Oops! They did it again.
Massachusetts General Hospital has paid a staggering $32.7 million since 2019 to settle three whistleblower claims arising “from the controversial practice known as concurrent surgery, or double-booking, in which surgeons juggle two operations simultaneously,” The Boston Globe recently reported.
Anesthesiologist Dr. Lisa Wollman alleged in the most recent claim that at least five orthopedic surgeons at the renowned Harvard-affiliated teaching hospital also known as MGH, regularly kept patients under anesthesia longer than medically necessary, sometimes for an hour or more, as they worked in two operating rooms.
After repeatedly witnessing and complaining about the practice between 2010 and 2015, Wollman left MGH after 24 years, relinquished her position at Harvard Medical School, and filed suit on behalf of the federal and Massachusetts state governments. She alleged that MGH violated Medicare and Medicaid rules when it “fraudulently billed government insurers for surgeries performed by trainees without proper oversight because supervising surgeons were working in another operating room.” Although some overlapping of procedures is permissible, surgeons must be present during critical portions of operations and they must designate backup surgeons for trainees who might need immediate assistance. The suit also alleged that MGH overbilled government insurance programs for anesthesia services because surgeons prolonged procedures when they moved back and forth between operating rooms.
Wollman sued pursuant to the False Claims Act, a federal law that allows private citizens to bring cases alleging fraud on behalf of the federal government. She will receive approximately 25 to 30 percent of the recent $14.6 million settlement with the remainder going to the federal and state governments. “I did this entirely for patient safety and transparency,” said Wollman, who now works at New England Baptist Hospital. She said that her career trajectory hasn’t recovered from this personal choice.
Wollman’s suit listed 16 dates between 2011 and 2013 when five orthopedic surgeons performed overlapping operations over a period of hours. One instance involved a 65-year-old patient who was under anesthesia for 90 minutes while waiting for the surgeon who was performing another procedure. The surgeon, who noted in his report that he had been present for the entire operation, later was required to correct this inaccuracy. Another instance involved a surgeon who “never appeared in the room” for an ankle operation even when the patient experienced serious and sudden airway constriction, which forced a senior trainee to take charge.
Wollman said that MGH senior medical officials failed to follow up on her concerns about the surgeon’s absence during the emergency except to threaten her with legal action for an alleged violation of patient privacy.
This most recent settlement requires all surgeons at hospitals in the Mass General Brigham network to inform patients when they plan to overlap operations. Wollman alleged that the surgeons named in her lawsuit failed to do so.
MGH leaders strongly defended concurrent surgery and said in a statement that the hospital, which admitted no liability, determined settlement was prudent at this time despite its belief that it complied with all legal requirements.
The settlement “sends a very strong signal,” said Dr. Jim Rickett, an orthopedic surgeon in Bloomington, Indiana and president of the Society for Patient Centered Orthopedics. “There’s no world in which you should have a person under anesthesia waiting for a surgeon for an extended period of time when it’s all scheduled, elective surgery,” he said. “Any patient should think twice about going to an institution that sanctions this kind of behavior.”
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