Checks and balances for the medical profession

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Victims of Dr. Farid Fata listened anxiously as United States District Judge Paul Borman sentenced Dr. Fata to forty-five years in prison on July 10, 2015.  Dr. Fata pled guilty in September 2014 to twenty-three counts of health care fraud, two counts of money laundering, and one count of conspiracy to pay and receive kickbacks.  These charges do not even begin to describe the manipulation Dr. Fata performed on his vulnerable patients.

Since 2009, Dr. Fata has been scamming patients into paying for improper cancer treatments

Dr. Fata was known as one of Michigan’s most respected hematologist and oncologist.  He had practices across seven cities and had seen over 16,000 patients since 2005.  Additionally, he received $35 million from Medicare and was ranked the highest-paid oncologist in terms of payment in 2012.  Between his seven medical businesses, Dr. Fata had 1,200 patients and billed Medicare more than $150 million.

Since 2009, Dr. Fata has been scamming patients into paying for improper cancer treatments.  He falsely diagnosed patients with cancer knowing they did not have cancer, gave improper treatment to the patients who actually suffered from cancer, and prolonged painful chemotherapy treatments when it was no longer needed.  Prosecutors compared Fata to a “medical version of convicted Ponzi scammer, Bernard Madoff.”  Fata did not provide chemotherapy to help keep the patients alive; he prescribed the toxic medicine to make money.

Before sentencing, Judge Borman allowed victims and families of victims to testify about the pain and suffering they or their loved ones went through because of the unnecessary treatments.  Fata showed no emotion when families cried about the loved ones they lost due to his improper treatments.  Testimony revealed that one patient received 260 weeks of chemotherapy where he should only have received twenty-four.  Expert testimony exposed that a drug used to treat aggressive lymphoma, Rituximab, was given to a patient 94 times when the maximum amount it should ever be given to someone is eight.  If patients wanted to get a second opinion or questioned finances, Fata would tell his patients they risked their death without him—“Your life or your money.”  These threats even caused a patient to go into bankruptcy while trying to pay for treatment.  Some of Dr. Fata’s former patients will suffer long time medical issues.

It was not until whistleblower, George Karadsheh, the practice manager, was alerted by a former employee of Fata that the FBI began its investigation

Angela Swantek, a chemotherapy nurse, recognized Fata’s suspicious practices back in 2010, when she interviewed for a position in his office.  She recognized that patients were receiving chemotherapy in an improper manner.  Swantek left the office feeling uneasy and reported Fata to Michigan’s Bureau of Health Professions.  A year later, Swantek received a letter stating Fata was cleared of any wrongdoing.

It was not until whistleblower, George Karadsheh, the practice manager, was alerted by a former employee of Fata that the FBI began its investigation.  Dr. Soe Maunglay, a former co-worker of Fata, notified Karadsheh of his suspicions after doing rounds in Crittenton Hospital Cancer Center.  Dr. Maunglay used to work for Fata in 2012.  He resigned after finding out that Fata was lying about certifications he claimed to have and allowed unlicensed doctors to take place of a licensed doctor when administering chemotherapy treatments.

On the night Dr. Maunglay did rounds in the Crittenton Hospital Cancer Center, he noticed Monica Flagg, a patient of Fata who was in the hospital with a broken leg.  Luckily, at that time, she only received the first of many chemo sessions.  Dr. Maunglay realized it was very unlikely Monica had cancer, and consequently warned her to never go back to Fata and to get a second opinion.  It was then he contacted Karadsheh about his concerns, who then contacted the FBI.

Fata kept up with appearances and dodged suspicion from his medical staff by claiming his practices were part of a “revolutionary ‘European’ or ‘French’ protocol.”  If patients asked for their medical files, he would purposely deny them access to the full file.  Effectively, Dr. Fata’s actions hindered his patients’ ability to seek second opinions.

[D]octors unknowingly profit from their treatment decisions because of the demands of the health care system

The Department of Health and Human Services conducted a report finding that Medicare’s Part D spending, which subsidizes prescription drug costs with federal drug dollars, has more than doubled since 2006.  This has caused doctors to run up their patients’ bills.  In addition, pharmacies participate in questionable billing for drugs available through Part D—more than 1,400 pharmacies billed extremely high amounts in 2014 alone.  Fortunately, in 2014, the Physician Payments Sunshine Act was passed.  This Act requires “drug and medical product manufacturers, who are reimbursed by federal health care programs like Medicare, to report any financial payments or services provided to doctors or teaching hospitals.”  The Act is just the first of many steps that needs to be made for more transparency to prevent an outrageous act, such as this one, to happen again.

Nicholas G. Evans, medical ethicist at the University of Pennsylvania, says doctors unknowingly profit from their treatment decisions because of the demands of the health care system.  It is more common for doctors to “bend their treatment decisions toward making the most money possible.”  For instance, a study reported in The New England Journal of Medicine in 2013 found that urologists who own the state of the art radiation therapy services were more than twice as likely to prescribe it to patients compared to those who did not have the services available.

There is no such thing as the medical police; it takes a whistleblower to bring the corruption to light

Similar to the legal profession, the medical field is self-regulating.  Medical peer review is a common practice, and it allows professional organizations such as the American Medical Association to perform internal reviews.  However, these reviews are not exactly close examinations, and some but not all the information from the reports are made public.  Although reports from internal reviews can be made public, some state laws, including Michigan, prevent the public from knowing the identity of anyone involved in an investigation.  Lawyers cannot seek this information either.  Thus the statute causes the public to be in the dark about a doctor’s past investigations in regards to negligence.  There is no such thing as the medical police; it takes a whistleblower to bring the corruption to light.

In regards to recovery, Michigan’s medical malpractice cap is at $450,000 for punitive damages such as pain and suffering.  Fortunately, there is no cap for economic damages such as medical bills, loss of wages, and future earnings.  Currently, there are more than 40 pending civil cases against Fata.  However, as is true to our justice system, it may take years before those patients reap any award.