Concurrent Surgeries: Heart surgeons play musical chairs with patients’ lives, pay $15 million.
What are concurrent surgeries?
Concurrent surgeries, also known as "double-booked" or "simultaneous" surgeries, occur when a surgeon is scheduled to perform more than one operation at the same time. In these cases, the surgeon might start one procedure, leave to begin or assist in another surgery, and then return to the first procedure. The time when the surgeon is not present is usually handled by other medical staff, such as residents or fellows, who may not have the same level of expertise.
The Senate Finance Committee investigated and published a report on the practice, but the risks of concurrent surgeries should be fairly obvious. A surgeon cannot be in two places at once. This practice can be risky, especially during critical moments in surgery, as the absence of the primary surgeon may lead to complications or errors. In the context of heart surgeries, which are highly complex and delicate, the stakes are even higher. Concurrent surgeries have raised significant ethical and legal concerns, especially when patients are not informed that their surgeon might not be present for the entire procedure.
As the U.S. Attorney for the Southern District of Texas commented:
“One missed cut is the difference between life and death”
It doesn’t take a brain surgeon to figure that out.
The scheme
Heart surgeons, on the other hand, need a reminder from time to time. In this case, Baylor St. Luke’s Medical Center (BSLMC), Baylor College of Medicine (BCM) and Surgical Associates of Texas P.A. allegedly engaged in a regular practice of running two operating rooms at once and delegating key aspects of extremely complicated and risky heart surgeries to unqualified medical residents. The heart surgeries at issue are some of the most complicated operations performed at any hospital including coronary artery bypass grafts, valve repairs and aortic repair procedures. At times, surgeons ran two operating rooms at once and failed to attend the surgical “timeout”— a critical moment where the entire team would pause and identify key risks to prevent surgical errors, according to the allegations. On top of that, the surgeons allegedly hid these activities by falsely attesting on medical records they were physically present for the “entire” operation and did not inform patients that they would be doing so.
The consequences were as predictable as they are heartbreaking. According to the Houston Chronicle, at least four patients died during scheduled overlapping surgeries, patients were under anesthesia for longer and suffered excessive internal bleeding that required re-opening their chest, heart valve sutures came loose, and surgeries needed to be redone.
Why would they allegedly do this? Well, money of course. Again, according to the Houston Chronicle, the physicians’ compensation was tied to their surgical volumes. Their compensation package was “some four-times higher” than the average for their specialty in Houston, reaching over $2 million each year, according to the lawsuit. Together, they performed more than 5,000 overlapping surgeries, with those cases alone boosting revenue for the hospital by $150 million, the lawsuit alleged.
The penalty
$15 million. Baylor St. Luke’s Medical Center (BSLMC), Baylor College of Medicine (BCM) and Surgical Associates of Texas P.A. will pay $15 million to resolve the claims. The $15 million recovery is the largest settlement to date involving concurrent surgeries.
The whistleblower
For speaking up and putting patients over profits, the whistleblower will receive $3,075,000.
Under the qui tam provision of the False Claims Act, a private party (also referred to as a whistleblower or relator) may file an action on behalf of the United States and receive a portion of the recovery, typically between 15-30%.
If you think you’ve observed fraud or misconduct, we can evaluate your options. Vivek Kothari is a former federal prosecutor who represents whistleblowers. For a free consultation, contact Vivek by email, phone, Signal, or fill out the contact form.