WEBVTT - Doctors Ghosting Patients During Surgeries 0:00:03.200 --> 0:00:08.000 This is Bloomberg Law with June Grosso from Bloomberg Radio. 0:00:10.440 --> 0:00:14.680 Imagine a patient who's anesthetized and intubated, and he goes 0:00:14.720 --> 0:00:17.680 into the operating room, and he's met with his surgeon, 0:00:17.760 --> 0:00:20.040 and he has confidence in that surgeon. He believes that 0:00:20.120 --> 0:00:22.160 he or she is going to be the person who 0:00:22.239 --> 0:00:24.680 is going to take them through the procedure and be 0:00:24.800 --> 0:00:27.760 there in the recovery room and give them, hopefully the 0:00:27.760 --> 0:00:30.880 good news that it went well. Unbeknownst to the patient, 0:00:31.240 --> 0:00:33.519 that surgeon, as the book A Matthew might say, is 0:00:33.560 --> 0:00:36.879 serving two masters or maybe three masters, and the surgeon 0:00:36.960 --> 0:00:39.920 might be involved in multiple surgeries at the same time. 0:00:40.479 --> 0:00:45.360 And so while that patient is unconscious, intubated, obviously anesthetized, 0:00:45.680 --> 0:00:48.600 he or she may be operated on by a fellow 0:00:48.760 --> 0:00:52.879 or a resident in someone substance, not the person entrusted 0:00:52.880 --> 0:00:53.800 to do the surgery. 0:00:54.480 --> 0:00:59.960 Doctors ghosting patients during surgeries, scheduling two or even three 0:01:00.120 --> 0:01:04.720 operations at the same time, and leaving during critical portions. 0:01:05.080 --> 0:01:08.000 It happens more than you may think, and it's been 0:01:08.080 --> 0:01:11.920 going on for years. That's because double or even triple 0:01:11.959 --> 0:01:15.479 billing Medicare can bring in hundreds of millions of dollars 0:01:15.520 --> 0:01:21.360 to hospitals and cost taxpayers billions. Attorney Reuben Guppen represents 0:01:21.440 --> 0:01:24.839 two doctors who blew the whistle on their fellow surgeons 0:01:25.200 --> 0:01:28.759 and were then fired by the Erlinger Health System in Tennessee. 0:01:29.240 --> 0:01:31.720 He compares the setup to Las Vegas. 0:01:32.200 --> 0:01:37.880 The reason I have that Las Vegas analogy is you 0:01:37.959 --> 0:01:41.160 have these hospitals and they make their money on the 0:01:41.240 --> 0:01:43.480 room and the board and the tests and all the 0:01:43.560 --> 0:01:47.040 ancillary services that go part and parcel with the surgery, 0:01:47.560 --> 0:01:51.680 and they want to recruit doctors who can bring in patients, 0:01:51.760 --> 0:01:55.280 that is into Las Vegas, bringing in patrons to the 0:01:55.520 --> 0:01:58.480 gambling halls. And so what they do is they give 0:01:58.520 --> 0:02:00.520 the doctors the round of the mill, allow them to 0:02:00.560 --> 0:02:02.920 do whatever they want to make as much money as 0:02:02.960 --> 0:02:06.360 they want, and they reward them by allowing them to 0:02:06.560 --> 0:02:09.200 build for surgeries for which they were not allowed to 0:02:09.240 --> 0:02:12.000 bill under the Medicare and Medicaid billing rules. And that's 0:02:12.040 --> 0:02:14.160 why it's kind of akin to Las Vegas. 0:02:14.600 --> 0:02:18.639 John Holland, senior investigative reporter for Bloomberg Law, has been 0:02:18.680 --> 0:02:23.600 investigating these concurrent surgeries and he joins me, now, so, John, 0:02:23.639 --> 0:02:27.520 you've reviewed more than a dozen federal and state lawsuits 0:02:27.600 --> 0:02:30.919 over these ghost surgeries. How prevalent are they? 0:02:31.480 --> 0:02:34.000 It's happening more than we thought. Basically, you go in, 0:02:34.120 --> 0:02:36.440 you have a surgeon, you've met with him, You've talked 0:02:36.480 --> 0:02:39.160 to him about what the procedure will be like. What 0:02:39.200 --> 0:02:42.200 the surgeon isn't telling them, at least in these lawsuits, 0:02:42.520 --> 0:02:45.080 is that I may not be there during large chunks 0:02:45.080 --> 0:02:47.920 of the operations, and a lot of patients never know. 0:02:48.360 --> 0:02:51.919 That's why you don't see too many malpractice claims connected 0:02:51.960 --> 0:02:55.120 with these, because the patients just don't know that their 0:02:55.160 --> 0:02:58.680 doctor didn't perform the surgery. Since the story ran, I 0:02:58.720 --> 0:03:02.240 have gotten fifty or six the emails from doctors, hospital 0:03:02.280 --> 0:03:06.160 administrator's residents saying that they've seen this problem firsthand, and 0:03:06.200 --> 0:03:09.840 it's far wider than even these lossuits have talked about. 0:03:09.960 --> 0:03:12.880 So I was a little surprised just how wide spread 0:03:12.919 --> 0:03:13.160 it is. 0:03:13.840 --> 0:03:17.160 Yeah, So just to be clear, are residents allowed to 0:03:17.280 --> 0:03:20.040 operate when the surgeon is there supervising. 0:03:20.560 --> 0:03:24.160 Yes, the residents cannot do what it's called critical portions 0:03:24.160 --> 0:03:26.840 of a procedure. There is as one of the doctors 0:03:26.840 --> 0:03:29.440 we talked to, there's nuance on that of how you 0:03:29.520 --> 0:03:33.800 define critical, but in general, the residents should be opening 0:03:33.800 --> 0:03:37.960 a patient, closing the patient, and doing some minor parts 0:03:38.000 --> 0:03:42.360 of a procedure only if the surgeon is in the 0:03:42.400 --> 0:03:45.600 operating room. He can't just walk away and turn over 0:03:45.640 --> 0:03:48.920 the patient to a resident. And in this case, that 0:03:49.080 --> 0:03:49.960 is what is happening. 0:03:50.400 --> 0:03:55.520 And you found cases where doctors build for simultaneous surgeries 0:03:55.880 --> 0:03:58.560 but at two different hospitals that were a. 0:03:58.480 --> 0:04:02.040 Mile apart, and that's exactly what's happening. We saw in 0:04:02.040 --> 0:04:05.760 the University of Southern California case where one of the 0:04:05.880 --> 0:04:10.160 chief star surgeons booked five surgeries for the same morning 0:04:10.640 --> 0:04:14.200 from eight am until two and wrote basically when he 0:04:14.200 --> 0:04:16.640 submitted the bill that he was there for the entire 0:04:16.839 --> 0:04:19.400 time of all five surgeries, even though they were in 0:04:19.400 --> 0:04:22.440 different operating rooms and one was conducted at a hospital 0:04:22.480 --> 0:04:25.159 more than a mile away. So obviously it was fraudulent. 0:04:25.400 --> 0:04:28.520 There was not a lot of mystery from what we understand. 0:04:28.839 --> 0:04:31.760 All sides are deep in settlement talks and the case 0:04:31.800 --> 0:04:35.040 could be wrapped up later this month. I don't believe 0:04:35.200 --> 0:04:38.320 USC will contest some of these cases. That remains to 0:04:38.320 --> 0:04:40.440 be seen, but it looks like they're trying to settle. 0:04:40.920 --> 0:04:46.520 Is this about violating Medicare rules or violating patients rights 0:04:46.800 --> 0:04:49.640 or harming patients. 0:04:48.960 --> 0:04:51.239 All of the above. In the beginning, I didn't expect 0:04:51.240 --> 0:04:52.919 to see the harm. I thought this was going to 0:04:52.960 --> 0:04:55.520 be more of a billing of fraud issue. But as 0:04:55.560 --> 0:04:58.719 we started looking through these lawsuits and many others and 0:04:58.760 --> 0:05:02.000 started talking to a lot different doctors, this is a 0:05:02.040 --> 0:05:06.400 real issue, particularly since you're putting someone under anesthesia for 0:05:06.800 --> 0:05:09.880 hours longer than they should be because you're bouncing from 0:05:09.920 --> 0:05:12.880 operating room to operating rooms. In some cases, the residents 0:05:12.880 --> 0:05:15.640 are finishing. In other cases, the residents are acting almost 0:05:15.680 --> 0:05:18.599 as babysitters, waiting for the lead surgeon to come back, 0:05:19.080 --> 0:05:22.000 and that could be many hours, and that puts patients 0:05:22.000 --> 0:05:24.719 in nager. One of the studies that we cited looked 0:05:24.720 --> 0:05:28.120 at hip surgeries a year out and they found it 0:05:28.400 --> 0:05:32.760 without any question, the adverse outcomes went up exponentially the 0:05:32.800 --> 0:05:36.839 longer someone was under anesthesia, and that was directly tied 0:05:36.880 --> 0:05:40.640 to doctors not performing one surgery and then moving on. 0:05:40.800 --> 0:05:41.799 So it's a little both. 0:05:42.320 --> 0:05:46.960 If these claims are being filed, five claims wants different hospitals, 0:05:47.080 --> 0:05:50.200 why isn't Medicare catching that. 0:05:50.200 --> 0:05:52.240 That is the biggest question I have and that we 0:05:52.360 --> 0:05:55.040 are following up very hard on that now to see 0:05:55.240 --> 0:05:59.440 why does it take doctors coming forward to essentially expose 0:05:59.520 --> 0:06:03.599 their own institutions. Why is medicare not catching these very 0:06:03.680 --> 0:06:07.000 blatant billion practices. We didn't get into the subtle ones 0:06:07.080 --> 0:06:10.080 the story. I took the ones that, after spending months 0:06:10.080 --> 0:06:13.839 on this, were as open and shut as we could 0:06:14.040 --> 0:06:17.040 possibly find. It's hard to believe that Medicare would be 0:06:17.120 --> 0:06:20.640 showing out hundreds of millions of dollars without somebody saying, hey, 0:06:20.680 --> 0:06:23.840 there's a problem here. And so that is the thing 0:06:23.920 --> 0:06:26.080 I'm working on right now to see if we can 0:06:26.160 --> 0:06:29.080 nail down what is going on and why did nobody 0:06:29.080 --> 0:06:29.520 catch this? 0:06:29.800 --> 0:06:33.880 Are we talking hundreds of millions of dollars? Billions when 0:06:33.880 --> 0:06:34.680 you consider all. 0:06:34.560 --> 0:06:37.880 These When you look at this, it's in the billions. 0:06:38.080 --> 0:06:41.520 The government alleged in the Pittsburgh case that it was 0:06:41.680 --> 0:06:45.719 thousands of surgeries done by particular doctor, doctor Luke Dich. 0:06:45.880 --> 0:06:50.520 Southern California attorneys are claiming that this is several hundred 0:06:50.600 --> 0:06:55.520 million at that one institution alone, and Ellinger Hospitally in 0:06:55.640 --> 0:07:00.200 Chattanooga Tennessee. They are alleging minimum of eighty five one 0:07:00.279 --> 0:07:04.160 hundred incarnoral overlapping surgeries. So again, that would get into 0:07:04.160 --> 0:07:06.960 the tens of millions of dollars worth of billings. It 0:07:07.080 --> 0:07:10.240 is staggering the amount of money that we're talking and 0:07:10.280 --> 0:07:13.080 it's equally staggering that nobody caught it. And so that's 0:07:13.160 --> 0:07:15.680 what we're trying to figure out. The next step is 0:07:16.040 --> 0:07:18.760 what is going on here in terms of the payment. 0:07:18.920 --> 0:07:22.040 The first focused on the patients and the practices and 0:07:22.080 --> 0:07:25.880 the deception, but the bigger question for the next round 0:07:26.000 --> 0:07:28.080 is why did nobody catch this? 0:07:28.680 --> 0:07:32.280 So there are a lot of people in an operating room, 0:07:32.760 --> 0:07:36.000 I'm shocked that a lot of those people haven't talked 0:07:36.040 --> 0:07:39.000 about this, complained about this, reported this. 0:07:39.760 --> 0:07:42.440 Apparently they have. There've been a lot of internal complaints 0:07:42.440 --> 0:07:45.680 at Hospital twenty fifteen in the Boston Globe did a 0:07:45.800 --> 0:07:48.960 great theories on this. This spotlight team looking at just 0:07:49.000 --> 0:07:53.000 one hospital, Mass General, and they talked to a star 0:07:53.120 --> 0:07:57.120 surgeon named Dennis Burke, and they talked to their top anesthesiologist, 0:07:57.440 --> 0:08:01.240 Lisa Bahman, who went on the record of the problems 0:08:01.280 --> 0:08:03.560 they were seeing. But it wasn't enough to get the 0:08:03.600 --> 0:08:05.760 hospital to stop what it was doing. It was only 0:08:05.800 --> 0:08:09.000 after lawsuits came that the hospital changed its ways a bit, 0:08:09.360 --> 0:08:12.280 but that was rare and the hospital. The medical profession 0:08:12.360 --> 0:08:15.320 is very tight lipped and they do not speak up 0:08:15.640 --> 0:08:18.360 against each other. Is very tough to even get a 0:08:18.400 --> 0:08:22.200 doctor to testify a trial against another doctor in malpractice cases. 0:08:22.280 --> 0:08:24.840 So it doesn't surprise me just because of the nature 0:08:24.840 --> 0:08:28.000 of the profession. You risk losing your career. So it's 0:08:28.040 --> 0:08:31.200 sometimes you may be outrage, you may complain internally, but 0:08:31.320 --> 0:08:32.880 then you throw your hands in the air and say, 0:08:32.880 --> 0:08:36.080 what can I do about this? And that is based 0:08:36.080 --> 0:08:38.080 on all of the doctors I talked to and all 0:08:38.120 --> 0:08:40.880 the attorneys. That is the biggest problem. People are afraid 0:08:40.880 --> 0:08:43.280 to come forward because the hospital can crush them. 0:08:43.640 --> 0:08:47.200 And Reuben Gutman told me that two clients who were 0:08:47.320 --> 0:08:53.119 nationally recognized orthopedic surgeons were crushed after they reported concurrent 0:08:53.280 --> 0:08:56.320 surgeries on the hospital's internal system. 0:08:56.840 --> 0:09:00.280 So our clients made a report to the hospital, the 0:09:00.480 --> 0:09:05.000 document their concerns, which they had been articulating for a 0:09:05.040 --> 0:09:08.120 period of time, and then within forty eight hours is 0:09:08.120 --> 0:09:11.440 our complaint alleges their services at the hospital will terminate. 0:09:11.679 --> 0:09:14.760 It's been almost impossible for them to get a position 0:09:15.040 --> 0:09:17.200 in the United States, and two of them are now 0:09:17.360 --> 0:09:21.959 in Scotland. These are folks of national reputation. They are 0:09:22.160 --> 0:09:25.560 probably some of the leading surgeons in the country and 0:09:25.760 --> 0:09:29.040 what Erlanger has done to them made it impossible for 0:09:29.080 --> 0:09:31.480 them to get jobs and es centrally tried to destroy 0:09:31.559 --> 0:09:34.160 their careers. But you know, as a lawyer, believes that 0:09:34.160 --> 0:09:36.280 at the end of the day, when the full story 0:09:36.360 --> 0:09:39.440 comes out as it has been, these folks are our 0:09:39.559 --> 0:09:40.360 national heroes. 0:09:40.800 --> 0:09:44.120 And in that case, the doctors say they filed the 0:09:44.200 --> 0:09:49.040 report because hospital administrators suggested they do so, and then 0:09:49.080 --> 0:09:50.880 they got fired two days. 0:09:50.760 --> 0:09:53.920 Later after being told by the administrators, we're going to 0:09:53.960 --> 0:09:56.280 address this. Put it in writing so that we can 0:09:56.320 --> 0:09:59.640 do something about it, and according to lawsuit, they did 0:09:59.640 --> 0:10:02.760 do that. They were very respected surgeons. Both had taught 0:10:02.800 --> 0:10:05.360 at the Mayo Clinic in Minnesota. One of them had 0:10:05.400 --> 0:10:07.400 been born in Aerlanga and she wanted to go back 0:10:07.440 --> 0:10:10.679 and be close to her family. Her husband was the 0:10:10.720 --> 0:10:13.160 head of orthopedics. He was one of the best orthopedic 0:10:13.240 --> 0:10:16.560 surgeons in the country, and within two years they were gone. 0:10:16.760 --> 0:10:19.400 Talking to them, they said the practices were so much 0:10:19.440 --> 0:10:21.840 worse than they had ever seen. They felt like they 0:10:21.840 --> 0:10:24.240 didn't have a choice. They had to speak up. They 0:10:24.320 --> 0:10:27.800 kept assuming that the hospital would fix it. They didn't 0:10:27.840 --> 0:10:30.520 realize they were losing their jobs until it was too late. 0:10:30.880 --> 0:10:33.160 They kept thinking, well, expose it, will write the ship 0:10:33.360 --> 0:10:35.840 and we'll come up with new policies, and instead they 0:10:35.960 --> 0:10:37.640 kept the policy and fired the surgeon. 0:10:37.880 --> 0:10:43.040 Explain why these respected doctors are now practicing in Scotland 0:10:43.280 --> 0:10:47.080 because they couldn't get a job in the US after reporting. 0:10:46.640 --> 0:10:50.480 This, because in the beginning they couldn't explain these sealed lawsuits, 0:10:50.600 --> 0:10:53.280 so they couldn't even say why they left the hospital 0:10:53.520 --> 0:10:55.800 or that they had these going. They suddenly were no 0:10:55.840 --> 0:10:58.440 longer at the hospital. They were fired and they couldn't 0:10:58.440 --> 0:11:01.600 get a good reference. But every about their case was sealed. 0:11:01.760 --> 0:11:04.200 They couldn't even say I followed the lawsuits or describe 0:11:04.200 --> 0:11:06.679 any of the reasons for them leaving. So suddenly you're 0:11:06.720 --> 0:11:10.840 unemployed and you can't explain why, and the hospital's refusing 0:11:10.880 --> 0:11:13.120 to give you a recommendation. It stay on the seal 0:11:13.240 --> 0:11:16.120 for years. That was just unsealed in March. That's why 0:11:16.160 --> 0:11:18.520 I found it. And the other one was unsealed about 0:11:18.520 --> 0:11:21.560 a year ago the USC case, so it takes a 0:11:21.640 --> 0:11:24.960 lot to come forward, least so woman quit before she 0:11:25.080 --> 0:11:27.440 was fired, which made her life a little easier, but 0:11:27.559 --> 0:11:30.280 trying to explain why I walked out of Mass General 0:11:30.679 --> 0:11:33.040 without being able to provide the details, she sort of 0:11:33.280 --> 0:11:35.200 ruined her career for about a year. 0:11:35.520 --> 0:11:37.600 I think the scariest part of your article is this. 0:11:38.280 --> 0:11:42.000 Some of Erlanger's residents were so unskilled that the hospital's 0:11:42.040 --> 0:11:46.360 own doctors said in secretly recorded conversations they were concerned 0:11:46.400 --> 0:11:49.800 about leaving them alone in operating rooms. And according to 0:11:49.880 --> 0:11:53.840 the lawsuit, an orthopede is told a colleague Resident III 0:11:53.960 --> 0:11:57.679 is scarier. He's got this spasmodic index finger. You know, 0:11:57.760 --> 0:12:01.560 he makes an incision and it's just, oh my god, stop. 0:12:02.480 --> 0:12:04.719 I mean, that's just astonishing. 0:12:05.600 --> 0:12:08.120 It was stunning to me. And this is the type 0:12:08.120 --> 0:12:10.319 of thing. Is a report you wouldn't include in a 0:12:10.400 --> 0:12:13.280 story very od because I don't trust it. In this case, 0:12:13.320 --> 0:12:17.040 they were fully recorded. These conversations were recorded that were 0:12:17.040 --> 0:12:21.240 transcripts filed with the court. This happened so during my 0:12:21.360 --> 0:12:23.680 fact check and once I started talking to the attorneys, 0:12:23.720 --> 0:12:26.720 I realized these were serious attorneys that are not going 0:12:26.760 --> 0:12:28.839 to put that in a filing, and then they had 0:12:28.840 --> 0:12:31.959 transcripts and tapes, So this is a whole different level 0:12:32.040 --> 0:12:35.840 than I have ever come across. Clearly, they are problems 0:12:35.880 --> 0:12:38.280 with those residents that they're turning patients. 0:12:37.920 --> 0:12:40.440 Over to Erlanger told you in a statement that it 0:12:40.520 --> 0:12:43.600 strongly denies the claims and looks forward to the truth 0:12:43.679 --> 0:12:47.080 coming out during the court proceedings. I'm wondering if the 0:12:47.120 --> 0:12:52.360 truth about residents performing surgeries ever comes out in personal 0:12:52.360 --> 0:12:56.400 injury lawsuits, or whether it's too hard to find out 0:12:56.600 --> 0:12:59.800 if a resident did perform the surgery. 0:13:00.200 --> 0:13:04.079 It's very difficult to tell, especially since when you are harmed, 0:13:04.400 --> 0:13:06.720 you may never know that there was a resident doing 0:13:06.840 --> 0:13:09.520 any portion of your surgery. That is not something that 0:13:09.600 --> 0:13:13.120 comes out, and most attorneys, you know so little about 0:13:13.160 --> 0:13:16.560 this practice that they never even wind up looking for 0:13:16.600 --> 0:13:20.400 in discovery. It's basically been a well held secret by 0:13:20.640 --> 0:13:23.360 the medical profession, and well it comes out once in 0:13:23.400 --> 0:13:26.280 a while, like the Boston Globe series a decade ago. 0:13:26.720 --> 0:13:28.880 For the most part, hospitals do a good job of 0:13:28.960 --> 0:13:31.839 keeping this down and keeping this quiet, and I think, 0:13:32.160 --> 0:13:34.880 judging by the response I'm getting that's going to change. 0:13:35.040 --> 0:13:38.280 I don't think there's much doubt. Doctors and surgeons around 0:13:38.280 --> 0:13:41.720 the country, and professors at medical schools all been reaching 0:13:41.720 --> 0:13:42.040 out to me. 0:13:42.280 --> 0:13:45.600 Do we assume that the administrators of these hospitals know 0:13:45.679 --> 0:13:49.240 what's going on because they're handling the billings, Yes. 0:13:49.080 --> 0:13:52.000 They would have doing. They're also strong federal law on 0:13:52.200 --> 0:13:56.000 paying kickbacks to doctors to pay them for referrals because 0:13:56.000 --> 0:13:58.920 they can be conflict of interest where they would basically 0:13:58.960 --> 0:14:04.440 prescribing a surgeries. In this case, the administrators were paying 0:14:04.840 --> 0:14:08.760 these huge sums to doctors. Who was a doctor Somadi 0:14:08.960 --> 0:14:11.680 out of Lenox Hill Hospital in New York. He made 0:14:11.720 --> 0:14:15.120 five million dollars in one year according to federal prosecutors, 0:14:15.440 --> 0:14:18.440 and that was in large part because of been proper kickbacks. 0:14:18.640 --> 0:14:22.880 Doctor Luketicch made millions of dollars according to federal prosecutors. 0:14:22.920 --> 0:14:26.360 That was again improper payments that were in violation of 0:14:26.760 --> 0:14:29.920 federal anti kickback statutes. So it can't happen if the 0:14:29.960 --> 0:14:33.280 administrators don't know about it. They just wouldn't because nobody 0:14:33.320 --> 0:14:34.000 could pay them. 0:14:34.200 --> 0:14:37.840 Are the lawsuits we're talking about all false claim lawsuits. 0:14:38.160 --> 0:14:41.000 For the most part, Doctor Burke was a wrongful termination. 0:14:41.120 --> 0:14:43.760 He was the mass general doctor. But all of the 0:14:43.800 --> 0:14:47.320 others that I mentioned in the story were false claims cases. 0:14:47.440 --> 0:14:49.880 I looked at maybe a dozen others that were a 0:14:49.880 --> 0:14:53.440 combination of false claims and employment law. But for the 0:14:53.440 --> 0:14:56.440 most part, these are doctors coming forward and finally on 0:14:56.480 --> 0:14:57.520 behalf of the government. 0:14:58.080 --> 0:15:00.400 Explain a little more for those who don't know the 0:15:00.440 --> 0:15:03.920 mysterious world of fault claimed lawsuits. 0:15:04.080 --> 0:15:07.520 I am learning on the fly, But essentially in this 0:15:07.680 --> 0:15:10.400 you see it with defense contracting quite a bit. If 0:15:10.640 --> 0:15:13.000 someone is being paid by the federal government and they 0:15:13.000 --> 0:15:17.120 commit fraud on the federal government, anyone who learns about 0:15:17.120 --> 0:15:19.880 it and can expose that fraud is entitled to file 0:15:19.920 --> 0:15:22.160 a lawsuit as long as they can prove the allegation 0:15:22.640 --> 0:15:26.000 on behalf of the Justice Department. It remains under seal, 0:15:26.320 --> 0:15:30.440 often for many years while the Justice Department investigates, and 0:15:30.440 --> 0:15:34.080 then the Justice Department has a choice of joining the lawsuit, 0:15:34.320 --> 0:15:36.400 or often if they see it's going well, they just 0:15:36.400 --> 0:15:39.040 step out of the way and they let the attorneys 0:15:39.040 --> 0:15:42.080 in the plaintiff continue their lawsuit, and then when there's 0:15:42.080 --> 0:15:45.760 a settlement, the Justice Department steps in and signs off 0:15:45.800 --> 0:15:47.840 on that settlement and gets all of the money. So 0:15:47.880 --> 0:15:50.240 if there's a settlement for one hundred million, it goes 0:15:50.280 --> 0:15:54.880 to the government to taxpayers, and then the whistleblower will 0:15:54.920 --> 0:15:58.280 get thirty percent of whatever the settlement is, but all 0:15:58.320 --> 0:16:00.640 of the money is filed in good to the US 0:16:00.760 --> 0:16:03.200 government and the whistleblower gets paid on the back end. 0:16:04.120 --> 0:16:07.720 If it's a false claims, are there any provisions then 0:16:08.040 --> 0:16:10.880 for things to be corrected at the hospital so it 0:16:10.920 --> 0:16:11.840 doesn't happen again. 0:16:12.120 --> 0:16:14.480 That is usually as part of the settlement, and we 0:16:14.520 --> 0:16:17.720 saw this in Pittsburgh. The government said that it was 0:16:17.760 --> 0:16:20.880 going to be auditing some of the surgeons practices. They 0:16:20.880 --> 0:16:24.120 were going to be monitoring them for three years. That's 0:16:24.200 --> 0:16:26.720 a little unusual just because that was one that the 0:16:26.880 --> 0:16:30.560 Justice Department took over from the initial attorneys. For the 0:16:30.560 --> 0:16:33.000 most part, if there's just the settlement, there aren't a 0:16:33.040 --> 0:16:35.960 lot of restrictions placed on the hospital. Lisa Wollman, the 0:16:36.000 --> 0:16:39.440 anesthesiologist of Mass General. As part of her settlement, she 0:16:39.600 --> 0:16:43.440 insisted that the hospital change its consent form so the 0:16:43.520 --> 0:16:46.920 patients would know one hundred percent who was going to 0:16:46.920 --> 0:16:50.640 be doing their surgery. So that was just her tenacity 0:16:51.120 --> 0:16:53.680 winning out on that issue, but for the most part, 0:16:54.080 --> 0:16:57.400 unless the government handles it directly, they weren't a lot 0:16:57.440 --> 0:16:59.040 of sanctions put in at the end. 0:17:00.160 --> 0:17:04.840 You also reported about the University of Southern California's hospital 0:17:04.880 --> 0:17:09.000 system being accused of billing for thousands of cases where 0:17:09.000 --> 0:17:14.680 the teaching physician left residents unattended to perform even spine 0:17:14.800 --> 0:17:15.560 and brain. 0:17:15.440 --> 0:17:19.000 Surgeries, and this kind of goes to the heart the 0:17:19.040 --> 0:17:23.560 allegations at the usse that they were different outcomes at 0:17:23.600 --> 0:17:27.920 their different hospitals, where in one of the hospitals in 0:17:27.960 --> 0:17:31.719 the system, patients were more than twice as likely to 0:17:31.720 --> 0:17:34.520 be injured or harmed during surgery according to the laws, 0:17:34.520 --> 0:17:38.040 and it's mentioned several times in the lawsuits. The attorney 0:17:38.280 --> 0:17:42.280 and the surgeon who brought the lawsuit alleged that one 0:17:42.280 --> 0:17:46.159 of the administrators said, that's where we send residents to 0:17:46.240 --> 0:17:49.919 practice on poor folks. So, if the lawsuit is correct, 0:17:49.920 --> 0:17:52.000 and it seems to be in the final stage of the settlement, 0:17:52.240 --> 0:17:54.920 the hospital knew that it was putting patients in one 0:17:54.960 --> 0:17:57.760 of their institutions in harm, but they were doing it 0:17:57.800 --> 0:18:01.520 so that they could have residents practicing their work. That 0:18:01.640 --> 0:18:02.480 was pretty stunning. 0:18:02.760 --> 0:18:06.800 I found so much in your story, stunning, John, and 0:18:06.840 --> 0:18:08.639 I hope you'll come back with the next part of 0:18:08.680 --> 0:18:13.320 your investigation. Thanks so much. That's John Holland, senior investigative 0:18:13.400 --> 0:18:16.640 reporter for Bloomberg Law. And that's it for this edition 0:18:16.680 --> 0:18:19.320 of The Bloomberg Law Show. Remember you can always get 0:18:19.320 --> 0:18:22.480 the latest legal news on our Bloomberg Law podcasts. You 0:18:22.520 --> 0:18:26.600 can find them on Apple Podcasts, Spotify, and at www 0:18:26.720 --> 0:18:31.000 dot Bloomberg dot com slash podcast Slash Law, and remember 0:18:31.040 --> 0:18:34.000 to tune into The Bloomberg Law Show every weeknight at 0:18:34.040 --> 0:18:37.480 ten pm Wall Street Time. I'm June Grosso and you're 0:18:37.600 --> 0:18:38.800 listening to Bloomberg