MASS GENERAL HOSPITAL TO PAY $14.6 MILLION TO RESOLVE OVERLAPPING SURGERY CLAIMS; STANDARD CONSENT FORMS TO CHANGE

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BOSTON, February 19, 2022 /PRNewswire/ — Massachusetts General Hospital (MGH), the clinical teaching arm for Harvard Medical School and one of the most prestigious hospitals in the world, resolved a federal whistleblower case stemming from allegations that some of the hospital’s orthopedic surgeons engaged in overlapping surgeries that violated the rules Federal Medicare and Commonwealth of Massachusetts Medicaid.

MGH will pay $14.6 million to the federal government and Massachusetts and changing its informed consent language to better inform patients when their surgeon has an overlapping surgical obligation.

The settlement — reached after a sweeping discovery — resolves claims brought by an anesthesiologist, Dr. Lisa Wolmanin terms of United States ex rel. Lisa Wolman, MD and. Al.c. Massachusetts General Hospital, et al., No. 1:15-CV-11890-ADB.

Dr. Wollman sued under federal and Massachusetts misrepresentation laws. These laws allow individuals, under certain circumstances, to bring an action on behalf of the government to return money to the public purse.

Dr. Wollman, known as the “Relator” under the False Claims Act, brought her lawsuit as a vehicle to resolve patient care issues; she alleged the following:

  • Teaching surgeons were not present or did not perform key and critical parts of some surgeries;
  • Teaching surgeons did not wait for the key and critical parts of one surgery to be completed to begin a second, overlapping surgery;
  • The teaching surgeons did not designate another qualified surgeon to be immediately available to assist as needed in non-essential and non-critical portions of the overlapping surgeries for which the teaching surgeons were not present;
  • The government was billed for excessive anesthesia services;
  • Informed consent was not sufficient for overlapping surgeries.

In addition to monetary payment, Mass General Brigham will add the following language to its standardized procedural consent form for Massachusetts– hospitals based within its system:

My surgeon has informed me that my operation has to overlap with another procedure he has to perform. I understand this means that my surgeon will be present in the operating room during critical parts of my surgery, but may not be present during all of my surgery. I understand that my surgeon or another qualified surgeon will be immediately available if needed during my surgery.

“This lawsuit has been the catalyst for an important dialogue that will lead a world-renowned institution to set a precedent for a new standard of care in informed consent for overlapping surgeries,” said Ruben Guttman of Guttman, Buschner & Brooks, PLLC, lead counsel for Dr. Wollman.

“The MGH has a new direction and I’m glad this case puts us in a position where we can have a dialogue that will improve patient care and, just as importantly, transparency,” said Dr. Wollman. .

Dr Wollman originally filed his case in 2015 and continued even after the government refused to intervene. She persisted with an amended complaint despite the court’s rejection of her original filing.

An amended complaint resulted in a court decision, United States ex rel. Wollman v. Massachusetts General Hospital, 394 F. Supp. 3d 174 (D. Mass. 2019), which provided the legal groundwork for the government and other whistleblowers to challenge overlapping improper surgeries. Since the court’s precedent ruling, overlapping surgery cases have been brought and resolved in new York and Arizona.

The hotly contested litigation also resulted in a decision denying the applicability of peer review privilege under the federal misrepresentation law, United States c.Massachusetts Gen. Hosp., Inc.., 498 F. Supp. 3d 186 (D. Mass. 2020), and a ruling on the applicability of privilege for an internal review of Dr. Wollman’s allegations conducted by a Boston law office, to see United States ex rel. Wollman v. Massachusetts General Hospital, 475 F. Add. 3d 45 (D. Mass. 2020).

The case received help from United States law firm at Boston and the Office of Massachusetts Attorney General Maura Healey. In particular, Relator acknowledges the critical support of the Assistant United States Attorney Abraham-Georges and Kevin Lowndsdeputy head of the Massachusetts Attorney General’s Medicaid Fraud Division.

As a result of the Covid outbreak, much of the active litigation in the case – including the pleadings and all depositions – was conducted remotely.

GBB lawyers who worked on the case included: Ruben Guttman, Traci Buschner, Justin Brooks, Liz ShofnerThe deputy. Nancy Gertner (retired) and Dan Guttman.

Co-Advisor at Burns & Levinson in Boston included: Paul Mastrocola.

The Relator recognizes the earlier groundbreaking efforts of Burns & Levinson and, in particular, Ellen Zucker in their portrayal of Dr. Dennis Burke who – along with Dr. Wollman – raised concerns about concurrent surgery.

Guttman, Buschner & Brooks PLLC is a boutique firm whose attorneys have worked on cases recovering nearly $6 billion for state and federal governments, including a $280 million dollars recovered in an unaddressed case against Celgene Corporation on the brink of litigation (United States ex rel. Brown v. Celgene) and a settlement against Humana Inc. reached on the verge of trial (United States ex rel. Graves vs. Humana). Lawyers for the firm represented the lead informant in United States ex rel. McCoyd v Abbott Labs, which involved the recovery of $1.6 billion for the government; one of many whistleblowers to file lawsuits against GlaxoSmithKline in 2012, which resulted in the recovery of $1.04 billion (United States ex rel. Graydon vs. GSK); one of the whistleblowers suing the FCA against Pfizer, which resulted in the recovery of $2.3 billion (United States ex rel. DeMott vs. Pfizer); the main whistleblowers in United States ex rel. Sandler and Paris vs. Pfizer, which resulted in a recovery of $257.4 million; the main whistleblower in United States ex rel. Szymoniak vs. Bank of America, which recovered $95 million; three of the whistleblowers in the CAF cases against a large chain of hospitals (United States ex rel. Dogramji c. CHS), which resulted in the recovery of $98 million; the main whistleblower in United States ex rel. Kurnik vs. Amgen, which resulted in the aggregate recovery of $30 million from Amgen, Inc., Omnicare and PharMerica Corp. ; and the whistleblower in United States ex rel. Abrahamsen v. Hudson Valley, resulting in a recovery of $5.3 million for the federal and state governments. More information about GBB can be found at www.gbblegal.com. The firm also operates the following information site for whistleblowers, media and academics: www.whistleblowerlaws.com.

SOURCE Guttman, Buschner & Brooks LLC

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