Performance Report – Dr. Myron Shank
Chief Medical Officer - Allen Correctional Institution
Prepared by Dean McCombs, Warden Assistant – 2
August 9, 2011

Table of Contents
Purpose of report and documents ………………………………………………………..1
Performance Issues ……………………………………………………………………….2
Corrective Action…………………………………………………………………………4
Institution Grievance Statistics…………………………………………………………...6
Conclusion………………………………………………………………………………..7

Attachments
Bureau of Medical Services Joint Staff Site Visit, May 24, 2011………………………A
ACI Root Cause Analysis, February 22, 2011…………………………………………..B
ACI Medical Plan of Action, August 5, 2010…………………………………………..C
ACI grievance statistical information…………………………………………………...D
Medical Services Policy 68-MED-01. …………………………………………………..E
Chronic Disease Management Policy 68-MED-19……………………………………...F
OAKS report – Dr. Myron Shank…..………………………………………………….. G

Performance Report – Dr. Myron Shank
Chief Medical Officer - Allen Correctional Institution
Prepared by Dean McCombs, Warden Assistant – 2
August 9, 2011

Dr. Myron Shank served as the Chief Medical Officer, (CMO), at the Allen Correctional
Institution from July 6, 2010 to his resignation on June 20, 2011. The purpose of this report is
to address the performance of Dr. Shank during his tenure at the Allen Correctional Institution.

The documents listed below were used as reference material in the completion of this report:
1. Bureau of Medical Services Joint BOMS Staff Site Visit Report dated, May
24, 2011. See attachment A
2. ACI Root Cause Analysis – Follow up with ALP within 14-days after return
from consults, dated February 22, 2011. See attachment B
3. ACI Medical Plan of Action dated August 23, 2010. See attachment C
4.

ACI grievance statistical information. See attachment D

5. Medical Services Policy 68-MED-01. See attachment E
6. Chronic Disease Management Policy 68-MED-19. See attachment F
7. Personnel Action – Dr. Myron Shank. See attachment G

Performance report – Dr. M Shank

page 2 of 7

Performance Issues
Listed below, are specific areas of concern regarding the performance of Dr. Shank during his
tenure as Chief Medical Officer at the Allen Correctional Institution.

Bureau of Medical Services Joint BOMS Staff Site Visit
Report dated, May 24, 2011

See attachment A

Chronic Care Clinic – HIV: Lack of follow up by Dr. Shank reference HIV patients.
Chronic Care Clinic – Seizure: No documentation that “physician” follows up with patients
of dosage/prescription changes. No documentation of
discussion or follow up plan.

Specialty Consults – 20% of patients seen post consultation. At times, a chart review is
completed. Orders may or may not be written. This is problematic as the
treatment plan is not discussed with patient. Discontinued consults were
not discussed with patients.

ACI Root Cause Analysis – Follow up with ALP within 14-days
February 22, 2011

See attachment B

Doctor’s orders written that contained information to not schedule for follow up/have the
patient sign up for Doctors Sick Call if they want to discuss results.

Performance report – Dr. M Shank

page 3 of 7

ACI Medical Plan of Action
August 5, 2010

See attachment C

Per the Fussell Agreement, Dr. Shank did not assure that:
1. Routine orders shall be implemented after reviewed and ordered by the Advanced
Licensed Practitioner, (ALP).
2. The consult and doctor order shall be flagged and placed in the consult box.
3.

The ALP shall review, sign and date these orders and recommendations the next date
they are on-site.

4. All Inmates shall be evaluated by the ALP within 14 days of completion of the specialty
consults. The treatment and recommendations shall be discussed with the inmates and
implements during the Doctor’s Sick Call (DSC) visit.
5. The ALP shall communicate directly with the consultant to resolve treatment conflicts of
diagnosis issues.
6. All inmates shall be scheduled in DSC for follow up within two business days after their
return. They will be placed at the top of the DSC schedule. A pass will be written and
given to the inmate for the next business day appointment.
7. The ALP shall document the emergency event in the Interdisciplinary Notes (ID).
8. The ALP shall document daily notes when they are on site.
9. There will be a complete admission order that contains Dx (diagnosis), purpose, intent,
medications, etc.

Performance report – Dr. M Shank

page 4 of 7

Corrective Action
The documents listed above, as well as an increase in inmate medical complaints resulted in the
following corrective meetings with Dr. Shank:
Date

Staff Present

Discussion

December, 2010

Pamela Neal HCA*
Lisa Petersen, CQ1*
Sheila McNamara, DWSS*

Proper documentation
of physician review
reference follow up.

January, 2011

Todd Wilkerson, Acting HCA*
Lisa Petersen, CQ1
Sheila McNamara, DWSS

Consults with Patients.
Chart reviews were not
acceptable.
Dr. Shank or Nurse Practitioner
must follow up from emergency
room visits within two days.

March, 2011

Todd Wilkerson, Acting HCA
Kevin Jones, DWSS
Lisa Petersen, CQ1

March, 2011

John Coleman, Warden
Kevin Jones, DWSS
Todd Wilkerson, Acting HCA

Labs must be reviewed by Dr. the
next work day at the institution
with Dr. review and dates
indicated.

Dr. Shank needs to improve
teamwork.
Meet with patients and discuss
Medication and discontinuation of
medication.
Dr. Shank must not stop
medication without clarification
and patient education.

Performance report – Dr. M Shank

page 5 of 7

Corrective Action
(Continued from pervious page)

April, 2011

Kevin Jones, DWSS*
Todd Wilkerson, Acting HCA

Dr. Shank must see patient himself.
Dr. must discuss his plan of action.
ALP shall document distinct
admission and discharge notes.
ALP shall document daily notes
when on site.
Must be a complete admission
order that contains treatment,
purpose, intent medications, etc.

* HCA- Health Care Administrator
*Acting HCA – Acting Health Care Administrator
*DWSS – Deputy Warden of Special Services
*CQ1 – Quality Improvement Coordinator

Performance report – Dr. M Shank

page 6 of 7

INSTITUTION GRIEVANCES STATISTICS
7/6/2008 thru 6/20/2009
One year prior to Dr. Shank’s arrival at ACI
See attachment D
GRANTED DENIED INSTITUTIONAL OPERATIONS - Health Care
3
8
Access / Delay in receiving medical care…19 %
1

12

Improper / inadequate medical care……….23 %

2

8

Delay / denial of medication………………18 %

0

0

Medical records…………………………….0 %

0

3

Eye glasses………………………………….5 %

0

0

Forced medical testing……………………...0 %

0

0

Medical transfer…………………………….0 %

0

0

Prosthetic device……………………………0 %

0

2

Medical co-pay……………………………..4 %

0

0

Medical restriction…………………………0 %.

0

4

Medical aide / device………………………7 %

0

8

Disagree with diagnosis / treatment……….14%

0

6

Other………………………………………..11 %

INSTITUTION GRIEVANCES STATISTICS
7/6/2010 thru 6/20/2011
Time period that Dr. Shank was Chief Medical Officer at ACI
GRANTED DENIED INSTITUTIONAL OPERATIONS - Health Care
1
15
Access / Delay in receiving medical care...12 %
+ 5 from previous year
0

33

Improper / inadequate medical care………25 %

+ 20 from previous year

1

31

Delay / denial of medication………………24 %

+ 22 from previous year

1

0

Medical records……………………………08 %

+ 1 from previous year

1

4

Eye glasses………………………………….4 %

+ 2 from previous year

0

0

Forced medical testing……………………...0 %

N/A

0

0

Medical transfer……………………………0 %

N/A

0

0

Prosthetic device…………………………...0 %

N/A

2

4

Medical co-pay…………………………….5 %

+ 4 from previous year

0

9

Medical restriction…………………………9 %

+ 9 from previous year

0

1

Medical aide / device………………………08 %

- 3 from previous year

0

22

Disagree with diagnosis / treatment……….17 %

+ 14 from previous year

0

6

Other………………………………………...5 %

same as previous year

Performance report – Dr. M Shank

page 7 of 7

Conclusion

Medical complaints significantly increased at the Allen Correctional Institution after Dr. Shank
became the Chief Medical Officer, (CMO). Fifty-seven medical grievances were filed with the
Inspector of Institutional services at ACI during the year prior to Dr. Shank’s arrival. One
hundred and thirty one medical grievances were filed during Dr. Shank’s tenure as CMO. Only
six of those grievances were granted, but other indicators clearly suggested that improvement in
medical services was necessary.

Bureau of Medical Services reports, ACI Root Cause Analysis, and ACI Medical Plans of
Action identified the following issues:
1.
2.
3.
4.
5.

Lack of appropriate follow up with patients following specialty consults.
Complete and timely documentation in the patient’s Interdisciplinary notes.
Proper follow up with patients after emergency room visits.
Review of lab work.
Discontinuation of medication and treatment without first meeting with patients,
discussing options and patient education.
6. Lack of teamwork.

Warden John Coleman, as well as both Deputy Wardens, the CQ1, and the HCA met with Dr.
Shank on several occasions to address the above issues. Dr. Shank’s propensity to discontinue
and/or change medication or treatment without effective communication and patient education
was problematic in a correctional setting and inconsistent with applicable ODRC medical
policy.