On Monday, court documents were released about risky practices followed by three prominent Houston heart surgeons at Baylor College of Medicine. The lawsuit was filed in the Southern District of Texas by the U.S. Attorney’s Office. The violations are serious, and many patients may have been affected by these allegations.
Who Was Named in the Lawsuit?
St. Luke’s Hospital, Baylor College of Medicine (the hospital’s academic affiliate), and the Surgical Associates of Texas P.A. were named in the lawsuit because they were aware of and participated in the violations. For example, Baylor was supplying operating rooms and trainees.
Three heart surgeons were named in the court documents: Dr. Joseph Coselli, Dr. Joseph Lamelas, and Dr. David Ott. The lawsuit indicated that 10 other surgeons at Baylor were also performing concurrent surgeries, but the violations weren’t as severe as these 3 defendants.
Originally, the allegations were filed in a sealed case in 2019. A whistleblower, Dr. Jeffrey Morgan, came forward to share these concerns. He was the director of the transplant program from 2016 – 2018.
Summary of the Allegations and Violations
The allegations cover malpractice concerns over a period of seven years (between 2013 and 2020). Violations include:
- Using unqualified trainees to perform thousands of surgeries
- Leaving medical residents and fellows in operating rooms alone and during critical moments of complex surgical procedures
- Not informing patients that trainees were performing the medical procedures
- Performing 2 or 3 heart procedures simultaneously, then fraudulently billing the government for all operations
Additionally, the lawsuit shared concerning information about broader problems in the operating room practices. For example, when surgeons were rushing from one patient to the next, there were times when the patients were under anesthesia for longer than necessary. Some patients experienced excessive internal bleeding, requiring that their chests be re-opened to mitigate the resulting complications. Other concerns were that heart valve sutures came loose, which meant that some patients needed to have their surgeries redone.
What Were the Surgeon’s Motivations for These Violations?
Because the doctor’s compensation is based on their surgical volumes, these practices increased their personal incomes by as much as 4x higher than industry averages for their specialty. The volume of cardiac surgeries was 2 – 4 times more than those performed by other cardiac surgeons in other parts of the country.
A simple explanation is that they were moving through as many surgeries as possible in an effort to generate more revenue for Baylor and the surgeons. Regulations were overlooked and improper procedures were followed, resulting in a high monetary benefit for those involved.
They were basically running a heart surgery assembly line: starting one surgery, then leaving the operating room to have an inexperienced medical resident or fellow finish the procedure. The surgeon would move from one operating room to the next, leaving the less experienced trainees in the room with the uninformed patients. It’s not just about surgeons being overbooked – deliberate planning and scheduling was used for years to maximize the number of patients that were moving through the operating rooms.
One example in the lawsuit is that in 2018, there was one point where Dr. Coselli was scheduled to perform over 32 hours of surgery, and these procedures were completed in a 16-hour period of time.
It’s estimated that these practices brought in $150 million. The doctors’ incomes reached more than $2 million annually. More than 5,000 overlapping heart surgeries were performed in these 7 years.
Settlement to Resolve the Allegations Out of Court
Instead of going to court, an amicable resolution was negotiated – to minimize legal fees and anticipated costs in the future.
A settlement was reached, and three organizations will pay $15 million: St. Luke’s, Baylor College of Medicine, and the Surgical Associates of Texas P.A. Because of this settlement, the charges are being dismissed, and the defendants are found not guilty in the case.
Baylor College of Medicine released a statement assuring that no patients were harmed and claimed that the school didn’t violate any regulations or federal law. St. Luke’s also released a similar statement and pointed out that these claims are “strictly allegations.” The statement reassured that the hospital continues to “remain committed to complying with all CMS regulations.”
A Questionable History at Baylor and St. Luke’s
These most recent violations aren’t the first accusations against Baylor School of Medicine and St. Luke’s. The hospital is known for being the location where the first successful human heart transplant was performed in 1968, and it has a reputation as one of the best places in the country for patients needing heart surgery.
But an investigation in 2018 discovered that there was an unusually high number of deaths among heart transplant patients. Additionally, other issues were discovered with patients who received other types of heart surgeries.
Because of this investigation, in 2018 the Centers for Medicare and Medicaid took away their funding for the transplant program. Then the funding was reinstated again in 2020.
What the Future Has in Store
Even though none of the named defendants were found guilty (because of the settlement terms), there’s no question that this lawsuit will affect the reputations of Baylor, St. Luke’s, and the involved surgeons.
It’s a good reminder that medical malpractice can occur at even the most prestigious healthcare clinics in the country. Patients need to be diligent about protecting their healthcare rights and watching out for questionable medical practices and ethical concerns. As a patient, you have the right to know who is performing your surgery.
Talk to the Medical Malpractice Experts
Do you think you or a loved one is the victim of medical malpractice? The best thing that you can do is consult with an experienced attorney who can review your case.
Wormington & Bollinger is always here to help, offering the skilled legal services you need to protect your rights and help with compensation when necessary. If you have questions or need more information, then we invite you to contact us for a consultation.