A Medical Device Daily

A physician from the San Francisco Bay area community of Los Gatos was sentenced last week to a year in jail for a false diagnosis of prostate cancer in an 87-year-old patient and subsequently subjecting him to an unnecessary brachytherapy treatment.

According to a San Francisco Chronicle report, Ali Moayed, MD, pleaded guilty Jan. 25 to charges of felony elder abuse and felony insurance fraud.

The urologist also was accused of falsifying pathology reports for two other patients and recommending that they also undergo brachytherapy treatments, but the deception was uncovered before those men had the procedure, according to the Chronicle.

All three cases occurred in 2005.

Deputy District Attorney Bill Butler said all three men were older men who spoke English as a second language.

The newspaper story said it was unclear why Moayed engaged in the deception, as the roughly $5,000 received in insure payments for the treatment “was paltry compared with his income and property holdings.”

Prosecutors indicated that the physician told the patient who received the treatment that he had cancer just weeks after his son had died of another form of cancer. “He had just buried the son, and the doctor was aware of that,” Butler said. “That’s the thing that’s really appalling about this.”

In addition to other fines and what will be three months of actual jail time followed by serving the rest of his sentence under electronic surveillance, Moayed paid $75,000 to the man who underwent the procedure and $12,500 to each of the other two men.

He also lost his license and, will never practice medicine again, according to Butler.

In other legalities:

• A federal jury in Miami convicted a physician and the owners and operators of two durable medical equipment companies and a home healthcare agency of Medicare fraud, Assistant Attorney General Alice Fisher of the Criminal Division and U.S. Attorney Alexander Acosta of the Southern District of Florida reported.

After a five week trial in Miami, the jury found Maria Hernandez, 50, Marta Jimenez, 67, Maivi Rodriguez, 34, and Ana Caos, MD, 62, guilty on all charged counts, including: conspiracy to defraud the U.S. government, to cause the submission of false claims to Medicare, and to solicit and receive kickbacks; and conspiracy to commit healthcare fraud. Additionally, defendants Hernandez, Jimenez and Rodriguez were found guilty on six counts of receiving kickbacks in exchange for referring Medicare patients.

Sentencing has been scheduled for May 16, 2008. Hernandez faces a maximum of 35 years in prison, Rodriguez and Jimenez each face a maximum of 25 years in prison, and Caos faces a maximum of 15 years in prison.

Hernandez, Jimenez and Rodriguez controlled more than 60 Medicare patients. Between February 2001 and June 2003, Medicare was billed $487,783 by complicit pharmacies for unnecessary aerosol prescriptions for these patients. In exchange for bringing the prescriptions to the pharmacies, the defendants received about $150,000 dollars from the pharmacy owners, who have also been sentenced to federal prison. Between December 1997 and January 2007, the defendants directly billed Medicare more than $1.6 million dollars for medical equipment for these same patients.

Hernandez owned and operated Action Best Medical Supplies, and Jimenez and Rodriguez owned and operated Esmar Medical Equipment, both Miami durable medical equipment companies (DMEs). Rodriguez also owned and operated A & A Medical Services, a home healthcare agency, and M & M Comprehensive an assisted living facility. Caos practiced at Larkin Community Hospital and operated a private practice.

The patients testified that they were paid cash kickbacks to accept delivery of the unnecessary medication and medical equipment that was billed to Medicare. One Medicare beneficiary testified that he donated all the medication to a charity while another testified that she threw it in the trash. Former physician, Pedro Cuni, who is serving time in prison for Medicare fraud, testified that he was paid $50 apiece to write prescriptions for the patients controlled by these defendants.

• The law firm of Parker Waichman Alonso (New York) reported it has filed suit on behalf of a man who was diagnosed with nephrogenic systemic fibrosis (NSF) after receiving two injections of Omniscan, a gadolinium contrast agent manufactured by General Electric (Fairfield, Connecticut) its subsidiaries and Novation (Irving, Texas).

The plaintiff, Zbigniew Marcinczyk, a resident of Philadelphia and a patient with pre-existing kidney disease received two injections of the gadolinium contrast agent in September and December of 2005.

NSF, also known as nephrogenic fibrosing dermopathy (NSD) causes bodily impairment, disfigurement and scarring, as well as fibrosis and contractures in the extremities. NSF has been shown to occur in patients presenting with renal insufficiency who undergo an MRI exam that employs a gadolinium-based contrast agent.

The lawsuit alleges that the chemical make-up of Omniscan makes it more likely that gadolinium will become free within the bodies of recipients, thereby making it more likely that patients with kidney disease will develop NSF. The lawsuit further alleges that Omniscan is defective, and that the defendants failed to adequately test Omniscan and failed to warn patients about its potential to cause NSF.