WEST LICENSE REVOKED-MEDICAL BOARD OF CA DECISION

Justice is FINALLY served. License will be revoked effective June 25, 2009. (See decision on pgs 23-24)

Per Medical Board of CA, under Enforcement.
http://www.mbc.ca.gov/

Quote: "Respondent's dishonesty with Schlie occurred on February 1, 2007, after he was placed on probation. He had already completed an ethics course in compliance with the conditions of his probation. His continued dishonesty cannot be adequately addressed by imposition of another ethics course. Honesty goes to the heart of a physician's practice of medicine - both with respect to the physician-patient relationship.....

Dishonesty is incompatible with the practice of medicine. Dishonesty cannot be compartmentalized.....

Respondent's prior discpline was based in part upon multiple acts of dishonesty. The panel concludes from respondent's pattern of dishonesty that probation will not change his practices and therefore the public interest will not be served by leaving respondent on probation under any circumstances."

HEARING - STATE OF CA VS. WEST 9/29/08-10/8/08

OFFICE OF ADMINISTRATIVE HEARINGS
2349 GATEWAY OAKS DR. SECOND FLOOR
SACRAMENTO

BEGINS AT 9AM ON MONDAY, SEPTEMBER 29, 2008 - THURSDAY, OCTOBER 2, 2008
NO HEARING ON FRIDAY
THEN IT CONTINUES ON MONDAY OCTOBER 6, 2008 - WEDNESDAY, OCTOBER 8, 2008

PATIENT ADVOCATES

HELEN HASKELL: MOTHERS AGAINST MEDICAL ERROR
http://www.lewisblackman.net/

JANET MITCHELL: TAKING A STAND
http://www.janetlynnmitchell.com/

CAROLE MOSS: NILE'S PROJECT
http://www.nilesproject.com/

ALICIA COLE:
http://www.aliciacole.com/

JOHN JAMES: PATIENT SAFETY AMERICA
http://www.patientsafetyamerica.com/

VICTORIA NAHUM: SAFE CARE CAMPAIGN
http://www.safecarecampaign.org

PATTY SKOLNIK: COLORADO CITIZENS FOR ACCOUNTABILITY
http://www.coloradocitizensforaccountability.org

BILL THIEL: MAUREEN'S MISSION
http://www.maureensmission.org

LISA LINDELL: 108 DAYS
http://www.108days.com/home

LORIN JONES: PAM'S JOURNEY
http://www.pamsjourney.org/

FAREWELL OUR DEAR FRIEND BECKY, HER FINAL INTERVIEW

http://cbs13.com/consumer/call.kurtis.kurtis.2.697223.html
(Becky's Final Interview - VIDEO)

April 17, 2008
My sister, Becky would be surprised to know that she made a difference. Beck, we miss you more than we knew we would...and we thought we would miss you a lot. Our lives will never be the same for having you in our lives.....love, Sherry
Sherry Bural (Portland, OR)

Honoring Becky Anderson

When my friend and fellow advocate, Tina Minasian, first shared Becky’s story with me, I was so touched by Becky’s strength. She showed so much courage in her battle with cancer and complications from multiple surgeries. She fought the good fight not only for herself and her family but for countless numbers of people she never met. She so courageously came forward with her story and allowed us advocates to continue to share her story with the hope of helping others. She had every right to battle her illness out of the public light but she was too good of a soul to do that. She wanted to be the public image of the issue that her story brought to light in the State of California with the intention of protecting the public.

On behalf of the patient advocates across the State of California, I would like to thank Becky Anderson along with Linda Starr, Ken Mikulecky and of course Tina Minasian, for allowing their stories to become the foundation of what laid the groundwork for the battle for the rights of patients in California. I never had the honor of meeting Becky but I felt like I knew her. Tina Minasian, Janet Mitchell and I will continue the fight for patients rights in the State of California in memory of Becky, Sharon and my late fiancé.

Thanks to Becky’s grace and courage, positive change for patients rights has been made and will continue to be made in her honor.

In her memory,
Michele Monserratt-Ramos

April 12, 2008
Ms. Becky Anderson lived a life of activism few have understood in the past. She inspired me, the life she lived will now inspire more--that is just what the doctor ordered. Thank you Becky. Joseph A. Mungai (Elgin, IL)

April 12, 2008
Becky planned to be busy once she made her grand entrance into heaven. First she said she was going to embrace her Lord, and then she said she was going to have a meeting to discuss some business--asking God to take care of a few things. I believe Becky then planned to spend the rest of her time dancing, celebrating, and worshiping her God. Becky's life and her eternal life have a will make a difference. She will be missed, but only for a time. I know that I will one day see Becky again. Until then ...
Janet Mitchell (Orange, CA)

April 11, 2008
I too had never personally met Becky but felt I had because I'd heard so many things about her from her loving sister Sherry. Especially how she battled her illness so hard the last couple years with courage and dignity. Someone already said Becky fought many battles during her short life but I know she also had to make some tough choices which most of us never have to make. One of those choices allowed her birth son Nate to be in our lives here in Portland and be my son Zacks best friend since he was 6 months old. Thank you for that gift Becky. You impacted more lives in Portland then you probably ever realized. I'm sure you're already singing in the choir of angels.
Jeff Gage (Portland, OR)

April 11, 2008
My thoughts and prayers are with everyone that was in the blessed circle of Becky's life. May our memories of Becky's Laughter and uplifting spirit she bestole on everyone's heart she touched, bring everyone the comfort we all need at this time in our lives. Rest in the arms of Angels Dear Becky. Vicky Martin (Sacramento, CA)

April 10, 2008
I only knew of Becky through my good friend, Tina Minasian. Through Tina, I learned what a brave and wonderful person Becky Anderson was...a true inspiration to those who were fortunate enough to be a part of her life. My thoughts and prayers go out to all of her family and friends. Leslie Hilliard (Sacramento, CA)

April 10, 2008
My Dearest Becky--I`ve been thinking about you daily for quite sometime--then found you had passed--know you are at peace with the angels-your warnth-smile-and that beautiful melodious voice will always be in my memory--you fought many battles during your short time here-yet were always there when needed for others needing help!I know you saved this life. My condolences to your dad-sister`s-children-and grandchildren. Love Always-Betty Viegas Matczok and family. Betty viegas-matczok (sacramento, CA)

April 10, 2008
A bright and shining light that will never fade. Darlene DeSoza (Citrus Heights, CA)

April 9, 2008
I extend my deepest condolences to Becky's family and dear friends. Becky's courage, determination, and strength will always be an inspiration to those who knew and loved her. Becky was a lady with incredible wit & humor, and she brought love and laughter to everyone around her. Becky's battle is over, but her spirit will forever remain in our hearts.
Linda Osborne (Grantsville, UT)

April 9, 2008
I never met Becky, but through her dear Friend Tina, I felt I had come to know her in many ways. Tina explained to me what a wonderful person Becky was and I know that Tina loved her a great deal. And of course her family is enduring a great loss. But people like Becky, in spite of losing the fight for life, give all they have to make things better when they are alive. She will be remembered I'm sure for all the good things she had done, and for having courage in adversity. She is a positive example for us all. I know that many will miss her greatly.
Lorin Jones (NM)

April 9, 2008
I miss you deeply but I will remember you forever. You inspired me from the day we met. You were my Angel, a wonderful friend and warrior. You fought a good fight and now you will be crowned. Thank you for making a difference in this world. Tina Minasian

April 9, 2008
I only met Becky a few times but they were special times. My condolences go out to the family at this very difficult time. Becky fought a very difficult battle with a grace that many do not show. She will be missed. Geri Royer (Sacramento, CA)

April 9, 2008
Becky was an amazing woman, and I am happy I had the chance to know her! We will miss her!
Candice Webb (Sacramento, CA)

MUST READ: Arizona Medical Board's hands-off approach to relapsed addict physicians is endangering patients

http://www.phoenixnewtimes.com/2008-03-06/news/arizona-medical-board-s-hands-off-approach-to-relapsed-addict-physicians-is-endangering-patients/1

MUST SEE VIDEOS "Addicted Doctors Allowed to Practice" (Diversion)

http://youtube.com/watch?v=KYCOAvCqbOs
Part 1

http://youtube.com/watch?v=QCHLaWogXTw&feature=related
Part 2

Consumer's Union

www.stophospitalinfections.org

Hospital Infections

www.hospitalinfection.org

MUST SEE VIDEO "Nile's Project"

A coalition to eliminate unnecessary deaths from MRSA, VRE, Staph and other preventable hospital acquired infections.
http://www.nilesproject.com/

MUST SEE VIDEOS "Alicia Cole's Story"

http://www.aliciacole.com/

www.MySpace.com/MRSAawareness

www.YouTube.com/Mizcole

www.YouTube.com/AmendtheCap

http://www.amendthecap.com/

www.MySpace.com/DirtyHospitals

www.MySpace.com/AliciaRCole (Alicia the Warrior)

Helen Hakell's Story-Mothers Against Medical Error

http://www.lewisblackman.net/

John James's Story

http://www.patientsafetyamerica.com/

Victoria Nahum's Story

http://www.safecarecampaign.org

Patty Skolnik's Story

http://www.coloradocitizensforaccountability.org

Bill Thiel's Story

http://www.maureensmission.org

Lisa's Story

http://www.108days.com/home

Pam's Story

Pamela was more than a wife, a mother, a child. She was the example of what all of us should strive to be.Her love for others was endless, and this love was given freely to all those in need. Pam saw no distinctions between race, or status. Pam treasured every moment of her life and yet faced it’s end with courage that could only come from God.Please read Pam’s Journey. It will tell you how Pam died and why. God had a purpose in taking her. To save others from what Pam endured.

http://www.pamsjourney.org/

80 year old former patient

My complaint is that Dr. West put an implant in my right side that was much larger than my normal breast on my left side. I had breast silicones in me for 30 years. West was suppose to replace one silicone and remove the other completely and have it match to the size of my left breast. When I went in for my follow up visit he said, “Oh my God, I made you a different size breast!” I was so angry with him, how could he not know that he was putting in such a big huge breast. My left breast was no where near the size of the new implant on my right side. A few weeks later I went to his office on “K” Street again to follow up and he was gone. No number, no forwarding address. He was gone. He closed his office but I still had tubes in my breast that needed to come out. I didn’t know what to do so I called Dr. Jay Owens and he told me to come in and he removed the tubes.

Dr. West abandoned me without removing the tubes and placed the wrong size implant in me. The implant since then has deflated and the silicone is in my body. I suffer from pain constantly. I have no financial means of replacing the silicone. What he did to me was wrong and he should have his license revoked for this.

Sharon Mikulecky's Story

Tram Flap Surgery

Sharon passed away after suffering excruxiatingly for a year from multitudes of infections, due to the "Tram Flap Surgery" with Brian West MD and because of all this the cancer eventually came back and it spread throughout her body.

Public Please Be Informed

Unfortunately, many patients have no idea that by filing a Medical Malpractice case against a doctor it does not necessarily constitute a medical complaint with the board. As a matter of fact, the board is soooo short staffed they do not investigate lawsuits or even know about them. Unless there is a settlement or judgment for more than $29,999. (This is the magic dollar amount doctors will settle for, because the board will not investigate.) It is unfortunate, the very entity that is suppose to protect us does not have the time or the manpower to do so.

If you feel you have been injured or the doctor fell below the standard of care. Please be aware your complaint should be two fold: One is CIVIL and one is a COMPLAINT WITH THE MEDICAL BOARD OF CALIFORNIA. BOTH MUST BE DONE!!! The First is a "CIVIL LAWSUIT" this must be done by a CIVIL ATTORNEY and Secondly a "MEDICAL COMPLAINT" must be filed by YOU, THE PATIENT. Almost every attorney that turns down Medical Malpractice cases for one reason or another and hardly ever advises the patient/plaintiff that their other recourse would be to file a complaint with the Medical Board of California.

We want to educate the public. Filing a lawsuit against a doctor is not your only recourse. You must file a complaint with the California Medical Board, irregardless if you have a medical malpractice lawsuit or not. The California Medical Board needs to know about your complaint, even if your Attorney does not want too.

If you want to keep healthcare affordable, get rid of bad doctors. If you want to keep medical malpractice cases low, get rid of bad doctors. If you want to keep medical complaints at a minimum, get rid of bad doctors.

Julie D'Angelo Fellmeth's Testimony

This is Julie's testimony at the California Medical Board Meeting on June 18, 2007. She is an inspiration to all of us. She has been fighting for years for the board to make necessary changes in the Diversion Program. It's unforunate, that we meet Julie under these circumstances. We are the first patients that the board has ever heard of, that were injured by a doctor in Diversion. Honestly, this is because the public has not been informed. If more patients knew that filing a Medical Complaint with the Medical Board of California was an option, they would do so.


http://www.cpil.org/download/Testimony_BSA.pdf

Ruby's story

I had a tram flap surgery by Dr. West. He suggested that I have a tummy tuck at the same time. I had so many infections that Dr. West had me on a dozen different types of antibiotics. The sutures were coming undone, so he used his bare hands and took every stitch out one by one without any gloves on. For the next several months, I had nurses who came to assist me. I had to irrigate the infected area with saline and was put on a wound vac for several months. It was extremely, extremely, painful.

Medi-Cal Fraud

Ever since Pres. Clinton passed the bill regarding breast cancer patients being able to get reconstruction surgery through Medi-Cal, alot of these plastic surgeons have gone to town with performing multiple surgeries on these women, whether they needed it or not. West performed multiple surgeries on the same women and billed Medi-Cal for it. You would think Medi-Cal would have caught this fraud! In Becky's case the judge forced West to pay back Medi-Cal but that was only one case. How many more do you think there could have been or are still out there? He's operating again in Beverly Hills, do you think maybe he's doing the same thing down there that he did in Roseville? Since West filed bankruptcy against Medi-Cal, he wouldn't be able to file bankruptcy against them a second time if he's caught with Medi-Cal Fraud. By the way, why did West file for bankruptcy against the very entity that paid him, handsomely at that? I honestly believe West is not an isolated case, these plastic surgeons have taken advantage of these Medi-Cal recipients and used them as money making machines with all the unnecessary surgeries and Medi-Cal never questioned these doctors.

Sandi's Story

I

I was involved in a horrific bicycle accident that nearly took my life. Dr. West was supposed to help me and fix my leg but that’s not what happened. He seemed pissed out and smelled of alcohol. I asked him about the bandage on his head and he said he had a concussion from Water World. I persisted about how he smelled profusely like alcohol and then he said, “Oh, that’s not alcohol that’s my cologne.” I told him that it did not smell like cologne, it smelled like alcohol.

Dr. West put his uncleaned, ungloved hands inside my surgerical wound and opened it from top to bottom. He just ripped his finger through all the sutures really really fast without warning me. It was excruciatingly painful, I screamed to the top of my lungs. No one else was in the room, just me and Dr. West. As he ripped the sutures out down my leg, I passed out not only because of the pain but my entire leg was exposed and split open like a fish. The entire leg with blood and flesh were exposed. When I came to, I yelled at him, “What did you do to my leg, what did you do to my leg.” He said this is a common thing. He left the room upset and never came back.

Not too long afterwards, my leg became so humongous like a huge ball that I went to the hospital and they put a giant sponge in the wound. The wound measured at least 12 inches by 6 inches. It turned out they said I had a staph infection called, (MRSA) Methicillin Resistant Staphylococcus Aureus. I was treated in the hospital for 11 months.

I know that this staph infection was caused by Dr. West. The day he ripped those sutures off of me with his bare hands and with all the blood that gushed out, it’s no wonder I had a staph infection. It turns out I will live with MRSA and the affects of it for the rest of my life. I was told once you get it, you can never get rid of it and I have to wear a leg brace for the rest of my life.

Terri's Story

Dr. West on my first surgery left horrible scars, to reopen the incision and then they had to heal from inside out. This happened over and over again. Dr. West said that I was spitting sutures so he had to dig them out and I had to pack them with gauze and a special bleach solution. At this time I thought it was a normal process with this type of surgery.

The second surgery was to “clean” up the scars from the first surgery and remove excessive skin from my thighs and legs. The scars are much worse then the first surgery. I was horrified that he had done liposuction on my thighs, when I awoke after. I didn’t know why I had small dots all over my upper legs. I was in extreme pain, very swollen and very bruised. When I saw what was done to my legs, Dr. West said that the incision would heal and he was happy with how everything looked. He could not explain why I had a large gash on my right leg.

Again he had to dig out sutures on my legs and stomach and back. Several times he had to put me on antibiotics because it looked infected. He did a culture on some of the openings but never told me what the results were.

My young daughter went with me to an appointment and saw Dr. West without any numbing dug out sutures. This has left me with large scars on my legs, stomach and back. I have stayed the same weight so there is no reason my skin should be hanging to where I’m embarrassed to wear shorts because people stare. Dr. West did not take care of the hanging skin, but I have scars that are ugly and red, that don’t get any better. Dr. West said the scars would lighten but they have not. I still have numbing in all the scars. My legs swell since surgery and I am now on water pills. I have a very difficult time finding clothes that get because of loose skin and the swelling in my calves of my legs.

Dr. West told me he was trained for a new procedure regarding my thighs and legs but it looks like he did not know what he was doing. The numbing is very bothersome and very uncomfortable especially in the summertime. He also said he could save my belly button but (1) week after surgery, in his office, he said it died and dug it out.

Today, my legs are so heavy that my back is always in pain. I have to have something done to correct what Dr. West did, but I’m so scared of the pain, infection and scarring.

Janet Mitchell's Story - "Taking A Stand"

When Doctors Make MistakesHow should Christians respond to medical malpractice?
by Janet Lynn Mitchell

How should a Christian respond when her physician makes a mistake? If you're like most of us, you'd probably rather not ask the question and hope you never have to answer it. But each year medical mistakes kill between 44,000 and 98,000 hospitalized Americans—more than car accidents, breast cancer, or AIDS. Thousands more are injured, often causing permanent disabilities.
Not only does medical malpractice affect its victims and perpetrators, it creates higher insurance costs and the fear of baseless and/or excessive litigation for everyone else too. Increasingly, women in many parts of the country have a hard time finding a local OB/GYN from whom to receive pregnancy care because many obstetricians have either given up delivering babies or have moved to other locales to avoid skyrocketing malpractice insurance rates.
In this TCW Special Report, we present two perspectives on the problem of medical malpractice, including Janet Mitchell's harrowing tale of surgery gone wrong and her crusade to hold her doctors accountable. Dr. David Stevens, executive director of the Christian Medical and Dental Associations, shares biblically based suggestions for dealing with malpractice, and we provide six tips to getting the best healthcare possible.
So, how should you respond if your doctor makes a mistake? Read on. —The Editors
I never saw the melted ice cream that caused me to slip haphazardly and twist my right knee. As I sat in my orthopedic surgeon's office waiting to hear how much damage had been done, I thought back 15 years to the first surgery I had to straighten my legs, which had grown crooked from overcorrecting a congenital hip problem diagnosed when I was an infant. At the age of 17, I was an active teenager with an unusual gait, but I was told by my physicians that without surgery I faced debilitating arthritis in my knees by the age of 30. "We'll cut your tibias (one of the two bones that make up a person's shin), rotate them slightly, and let them heal," my doctors had said. They made it sound simple, but it wasn't.
I had surgery on my right leg first. Seven weeks later, I underwent the same surgery on my left. But when both casts were removed and I tried to rise from my wheelchair, my right leg buckled beneath me. I couldn't stand, much less walk. My surgeons, Dr. Ulild* and Dr. Allgood*, explained that the poor surgical results were due to "the way God made you in your mother's womb." Over the next three years, I underwent seven additional surgeries—three of them in another state, thousands of miles away from friends and family—in my bid to walk again. In one procedure, my tendons were strung to function in place of my ligaments, which had turned to mush. Although I did walk again, I was often unsteady and always feared falling.
Now what I dreaded had happened, and I was once again back in Dr. Ulild's office. He entered the room and said the words that changed my life: "It's time you know the truth." He revealed that the first surgery I underwent 15 years ago had been botched. "Dr. Allgood cut your bone at the wrong angle. I tried telling him not to cut there, but Allgood goes too fast. Your ligaments were cut. The rest of your surgeries on your right knee were to fix his mistakes."
My heart pounded. My physicians had lied to me?
I fought tears as Dr. Ulild told me the fall hadn't re-injured my knee, but the botched surgeries had resulted in degenerative arthritis that was far worse than anything I feared when I was 17. At 32-years- old, my best option was knee-replacement surgery, but it came with great risks. Due to the amount of nerve damage I'd suffered through the multiple surgeries, I could lose my leg entirely.
As I sat speechless, Dr. Ulild reached for the set of X-rays I'd brought to my appointment that were taken while I was under the care of the out-of-state surgeon. "I'll make sure you get these back. I want to evaluate and compare them with your others," he said.
Facing the TruthI drove home in a fog. I felt betrayed and scared. Months before Dr. Ulild's revelation, I'd delivered a premature baby. Weeks later my six-year-old daughter was diagnosed with juvenile diabetes. Now they were both being treated at the same local hospital where my botched surgery had taken place years ago. Were my kids safe there? Fear filled my mind.
Then I got angry. My teen years had been filled with crutches, braces, and wheelchairs—all because of my doctors' secret mistakes and lies. As I tried to process everything, God brought to mind Genesis 50:20, where Joseph confidently stated, "You meant evil against me but God meant it for good." I wanted to have a heart as gracious as Joseph's. God, please bless this mess! I prayed.
Weeks later my friend Jane went with me to Dr. Ulild's office to pick up my X-rays.
"You can't have them," the nurse insisted. "I've been told to guard them with my life!"
"But they're mine … "
"Janet, they're not here."
"They have to be," I insisted.
Confused, the nurse laid my medical file down and went to look again. I glanced at Jane—she nodded. Grabbing my medical file, we rushed to my car and began to read. Right away we realized an entire year was missing from my medical chart. Then we started to see mistakes.
"Janet, this states you had hip surgery, not surgery on your leg. Instead of being wheelchair bound, it says you were walking when you left the hospital!"
Once back at Jane's, I called my cousin, George, an attorney in Nebraska. I told him about Dr. Ulild's confession and the "hot" medical file. He instructed me to make a copy of the entire chart and return it immediately.
The next day, Jane and I anonymously returned the file. At George's suggestion, our next stop was the local courthouse. There we discovered that my doctors had been sued more than 50 times, including charges of surgery conducted on the wrong limb and wrongful death. Several court files were stamped with the word dismissed.
"Means there was a pay-off," the clerk told me. "That's what's stamped when a case settles out of court. A judge may have tossed out one or two, or the plaintiff might have dropped his case, but for the most part, I'd say the docs made a deal."
I knew that when a physician settled a lawsuit in California, a confidentiality agreement usually followed— one that precluded the State Medical Board from being informed of any possible wrongdoing. That meant Dr. Allgood and Dr. Ulild had long histories of allegations from patients but probably had never been held accountable for their actions by the agency charged with protecting the public.
To Sue, or Not to Sue?My heart was full of rage and betrayal. But as a Christian, I knew I needed to forgive my doctors. Through counseling I came to understand that forgiveness isn't saying what happened to me didn't matter—it's releasing my doctors into God's hands. Forgiveness could take place regardless of my emotions; it was my choice—an act of obedience to God.
But it's one thing to forgive my physicians for what they did to me; it's another to stand by while they hurt others. I was challenged by the idea that sometimes our faith requires action. So my husband, Marty, and I prayed and sought godly counsel from our pastor, elders, and family.
In light of the level of ongoing deception involved and its effect not just on me but on other patients as well, Marty and I knew God was directing us to take legal action. We filed a lawsuit for professional negligence, negligent misrepresentation, fraud, and concealment.
An Uphill BattleObtaining legal representation wasn't easy. One prospective attorney told us 90 percent of all medical malpractice cases settle. Ten percent actually go to trial, and physicians win 90 percent of the time. But God provided. Through my cousin, George, I met Bridgett Halvorson, a young, confident attorney from Northern California who was willing to take my case.
It wasn't long before Dr. Allgood revealed that he didn't carry malpractice insurance—a hospital requirement. Outraged, I met with the legal department of the hospital where my surgeries were performed and informed them of Dr. Allgood's lack of insurance. His staff privileges were terminated that afternoon.
It was a small victory, but my doctors were determined to win the battle. Before we could get to trial, they filed a motion for summary judgment. After reviewing the case, the judge waived a jury trial and ruled in favor of the physicians. Just like that, I lost my right to sue.
We appealed the ruling, but the judge upheld his decision. I felt confused. God, didn't you direct me to file a lawsuit? Tell me what you want me to do. Marty and I prayed and decided to continue to pursue our legal options. We filed another appeal.
A year and a half later, we sat before a panel of three judges at the Appellate Court. They were disgusted with the course the case had taken thus far; after reviewing the evidence, one judge said, "If I were these doctors, I would plead the Fifth and run out of town!" That afternoon they reversed the lower court's ruling and I was headed back to trial.
At TrialIn May of 1999, seven years after I'd learned of the malpractice and 22 years after the botched surgery, my trial finally began. Attorney Marjorie Day, a 76-year-old elder in my church, came out of retirement to try my case with Bridgett by her side. Dr. Allgood represented himself, and a pattern of deception and incompetence soon came into focus. Dr. Ulild testified that no surgical mistake occurred; he had suffered "a wrong memory synapse" when he told me otherwise. Dr. Allgood admitted my medical records had been discarded. When asked about Informed Consent prior to surgery, Dr. Allgood said, "I've never gone along with Informed Consent." And indeed, he'd radically downplayed the risks associated with my first surgery and then lied about what took place in subsequent procedures.
Within weeks, the jury concluded my surgeons had intentionally concealed vital information concerning my medical care, and this intentional concealment had caused me harm. From defeat to victory, God was faithful!
With judgments in hand, I filed a complaint with the California Medical Board. Regretfully, they informed me they were unable to investigate my doctors. The existing law stated only occurrences that had taken place within the last seven years could be investigated. The statute of limitations held no provision for cases where fraud and/or concealment were issues.
I then wrote one letter to Assemblyman Bill Campbell of California, sharing my story. He introduced legislation born out of my medical disaster and within months, Assembly Bill 2571 passed both the State Assembly and the Senate unanimously. Physicians in California can no longer change medical records or conceal medical information and rely on a statute to exonerate them from investigation. Congress is currently considering similar legislation on the federal level.
Speaking UpToday, I have a passion to educate others about how they can partner with their physicians and manage their own healthcare. I also continue to speak on behalf of legislation to help prevent medical malpractice. Recently, I made my fourth trip to my state's capital to testify, in an effort to protect the patients of tomorrow.
I don't know exactly what the future holds for my knee. For now, I can walk with occasional help from a cane or brace, and I use my wheelchair for extended trips to the mall or to Disneyland. When I think about the knee-replacement surgery ahead and the possibility of losing my leg, I take a deep breath and draw upon my faith. God has assured me that walking or not, I will be OK. While physicians can make mistakes, the Great Physician never does.
Janet Lynn Mitchell is the author of A Special Kind of Love (Broadman & Holman) and lives in California.
*Names have been changed

Judy S's story

Dr. Jay C. Owens (Dr. performing mastectomy) recommended Brian R. West another doctor with the Sutter Group. (Dr. West explained I could have either surgery, that being stomach or implant for the reconstruction of my left breast. I chose the implant.) Dr. West told me, with this choice I would have to have this implant changed in ten years time. (The end of July 2000 the mastectomy was performed and first implant was placed in my chest.) I decided to stop inflations to implant after one treatment until I had finished chemo and radiation, which I had discussed with my oncologist Dr. Bobolis. Starting back with Dr. West (West now in Roseville , approximately end of April 2001, (Dr. West said inflations weren’t going correctly, so I went into surgery to have a new implant put in my left breast area). Went back to his office, was cleared to make next appointment to start inflations. Postponed next appointment for a week due to exhaustion. (Then went in for first inflation to the second implant).

I then had a scheduled appointment with Dr. Bobolis and told her during the office visit that I had the first inflation. Dr. Bobolis began shaking her head, and I said, what do you mean? She would not say, but continued to shake her head. I said I have another inflation tomorrow, she shook her head again. I said, the inflation is too soon and she acknowledged with shaking her head. Going to my appointment with Dr. West the following day I explained what had taken place the day before. (He said (Dr. West) the inflation was not too soon, but checking my chest I had scabs along the incision and he ripped the length of the incision open.) I remained taped together from that Wednesday until Friday evening when the third implant surgically was placed in my chest). He told his assistant Karen, I would have the inflations when I wanted them. I told Karen, I’m not a doctor, but because of what has transpired I will take a slower road.

Then calling to make appointment, I was told Dr. West was sick and wouldn’t be in his office for a while. I thought this might be a good thing to give my chest time to heal, and I time to rest. He returned to his office approximately a month and a half and said a woman was trying to kill him and he couldn’t come into his office part-time and still collect his medical benefits (Karen his assistant was also in the room). (I went through all inflations necessary and the end of 2002. Approximately November 2005 the permanent implant was inserted in my chest being the fourth surgery.) On seeing Dr. West for a follow up, (I talked to him about my permanent implant, as it was much higher than my right breast.) (He said, it had slipped and he gave me a white elastic strap to use. The strap never helped the location of the permanent implant; it remained up near my left collar bone looking more like a tumor than a breast). Then he was gone, had blown the coop!

I was sent to Gary Smith’s office for my next implant check and on entering the room he (Gary Smith) had a smile, until his assistant told him I was a patient of Brian West. Dr. Gary Smith’s demeanor took an immediate turn and I have never been treated so rudely. He sat in a chair, never leaving that chair to check my permanent implant. He had no advice, nor direction in regards to the high placement of the implant. I asked him about the last step the making of the nipple. I brought up the choice of using the skin from the leg or a tattoo. Dr. Smith said no one does the tattooed anymore. I said, Dr. West does, as we had discussed the same topic on the last office visit. Dr. Smith said nothing. When I was leaving Dr. Smith’s office his assistant said, he doesn’t get paid for this. On my next visit with my Oncologist Dr. Bobolis and I talked about the negative appointment with Dr. Smith and I decided not to finish the breast (the nipple procedure).

(Then October 8, 2003 approx.) I became very ill with flu like symptoms. The evening of the seventh day, I was finally able to get in the shower, when I saw my chest area very red. I called Dr. Bobolis and saw her the following day. She put me on an antibiotic. I wasn’t improving, she sent me for an echogram. This person was upset when he saw me and called Dr. Bobolis. He tried to get me right into see a plastic surgeon but she could not take me until the next morning. I was put in the hospital that same day. I was put on antibiotics through IV (pic-line) trying to keep the infection from spreading through out my body. Many pictures of my chest were taken showing gross infection. Implant was removed and the plastic surgeon said that only one doctor at her practice would use this implant due to the amount of radiation treatment undergone, and only if the patient insisted, and that it would come with a strict warning of the likelihood of ever keeping the implant. If you remember I was told I had to change the implant after 10 years. After 5 surgeries, I wore the permanent implant less than 1 year. The plastic surgeon asked if Dr. West knew of my radiation treatment. I responded, he certainly did! Today I live with a scar from the infection, and the skin I grew to make the breast could not be cut off due to further infection (the skin was rolled over). I have gone to Dr. Smith’s office requesting my records, I was told to call Channel 13. I called Channel 13 and was told to contact the Medical Board.

Linda's story

Procedure for tram flap was performed following mastectomy.

Cancer came as a surprise to me. The same day my right breast was remove, Plastic Surgeon Dr. Brian West performed the reconstruction. It was an operation, I was told, had a low risk for infection--less than a one percent chance. The recovery time was expected to be three weeks then I'd go in for cancer treatment. I was told it was very important I had chemo and radiation.Weeks after my operation, instead of a healed wound, I was infected. My incision turned green, purple and black. Treatments continued; however, despite concerns by visiting nurses, nothing was done to determine the nature of my infections.Without anesthesia and without warning Dr. West took a scalpel to my sewed up incision and cut me open. You're coming apart. You're seeing parts of your body, you're not meant to see.I was left to heal but the infection kept growing, tunneling through my body into my new breast, and deep across my stomach. Then, instead of diagnosing the type of infection Dr. West turned hostile. He didn't want to deal with it; he would be very harsh when he would pull the sutures out. This went on for 5-months. My gaping wounds expanded to leave this massive hole in my stomach and breast. My decaying flesh and tissue made my house smell like death. I could smell it on the bandages. It smelt awful.

Depressed, feeling ignored, seeing my body waste away, I carried out a plan at my next doctor's appointment so Dr. West would listen. I grabbed his tie and he said, “What's the matter?” I said ‘I'm dying.’ And he said, “What do you want me to do?” And I said, “Put me in the hospital. I need to go in the hospital.” I was near death.

I was admitted, and that's when I found out the scope of the infection. It was so bad that I had to be given a blood transfusion. A test showed “hospital staph,” only (1) antibiotic registered effective for my infection. It took over 3 weeks in hospital and 6-8 weeks of a pump to cure the infections. While I was in the hospital Dr. West was shaky. One morning he seemed very hung-over and he smelled like he had a big night. I never questioned him.I eventually recovered. But remember that cancer treatment I desperately needed? When I had the infection, they couldn't do it. I needed to be healed so I could have the chemo or radiation. I would learn the cancer did spread. I was given two years to live. So far, I’ve beat the odds but I know it's just a matter of time. I was so angry to learn it had spread.I begged Dr. West to never allow anyone to suffer the same infection. I asked Dr. West to never let this happen again and to be more vigilant with infections. He said I was the only patient who had this problem. He promised me that he would never let that happen again. That was a promise Dr. West didn't keep.

I was Dr. West’s Humpty Dumpty.

When I take a shower I still fear my stomach is going to drop open.

Darlene DS's Story

­Good Afternoon,

I was a patient of Dr. West in early 2001. I was referred to him by our then primary care physician for a leg ulcer repair.

I had a muscle flap surgery done by him in early 2001. The ordeal with my then primary care physician is another story. The doctor I reported to our health provider, Healthnet, who took action against the man. My primary care was located on Scripps Drive and so was Dr. West before he was fired. I really did not understand why a plastic surgeon but at this time my leg was grossly infected and I had large red bands around the area and a line going up my leg. Two days after I had the muscle flap surgery by West, the stitches snapped inside and I was back to where I began. I went back to West and he told me that he had already discounted his fee to do the surgery and he could no longer assist me. Bottom line, I ended up having to go through 36 treatments at Mercy San Juan Hospital in the oxygen chamber unit. 5 days a week and 3 hours each time. To this day my leg has never been the same. I have to wear protective covering around the wound when I do outside activities etc. Just one of the daily facts of my life... My health has never been the same since then and I continue to have health issues. Needless to say, my scarring and pain is nothing compared to the other people.

It is my desire to help in anyway to this man never hurts another person. He is a criminal and should be held accountable for his actions. I wonder how many people he ruined were HMO patients or PPO patients. I was an HMO person and perhaps he knew that he should just leave me alone and wait for the next victim who would be easier prey.

Thank you for your time and all the work you have done. I am certain there will be many people who will be saved from the doctor because of you.

Injured Patient

Having received the notice about Dr. West's practice, let me add my case. After mastectomy in March of 2000, and owing to his repeatedly botching the job, I was required to have four surgeries over a period of more than a year, and a final tattoing . My first reconstruction resulted in a big size difference and a terrible tightness, My last reconstruction involved yet another lift to try to make the breasts match. They never did and still don't.Dr. West left the tattooed nipple with a polka-dotted border. The scars around my other breast have an awful, sunburst look. Up until 3 years after the surgery, I would get small infections around it and the stitches would eventually pop out. The scar under my breast was, and still is, painful. Further, he destroyed any feeling in my natural breast without ever warning me that that would be the result. My heart goes out to all the women he treated. He took them during very vulerable times in their lives and made the nightmare all the worse. When I asked my other doctors if all of this was normal, they all hemmed and hawed, seemed to suggest that what I got was as good as could be expected and that it would not be worth the effort to seek out improvement. Frankly, after what I had been through, I was fearful and reluctant anyway. But, now that your notice has made me aware of Dr. West's track record and reputation, I cannot help but ask over and over again, where was, and is, the medical profession on this. Although I have received notices of Dr. West's bankruptcy, none of the doctors who have treated me have ever suggested that his work was below the standard that I would have a right to expect. They instead advised me to the opposite effect. So, while my case is nothing like as bad as others that have been posted, I am nevertheless relegated to unbalanced breasts, devoid of feeling and with no support from supposedly honest and forthright professionals.

Judy M's Story

I first met Becky when we were in Dr West’s' office. I had already had 3 surgeries from him, was FINALLY over infections, and she looked sooo ill, I started talking to her. Told her I had the same surgery, tram flap, as she, but I got infection. Her sister who had brought her, nearly jumped in my lap. She said "Becky has infection and I'm afraid this doctor is going to kill her! Can we talk?" We exchanged names and numbers then & there. Another in the waiting room said she had infection, then another--and another said she had had one--like me. I was furious by the time I was seen. I immediately asked him if he had a high infection rate. He said "no, it's really low--you can check on me at the hospital". He instantly said maybe I should see someone else for a second opinion for the current problem.

** Here's another twist: I had a mastectomy, cancer stage 0, but my third bout with it. The surgeon who removed my breast was Dr Marci Dalton. She is the one who recommended Dr West, saying he was "ONE OF THE BEST" ! Can you believe that?! I found out she and her husband, and West were buddies, often doing surgery all hours of the night and were referred to as the midnight doctors. Guess who he wanted to send me to for a second opinion? Marci Dalton's husband!! I also wrote her a scathing letter, asking why she would refer me to a man that she had to know had a drinking problem. She denied the whole thing, saying his name was just on the list. Is that how you refer to just a name---ONE OF THE BEST?!

The next week I went to Becky's home --when she lifted her gown, I started crying! I felt so bad--I apologized and said I was not crying because she looked so bad---it was because of what he had done to her. Her leg had just been "filleted" and it was absolutely scarlet in color. I went to an attorney with her to see what we could do. After reviewing my case and medical photos, I was told I would not win--I just wasn't bad enough! He said it didn't matter what I went through, I ended up okay! Something wrong there, anyway, he returned my retainer. I said I would be more than happy to be a witness for Becky if it was ever needed, but never heard from him. After that, we only spoke on the phone a few times. I even tried to locate her, but lost her. Would love to chat with her---and she should have gotten millions, not the measly bit she did get from West!

About me: Dr West did a tram flap on me the same night--yes about 10pm-- as my breast was removed by Marci Dalton. I went home on about day 5 with 3 drains. About 2 or 3 days later, one drain started to fail. I had infection---and I also was sooo tight, could hardly stand up. Anyway, that was the beginning. About 3+ months of infection---and NEVER was I referred to an infectious disease doctor--he tried to treat me himself. I started to come unsewed, gut and breast--thought my guts were going to fall out. I had never been sick like that before and was terrified and stunk. Some stitches just tore, some he just cut away, pretty scary stuff! My abdomen finally stopped at about 12 to 14" wide, about 3" high and a couple inches deep. My breast also came unsewed here and there. I had visiting nurses 2 times daily, wet to dry packs that I also had to remove myself and he told me to get in the shower saying "water is sterile". I remember the first time I did that, looking into my gut with a mirror --I was shaking so hard that I could hardly see, thought everything was going to fall out. Finally they tried a wound vac on me,--got sooo blistered from the thing, my body would NOT release that tape, and I became anemic.

Then, after about the 3 months, my blood work said normal. I knew I still the infection because I smelled horrible. He said "bodies just smell bad". I also had a fever on occasion. But the blood work passed, so he scheduled a 2nd surgery to sew me back together. In surgery, he was feeling around to see where the mesh ended and a ball of infection about the size of a grapefruit burst in my gut! He worked on my about 5 hours to clean up the mess and sew me back together. I had 7 kinds of bacteria growing in me--West said basically I was growing a sewer. Because it happened in the hospital (Sutter Roseville) he HAD to call in a specialist. I got Dr Randy Martin. They put a pic line in me and I was on Vancomycin for a month. Had to learn how to administer that to myself which was also terrifying! That drug is so strong, for the first few days I sat in bed with a glass of water and a straw in my mouth constantly. The whole inside of my mouth and the outside too, was sores and scabs. Ouch. But---it got the job done. The first thing West said to me after that surgery was "someone up there must love you. If that had burst anywhere else, you probably would have died. Guess I should have listened to you when you said you still had infection." YEP --more visiting nurses, thank goodness for insurance.

On a third surgery, he also completely changed my areola, made it way smaller completely different without my permission! I had no idea he was going to touch that. He said he could make me match better by giving my other breast a "lift", it would be the same size only perky. He reduced it from a D to a B, and made that change, and my reconstructed breast into a C. I was a slow learner---can't believe I let him touch me that third time. I also thought I was the only one going through this. It was after all this that I met Becky, and it was the last straw.

I also went to Brian Klink after all that and had a fourth surgery. He tried to repair as best he could, but I am left with: 2 different sized, way too small for my body--breasts-------my abdomen is completely numb---my belly button is numb and on my pubic hair line------and I have a lump/bulge on either side of my abdomen. Nothing compared to Becky, but none of us should have any of these things!

Judy

Darlene D's Story

I went to see Dr. Brian R. West for a breast reduction. He seemed so charming and knowledgable, but I now know that was all a front.

He tore up my breast and ruined me. After the surgery, I was infected and my breast wrapped around my entire upper body like a tire or donut. One big giant breast. I had holes everywhere. A month afterward, I almost died and was rushed to the hospital due to the infections.

For over a year and a half, I had a hole 1 1/2 inches deep and over 12 inches wide that I to pack with gauze because of the infection. Also, I spent over 2 months in the hyper oxygen chamber 2 hours per day due to the infections. This was a "Nightmare." The suffering, the pain was more than I could bare. I wish this on no one.

What makes me even more angry is that Dr. West sent me a letter dated April 14, 2003 that he was closing his practice and the envelope was stamped April 26, 2003; however, my surgery was on April 18, 2003. (see above) He was in such a rush to do my surgery, to make his money quickly, close his practice in a hurry, file for bankruptcy and had the nerve to list all his patients in it (including Medi_Cal, who was my insurance for this surgery). He knew he would be sued from many patients, so he filed for bankruptcy before any of us had a chance to sue for medical malpractice. He had planned his getaway very cleverly. But unfortunately, he injured so many before the closure of his office.

How could he have done this to me, knowing he was closing his practice. The suffering and pain I have gone through and continue to go through, not to mention the so-called breasts I'm left with. It looks like I have 4 breasts. I hope and pray the Medical Board revokes his license.

Becky Anderson's Story

Dr. West performed a tram flap surgery on me, when I was not a candidate. I’m a smoker and I have hepatitis C. I found out later. I consented to the tram flap not knowing that I wasn’t a candidate. I was totally unaware of the risk.

The first surgery Dr. West did was to cut my abdomen open to help the blood flow. Then Dr. Morse went in and did the bilateral. Then Dr. West went in and did the tram flap.

Dr. West constantly performed over a dozen surgeries on me after the tram flap. There are too many surgeries to remember but the majority of them were done at Mercy San Juan in Carmichael, CA. He kept debreeding and doing more surgeries. There were times where he cut dead tissue and placed it on my chest. He didn’t even bother to put it somewhere else where I didn’t have to see it. He would cut in different parts of my abdomen. I had tons of tunnels. I had to constantly do dressings for 2 years, wound care and had repeated repeated infections.

I was suppose to have chemo but could not because I was infected and had a massive open wound. My chemo was delayed by 2 months and I could only have 4 months instead of 6 months.

The very last surgery Dr. West performed was NOT CONSENTED.

He was suppose to remove the mesh and replace it; use the oblique muscles to cover a dime size hole, but instead he cut the muscle from my right leg and filleted me open. He did not have my consent to use my leg. He asked me and I said NO. He even measured my leg and said it wouldn’t work. He said the muscle was too short. This surgery was done at Sutter Roseville.

After this surgery, I was in and out of hospitals. There are just too many to mention in this complaint. Then I saw Dr. Klink after what Dr. West did to me. He worked at the Plastic Surgery Center in Sacramento. He did what he could to help me and removed mesh. It had stuck to the bowels and was colonized with MRSA. I was on a wound vac for one month at downtown Mercy General Hospital. After a month, Dr. Klink removed skin from my left leg to cover the omentum.

I don’t even know how I survived all of this but I am here to tell my story. And it needs to be told. During all this time that Dr. West treated me, he never treated me for infections. As a matter fact he never knew I lost so much blood and needed a transfusion. A doctor in the hospital ordered the transfusion and Dr. West walked in and said, “Oh, I didn’t know you lost so much blood.”

At one point while I was in the hospital, I went to the emergency room and they admitted me at Mercy San Juan in Carmichael. I called over and over to Dr. West’s office to tell them I was in the hospital. In the meantime, Dr. Kailath came to me and finally got a hold of Dr. West three days later. And Dr. West told Dr. Kailath he was on his way to see me. He never showed up because he got thrown in jail for a DUI. So he was on his way to see me and possibly treat me but he was under the influence of alcohol.









Dr. Kailath constantly told me to find another doctor and he even tried to find one for me, but no one would take me.

I will never ever be the same. I have lived like this since 1999. I don’t feel like a woman. I don’t look like woman. My intestines are on the outside of my body; it’s like an alien with brains. I can literally lie down and watch my intestines move. I have massive, massive scaring from my neck down to my knees. My pursuit for happiness, health and life will be forever altered because of Brian R. West. His license needs to be revoked or there will be more people like me or worse.

I eventually sued Dr. West for Medical Malpractice and he settled out of court with me for $250,000. However, the money will never bring my health and body back to normal.

Tina Minasian's Story

I went in for a tummy tuck consultation in 2001 and later in 2002 for further consultation. During this time, I consulted with Dr. West again about the tummy tuck and he decided that a total body lift, a more complex procedure was best for me. He stated a tummy tuck will not leave me with an hour glass figure. He said the tummy tuck will leave me with a box like figure. To make a long story short, I went ahead with the surgery because I believed and trusted Dr. West’s opinion; especially, because he was a doctor, the expert. The body lift operation was a total abomination and mutilation of my body. He cut me around my entire waist line, like a tree trunk. The stitches were extremely, extremely tight, I could barely move. Experts have said that I was never a candidate for the surgery to begin with. This surgery is for people that have had gastric bypass surgery or weight loss of over 100 lbs. or more.

After learning West closed his practice literally within 4 months after my surgery, I panicked and called every attorney in the Sacramento yellow pages until someone would listen to my story. Finally after a year, an attorney took my case. I learned that Dr. West was abusing alcohol, had financial problems, filed for bankruptcy, had several medical malpractice lawsuits filed against him, and he was dealing with a former fiancé who had hired a hit man to kill him.

I had thought that by filing a lawsuit with the expectation that the Medical Board would be notified but I was wrong. The board is supposedly only notified if a plaintiff settles or gets a judgment for more than $29,999. This is the magical number. If you settle for more than this amount the superior court clerk is suppose to notify the Medical Board but like I found out, many clerks failed to do this and so the board would not know. Knowing this, I filed a medical complaint with the Medical Board of California and their expert found that Dr. West was grossly negligent with the surgery he performed on me. They also said as of September 2006 Dr. West had 5 cases of extreme departure (gross negligence) and is currently under investigation again. I am appalled that he has the gall to continue to operate given all of us who have been infected and disfigured.

I hope and pray that the Medical Board of California finally revokes Dr. Brian R. West’s license (like they should have) and never ever let him hurt another person again. Like Becky Anderson said "He should never be able to practice medicine again, let alone diagnose a sore throat. He shouldn’t be able to practice on us like ginnie pigs. He shouldn’t be able to practice any type of medicine.” And like the Medical expert said, “He just doesn’t have the technical skills that a surgeon should have in his field. You just cannot go and take a weekend seminar or class and come back an expert in that field. It takes years of practice and education."

File a Complaint Against a Doctor

Here’s a list of things to do if you have a medical complaint against Dr. West or any doctor:

1. File a complaint with the California Medical Board, go to the California Medical Board’s website and print out the Medical Complaint form, read the instructions and complete it.
   
2. Make copies of your complaint along with your photos, before and after surgery and any other documentation you feel is necessary to make your case.
   
3. Hand deliver or send a return receipt to the California Medical Board located at 1426 Howe Ave. Suite 54 Sacramento, CA 95825-3236. If you hand deliver your complaint form, make sure you have two copies, one for them to keep date stamped and one for your records date stamped as your proof of delivery.
   
4. Consult with a Medical Malpractice Attorney to see if you have a case and bring your records, documentation and photos.
   
5. Call the California Medical Board within 30 days to see if your case has been assigned to an Investigator 916-263-2382. Follow up periodically with the Investigator to see if they need anything further from you and what the status of your case is.
   
6. Be patient. It took 11 months for me to hear back from the Medical Board. I was told they are short staffed and they receive hundreds of complaints.
   

Questions to Ask Before You Have Plastic Surgery

Here’s a list of questions to ask your doctor before you have plastic surgery:

• Gather names of plastic surgeons from friends or your local medical society
  
• Go to your county court house or website and check Civil and Criminal Records to see how many times he or she has been sued, or arrested.
  
• Check with the state medical board website to make sure the doctors are in good standing. Log on to the state medical board's public document search to find out.
  
• Meet with the doctors and ask questions
  
• Is he or she "Board Certified", which means they have received specific training in the field in which they work? Confirm the information with the society, and ask how one becomes certified.
  
• How many times has the doctor performed the particular procedure?
  
• When was the last time the doctor performed that operation?
  
• See pictures of other patients who went through similar procedures.
  
• Research the procedure yourself
  
• Weigh the risk vs. the benefits