Lawsuit: DMC cost-cutting, fraud led to patient deaths

Karen Bouffard
The Detroit News
Hospitals at the Detroit Medical Center are being investigated for faulty patient conditions after complaints were filed against the health system.

Two Detroit Medical Center cardiologists say in a lawsuit against the health system that they were fired from leadership positions after complaining about dirty surgical instruments and other problems — including unnecessary surgeries that resulted in patient deaths.  

The lawsuit filed Monday by cardiologists Dr. Mahir Elder and Dr. Amir Kaki claims they lost their DMC leadership roles in October in retaliation for complaining about quality-of-care issues at the health system. 

Elder and Kaki were among four top DMC cardiologists fired from their leadership posts in October. Dr. Tammam Mohamad and Dr. Ted Schreiber, the DMC's top medical executive for cardiology at the time, were also asked to step down. 

Their firings were made public by the DMC in October, which said in a statement at the time that the doctors were asked to step down for unspecified violations of the health system's standards of conduct. The DMC is owned by for-profit Tenet Healthcare in Dallas.

Asked to respond to Monday's lawsuit, the DMC issued a statement saying the health system doesn't comment on litigation, but added: "As we’ve said previously, we asked Drs. Elder and Kaki to step down from their administrative leadership roles in the DMC cardiovascular service line in October 2018 due to violations of our Standards of Conduct.

"Any suggestion that these leadership transitions were made for reasons other than violations of our Standards of Conduct is false.”

According to the lawsuit, Elder and Kaki were fired after complaining to DMC management that unnecessary and dangerous cardiac medical procedures were performed by other physicians at the DMC. 

"Defendants' goal was to be profitable and medical procedures generated significant income for the DMC, paid by Medicaid and Medicare," the lawsuit alleges.

The lawsuit cites the examples of three patients who died after unnecessary heart procedures, including that of a patient admitted with a pulmonary embolism in late 2015.  According to Elder and Kaki, the patient was given an aggressive procedure which was not required, then suffered complications and bled to death.  Several other patients were subjected to unnecessary carotid stent procedures, the lawsuit claims. 

The lawsuit alleges the DMC billed and continued to bill the government for these and 
other improper procedures.

The lawsuit comes after the Michigan Department of Licensing and Regulatory Affairs inspected Harper University and Detroit Receiving hospitals in October, on behalf of the federal Centers for Medicare and Medicaid Services, after the three cardiologists and the top doctor at DMC Heart Hospital claimed they were terminated from their management roles in retaliation for complaints they made about quality-of-care issues.

Heart Hospital adjoins Harper and shares many of its facilities and services.

The two DMC hospitals face the potential loss of federal funding on April 15 after failing two inspections, according to government documents obtained by The Detroit News. The inspections were in October and Dec. 13, but the results of the December probes haven’t been released.

CMS officials didn't immediately respond Monday to a request for any updates on the DMC's government funding issues.

"Tenet has a long history of violating the law at the taxpayers’ expense by making false claims to the government for payments they are not entitled to,” said Deborah Gordon, the doctors’ Bloomfield Hills attorney. “My clients are top flight cardiologists who devoted themselves to serving the Detroit community, where there is a high rate of cardiac medical issues.

“They made a difference in people’s lives — literally.  But defendants could not tolerate their speaking out against fraud and improper medical care. After all, they admit profits are their “#1” priority. The terminations were  an attempt to silence and punish my clients. This lawsuit is the result.” 

CMS sent preliminary letters of determination to Harper University Hospital and Detroit Receiving Hospital on Jan. 15, saying the hospitals do not meet federal requirements for their "physical environment" to participate in Medicare, the federal health insurance program for elderly and disabled Americans. 

Michigan hospitals barred from participation in Medicare are automatically terminated from the federal Medicaid program for low-income residents, according to the Michigan Department of Health and Human Services. The majority of patients served by DMC hospitals are funded by the federal health insurance programs. 

An inspection at Harper found flying insects in an intensive care unit, improperly attired surgical personnel and lapses in sterile processing of surgical instruments. At Receiving, inspec tors discovered the hospital had discontinued surveillance of most surgical site infections due to staff cuts in 2018, including for patients exposed to dirty surgical instruments. 

Both Harper and Receiving were found not in compliance with Medicare's conditions of participation for infection control and threatened with the end of federal aid. 

DMC Sinai-Grace Hospital spent most of last year in jeopardy of losing its federal Medicare funding after inspections found "significant" deficiencies in nursing care and building safety, according to government reports obtained by The Detroit News.

Sinai-Grace lost its Medicare-compliant status for nursing care in March 2018 and for the hospital's "physical environment" in April after the federal CMS requested inspections in response to a substantiated complaint. The hospital ultimately was able to regain its Medicare status in September, and the termination was rescinded.

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