Unnecessary Procedures Can Lead to Medical Malpractice Claims

By Greg Kohn

In most medical malpractice lawsuits, the plaintiff has a medically necessary operation that is performed negligently resulting in harm. But medical malpractice claims can also arise because plaintiffs did not require a particular course of treatment or procedure, but surgeons operated anyway out of greed or ignorance.

One instance of this type of malpractice and fraud, on a grand scale happened in Kentucky, according to the Louisville Courier Journal. It reports an Ashland hospital agreed to pay $40.9 million to the federal government to settle claims that it made millions of dollars by falsely billing Medicaid and Medicare for unnecessary heart procedures.

The payment announced by the hospital, King’s Daughters Medical Center, settles a government lawsuit claiming the hospital “knew, deliberately ignored or recklessly disregarded the fact” that its cardiologists were inserting stents and performing catheterizations on patients who didn’t need them.

The following are some key details from the case:

  • The government claims that between 2006 and 2011, King’s Daughters billed Medicare and Kentucky Medicaid for numerous unnecessary coronary stents and diagnostic catheterizations performed by its doctors.
  • The physicians are accused of falsifying medical records in order to justify the unnecessary procedures.
  • The suit alleges the hospital paid some cardiologists salaries that were unreasonably high and the doctors returned the favor by referring patients to the hospital.
  • The settlement amount is roughly double the amount the hospital received from the alleged fraudulent billing for the unnecessary services.

The problems facing the hospital and cardiologists aren’t over yet. The settlement doesn’t protect the hospital or its doctors from potential criminal charges or about 520 lawsuits filed by former heart patients against the hospital and its coronary group. One such accused physician is Dr. Richard Paulus, for whom the hospital’s coronary center is named.

Ashland, Kentucky is a small town (population 21,506) and if this level of patient abuse is going on in rural Kentucky, the potential number of patients needlessly going through painful, time consuming, expensive, useless procedures that could result in infections and serious harm in New Jersey could be staggering.

If you have discovered that a serious medical procedure you’ve endured was actually unnecessary and harmed you as a result, contact our nearest New Jersey office so one of our medical malpractice attorneys can talk about your situation and your possible legal options to seek compensation.

About the Author
Greg Kohn is a partner at Nagel Rice and specializes in complex civil litigation cases, including professional malpractice, personal injury, class actions, wrongful death, products liability, and commercial litigation.  He has extensive experience representing clients in both state and federal court. Greg has tried many jury trials to verdict and has recovered over $50 million in settlements and verdicts in all types of personal injury matters including automobile accidents, wrongful death cases, slip and falls, and other catastrophic injury cases. Greg also handles medical malpractice cases, involving misdiagnoses, wrongful birth, and delayed cancer diagnosis. If you have questions regarding this article, you can contact Greg here.