SPARTANBURG, S.C. (WSPA) – An Upstate doctor’s office shut down leaving some patients concerned. Dr. Gordon Early’s office in Spartanburg has been closed.
7 News has learned his license to practice has been temporarily suspended by the state medical board.
Wanda Eller was one of the several patients who arrived at wellness family medicine in Spartanburg wondering what happened to their doctor.
“I’ve been coming here.. this is my 10th year,” said Eller. “He’s always helped me out, he’s a good talker.”
The sign out front read walk-ins are being accepted, but a letter on the door read otherwise.
The letter is from Dr. Early telling patients “the practice has been closed until further notice.”
A letter from the South Carolina Department of Labor, Licensing, and Regulation, dated Feburary 6th [sic}, explains what happened.
It said Dr. Early’s “license to practice in this State is hereby temporarily suspended.”
“Although this process is intended to be confidential, I can say that I’m vigorously contesting the allegations made against me,” said Dr. Early to 7 News Reporter Nickelle Smith. “I strongly disagree with the board’s actions in suspending my license.”
Kim High said she’s been a patient for more than a decade. “I couldn’t believe it,” she said. “He’s a phenomenal physician.” She said she was surprised at how she learned of the closure. “The doors were locked. The blinds were closed. There were two signs on the door,” she said.
Dr. Early said he’d seen over 800 patients in the past three months.
“I’m saddened by the impact this has had on my patients,” he said.
He said was not able to give advanced notice because the suspension was effective immediately, and he was awaiting the results of an emergency appeal. He says some patients received an email, and others will get a letter with information on how to get their medical records and find another doctor.
“It’s a headache. It’s a headache right now,” said High.
Dr. Early said he’s now working to get the temporary suspension lifted. There’s no word on how long that will take, but Dr. Early said he anticipates the closure will last at least three months. (LINK)—2/21/2017
Upstate doctor’s license reinstated after temporary suspension
SPARTANBURG, S.C. (WSPA-TV) – An Upstate doctor looks to be back in business after his license was reinstated.
Dr. Gordon Early closed Wellness Family Medicine in Spartanburg after his license was temporarily suspended. A letter from the State Board of Medical Examiners dated March 14, 2017, stated the doctor’s license has been reinstated.
Dr. Early’s office is expected to reopen Tuesday.
There’s no word on what caused that temporary suspension. (LINK)—3/21/2017
WHEREAS, the threat identified in the TSO has now been eliminated and the Board
believes that it is in the public interest to reinstate Respondent to the practice of medicine in the
interim upon the limited and certain conditions, as specified below.
THEREFORE, IT IS ORDERED THAT:
Respondent shall be reinstated to the practice of medicine pending a Final Order or
further Order of the Board concerning the aforementioned allegations of professional misconduct,
provided Respondent faithfully complies with the following terms and conditions, which shall
continue in effect until further Order of the Board:
a. Respondent shall be prohibited from administering or dispensing any medications,
vaccinations or other medical products, and shall not keep the same in his practice
site. Use of alcohol and/or drug testing methods will be allowed, only.
b. Respondent shall permit access to the entirety of his medical practice for the
purpose of inspection at the request of the Board or its designees.
c. Respondent shall appear and report to the Board as requested by the Board.
d. Respondent shall promptly advise this Board in writing of any changes in
employment, address, activities, hospital privileges, professional status, or
compliance with this Interim Order.
MEDICAL BOARD RECORD— MD5232 DISCIPLINARY ACTIONS—License active; no actions listed as of 2/23/2017
Board bars Orono doctor’s ability to prescribe controlled drugs
AUGUSTA, Maine — The Maine Board of Licensure in Medicine on Tuesday ordered an immediate partial suspension of Dr. Harry Peddie’s medical license, effective immediately, pending an adjudicatory hearing on March 14, the board said Friday in a news release.
The suspension prohibits Peddie from prescribing controlled substances for 30 days. Peddie’s most recent work was for a Bangor methadone clinic, according to the order outlining the board’s preliminary findings.
According to the initial findings, the board received reports in September 2016 that Peddie had been been prescribing an anti-anxiety drug for his wife for many years and that he had been self-prescribing two drugs, one for anxiety and the other for anxiety and sleeping problems, for more than 30 years.
The board also received records from a pharmaceutical distributor indicating that Peddie ordered and received controlled substances and other drugs regularly after his clinic closed through at least May 2016.
The board alleged that Peddie falsely stated that none of the controlled substances were for his use or for his family’s use.
The board also alleged that Peddie said that his work for the methadone clinic, which was not identified in the board order, involved performing medical histories and physical exams but that the methadone clinic’s medical director told the board that Peddie prescribed methadone as part of his duties.
After the review, the board concluded that Peddie’s continued ability to prescribe controlled substances represented an immediate risk to the public, the board said in its news release.
According to published reports, Peddie took over the Orono Medical Center, formerly known as MedNow, in 1989 but closed it in July 2012 because the walk-in and primary care facility was losing money.
Also that year, the Maine Human Rights Commission ruled 2-1 that Peddie had wrongly fired a radiographer who had alleged that the Orono facility ran unnecessary tests and billed maximum charges to make extra profit.
In 2011, Peddie opened a walk-in clinic at Orono Pharmacy. It was not immediately clear early Friday evening if a relationship between Peddie and the pharmacy still existed. Walk-in care was not among the services listed on the pharmacy’s website.
All board disciplinary actions are reported to the National Practitioner Data Bank and the Federation of State Medical Boards Action Data Bank. These reports are regularly reviewed by every state licensing board in the country.
The state board consists of six physicians, three public members and a physician assistant appointed by the governor.
Information about disciplinary actions taken by the board are available by calling 287-3601 or visiting its website. (LINK)—2/17/2017
MEDICAL BOARD RECORD— ME108410 DISCIPLINARY ACTIONS—License clear; no actions listed as of 2/23/2017
FBI raids office of Jacksonville doctor
The Federal Bureau of Investigation has raided the Southside office of Nikhil Nihalani, a Jacksonville psychiatrist.
It’s unknown why the FBI conducted the raid because Action News Jax learned the search warrant is sealed.
Nihalani had been arrested in 2016 for violating a domestic violence injunction. He had also been arrested in November 2015 on an out of state warrant.
According to Department of Health records, Nihalani has no active complaints or discipline on file.
Sunitha Menon, the nurse practitioner at Nihalani’s office, said she never heard of anything illegal happening in the office. Menon said she had been working at the office for about a year.
Action News Jax spoke with a patient who wasn’t able to get her medications because Nihalani’s office was closed.
She said she didn’t think the doctor was doing anything wrong.
“He’s trying to help people but he has other people underneath him that aren’t doing what they are supposed to,” she said.
She said the office needs to reopen.
“There’s people here they need to get their prescriptions and stuff like that. Because if you are on a drug, you can’t stop taking it or you’re going to get sick,” she said. (LINK)—2/22/2017
Jacksonville doctor raided by FBI was involved in fatal love triangle
A day after the FBI raided a Jacksonville psychiatrist’s office, an Action News Jax investigation uncovered a love triangle that ended in suicide, reportedly using the doctor’s gun.
This extensive St. Johns County Sheriff’s Office report on the suicide showed Dr. Nikhil Nihalani was having an affair with one of his employees.
Her husband shot himself with a gun she said belonged to the doctor.
Since the FBI search warrant is sealed, we don’t know what agents were looking for on Wednesday.
“Something’s definitely wrong with that picture,” said Tomas Cruz, who is a patient of Nihalani’s.
Action News Jax did some digging into past investigations involving Nihalani and found the St. Johns County Sheriff’s Office report on Jacob Carlson’s suicide.
The report said, in 2015, Nihalani had an affair with his married employee Amanda Carlson.
She told deputies she took a gun from Nihalani’s home because he’d been making suicidal threats.
She said she hid the gun in her home in pieces because her husband Jacob Carlson, who knew about the affair, was also making suicidal threats.
On Oct. 13, 2015, her husband shot and killed himself with that gun.
Amanda Carlson told deputies she took the gun from Nihalani a month before a judge forbid the doctor from owning a gun because of a domestic violence injunction against him from another woman.
Nihalani and Amanda Carlson now live together in Jacksonville. The Jacksonville Sheriff’s Office has been called out to that home 10 times since 2015.
Nihalani and Carlson met while working at River Point Behavioral Health, a mental hospital Action News Jax has been investigating for months and the Office of the Inspector General has been investigating for years.
“When you’re in there, they can do whatever they want,” said Steve Smith, who was evaluated by Nihalani at River Point.
Smith is one of dozens of patients who tell Action News Jax they were held against their will under Florida’s Baker Act even though they were not suicidal so River Point could cash in on their insurance payments.
“The entire 10 minutes, he was writing. He asked me a couple of questions and he never looked at me once.”
The Florida Department of Health has no active complaints or discipline on file for Nihalani. (LINK)—2/24/2017
Jacksonville psychiatrist, raided by FBI in February, dies
A Jacksonville doctor whose office was raided by the FBI in February died on Thursday, according to an obituary.
Dr. Nikhil Nihalani was 43-years-old and treated psychiatric patients at an office on University Boulevard.
The doctor’s death comes in the middle of an FBI investigation into his office that already had some publicized details.
On February 22, agents raided his office, temporarily closing it, but not saying what the investigation concerned. Days later First Coast News learned the doctor was interviewed over a suicide committed by one of his patients. A police report of the suicide noted Nihalani was having a year long affair with his patient’s wife.
Nihalani was never arrested in connection with the raid or his patient’s suicide, but he did face charges in 2016 for a domestic violence incident.
First Coast News has reached out to the FBI on what will happen with their investigation and we are waiting to hear back. (LINK)—6/04/2017
MEDICAL BOARD RECORD— 2015021165 DISCIPLINARY ACTIONS—License current; no actions listed as of 2/21/2017
Guilty plea entered 1/22/2018
Physician charged with sexual assault in O’Fallon
O’FALLON, MO. - A St. Charles County doctor was accused of assaulting two women, both patients. Investigators are asking for any other potential victims to come forward.
O’Fallon, Missouri police arrested Dr. Howard Setzer, 39. He is charged with second-degree sexual abuse and second-degree attempted sodomy. The incidents occurred on Progress Point Parkway, where there is a medical building.
“Sometimes people are afraid to come forward. If there was someone, if there was an incident, we’re urging them to come forward and let us know,” said O’Fallon Police Officer Diana Damke.s
When Five on Your Side contacted Mid-County Orthopedic, spokesman Joel James refused to confirm whether Setzer was or is currently employed there.
But he did release the following statement:
“The physicians and staff at Mid-County Orthopaedic have a long history of providing excellent medical care and will certainly cooperate with any investigation by law enforcement. We have not been contacted by law enforcement at this time and because of privacy laws, Signature certainly cannot speculate or comment on any patient matters.” (LINK)—2/03/2017
Woman recorded visit to doctor accused of sexual assault
A woman who recorded a visit to the office of a doctor who was later accused of sexually assaulting several patients spoke to News 4 Tuesday.
Melissa Garanzini said she first visited the office of Dr. Howard Setzer in 2016 because she was having back problems. She said she left his office with a strange feeling.
“He was really nice, but it just felt weird. Kind of like how he would talk to me and he would ask me questions such as ‘What are you up to and what are you doing tonight?’ Garanzini said.
Garanzini added she thought she was reading too much into what Setzer was saying, but when she made another visit to his office a month later, she decided to record the appointment on her cell phone.
“I got it on video, I set the camera down by my chair,” said Garanzini.
Garanzini described the second appointment as weirder than her first visit, saying he seemed to caress her hips. She felt something wasn’t right.
“I’m there for my back, and even things like touching my breasts and things like that, I didn’t know if that was okay or not, but then again he’s a doctor and you trust the doctor, and whatever the doctor says you do it and don’t hesitate.”
At one point, Setzer is seen on video rubbing his crotch.
Garazini was 19 at the time. She said she wanted to report what was going on, but wasn’t sure how to go about it. She later showed the video to some male friends.
“Right off the bat they were like ‘That is so wrong Melissa. You need to do something about this.’ I didn’t what to do,” Garanzini said.
Garanzini then looked online.
“I printed out this uniform complaint form for the state of Missouri and I was told to just fill it and send it in,” Garanzini said.
She never took the next step, but when Setzer was charged with sexual assault, she decided to go public with her story.
“If something like this happened to anyone else, boy or girl, woman or man, I think they need to do something about it right away. That’s the mistake I wish I hadn’t made, I wish I would have done something about it right away,” Garanzini said.
A source told News 4 Garaznini met with a detective and that video is now with the St. Charles County Prosecutor. (LINK)—2/14/2017
More patients accuse sports medicine doctor of sexual abuse
More sexual assault charges have been filed against a doctor accused earlier this year of abusing patients.
Dr. Howard Orson Setzer, 39, of Webster Groves, was charged this week with two counts of misdemeanor sexual abuse, three counts of misdemeanor assault and one count of felony sodomy for incidents involving two patients at the Mid County Orthopaedic Surgery and Sports Medicineoffice in Richmond Heights. The incidents occurred in August and December.
Setzer was also charged in February with attempted sodomy and sexual abuse for incidents that involved two patients at Mid County’s office in O’Fallon, Mo., in January.
According to court documents, the abuse allegations include touching the bare buttocks, breasts or vagina of the patients; or rubbing his penis against a patient’s hand.
Setzer is no longer listed as a physician at Mid County Orthopaedic Surgery and Sports Medicine. (LINK)—4/26/2017
Progress West physician to be sentenced after pleading guilty to sexual abuse
Howard Setzer, who was charged with felony attempted sodomy and misdemeanor sexual abuse while employed as a physician at Progress West Hospital in O’Fallon, will be sentenced Monday, March 12.
The O’Fallon Police Department received two separate reports of sexual assaults on Progress Point Parkway and arrested 39-year-old Setzer on February 3, 2017. He posted bond later that day.
A grand jury indicted Setzer on July 28, 2017, and court records show that Setzer pleaded guilty on January 22, 2018. (LINK)—3/11/2018
Former Webster Groves sports doctor gets probation for sexually abusing patients – and billing for it
ST. CHARLES COUNTY • A former sports doctor from Webster Groves has been sentenced to 30 days in jail and five years of probation after admitting to charges of sexually abusing patients and billing insurance companies for their treatment.
Dr. Howard Orson Setzer, of Webster Groves, was sentenced to 30 days in jail and probation after he admitted sexually assaulting patients.
Howard Orson Setzer, 40, of first block of Rock Hill Road, was sentenced Monday by St. Charles County Circuit Judge Rick Zerr to a month in the St. Charles County Jail, a suspended eight-year sentence and probation for five years. The sentence was part of a plea agreement with prosecutors.
Setzer was charged with more than two dozen felony and misdemeanor counts including sodomy, assault, abuse of a Medicaid patient, and Medicaid and insurance fraud totaling nearly $5,900.
Court records say that after sexually abusing the women, Setzer fraudulently billed insurance companies and Medicaid to seek payment for his victims’ medical treatment.
A July 2017 indictment filed in St. Charles County lists the initials of 11 women as Setzer’s victims. The indictment says Setzer would kiss patients on the mouth, press himself against their bodies, pull off their clothing, and fondle their breasts and genitals without their consent.
During one examination, the indictment says, Setzer pulled down a woman’s underwear, touched her genitals and told her “it didn’t look like she had four children.” The woman left his office when Setzer stepped out of the exam room to get her a prescription.
Setzer pleaded guilty in January to 10 counts, including sodomy, attempted sodomy, insurance fraud, health care payment violations and misdemeanor sex abuse and assault. Prosecutors dismissed the remaining charges in exchange for his guilty pleas and agreement to surrender his medical license. Conditions of Setzer’s probation include mental health treatment and registering as a sex offender. St. Charles County Prosecutor Tim Lohmar said the agreement was appropriate “to avoid the embarassment and humilation of the victims,” some of whom were reluctant or refused to come forward against Setzer.
“Dr. Setzer is committed to continuing to seek therapy for his compulsive behavior while serving probation,” said his lawyer, John Rogers.
Setzer has pending sex abuse, assault and sodomy cases in St. Louis County as well. Those charges list seven victims sexually abused at an office at Mid County’s Richmond Heights location at 1027 Bellevue Avenue and at its Creve Coeur facility, 845 North New Ballas Court. No trial date has been set in the St. Louis County case. (LINK)—7/26/2018
Former sports doctor from Webster Groves gets 90 days in jail for sexually abusing patients
CLAYTON • A former sports doctor from Webster Groves — already serving probation for sexually abusing 14 women at his St. Charles County office — was sentenced Monday to 90 days in jail and five years of probation for abusing seven other women at two medical offices in St. Louis County.
Dr. Howard Orson Setzer, of Webster Groves, has pleaded guilty to multiple charges connected to the sexual assault of patients.
Howard O. Setzer, 40, was given a suspended seven-year prison sentence by St. Louis County Circuit Judge Gloria Reno for two felony counts of sodomy. Reno sent Setzer to jail for 90 days total for eight misdemeanor counts of sexual abuse and assault.
Setzer admitted abusing at least seven women in 2016 by touching their bare buttocks, breasts or vaginas or rubbing his penis against a patient’s hand. Prosecutors said he abused the women at the Richmond Heights and Creve Coeur offices of Mid County Orthopaedic Surgery & Sports Medicine.
At the hearing Monday, a psychiatrist hired by defense lawyer John Rogers testified that Setzer had a low risk of re-offending. Assistant Prosecutor Teresa Bomkamp challenged the psychiatrist’s assessment, suggesting that Setzer’s abuse of 21 victims “from a position of trust” as a doctor in his offices in St. Charles and St. Louis counties makes him a threat to the public.
“Mr. Setzer is grateful for the consideration he has been given by Judge Reno,” Rogers said after Monday’s sentencing. “He looks forward to resuming his treatment for his compulsive behavior in the near future.”
After the hearing, one of the victims, 62, of north St. Louis County, said she thought Reno’s sentence for Setzer was too lenient, calling it “a slap on the wrist” that “totally disregarded us as women.”
“This has really messed me up,” said the woman, who saw Setzer for back pain and sciatica. “You go to your doctor, trusting him, having trust in him, and for him to betray me like that?
“He’s going to reap what he sow.”
Setzer is serving probation for convictions in St. Charles County of more than two dozen counts of fondling women at his office at 20 Progress Point Parkway in O’Fallon, Mo., and then billing insurance companies for treatment of nearly $5,900. On those convictions, he served a month in jail and received five years of probation.
Setzer is also facing civil lawsuits by some of the victims. (LINK)—12/04/2018
CHARGES as of 3/12/2018:
Sodomy - 2nd Degree (Felony)
Commission of Fraudulent Insurance Act (Felony)
Abuse of health Care Resident - Physical, Sexual or Emotional Harm or Injury (Felony)
Violations Involving Health Care Payments 1st Offense (Felony)
Sodomy - 2nd Degree (Felony)
Commission of Fraudulent Insurance Act (Felony)
Commission of Fraudulent Insurance Act (Felony)
Sodomy - 2nd Degree (Felony)
Commission of Fraudulent Insurance Act (Felony)
Sodomy - 2nd Degree (Felony)
Commission of Fraudulent Insurance Act (Felony)
Sodomy - 2nd Degree (Felony)
Assault 3rd Degree (Misdemeanor)
Assault 3rd Degree (Misdemeanor)Commission of Fraudulent Insurance Act (Felony)
Sodomy - 2nd Degree (Felony)
Commission of Fraudulent Insurance Act (Felony)
Assault 2rd Degree (Misdemeanor)
Abuse of Health Care Recipient - Physical, Sexual or Emotional Harm or Injury (Felony)
Violations involving Health Care Payments (Felony)
Atmp-Sodomy - 2nd Degree (Felony)
Commission of Fraudulent Insurance Act (Felony)
Sexual Abuse - 2nd Degree (Misdemeanor)
Sexual Abuse - 2nd Degree (Misdemeanor)
Commission of Fraudulent Insurance Act (Felony)
Sexual Abuse - 2nd Degree (Misdemeanor)
Abuse of Health Care Recipient - Physical, Sexual or Emotional Harm or Injury (Felony)
Violations Involving Health Care Payments 1st Offense (Felony)
COURT VERDICT
DEFENDANT IS SENTENCED ON COUNT 1 TO 1 YEAR SES, 5 YEARS PROBATION (MOBDP&P), TO RUN CONSECUTIVE WITH ALL FELONY COUNTS, COUNT 2 TO 1 YEAR SES, 5 YEARS PROBATION (MOBDP&P), TO RUN CONSECUTIVE WITH ALL FELONY COUNTS, COUNT 4 TO 1 YEAR SES, 5 YEARS PROBATION(MOBDP&P), TO RUN CONSECUTIVE WITH ALL FELONY COUNTS, COUNT 5 TO 1 YEAR SES, 5 YEARS PROBATION (MOBDP&P), TO RUN CONSECUTIVE WITH ALL FELONY COUNTS, COUNT 8 TO 1 YEAR SES, 5 YEARS PROBATION (MOBDP&P), TO RUN CONSECUTIVE WITH ALL FELONY COUNTS, COUNT 12 TO 1 YEAR SES, 5 YEARS PROBATION (MOBDP&P), TO RUN CONSECUTIVE WITH ALL FELONY COUNTS, COUNT 18 TO 1 YEAR SES, 2 YEARS PROBATION (COURT), TO RUN CONCURRENT WITH ALL MISDEMEANOR COUNTS, COUNT 21 TO 1 YEAR SES, 5 YEARS PROBATION (MOBDP&P), TO RUN CONSECUTIVE WITH ALL FELONY COUNTS, COUNT 23 TO 1 YEAR SES, 2 YEARS PROBATION (COURT), TO RUN CONCURRENT WITH ALL MISDEMEANOR COUNTS BUT CONSECUTIVE WITH ALL FELONY COUNTS, COUNT 26 TO 1 YEAR SES, 2 YEARS PROBATION TO RUN CONCURRENT WITH ALL COUNTS, NO CONTACT WITH THE VICTIMS, PAY RESTITUTION AS ORDERED, SIGN THE SEXUAL OFFENDER SUPERVISION AGREEMENT FORM AND ABIDE BY ANY WRITTEN OR VERBAL DIRECTIVES GIVEN BY P.O., HAVE NO CONTACT WITH CHILDERN UNDER THE AGE OF 18, SUBMIT TO RANDOM POLYGRAPH EXAMINATION AT DEFENDANTS EXPENSE, ABIDE BY ALL SPECIAL CONDITIONS OUTLINED BY THE ST. CHARLES COUNTY PA OFFICE IN ATTACHED MEMORANDUM, ALL COUNTS CONSECUTIVE UNLESS OTHERWISED NOTES, 30 DAYS SHOCK IN SCCDOC AS PER EXHIBIT 1 ATTACHED, AND TO PAY ALL COURT COSTS AND FEES. SO ORDERED RKZ//BNG 24.035/29.15 IN EFFECT COUNSEL - No; ALLOCUTION - Yes
MEDICAL BOARD RECORD— ME82457 DISCIPLINARY ACTIONS—License Clear; no actions listed as of 2/21/2017
Driver, victim ID’d in fatal crash
INDIAN RIVER COUNTY —The driver and pedestrian involved in a fatal crash Wednesday night have been identified.
The driver has been identified as Angela Shelton, 44, while the pedestrian was identified as Nickolas Thomas Kenesky, 36, both of Sebastian.
According to the Florida Highway Patrol, Shelton was driving in the outside lane of eastbound County Road 512 near 104th Avenue when her 2011 Buick Enclave struck Kenesky.
Shelton did not realize she had collided with anyone or anything, according to FHP, until she got home and saw the damage to the front end of her vehicle.
At that time, Shelton called authorities, FHP said.
Currently, no charges have been filed and the cause of the crash remains under investigation. (LINK)—4/28/2016
Florida doctor charged in deadly hit-and-run crash
Dr. Angela Shelton usually spends her days at her hair removal clinic. On Wednesday night, she turned herself into police after learning there was a warrant for her arrest.
A lonely cross is where Nick Kenesky died after Florida Highway Patrol says Shelton hit him with her car, this past April. Kenesky’s girlfriend, Jennifer Sieminski, is relieved that after nine long months Shelton may wind up in prison for driving away.
“It was a great relief to finally have a little bit of closure and action on the case,” Sieminski said, “it helps a lot.”
Kenesky’s family visited the impound lot after the incident and snapped a photo of a dark Buick Enclave with extensive front end damage. They say its plates and type match Dr. Shelton’s as listed in the police report. Sieminski wonders how the car could have sustained such damage without Shelton calling police.
“There’s no way, no way she didn’t see him,” Sieminski said, “the front of her vehicle is tore up.”
Shelton’s lawyer, Andrew Metcalf, calls it a tragic accident. He says she didn’t realize she hit someone, but did call police when she got home afterward.
“When she did asses it, she’s the one that contacted law enforcement,” Metcalf said, “that’s the facts, as presented by Florida Highway Patrol.”
He says they will plead not guilty to felony hit-and-run. Sieminski says she’ll be there for each day of the trial of the woman FHP says killed “Big Nick.”
“He was an easygoing guy, got along with everybody. Kept a smile on my face and everybody else’s,” Sieminski said, “he had a great relationship with his mom. He was a good mama’s boy.”
Law enforcement wouldn’t say why the investigation took nine months to get to trial. Kenesky’s family says above all, they want to send a message that you can’t hit someone and just drive away. (LINK)—2/02/2017
A Medical Madoff: Anesthesiologist Faked Data in 21 Studies
A pioneering anesthesiologist has been implicated in a massive research fraud that has altered the way millions of patients are treated for pain during and after orthopedic surgeries
Over the past 12 years, anesthesiologist Scott Reuben revolutionized the way physicians provide pain relief to patients undergoing orthopedic surgery for everything from torn ligaments to worn-out hips. Now, the profession is in shambles after an investigation revealed that at least 21 of Reuben’s papers were pure fiction, and that the pain drugs he touted in them may have slowed postoperative healing.
“We are talking about millions of patients worldwide, where postoperative pain management has been affected by the research findings of Dr. Reuben,” says Steven Shafer, editor in chief of the journal Anesthesia & Analgesia, which published 10 of Reuben’s fraudulent papers.
Paul White, another editor at the journal, estimates that Reuben’s studies led to the sale of billions of dollars worth of the potentially dangerous drugs known as COX2 inhibitors, Pfizer’s Celebrex (celecoxib) and Merck’s Vioxx (rofecoxib), for applications whose therapeutic benefits are now in question. Reuben was a member of Pfizer’s speaker’s bureau and received five independent research grants from the company. The editors do not believe patients were significantly harmed by the short-term use of these COX2 inhibitors for pain management but they say it’s possible the therapy may have prolonged recovery periods.
Baystate Medical Center in Springfield, Mass., began investigating Reuben’s findings last May after its chief academic officer, Hal Jenson, discovered during a routine audit that Reuben had not received approval from the hospital’s review board to conduct two of his studies. Reuben “violated the trust of Baystate, the community and science,” Jenson says. The story of the investigation was first reported by Anesthesiology News late last month.
Reuben, 50, has been stripped of his research and educational duties and has been on medical leave since May. He received his medical degree from the State University of New York at Buffalo School of Medicine & Biomedical Sciences in 1985 and did his residency at the Mount Sinai Medical Center in New York City. In 1991, he joined Baystate, which serves as the western campus for Tufts University School of Medicine, and has worked as a staff anesthesiologist and the director of acute pain management.
His lawyer, Ingrid Martin of Dwyer & Collora, LLP, in Boston, told ScientificAmerican.com that Reuben has cooperated with the investigation and that he “deeply regrets that all of this happened.” She added that “with the [investigating] committee’s guidance, he is taking steps to ensure this never happens again.” She declined to answer any further questions, and Reuben did not respond to an e-mail request for comment.
Beginning in 2000, Reuben, in his now-discredited research, attempted to convince orthopedic surgeons to shift from the first generation of nonsteroidal anti-inflammatory drugs (NSAIDs) to the newer, proprietary COX2 inhibitors, such as Vioxx, Celebrex, and Pfizer’s Bextra (valdecoxib). He claimed that using such drugs in combination with the Pfizer anticonvulsant Neurontin (gabapentin), and later Lyrica (pregabalin), prior to and during surgery could be effective in decreasing postoperative pain and reduce the use of addictive painkillers, such as morphine, during recovery. A 2007 editorial in Anesthesia & Analgesia stated that Reuben had been at the “forefront of redesigning pain management protocols” through his “carefully planned” and “meticulously documented” studies.
Many orthopedic surgeons, however, were slow to adopt COX2 inhibitors due to animal studies that showed short-term use might hinder bone healing. Then, in 2004, Vioxx and Bextra were pulled from the market because of their link to an increased risk of heart attacks and strokes, leaving Pfizer’s Celebrex as the only COX2 inhibitor available. Celebrex sales plunged 40 percent after a study that same year suggesting that it, too, posed a heart attack risk. Despite this, Reuben continued to present “findings” in research funded by Pfizer that trumpeted Celebrex’s alleged benefits and downplayed its potential negative side effects.
He apparently hoped to erase doubts by persuading orthopedic surgeons to co-author papers with him based on his bogus data. In 2005 he and Evan Ekman, an orthopedic surgeon at Southern Orthopaedic Sports Medicine in Columbia, S.C., published a study on the use of Celebrex to control pain in back surgery patients. “The short-term administration of celecoxib,” they wrote in the paper published in The Journal of Bone and Joint Surgery, “results in no significant deleterious effect on bone or ligament healing or cardiovascular outcomes.”
Three years later, Reuben’s career would begin to unravel as Ekman began to suspect foul play. In addition to collaborating with Reuben on the now-retracted Celebrex study, Ekman agreed to review a Reuben manuscript on surgery on the anterior cruciate ligament (ACL) in the knee. But when he asked the anesthesiologist for the name of the orthopedic surgeon on the study, Reuben ceased communication with him.
Then, last year, Ekman was invited by Pfizer to give a talk. While there, he was handed a version of the very manuscript Reuben had asked him to review, which had subsequently been published in Anesthesia & Analgesia. To his surprise, and horror, he was listed as a co-author: Reuben had forged his signature on the submission form, Ekman says.
By then, Editor in Chief Shafer had already put several Reuben manuscripts on hold after learning that Baystate had initiated a probe into the validity of his research. The investigation later identified 21 articles based on patient data that had been partially or completely doctored. Although Pfizer funded Reuben’s research between 2002 and 2007, Baystate has no records of those payments and says that the research funds could have been paid directly to Reuben. Such an arrangement would be “highly unusual,” Shafer notes. “It’s just a little frustrating,” Baystate spokesperson Jane Albert says. “I don’t know how many dollars went to Dr. Reuben or his group.”
Pfizer spokesperson Sally Beatty insists the grants were properly disbursed to Baystate in accordance with Pfizer policy. “Pfizer is not familiar with the records retention policies of Baystate Medical Center,” she says, “However, independent investigator-initiated research grant agreements were executed between Pfizer and Baystate Medical Center.” Beatty was unable to provide information on the dollar amount of the grants, but editor White says they typically range between $10,000 to $100,000.
The question is: Why did it take 12 years before a “routine audit” revealed Reuben’s widespread data fabrication? “Baystate publishes about 200 [studies] every year, and of those [articles], the audit rate might only be 5 percent,” Baystate’s Jenson says, acknowledging that ultimately “Baystate is responsible” for making sure that research done there is properly conducted and reported. He says that the hospital has been trying to strengthen its oversight program over “the past few years” and that it is in the process of applying for accreditation from the Association for the Accreditation of Human Research Protection Programs (AAHRPP) in Washington, D.C., which provides an independent evaluation of an organization’s ethical standards and oversight. The lack of accreditation is not unusual because the nonprofit program was not established until 2001 and only recently has grown to include 159 hospitals, academic institutions and other organizations.
In hindsight, Anesthesia & Analgesia editors Shafer and White admit that it should have been a “red flag” that Reuben’s studies were consistently favorable to the drugs he studied. White, who has also received drug company educational grants, says that such funding comes with “subtle pressure” to give the companies the results they want. For now, at least, neither the drug companies nor Reuben’s co-authors are officially sharing in the blame, but that’s expected to change. “There’s a lot of responsibility to pass around,” White says, “It’s all being focused on Scott Reuben, but the reality is there are many other responsible parties.” (LINK)—3/10/2009
Doc Who Faked Pfizer Studies Gets 6 Months in Prison, Showing Why Gift Bans Are a Good Idea
Massachusetts anesthesiologist Scott Reuben received six months in prison for faking medical research into Pfizer (PFE)’s Celebrex and Bextra painkillers just as the Bay State’s legislature is considering repealing the ban on doctors taking gifts from drug companies. Technically, the two events are unrelated – but it sure doesn’t feel that way once you know Reuben’s history.
Reuben was convicted of staging a bogus 2007 pain management study involving patients who had knee surgery. Pfizer paid $73,000 in a research grant for the trial, which was supposed to measure the effectiveness of its Cox-2 painkiller Celebrex in reducing post-operative pain. Ultimately, many of Reuben’s pain studies were retracted by medical journals. He wrote 21 manuscripts in 15 years. The journal Anesthesia & Analgesia retracted 10 of Reuben’s studies and Anesthesiology retracted three. Six of the studies were funded by Pfizer, Wyeth or Merck (MRK), according to prosecutors’ sentencing memo.
If you go to PubMed and plug in “Reuben S coxib” (a search term that picks all of his Cox-2 studies) you can see which studies were actually retracted and which are still sitting in the online medical database unchanged. Of course, we don’t know that everything Reuben did was fake … but how are we to tell the difference if it’s got his name on it? This study doesn’t bear the “retracted” label, nor does this one nor this one nor this one nor this one.
It’s not the case that Reuben took the kind of “gifts” from Pfizer that the Massachusetts law bans. But it is the case that Reuben was showered with cash by Big Pharma. Here’s what he must pay in restitution to his victims:
$296,557 payable to Pfizer
$49,375 payable to Merck
$8,000 payable to Wyeth (which is now Pfizer)
$8,000 payable to Rays of Hope (a breast cancer foundation)
Total: $361,932
Pfizer wasn’t looking for research that simply broadened doctors’ knowledge of how Cox-2 painkillers work. It was almost certainly using that research to bolster its “operate for cash” promotion, in which pharmaceutical sales reps persuaded surgeons to write “protocols” for using Pfizer’s Bextra and Celebrex as post-operative painkillers instead of opioid drugs. Such uses were not approved by the FDA. Reuben’s distorted research was largely a product of his suicidal bipolar depression, according to his sentencing memo. But the fact that he was doing it on Pfizer’s drugs, and producing results that Pfizer could use, is a function of the source of Reuben’s funding: Pfizer and Merck.
Which is why repealing the gift ban is a bad idea. Although the end of meals and freebies for docs “has cut back on local business profits,” according to the Boston Globe, there’s more at stake here than the fortunes of the catering-services-industrial complex. Pharma company gifts contribute to an atmosphere that biases doctors’ opinions toward certain drugs for non-scientific reasons.
The ban should stay, and the Reuben case is one of the reasons why. (LINK)—6/25/2010
Dr. Reuben now claims he had “bipolar disorder” which caused him to fake clinical trials
(NaturalNews) Defense attorneys for the perpetrator of one of the largest research frauds in history have claimed that their client, Scott S. Reuben, MD, suffered from “serious, but undiagnosed” bipolar disorder that led him to fabricate data and otherwise falsify his research.
Reuben graduated from medical school in 1985, and soon became a widely published and cited pain researcher. By 2009, he had published at least 72 research studies, and his work had led to a major change in the way pain is treated. But a routine audit in 2008 at Baystate Medical Center, where Reuben had worked since 1991, uncovered discrepancies in Reuben’s research. This led to allegations that Reuben had not actually conducted many (or even any) of the studies that his supposedly groundbreaking findings had been based on.
More than 20 of Reuben’s papers have since been retracted. He has pleaded guilty to fabricating data and patients, and has also been accused of adding the names of uninvolved co-authors without their permission. He has agreed to repay $361,932 in research funding to several pharmaceutical companies, and $50,000 in penalties to the U.S. government.
Seeking a light sentence for Reuben – who faces up to 10 years in prison for his crimes – defense attorneys have argued that his undiagnosed bipolar disorder caused Reuben to commit suicide twice, be hospitalized three times, and fabricate his data.
Yet many of Reuben’s colleagues questioned this story.
“To my knowledge, nobody in the department was aware … that he had any mental illness,” said anesthesiologist Steven Dunn, MD, of Baystate.
Glenn J. Treisman, a professor of psychiatry at Johns Hopkins University School of Medicine, expressed skepticism that Reuben, an MD married to a psychiatrist, could suffer from undiagnosed bipolar disorder for so long.
“By the time someone’s tried suicide twice, their psychiatrist wife would have known something was going on,” he said. (LINK)—8/09/2010
Scott Reuben notches 25th retraction, for a letter to the editor
The letter, published in 2001, argues that local anesthesia is a “safe, reliable, inexpensive, and practical alternative to the use of epidural, spinal, or general anesthesia” for outpatient knee surgery. But to support his point, he uses one of his papers that has since been retracted for data fabrication.
The Letter to the Editor by Scoot Reuben, “Ambulatory Anesthesia for Knee Arthroscopy,” that appeared on page 556 in the February 2001 issue of Anesthesia & Analgesia is being retracted. The Letter to the Editor references a manuscript by Reuben and Connelly to support the claim that “the use of intraarticular analgesics provides for improved patient comfort and allows us to avoid the administration of opioids in the preoperative period.” The manuscript by Reuben and Connelly has been retracted for data fabrication. Therefore, the subsequent Letter to the Editor by Reuben relying on these fabricated data is hereby retracted.
The faulty paper, “Postarthroscopic meniscus repair analgesia with intraarticular ketorolac or morphine,” was retracted in 2009.
It wasn’t until we asked Shafer this summer to confirm the number of Reuben retractions — Anesthesia & Analgesia had published and retracted many of his papers — that Shafer realized someone had dropped the ball.
A 2011 editorial in Anesthesia & Analgesia titled “The Scott Reuben saga: one last retraction,” which analyzes much of the researcher’s work for accuracy, references that retraction:
A Letter to the Editor by Dr. Reuben referenced a previously retracted article by Reuben and Connelly. It is therefore retracted.
Shafer told us the publisher was
supposed to retract it, based on the editorial. I’m surprised, and disappointed, that they didn’t follow through.
That editorial ends:
As for Anesthesia & Analgesia, we hope that the Scott Reuben saga has come to an end.
But often, retractions aren’t the end of the story: As we learned this summer, many of Reuben’s retracted papers have continued to be cited years after they’ve been pulled from the scientific record. (LINK)—11/23/2015
MEDICAL BOARD RECORD— 25MB02154700 DISCIPLINARY ACTIONS—License active; Pre-Renewal Accepted; no actions listed as of 2/21/2017
N.J. doctor took $200K in bribes, indictment says
NEWARK – Federal authorities Tuesday charged a Saddle Brook family doctor with taking $200,000 in bribes over a period of years in exchange for sending tests to a Parsippany laboratory, court records show.
Bernard Greenspan, 78, is facing a 10-count indictment relating to kickbacks and wire fraud, according to U.S. Attorney Paul J. Fishman’s office.
Greenspan’s attorney, Damien Conforti of Newark, said Greenspan denies all the allegations.
Thirty-nine individuals already have pleaded guilty in the bribery case involving Biodiagnostic Laboratory Services.
“This indictment is another reminder that kickbacks in connection with federal health care programs are illegal and unacceptable,” said Scott J. Lampert, special agent in charge at the Office of Inspector General, U.S. Department of Health and Human Services. “Taking such payments subverts the notion that patients should come before profits.”
The indictment says that from March, 2006 through April 2013, the lab’s agents paid physicians bribes so they would send blood samples to the lab for testing. Medicare and private insurance paid for the tests, it said.
Tests sent by Greenspan netted the lab more than $3 million, the indictment says.
In return, lab agents paid Greenspan checks that were ostensibly written for “rent payments” of $2,000 to $2,500 a month. He also took payments for “service agreements” and “consulting agreements,” all of which totaled to about $200,000, the indictment says.
It also says Greenspan ordered additional patient tests in return for payment for holiday parties for Greenspan and his staff.
As part of the plan, it says, the lab agreed to employ an unnamed person with whom Greenspan was having a relationship.
An EMT and a former vice president allege the company regularly falsified reports to increase the charges to the Medicare and Medicaid programs.
Conforti said prosecutors twisted what Greenspan considers “good patient care” to fit their needs. He said he did not want to address specific allegations, including the allegation about the patient who was hired by the lab, at this time.
He said he was saddened by the charges, considering that Greenspan has served patients in Bergen and Passaic counties for nearly five decades.
Of the 39 who have pleaded guilty to taking bribes from the lab, 26 have been physicians, according to Fishman’s office. The investigation has recovered more than $11.5 million through forfeiture, it said.
Each of the counts alleging violations of the Anti-Kickback and Federal Travel Act carry maximum sentences of five years in prison. Each of the four wire fraud counts carries a maximum of 20 years in prison and all 10 counts carry a maximum fine of $250,000.
He will be arraigned at a later date, according to Fishman’s office. (LINK)—3/08/2016
The Latest: 79-year-old doctor on trial in kickback scheme
NEWARK, N.J. (AP) — The Latest on the trial of a 79-year-old doctor charged with participating in a $200 million bribery scheme (all times local):
11:45 a.m.
Jurors have heard opening statements in the trial of a 79-year-old New Jersey doctor charged in a $200 million health care fraud scheme.
Bernard Greenspan is charged with crimes including violating federal anti-kickback laws.
More than 40 people have already pleaded guilty in the scheme involving a blood testing lab that bribed doctors for referrals.
Prosecutors say Biodiagnostic Lab Services bribed Greenspan with inflated rent payments and consulting fees that totaled $200,000 over a seven-year period.
Greenspan’s attorney told jurors the payments were legitimate and that Greenspan did nothing illegal.
The lab’s owner, David Nicoll, has pleaded guilty and is expected to testify. Authorities say he used the proceeds of the scam to buy luxury properties and rare and classic automobiles.
12:20 a.m.
More than 40 people have already pleaded guilty in a $200 million health care fraud scheme run by a New Jersey blood testing lab.
This week, the government’s evidence will be tested for the first time by a 79-year-old family doctor who hopes to convince a jury of his innocence.
Bernard Greenspan is charged with crimes including violating federal anti-kickback laws. Opening statements are scheduled for Tuesday.
Greenspan was arrested for his connection with Parsippany-based Biodiagnostic Laboratory Services.
The now-defunct company’s owners have pleaded guilty to bribing dozens of doctors in exchange for patient referrals.
Prosecutors say Greenspan was bribed with disguised lease payments, cash for holiday parties and a job for an alleged mistress.
Greenspan’s attorney says his client’s dealings with the lab were legitimate business transactions. (LINK)—2/07/2017
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Local doctor accused of writing illegal prescriptions online
RICHMOND, VA (WWBT) - A local doctor is facing charges in Massachusetts, accused of writing illegal prescriptions for online pharmacies. Now, we’ve learned similar allegations have been brought against him, right here in Virginia.
Federal prosecutors in Boston filed eleven charges against Dr. Torino Jennings of Mechanicsville including introducing mis-branded drugs into interstate commerce and tax evasion. Up until Thursday, he practiced medicine at Retreat Doctor’s Hospital in The Fan.
Federal court documents obtained by NBC12 show between 2004 and 2007, Dr. Jennings wrote between 50 and 100 thousand prescriptions over the internet for the muscle relaxant “Soma” and other drugs to people he never examined or even met.
The documents state Dr. Jennings received from online pharmacies between five and seven dollars per prescription and did not report hundreds of thousands of dollars in payments to the IRS.
A spokesperson for Retreat Hospital says Dr, Jennings’ privileges to practice were suspended Thursday morning after they were notified of the charges.
We checked with the Virginia Board of Medicine and discovered similar allegations in the Commonwealth, between 2004 and 2006.
Documents obtained from the Virginia Board of Medicine’s web site show Dr. Jennings paid a $10,000 fine last February for prescribing medications including Cialis, Levitra, Ultram and Viagra to people through the internet without a doctor’s visit. One of those people was treated for liver complications, according to the Board of Medicine.
Carmen Catizone with the National Association of Boards of Pharmacy says 93 percent of online pharmacies operate illegally and seek out willing doctors through advertisements in journals and on the web.
“Problem is these pharmacies try and fly under the radar and don’t register with states and doctors don’t register and takes some time to track them down identify them and bring them to court,” said Catizone.
Jennings is also facing four counts of tax evasion, he’s accused of not reporting hundreds of thousands of dollars in income between 2004 and 2007. So far, no court hearing has been set. (LINK)—2008
Doctor faces jail over Internet pharmacy scam
Online patients received up to 100,000 prescriptions; IRS didn’t get a penny
BOSTON — A doctor has pleaded guilty to writing tens of thousands of prescriptions for muscle relaxants and other drugs over the Internet to patients he’d never examined.
Federal prosecutors say Dr. Torino Jennings, of Mechanicsville, Va., pleaded guilty in U.S. District Court in Boston on Monday to seven counts of introducing misbranded drugs into interstate commerce and four counts of tax evasion.
Prosecutors say between 2004 and 2007, Jennings issued from 50,000 to 100,000 prescriptions based on forms completed for online pharmacies.
Jennings was paid from $5 to $7 per prescription, but never reported the income to the Internal Revenue Service.
Jennings faces a maximum of five years in prison at sentencing scheduled for November. (LINK)—7/14/2009
Doctor convicted of writing illegal prescriptions, now cares for the elderly
MECHANICSVILLE, Va. – Multiple people in Central Virginia who have loved ones living in assisted living facilities that see a Mechanicsville doctor reached out to the CBS 6 Problem Solvers after searching his name and finding that he served time in federal prison for writing up to 100,000 prescriptions over the internet for people he never met.
“I’m concerned, I’m very concerned,” one woman, who spoke to CBS 6 on the condition of anonymity, said. “I do not believe he should be practicing medicine, and if that were the outcome, I would be relieved.”
The woman said her 90-something-year-old loved one lived in a local assisted living facility where Dr. Torino Jennings serves as the “house physician.”
The facility does not technically employ him, but she said it has a relationship with his business, House Calls of Virginia.
“If they had done a worthwhile look into his history, I can’t believe they would go ahead and create this relationship, and put our loved ones in harm’s way by having him on as the house physician,” she said.
Records from the Virginia Department of Health Professionals show the state suspended Jennings’ medical license in 2009 after he was convicted of writing illegal prescriptions and tax evasion.
Two years earlier, the state fined Jennings for authorizing 150 prescriptions weekly over the internet even though he never saw those patients, according to state records.
Those records show one of the recipients of those prescriptions had to be admitted for detoxification and treated for liver complications.
Still, six months after he was released from prison, Virginia gave him a probationary license and it was fully reinstated in October of 2013.
“It’s a dangerous mindset to have to be dealing with people and to be manipulating drugs and to be profiting from drugs,” the woman said.
Another person whose loved one sees Dr. Jennings at a different assisted living facility also independently contacted CBS 6 about the doctor and wanted to speak out as long as we protected their identity.
“It is serious,” the person said.
They worry that some residents in assisted living facilities may not have the cognitive wherewithal to make sure Dr. Jennings takes care of them properly.
“If people can research him then they can make that decision to say yes, he can still be my doctor, but those people who are in senior homes and assisted living facilities and nursing homes, they’re not going to Google him, and they’re not going to know that past,” the person said.
CBS 6 reporter Melissa Hipolit emailed Dr. Jennings twice, visited his office and talked to his staff, and visited his home, but she never heard back from him.
However, she did talk to a woman who calls Jennings exceptional.
“He was heads and tails above many other doctors I’ve dealt with in terms of the quality of his patient care and the interaction with me and my mother,” Debbie Bowie said.
Bowie’s mom saw Dr. Jennings for over three years when she lived in an assisted living facility.
Bowie did not know about Jennings’ criminal past.
“It seems impossible,” Bowie said. “The man that I met was high integrity.”
She said had she known before meeting him, she might not have given him a chance, but she said he became a blessing for her and her mom who passed away last year.
“He was there for us and really made the whole journey that much easier for me,” Bowie said.
A spokesperson for Commonwealth Senior Living, which owns a couple of the assisted living facilities where Jennings see patients, said it is common for assisted living communities to work with preferred doctors, but every resident has the right to choose any doctor they want.
The spokesperson said they’ve received no complaints or concerns about Dr. Jennings. (LINK)—2/07/2017
Felony Conviction Information
Date of Conviction: 11/9/2009 Were you convicted in the US of a federal or state offense? Federal Conviction Code: 54.1-2915.A Written Description of Offense: tax evasion Location of Conviction: Boston, Mass Type of Sentence received: Incarceration and probation Date of Sentencing: 11/9/2009 Suspended Sentence: 1 Year(s) and 0 Month(s) Sentence Served: 0 Year(s) and 10 Month(s)
Port St. Lucie Dermatologist Applied Medicare Billing Code for Radiation Treatment Not Used by Many Doctors
While there is nothing basically wrong about a physician billing for mainly one treatment, a recent Wall Street Journal analysis showed that the Medicare billings of some single-procedure doctors raise red flags, especially with those who operate outside their area of expertise or greatly diverge from standard medical practice.
According to the June 10 article titled “Taxpayers Face Big Tab For Unusual Doctor Billings,” more than 2,300 providers earned $500,000 or more from Medicare in 2012, but some doctors collected more from a single procedure than any other doctor who billed for that procedure, as shown by Medicare billing codes.
The WSJ’s conclusions emerge from 2012 Medicare physician-payment data released for the first time in April, prompted by the newspaper’s legal action to make this information public.
One doctor whose billing practices were noted in the article is Port St. Lucie dermatologist, Dr. Gary L. Marder. According to the WSJ, Dr. Marder received $3.7 million from Medicare, and of that amount, $2.41 million surfaced from one particular radiation treatment. Only two other doctors in the 2012 Medicare billing code data set studied billed for that treatment, and neither came close to charging Medicare as much as Dr. Marder’s practice did.
The question at hand appears to be the type of machinery used to apply radiation treatment and the billing code used for a specialized machine. The billing code used by Dr. Marder corresponds to a higher-voltage radiation treatment machine that requires extra shielding in a controlled environment, similar to radiation-oncology departments in hospitals.
Broken down by the numbers, a lower-voltage machine (like the one pictured on Dr. Marder’s website) would have been reimbursed by Medicare at a rate of about $22 per treatment in 2012. However, Dr. Marder received an average of $154 per treatment by billing under the code for the higher-voltage machine that Dr. Marder said he used (and was not pictured on his website).
In addition, using the more selective code, Dr. Marder billed for the procedure 15,610 times in 2012, and performed the procedure on 94 patients, according to the Medicare data, adding up to 166 treatments per patient, on average.
According to a radiation oncologist in the WSJ article, the maximum number of radiation treatments appropriate per skin-cancer lesion is 35, and a more typical course of treatment would be 20. Several lesions treated at the same time usually get billed for as a single treatment, the oncologist explained.
Dr. Marder responded that his higher billing count per patient could be attributed to the fact that he billed for each lesion separately and treated each lesion about 40 times.
The question about the type of machine used for the billing code is somewhat similar to a whistleblower case that our May 20 ARONOVITZ Blog reported. In that $89.6 million whistleblower case, a radiation therapy technologist alleged in a qui tam complaint that a doctor and his treatment clinics billed Medicare for procedures that were supposedly performed with a certain type of imaging machine, even though the clinics never actually owned such a machine. (LINK)— 6/06/2014
Dr. Gary Marder Port Saint Lucie billed 2.3M in 2012 to Medicare
In Port St. Lucie, Fla., Gary L. Marder, a dermatologist, specializes in treating melanoma with radiation. Dr. Marder’s website, which features photos of smiling elderly couples, says he has cured more than 100,000 skin cancers.
Medicare paid Dr. Marder $3.7 million in 2012—$2.41 million of which came from a radiation treatment billed by just two other doctors in the data, which doesn’t include hospital billings. Neither of them came close to billing as much for it as Dr. Marder.
David Beyer, a radiation oncologist in Scottsdale, Ariz., said the procedure code Dr. Marder used to bill Medicare corresponds to higher-voltage machines than the one pictured on Dr. Marder’s website. Such higher-voltage machines require substantial shielding and a contained room typically found in the radiation-oncology departments of hospitals, Dr. Beyer said.
Under Medicare guidelines, the lower-voltage machine pictured on Dr. Marder’s website was reimbursed at a rate of about $22 per treatment in 2012, radiation oncologists say. Dr. Marder received an average of $154 per treatment by billing under the code for the higher-voltage machine.
In an email exchange, Dr. Marder said he used a machine different than the lower-voltage one pictured on his website, but didn’t respond to a question about what kind. Dr. Marder said he had “professionals who can vouch for my correct coding,” although he didn’t provide their names.
Dr. Marder billed for the procedure, using the more lucrative code, 15,610 times in 2012, and performed the procedure on 94 patients, according to the Medicare data. That works out to 166 treatments per patient, on average.
Dr. Beyer, the Arizona radiation oncologist, said the maximum number of radiation treatments appropriate per skin-cancer lesion is 35, and a more normal regimen would be 20. When a patient has several lesions, they commonly get treated simultaneously and are billed for as a single treatment, he said.
Dr. Marder said he billed for each lesion separately and treated each lesion about 40 times, explaining his high billing count per patient.
In 1998, Dr. Marder was disciplined by Florida’s Board of Osteopathic Medicine for alleged “fraudulent” billing. The board fined him $2,500 and ordered him to take courses in medical record-keeping and medical risk management. He neither admitted nor denied the allegations.
Dr. Marder said his medical care “was never in question” and that the medical board merely asked him to better document in his medical charts the justifications for his billings, which he said he has done since then.
Some of the Medicare doctors whose billings stand out aren’t performing procedures that are particularly technical or specialized. (LINK)—6/09/2014
Many elderly patients on Medicare who visited Dr. Gary Marder came to the dermatologist concerned about blotches on their skin.
Despite these patients having irritated skin, warts or other common skin conditions, he allegedly diagnosed them all with skin cancer and charged their insurance for expensive treatments and procedures, according to the Medicare abuse lawsuit filed by a whistleblower.
Medicare Abuse Lawsuit Allegations
The whistleblower accused Dr. Marder of defrauding the government by billing Medicare and Tricare, a federal health program serving active and retired military families.
The Medicare abuse lawsuit stated that from January 2008 until May 2014, Marder built the two federal health programs for more than $49 million.
These charges included overbilling the two programs by charging patients for biopsies and treatments deemed unnecessary.
These procedures and treatments were either not actually rendered, or they were rendered by improperly qualified physicians assistants who were not properly supervised to provide the interventions.
The whistleblower even stated that the doctor was out of the country many times the patients were supposedly treated.
In the medicare abuse lawsuit, the judge upheld many of the allegations brought forth by the whistleblower. The terms of the settlement have not been disclosed to the public.
Many settlements such as this one end with the accused person denying any wrongdoing but agreeing to the settlement to avoid further uncertainty, time and costs associated with continued litigation.
According to Dr. Marder’s website, he had claimed to have cured “over 45,000 nonmelanoma skin cancers with radiation therapy for the past 30 years.”
He is certified by the American Osteopathic Board of dermatology, and the whistleblower alleged that Dr. Marder lacked the necessary training to be able to perform radiation oncology on his patients.
This medicare abuse whistleblower lawsuit Dr. Marder has agreed to settle is a civil case, but there is a criminal investigation currently underway that is being conducted by the FBI.
The whistleblower lawsuit against Dr. Marder originally developed from a complaint filed by another dermatologist who works in the area.
This doctor saw many patients who he believed were misdiagnosed by Dr. Marder, investigated his suspicions and hired an attorney under the federal whistleblower’s act.
The doctor who acted as a whistleblower will receive between 15 and 25 percent of the settlement agreement for his help in exposing government fraud.
According to the medical abuse lawsuit, the whistleblower stated that Dr. Marder told his physician assistants that they needed to perform up to 50 biopsies a day to increase his billings to Medicare and Tricare.
The whistleblower stated that if the physician assistants met the quota, they would be eligible for cash bonuses of up to $10,000.
Dr. Marder’s physician assistants stated that they did not receive proper training to perform the radiation treatments.
According to a former physician assistant, “Dr. Marder instructed that every patient was to receive two radiation treatments a day to each lesion for 20 days. The treatment was the same for every lesion on every patient… The radiation dosage administered by the machine at each location was preset.”
Not only did the physician assistants perform the work, Dr. Marder allegedly billed Medicare at a higher rate that physicians receive for treating such patients.
The whistleblower accused Dr. Marder of conspiring with pathologist Dr. Robert Kendall. According to an FBI agent, Dr. Marder engaged in a kickback scheme with the pathologist.
Dr. Marder allegedly sent 35,000 patient samples to Dr. Kendall. Dr. Kendall allowed Dr. Marder to bill Medicare for the specimens, and allegedly paid Dr. Kendall an annual salary of $120,000, according to the Medicare abuse lawsuit.
Doctor’s Billing Practices Questioned
Apparently, this is not Dr. Marder’s first time for having his billing practices called into question. The Florida Word of Osteopathic Medicine fined Dr. Marder $2500 for his allegedly involvement in fraudulently billing private insurers in three different cases.
Not only did the Medicare billings defraud the government, his patients were also negatively impacted by his allegedly improper practices. Many patients did not have skin cancer, yet were given inappropriate medical treatments.
“This radiation therapy not only damages the cancer cells present in the body, but it also has a damaging effect on healthy tissue which surround the tumor being treated,” the whistleblower attorney stated. (LINK)—11/30/2016
Florida dermatologist wrongly diagnosed patients with cancer for profit
Dr. Gary Marder in Port St. Lucie, Florida has agreed to pay up to $18 million to reimburse the government for Medicare payments on patients who were not ill.
Prosecutors allege that Dr. Marder falsely diagnosed patients with skin cancer and put them through medically unnecessary radiation treatments, pocketing millions from the insurance companies.
Gloria Strumalo from Port St. Lucie was one of his patients.
She went to Dr. Marder’s office for a checkup and was diagnosed with skin cancer.
He recommended radiation therapy.
“I went for 20 days of 2 hours,” Strumalo said.
She had no idea that she didn’t need radiation therapy since she didn’t actually have skin cancer.
“You just take their word,“ Strumalo said. "You trust your doctors.”
The bills to the insurance company for her unnecessary treatments were stacking up.
Each visit cost between $1,600 and $3,500.
A few weeks later she went back for a checkup and she didn’t believe when Dr Marder said she had to undergo more radiation therapy.
Soon she found out she wasn’t alone.
She talked to another of Dr. Marder’s patients.
“She said: ‘You know that doctor wanted to do radiation on me again,” Strumalo said.
Strumalo decided against another set of radiation and opted for surgery instead.
The wound got badly infected.
“There was a lot of discomfort and a lot of pain,” Strumalo said.
She went to Dr. Ted Schiff for a second opinion and she wasn’t his first patient from Dr. Marder.
“Sometimes we recognize patients just by the sheer number of biopsies done,“ Schiff said.
"By the number of procedures and the excessive use of radiation therapy done in an improper manner.”
Schiff said over the course of three to five years he had seen numerous of Marder’s patients with benign conditions such as freckles or warts, who were told they had skin cancer.
"In all my years in the medical field I’ve never seen anything like this,” Schiff said. “As doctors we take an oath to do no harm.”
Schiff alerted the authorities and worked with the FBI to uncover the scale of the scheme and build a case against Dr. Marder.
A whistleblower lawsuit began in 2013 after Schiff noticed a big increase in patients that had undergone unnecessary treatments.
The lawsuit was picked up by the U.S. Attorney’s Office.
The settlement brings an end to the civil case against the dermatologist who has practices in Okeechobee and Port St. Lucie.
As part of the agreement, Marder can pay $5.2 million before the due date and avoid having to pay the full $18 million.
He will also have to give the government a vacant lot he owns on Hutchinson Island in Martin County, valued at $650,000.
Although he owns a 12,700-square-foot home, which is valued at $28 million, it can’t legally be seized.
As of Thursday, Marder’s medical license was still active, despite previous disciplinary actions against him.
The worst part for Strumalo was when she learned that she never actually had skin cancer on her leg and that the radiation treatments and surgeries were all for nothing. “It’s devastating,“ Strumalo said. (LINK)—2/09/2017
COLDWATER — An addiction to amphetamine has Coldwater doctor Christinia Whitaker, 42, back in jail, charged with illegal possession of the prescription drug, 10 years after her first arrest.
Dr. Whitaker was stopped as she drove back from Hillsdale County, where sheriff’s office deputies there said she had participated in an illegal exchange with an undercover informant.
Hillsdale officers said Dr. Whitaker would write a prescription for drugs, then receive part of it back as payment.
Branch County Sheriff’s Office Deputy Steve Foster was notified that the exchange had taken place and to look for three pills of Vyvanse inside a cigarette pack.
Foster stopped Dr. Whitaker’s car on East Chicago Street in Coldwater and found the pack and pills on the front seat. The police report indicated that Whitaker admitted the pills were an amphetamine and she had no prescription for the Schedule II narcotic.
Vyvanse is a synthetic amphetamine and a federally controlled substance because it can be abused or lead to dependence.
The officer also found another of her patient’s empty prescription bottles in Whitiker’s car. Dispensed seven days before for a 30-day dosage of amphetamine, the bottle was empty.
Whitaker was charged with illegal possession of the drug, a two-year felony. Her bond was set at $15,000 by Branch County District Court Judge Brent Weigle, who scheduled preliminary proceedings for Feb. 23 and March 1.
Dr. Whitaker admitted at the jail that she would test positive for amphetamines and did, along with THC, the active ingredients in marijuana.
Whitaker listed her employment as a doctor for Adapt on the jail booking form.
More charges could be filed later in Hillsdale County.
In 2007, Dr. Whitaker pleaded guilty to two counts of obtaining a prescription drug by fraud. She was able to continue to practice medicine during her three years probation, which fell under Section 7411 of the public health code.
With successful completion of probation, the record was sealed and no conviction is listed on her record.
Employees at the office where she worked said they had been approached by Dr. Whitaker to obtain the prescription drug Adderal for her. That is also a synthetic amphetamine.
State investigators found 37 improper prescriptions, some written to patients who gave them to Whitaker.
At that time, Dr. Whitaker told Branch County Circuit Court Judge Michael Cherry that she had been told to use Adderal in medical school to help with her patient rapport. She said she turned to it again in a residency program and after she came to Coldwater because “there was not enough time in the day to take care of all the patients I wanted to take care of.”
During her probation, Dr. Whitaker had to be monitored by another doctor and complete the Health Professionals Recovery Program for a second time.
In 2014, investigators for the Michigan Department of Licensing and Regulatory Affairs reviewed her records and determined she had written prescriptions for Adderall, as well as the narcotic pain killers Norco and Tramadol for four patients. She had not kept any patient records for the four people.
In a consent agreement with the state licensing board, on Sept. 3, 2015, Dr. Whitaker agreed to a one-year administrative probation. She had to receive continuing education, be under review by another physician, and comply with the public health code. She was fined $500.
That probation had ended last September. Records obtained by the Branch County Sheriff’s Office indicated Whitaker may have been improperly prescribing drugs during her probation.
More charges could be filed later in Hillsdale County. (LINK)—2/16/2017
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