MIAMI, FLORIDA, Dec. 22, 2015 - Hospital giant HCA has agreed to pay $2 million to the US and the state of Georgia to settle a whistleblower lawsuit brought by Phillips & Cohen LLP that alleged medically unnecessary and substandard heart procedures were being performed at an HCA hospital in Georgia.
The "qui tam" (whistleblower) lawsuit against HCA, Fairview Park Hospital in Dublin, Georgia, and two cardiologists was filed under seal in 2010 and transferred to federal district court in Miami in 2013. The settlement was announced today after the court unsealed the case last week.
Phillips & Cohen's whistleblower client, Dr. Michael Fenster, was the executive director of the cardiovascular program at HCA's Fairview Park Hospital in Dublin, Georgia, southeast of Atlanta. He is a board-certified interventional cardiologist.
"Dr. Fenster pursued this case against HCA for the past five years because his top priority is patient safety and health," said Colette G. Matzzie, a whistleblower attorney with Phillips & Cohen in Washington, DC. "He complained to upper management at both Fairview Park and HCA about cardiac procedures that were being done, and he provided supporting documentation, but his concerns were ignored."
In 2006, two years before Dr. Fenster was hired, Fairview Park Hospital had participated briefly in a nationwide study led by Johns Hopkins evaluating whether a heart procedure known as angioplasty, which is used to open blocked arteries to the heart, could be performed safely in small community hospitals without on-site cardiac surgery. The hospital stopped participating in the trial following one death within the first three months and conducted an internal investigation into the performance of unnecessary interventional procedures by a doctor.
Fairview Park Hospital recruited and hired Dr. Fenster in 2008 to run the hospital's cardiology program and be the principal investigator for the Hopkins study, which the hospital rejoined. Dr. Fenster pushed for greater supervision of the doctor who had been investigated previously and was still conducting invasive cardiology procedures, but, as alleged in his complaint, hospital and HCA officials rebuffed him. He provided information to hospital officials about a number of patient cases that merited investigation based on his review.
In subsequent years, HCA conducted reviews of the cardiology programs at Fairview Park and other hospitals in the southeastern US, finding a high number of procedures that raised concerns as detailed in a 2012 New York Times story.
The interventional cardiology procedures that allegedly were medically unnecessary or didn't meet professionally recognized standards of care, according to the settlement agreement, included diagnostic catheterizations, percutaneous coronary interventions, peripheral endovascular procedures, implantation of temporary or permanent pacemakers and implantation of automatic implantable cardioverter defibrillators. The vast majority of the patients receiving allegedly unnecessary procedures were covered by Medicare or Georgia Medicaid.
The qui tam complaint provides examples of patient treatment that allegedly were medically unnecessarily and in at least one instance, the complaint says, contributed to the patient's death days after the procedure.
"I was extremely frustrated by the response of Fairview Park and HCA officials when I raised very serious concerns about cardiac procedures being conducted," said Dr. Fenster. "I filed the qui tam whistleblower lawsuit as a way to draw government attention to this matter."
Phillips & Cohen litigated the case on its own because the Department of Justice didn't intervene in the lawsuit, which was brought under the whistleblower provisions of the False Claims Act. Whistleblowers are awarded 25 percent to 30 percent of the recovery when the Justice Department doesn't intervene, as specified under the law. Dr. Fenster was awarded 28 percent for his substantial contributions to the case.
Dr. Fenster has participated in many clinical trials, published original cardiovascular research in peer-reviewed journals and spoken at numerous professional conferences. He is currently on the faculty at The University of Montana College of Health Sciences. As a professional chef, he ties together his culinary skills and his passion for healthy living through his blog, www.cardiochef.com , and through the two books he has written about good food and good health.
Dr. Michael Fenster