We hate these stories… medical professionals abusing patients (and taxpayers too) all for the sake of a few extra dollars. Although Medicare fraud costs taxpayers tens of billions of dollars per year, rarely are patients’ lives at risk. We have said many times before; there is a special place in Hell for those who perform medically unnecessary procedures and surgeries.
Today a hospital is paying the price, although the surgeon accused of actually performing the surgeries is a fugitive from justice.
The U.S. Attorney’s Office in Cincinnati says Dr. Abubakar Atiq Durrani performed unnecessary spinal surgeries on several of his Medicare patients. Although the patients were not named, a statement from the government says they were especially vulnerable. Health and Human Services Special Agent Lamont Pugh said, “Any time greed replaces medical necessity as the primary factor in performing invasive procedures and surgeries on Medicare and Medicaid patients, our most vulnerable citizens — the elderly, disabled and economically disadvantaged — are imperiled.”
Dr. Durrani is today a fugitive from justice and criminally charged with five counts of Medicare fraud and five counts of making false statements. Ordinarily each healthcare fraud count carries a maximum 10-year sentence but judges can enhance the penalties if actual harm occurs. Any surgery involving the spinal column by its very nature is both dangerous and can have permanent and devastating side effects.
Prosecutors claim Durrani fled the United States after his arraignment and his whereabouts are currently unknown. After being arraigned he surrendered his passport but is believed to have left the United States in early 2014. There are some court records that suggest he may be a native of Pakistan.
Although Durrani is a fugitive, a Cincinnati hospital settled its portion of the civil whistleblower complaint. According to that complaint, Durrani was performing some very complex and dangerous surgeries including implanting metal rods into patients.
The complaint also says that Durrani was injecting some patients with a drug called Infuse BMP-2, a prescription drug not approved by the FDA for spinal use. The complaint says when used incorrectly or for off label use, the drug can cause uncontrolled bone growth. If that occurs with the spine, “intractable pain and paralysis” can result.
What makes this case so incredible is that prosecutors and his former patients both agree that many of the surgeries were medically unnecessary. Worse, some patients suffered serious injuries.
The civil whistleblower lawsuit was brought by several patients under the federal False Claims Act, a Civil War era statute that allows ordinary folks with inside information about fraud involving a government program to file a lawsuit in the name of the government. If the suit is successful, a whistleblower can receive up to 30% of whatever the government collects from the wrongdoer.
In this case, the suit was brought against UC Health and West Chester Hospital. Hospital systems have an independent duty to insure that surgeries performed at their facilities are medically necessary and a duty to supervise physicians who practice at their facilities.
The government recovered $4.1 million from the hospital (which was not required to admit any wrongdoing.) The whistleblower award portion of that recovery is $800,000. The settlement does not prevent the patients from pursuing whatever malpractice claims they may have against the hospital. They can also sue Durrani, although collecting won’t be easy.
Because Medicare and Medicaid paid for many of these surgeries, the civil claims could be brought under the False Claims Act. In this case the whistleblowers were patients although often the whistleblower is a healthcare professional.
If you have original, inside information about Medicare fraud and are interested in becoming a whistleblower, give us a call. Our clients have received over $100 million in whistleblower awards over the last 12 months.
Need more information, contact attorney Brian Mahany at or by telephone at (direct). All inquiries are always kept completely confidential. (You can also click here for more information about Medicare and Medicaid fraud.)
MahanyLaw – America’s Whistleblower Lawyers