| Complaint: | Complaint 22-56 |
|---|---|
| Respondent: | Timothy Menghini |
| Premises: | VetMed |
| Related: | 22-81, 22-82 |
The complainant (an emergency room doctor with board certification) states his belief that Menghini demonstrated unethical and possibly illegal behavior while providing substandard care to his dog. His dog suffered paralysis of her hind legs due to degenerative myelopathy but was able to move using her front legs; in doing so, she broke one of her front legs. A family veterinarian diagnosed the break and the dog went to VetMED which initially confirmed the diagnosis; there was also no evidence of metastatic disease.
The dog went back to VetMed to see Menghini for a surgical consult. He received a call stating that Menghini felt the fracture was pathologic and was ordering a CT scan, biopsy, and more. Some radiology results came back indicating a lesion in the dog's spine and some abnormal soft tissue, stating that it was likely cancer without any biopsy or other workup; Menghini refused to perform the surgery on ethical grounds and began pressuring the complainant to euthanize the dog. He told Menghini that he was a medical doctor, that he had long experience in taking care of dogs with severe medical problems, and that he would schedule euthanasia when it was time.
Menghini refused to release the dog without proof that euthanasia was scheduled. At the time the complainant didn't know his dog couldn't be held against his will (note that in other similar cases calls to animal control or cops might be in the mix), and he also wasn't sure that Menghini or someone else at VetMed wouldn't just bump off the dog. He felt that he had to play along and went the next day to see the dog and review the x-rays, providing an email confirmation of in-home euthanasia. He also claims Menghini told him that he should get a puppy next time.
When the dog was discharged he was shocked to see the dog's condition; he states the dog was severely dehydrated and weak. He also has serious concerns about Menghini's conduct in bullying him into the euthanasia; while he notes Menghini probably has an excellent surgical record, he notes that's easy to maintain if you can also euthanize difficult patients. He also wonders about VetMed as a facility; given the number of people showing up to pick up cremains, he wonders if the clinic as a whole relies too much on euthanizing sick patients.
Menghini's response stats that he's sorry to hear the complainant is still grieving for his dog and understand the emotion; however, he's committed to his veterinary oath and believes he did the right thing. He challenges the diagnosis of degenerative myelopathy and states that since it was presumptive, there's really no proof of it; he believes it was actually the result of the spinal lesion. He also states that the leg fracture may have been pathologic in nature. Regarding the lack of metastasis, he notes that it was only the case that no nodules were found in the lungs; further investigation revealed likely neoplasia in the spine and limb. (He does concede that proof would require a biopsy.)
He also states that there was a communication error with VetMed leading the complainant to expect surgery in the first place. Rather, more workup would need to be done based on the collective wisdom of the VetMed specialists, and much of the workup could be invasive or contraindicated in a sick dog. He also stated that biopsy results could take weeks to come back, so "it was difficult to know how to proceed." He believes that he has a duty to stand up for the pets who don't have a voice, and in this case, operating was the wrong thing to do morally. He tried to empathize by noting that he performed euthanasia on his own pets and would be willing to do so for the complainant's pet as well; indeed, Menghini states that one of the reasons he chose veterinary medicine over human medicine is the ability to relieve suffering via euthanasia.
He states that he was unhappy with releasing the dog without a euthanasia plan in place because people may not recognize pain in pets, but did not attempt to coerce the complainant. We're also told that he only suggested getting a puppy because the complainant had spent so much time taking care of sick dogs and a healthy young dog could bring new joy. He also states the dog was correctly provided with fluids and was only weak from being sedated; the dog was being fasted in preparation for possible surgery. He actually believes he helped the complainant as the dog may have lived for several more months without knowing the dog had cancer, and he believes the complaint is largely emotional in nature; he notes that perhaps he could have more strenuously argued for a second opinion. He concludes by stating VetMed has a fantastic team and quality care.
The Investigative Committee backed up Menghini, stating that the care he provided was correct and that he didn't believe surgery was in the dog's best interests. They did commend the complainant for "going above and beyond" for the dog. (Again, if anything, this shows the ethical difference between veterinary and human medicine, as well as between veterinary ethics and much of the rest of society; the medical implications in this case pale compared to the moral ones, and you're probably going to see a lot more of this in the years ahead. There was at least one more this same fiscal year in 22-129 at a different top-shelf specialty center.)
Menghini appeared via Google Meets for the Investigative Committee discussion; that may be because after "a year as a referral surgeon in a busy private practice in Arizona" he returned to the UK as a soft tissue surgery lecturer at what may well be the best veterinary school in the world (link).
VetMed's starting to build up a bit of a rap sheet on the site; many of the complaints have the subtext of the facility just doing whatever they want to pets.
| Source: | April 4, 2022 PM Investigative Committee Meeting |
|---|---|
| People: | |
| Timothy Menghini | Respondent |
| David Stoll | Respondent Attorney |
| Roll Call: | |
| Adam Almaraz | Aye |
| Amrit Rai | Aye |
| Gregg Maura | Aye |
| Justin McCormick | Aye |
| Steven Dow | Aye |
| Result: | Passed |
| Source: | May 5, 2022 Board Meeting |
|---|---|
| People: | |
| David Stoll | Respondent Attorney |
| Proposed By: | Robyn Jaynes |
| Seconded By: | Melissa Thompson |
| Roll Call: | |
| Craig Nausley | Aye |
| Darren Wright | Absent |
| J Greg Byrne | Aye |
| Jane Soloman | Aye |
| Jessica Creager | Aye |
| Jim Loughead | Aye |
| Melissa Thompson | Aye |
| Nikki Frost | Aye |
| Robyn Jaynes | Aye |
| Result: | Passed |
The primary source for the above summary was obtained as a public record from the Arizona State Veterinary Medical Examining Board. You are welcome to review the original records and board meeting minutes by clicking the relevant links. While we endeavor to provide an accurate summary of the complaint, response, investigative reports and board actions, we encourage you to review the primary sources and come to your own conclusions. In some cases we have also been able to reach out to individuals with knowledge of specific complaints, and where possible that information will be included here.