March 18, 2013

Heart doctor settles

Medical Licensure Board to inspect all patient records

By Nita Johnson
Staff Writer

LAUREL COUNTY, Ky. — One of the 11 doctors accused of performing unnecessary heart procedures in a slew of lawsuits against a London hospital made an agreement with the Kentucky Medical Licensure Board recently.

Rather than face hearings and/or penalties that could be as severe as revoking his license to practice medicine, Dr. Sandesh R. (Sam) Patil agreed to strict supervision of his medical procedures for the next five years.

Through the agreed order, Patil was required to enroll in and complete the Documentation Seminar at the Center for Personalized Education for Physicians and the CPEP Personalized Implementation Program. Both of these programs are to be paid by Patil. He must also provide documentation to the Kentucky Medical Licensure Board that he completed the two programs.

Additionally, Patil agreed to conduct a history and physical evaluation on each patient prior to performing any procedure and document in the patient records that it meets Medicare standards before doing any procedures. An exception is if the patient requires emergency treatment, which allows Patil to document the procedure after the emergency.

He must also abide by the guidelines of standard cardiology and coronary revascularization procedures and can only perform invasive procedures when a stress test has been completed by another cardiologist. As part of the agreed order, Patil will also allow medical licensure board members to inspect and obtain patient records for review and will reimburse the medical board for the costs incurred in this process. Failure to pay the board for their costs within 30 days of the procedure will violate the terms of the agreed order. Patil must also pay $6,906.25 for the costs of the investigation on the complaint against  him.  Any violations of the terms of the agreement could result in the issuance of an Emergency Order of Suspension or Restriction and could result in additional disciplinary action, including revoking Patil’s license to practice medicine.

The findings

Patil’s dilemma came after a complaint was filed with the Licensure Board in which he was accused of performing unnecessary heart-related procedures on patients.

According to the agreed order, the first patient’s records indicated the patient was taken to the cath lab 11 times, with 10 of those offering an intervention.

“The IVUS device is utilized more than usual or necessary, almost always to push for revascularization rather than as a tool to show that another procedure is not required.......It seems that the plan to treat and the procedure to be done are often pre-determined before the anatomy has even been seen. In the end, the patient needed surgery to correct complications if her treatment, not her disease,” the reviewer stated in his report.

In the second, third and fourth cases, respectively, the reviewer said care fell “below minimum standards,” “appear(ed) to be a false positive stress test,” and stents were place “without justification.”

In the fifth case, the reviewer found the care and treatment of that patient met medical standards.

The background

Patil is one of 11 physicians named in multiple lawsuits targeting the cardiology unit at Saint Joseph London. With more than 400 persons now filing claims that unnecessary procedures were performed on them, Patil is also the subject of a federal investigation for medical fraud, according to documents in files of a lawsuit with more than 300 plaintiffs named.

The majority of the lawsuits were filed by Louisville attorney, Hans Poppe, who said the cardiology patients’ charts were sent out to cardiologists and vascular specialists from across the nation. In a pretrial hearing in January, Poppe was ordered by a Laurel Circuit Judge to “show cause” why he did not have all records of those persons involved in the 300-plaintiff lawsuit.

“Due to the large number of plaintiffs in that lawsuit, the hospital has stated they haven’t had time to collect and send all the records,” Poppe responded. “I stated in court that I had not seen all the records because the hospital hasn’t sent them all.”

The multiple lawsuits against the London hospital, the cardiologists, billing companies and other related persons and/or agencies involved in the alleged “unnecessary procedures” has made national news and has been published in USA Today, Forbes magazine and other nationally distributed publications.

Dr. Peter Hasselbacher, University of Kentucky professor emeritus and researcher for the Kentucky Health Policy Institute, said the London hospital performed more angioplasties with stents than either the University of Kentucky or the University of Louisville — the state’s two largest teaching hospitals.

Barbara Mackovic, a spokeswoman for KentuckyOne Health, said Patil was never an employee of Saint Joseph London, but was a private practitioner. Hazard’s Appalachian Regional Hospital, stated the same — that Patil was not a hospital employee but conducted a private practice through Hazard’s Appalachian Heart Center.

He was an employee of The Heart Doctors, The Heart Specialists, and Premier Heart and Vascular Center.