Featured News 2013 Former Orthopedic Surgeon Sued and Charged for Health Care Fraud

Former Orthopedic Surgeon Sued and Charged for Health Care Fraud

A former orthopedist was indicted on Wednesday, the 16th. He was charged with a federal felony, accused of collecting millions of dollars in payment for operations he never actually performed. Meanwhile, more than 200 medical malpractice lawsuits against this surgeon are pending over the same issue, but they have been stalled due to the criminal court procedures.

The former surgeon is accused of committing this fraud against Medicare, the New York State Insurance Fund, and private insurance companies, say court documents. In the span of 2007 to 2011, the surgeon and his employer filed for more than $35 million, receiving $13 million in payment. The federal prosecutors want the surgeon to cough up a minimum of $5 million.

He has pleaded not guilty to the count of health care fraud, and he was released from custody. He is under supervision, part of which entails his going through mental health counseling. In answering the judge's questions, the surgeon had said that he was taking medication, as he was dealing with depression. There will be another hearing in this case on November 15, the Poughkeepsie Journal reports.

That is one count of fraud. He faces 21 other charges from the New York Office of Professional Medical Conduct. This entity has leveled charges that include counts of negligent care and improper billing and record keeping. This August, the former surgeon gave up his New York state medical license, and he has also relinquished surgical privileges at various medical centers.

In the meantime, he could soon face as many as 261 lawsuits which are in the state Supreme Court of Dutchess County. These have been filed by former patients between now and 2009. They all claim that the former surgeon committed medical malpractice, often through sending them a bill for operations he actually did not do. They claim that they were put under anesthesia, and then he never actually operated. And he still collected payment. Some hospitals and a physician assistant have been included in several of these lawsuits. A State Supreme Court judge has put claims on hold, saying that the lawyers for these plaintiffs cannot ask for testimony from those involved with the criminal proceedings.

This one-time surgeon had worked for New York hospitals since 1999. He was fired from one medical group back in July of 2011, says the group's president. At one point, the former surgeon was said to have performed an average of 17 operations on a daily basis; at least, that is what his surgical logs claim. That is really quite astonishing, since the American Academy of Orthopaedic Surgeons determined that the typical orthopedic surgeon performs 32 operations a month. This was based on a 2012 survey.

This high profile case has also been brought up with more than financial medical malpractice. It has also served as an illustration for the perils of the fatigued surgeon. That is, this alleged abuse showcases the fact that there is no limit placed on how many operations an orthopedist can perform a day. This is despite the fact that numerous studies have pointed to the dangers of a surgeon operating while they are tired. Georgia Regents University researchers discovered that surgeons claimed that "emotions, cognitive capability, and fine-motor skills" were affected by being tired, but almost no mention was made by surgeons on how this could adversely affect patients. According to the New England Journal of Medicine's article on the matter, tired surgeons can make for an 83 percent increased risk of complications in an operation.

The grounds for medical malpractice claims are manifold. If you believe you have been the victim of medical malpractice that resulted in financial and/or physical harm, then do not wait to get a successful medical malpractice attorney on your side today!

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