital, but said her claim was rejected.
The hospital, now run by Virginia Mason Franciscan Health (VMFH), told KIRO 7 it could not comment on patient specifics.
“We take any concerns raised by our patients very seriously and follow a comprehensive process for reviewing them,” a spokesperson wrote to KIRO 7. “Our process involves thorough evaluation by both clinical and patient experience experts, including review of the medical care provided and direct follow-up with patients and clinical teams.”
The hospital spokesperson noted Crandall was no longer employed by VMFH, but said they do not comment on personnel matters. They added that the hospital conducts ongoing, routine reviews of medical staff to ensure quality and safety.
After her surgery, Knight also ultimately complained to the Washington Medical Commission (WMC) — and eventually discovered she wasn’t alone.
At least five of Crandall’s other patients had complications too during surgeries before Knight’s.
“Why the hell did I let her cut me?” Knight said. “Why didn’t I do my research?”
The problem: at the time, there wouldn’t have been much available to find.
Crandall was only disciplined by the state following a more than two-year investigation, years after Knight’s surgery.
The state’s order from the Washington Medical Commission found Crandall had taken on five patients who were “poor surgical candidates” and that her “inadequate planning resulted in unusually high instances of compromised blood supply, deformity, or necrosis, of patients’ breasts.”
The order required she have her skills evaluated, complete additional training and pay a fine. The WMC said Crandall is making progress on her order requirements.
Through her attorney, Crandall told KIRO 7 she was legally unable to discuss the specifics of any patient’s care.
“Speaking in general terms, I can tell you that I have a strong respect for and deep commitment to my patients,” Crandall wrote. “We work collaboratively to outline their care goals and review clinical history to determine the best possible care plan. I also work with all of my patients to ensure they understand the options and risks, and I do everything I can to ensure that patients are happy and satisfied with their care. If concerns arise, I collaborate with patients to determine the best path forward.”
Medical malpractice attorney, Gary Samms, who was not involved in this case, told KIRO 7 that in general, just because a doctor has more complications does not mean they’re acting negligently.
“There are bad outcomes that can occur without any negligence,” he said.
Samms is a shareholder with the Marshall Dennehey law firm. He’s defended doctors and hospitals for more than 30 years.
He noted that some doctors perform more difficult procedures that may have higher rates of complications.
“Some just have a certain social demographic where the people don’t have access to continued follow up care, so they’re prone to more infections or things of that nature,” he said. “It’s a very nuanced issued.”
To determine negligence, Samms said experts must be involved in reviewing the medical records.
That’s what takes place during a Washington Medical Commission investigation.
Complaints are reviewed by a panel of investigators, which also gathers documents and interviews of witnesses.
A spokesperson for the WMC said every complaint received is assessed on individual merits. The decision to issue charges or take disciplinary action is not solely based on the number of complaints, the spokesperson said, but relies on the nature of those complaints and what can be substantiated with evidence.
In FY25, 30.3% of complaints received by the WMC were authorized for an investigation. 76% of these investigations were closed within 170 days.
During Crandall’s investigation, state records show Crandall told the WMC she was increasing pre-operative discussions with patients about expectations and would be more selective to avoid high-risk patients.
By the time Crandall’s disciplinary order was issued in September 2024, allowing it to be publicly searched online on the WMC’s website, records show she had already moved to Minnesota and was performing surgeries there.
“The states do not work very well together,” Samms said. “They are slow to report findings or conclusions from one state to the next.”
It took until March 2025 before Minnesota’s Board of Medical Practice adopted its order recognizing Washington’s.
Documents show it took about four months for Minnesota’s board to develop that order and finalize it by late January. By then, the board had to wait for its next board meeting in March to adopt it to public record.
KIRO 7 did request to see any additional complaints that may have been filed in Minnesota about Crandall, but complaints alone are not public record there.
As for Knight, the Washington Medical Commission took her complaint, but ultimately closed it. A spokesperson for the commission told KIRO 7 that it so closely matched the others that fully investigating it would have delayed Crandall’s discipline.
Ultimately, Knight had to pay about $17,000 out of pocket for a new surgery. She still doesn’t feel entirely healed.
“If I can be the voice for just one person,” she said. “Just so that this doesn’t happen to somebody else.”
By law, states are required to report certain disciplinary actions to a national database (the National Practitioner Database) and hospitals are required to check it before hiring an employee or granting them privileges, as well as on an ongoing basis.
The lag comes when those violations happen in between those mandatory checks.
Advocates for patient safety have pushed for more transparency, while medical malpractice defense attorneys have warned there is still a need for due process in complaints against medical practitioners.
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