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USA section    Series :- Tenet Healthcare and its Doctors

The fallout from the Redding Scandal

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Unnecessary cardiac operations at Tenet's Redding hospital sparked concerns in cardiology across the USA. There were allegations and investigations of other Tenet hospitals. A doctor at a non-Tenet hospital was charged. The Tenet case was settled. As far as I am aware the findings of the investigations and the validity of allegations were never released or tested. Tenet denied them.


The series:- Tenet and its doctors
In July 2003 I wrote a web page titled "Tenet Health Care and its doctors" which included the story of Tenet's relationship with its doctors going back into the 1990s. In 2007 I put the material about Redding hospital into a separate web page and wrote two more about this revealing scandal within a scandal. The kickback allegations too had become a major player in the wider scandal. This has also been moved to a separate web page and updated. More Tenet sagas which involve doctors have come to light and these throw additional light on the many problems in Tenet's operations. While they deal with more than just the doctors they all contribute to the story of doctors and form a saga. I have therefore arranged them as a series called "Tenet and its Doctors".

 The web pages are

The fallout from the Redding Scandal


The exposure of needless surgery at Tenet's Redding hospital set alarm bells ringing about not only about surgery in Tenet hospitals but about cardiology and cardiac surgery across the USA.

US wide impact

Patients and physicians across the US became far more wary and more conservative in agreeing to surgery.

Oct 2003 Widespread skepticism
The impact of the Redding case extends far beyond the Shasta County city of Redding, too. From Chico to Los Angeles, from doctors to patients, skepticism has seeped into conversations about cardiac care. And there's a new drive to prevent unwarranted treatment.
Some cardiologists and heart surgeons are more circumspect today, said Dr. Ismael Nuño, director of cardiac surgery at the Los Angeles County-USC Medical Center in Los Angeles and president of the American Heart Association's Western States Affiliate.
"This has introduced a new element of distrust that was never there," she (Dr. Janet Wright, cardiovascular department at Enloe Medical Center in Chico) said. "Some want data, or want to see the angiogram or they want to bring family members or a physician friend in and have them translate all that information."
Critical condition : Will new medical oversight and new leaders be able to revive hospital? Sacramento Bee October 26, 2003

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Tenet and Cardiology

The Redding scandal set off a train of investigations of Tenet hospitals and cardiology services across the country. We will never know what these revealed as the findings went into the governments investigation and were never disclosed.

Tenet reached a settlement without a trial and without admitting guilt. The findings, if any, were never tested and we do not know what part, if any, they played in the negotiations.

Was the US $900 million settlement a fair result or was it another massive Bush government cover up, making Tenet pay enough to appease the public while allowing a big donor to continue operating and expressing its gratitude with campaign support?

Nov 2003 Other Californian hospitals
Signaling that the government is investigating whether unnecessary heart surgeries were performed at Tenet hospitals in the Los Angeles area, federal prosecutors have requested documents related to coronary procedures and billing practices at three medical centers in the region.

Tenet Healthcare Corp. said Friday that it would hand over the documents, including arrangements with cardiologists who practice at Daniel Freeman Memorial Hospital in Inglewood, USC University Hospital in Los Angeles and Centinela Hospital Medical Center, also in Inglewood and home of the Tommy Lasorda Heart Institute.
State records show that these facilities have had a substantial increase in cardiac services in recent years.
The number of cardiac operations at USC University Hospital (run by Tenet), which is near the much larger L.A. County/USC Medical Center, more than doubled, to 442, between 1999 and 2001, according to the latest available data from the Office of Statewide Health Planning and Development.
According to the latest state data, the number of bypass and other cardiac surgeries at Centinela jumped from 75 in 1999 to 179 in 2001, and total catheterization services more than tripled during that period to 1,809.
Heart Care Scrutinized at 3 L.A. Hospitals L. A. Times, November 1, 2003

Jul 2004 Cardiology practices
And the Los Angeles Business Journal reported earlier this year that Apex Cardiology Consultants -- a high-profile practice at Centinela -- has fielded a subpoena and appears to be the focus of an investigation by the U.S. Attorney's office in Los Angeles.
Vulture Fund Circles Tenet Hospital Sale The (Melissa Davis) July 27, 2004

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Tenet's Doctors Medical Center in Modesto

In November soon after the Redding scandal Blue Cross did an audit of Tenet's hospitals in Redding and in Modesta. Its sample was small but it found that 59% of the coronary bypass operations at Modesta were inappropriate. It diverted all its patients to other hospitals.

Tenet contested the figures. It's own panel of experts found that the same operations were appropriate. It forced Blue Cross to cancel their cancellation of services and then sued Blue Cross. I don't know whether this was prosecuted or settled. Senator Grassley asked for all of the documents but his findings are unknown.

Nov 2003 Modesta accused
On Friday, Dr. Woodrow Myers, chief medical officer for Blue Cross, said an independent review of 52 bypass operations performed at Redding and Modesto-based Doctors Medical Center showed that 85% of those performed at Redding and 59% of those performed at Doctors were inappropriate. Myers said that as of the first week in October, Blue Cross will no longer authorize elective bypass operations at the two facilities.
California To Audit Billing Practices at 40 Tenet Healthcare Hospitals for Potential Medicaid Fraud Unknown source approx November 3, 2003

Nov 2003 Grassley takes an interest
Sen. Chuck Grassley, chairman of the Committee on Finance, today asked the federal Health and Human Services Department Office of Inspector General to investigate whether a second Tenet Healthcare Corp. hospital might have performed unnecessary cardiac procedures and surgeries and billed the federal government for them.
Grassley Seeks Government Investigation of Second Tenet Hospital Press Release Nov. 7, 2003

Nov 2003 Blue Cross stops operations
Blue Cross of California recently announced it would no longer cover nonemergency bypass surgeries at the Doctors Medical Center in Modesto, Calif., after an independent review of 23 operations found that 13 had not been medically necessary.
Tenet said Blue Cross had no right to end its contract with Doctors Medical Center based on what Tenet called "scant information."
Senator Seeks Inquiry Into Tenet Hospital LA Times November 8, 2003

Nov 2003 Tenet disputes findings
Tenet Healthcare Corp. said Wednesday that its own independent panel of doctors had reviewed 23 heart surgery cases at Tenet's Modesto hospital and concluded that all the patients had received appropriate treatment.
Tenet Panel Finds Care in Modesto Was Proper LA Times November 13, 2003

Nov 2003 Blue Cross backs down
Blue Cross of California said Friday it will not terminate its coverage at Doctors Medical Center in Modesto, backing off from its earlier threat to end coverage because of concerns over improper medical care.
Blue Cross Lets Tenet Keep Coverage The New York Times November 21, 2003

Dec 2003 A defamation lawsuit
Tim Joslin, CEO of Doctors Medical Center, Modesto, Calif., has filed a defamation lawsuit against Blue Cross of California, saying the state's largest health insurer damaged the 392-bed hospital's reputation by falsely accusing its doctors of performing unnecessary heart surgeries. Blue Cross' parent, WellPoint Health Networks, and Health Benchmarks, which conducts studies for healthcare companies, also are named in the suit.
Tenet hospital CEO sues Blues plan for defamation Modern Healthcare's Daily Dose Dec. 2, 2003

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Other Unnecessary Operations in Tenet hospitals

It was inevitable that surgery at other Tenet hospitals would be questioned and investigated. Whistleblowers would come forward. I have reports about a neurosurgeon and about a hospital in Texas.

The Neurosurgeon

The neurosurgeon had a long history of problems that Tenet had done little about. The peer review committee suspended him. Whether they could have got away with it prior to the Redding scandal is something we can speculate about. Senator Grassley included this in his investigations. For more about this and the possible role of Tenet's vice president click here.

Sep 2003 Grassley asks for documents
34. From 1995 to the present, all documents relating to any communications, which raise any questions or concerns regarding Dr. Israel Chambi (including, but not limited to unnecessary medical surgeries and procedures) at Western Medical Center, between any of the following: Tenet's board of directors; Tenet's committees, whether formally or informally constituted; Tenet's administrators or officers; any Tenet employee.
Letter from Senator Grassley, chairman of the Senate Committee on Finance to Trevor Fetter, CEO Tenet Healthcare September 5, 2003

Sep 2003 Neurosurgeon's history
The 54-year-old Chambi has been chief neurosurgeon since 1998, and has been accused by numerous former patients of malpractice and incompetence.

A spokesman for the hospital's parent company Tenet Healthcare said the hospital is investigating Chambi and results will be sent to the state Medical Board.
Chambi had previously lost his job at UC Irvine after he was accused of questionable judgment in cases there.

He has been sued 36 times for malpractice or wrongful death since 1992. He won most of the lawsuits, while ten patients obtained verdicts or settlements totaling $3 million. Four cases are pending.
Top Brain Surgeon Suspended From Trauma Center NBC4 TV Los Angeles ( September 12, 2003

Sep 2003 Peer Review Committee acted
The peer-review committee at a Tenet Healthcare Corp. hospital suspended the privileges of a physician who has drawn the interest of congressional investigators, a spokesman for the Santa Barbara, Calif., company said.
Peer committee suspends doctor at Tenet hospital Modern Healthcare's Daily Dose September 15, 2003

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Twelve Oaks Hospital

Twelve Oaks in Texas was once owned by OrNda Healthcare and was acquired during a takeover in 1997. It was once a high quality hospital with a reputation among the profession. Whistleblowers alleged that standards had deteriorated and unnecessary operations were done.

Sep 2003 Haunted House?
But Twelve Oaks -- an underperformer in Tenet's Houston market -- is not necessarily the picture of health. Referred to by some hospital insiders as "Twelve Jokes," the facility is accused of employing the same business practices that have come back to haunt some of Tenet's star hospitals in California. Specifically, the hospital is suspected of performing unnecessary surgeries like those alleged at Tenet's Redding Medical Center and Western Medical Center.
Whistleblowers Piping Up at Tenet The (Melissa Davis) September 30, 2003

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Concerns in non-Tenet hospitals

In fairness Tenet doctors were not the only ones accused of doing unnecessary heart operations. A cardiologist working in a not for profit hospital was charged with criminal activity in 2006 for doing unneeded procedures. It is not known whether he has been successfully prosecuted.

Mar 2006 Another cardiologist accused
Cardiologist Mehmood Patel has been indicted on 94 counts of healthcare fraud involving 94 different patients.

The indictment alleges Dr. Mehmood Patel performed unnecessary heart procedures at Our Lady of Lourdes and Lafayette General. Prosecutors say Patel's scheme defrauded public and private health insurance plans of $2.5 million. Four federal offices are taking part in the case. Investigators say fraud cases that exploit the public take on added importance.
The allegations also accuse Dr. Patel of falsely diagnosing diseases which didn't exist and falsifying records. Patel was unavailable when we stopped by his Lafayette office. Officials with both Lourdes and General say Patel is no longer on staff.
Washington says several patients have received serious injuries as a result of Dr. Patel's actions. Dr. Patel faces up to 20 years in prison if convicted of the charges.
Lafayette Doctor Indicted on 94 Counts of Healthcare Fraud 10 KLFY NEWSA March 23, 2006

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This page created July 2007 by
Michael Wynne