http://www.vaccinationnews.com/DailyNews/November2002/CaliforniaPatients4.htm
California Patients Talk of Needless Heart Surgery
By ANDREW POLLACK
EDDING, Calif., Nov. 3 — When her arm began hurting in 1990, Nellie Daniels
saw a heart specialist here. "It looks like you're getting ready to have a
heart attack," she recalled the doctor saying after an electrocardiogram.
So the doctor, Chae Hyun Moon, threaded a catheter into her heart through her
leg for further study and seemed to find little wrong. About 10 days later, she
said, she suffered a blood clot in her leg that hospitalized her for weeks and
still makes it hard for her to walk for long. She said she thinks the clot was
caused by the catheterization, adding that it probably was not needed anyway.
"It was a rush to judgment and I'm still having problems," said Ms. Daniels,
now 63. She consulted a lawyer then about suing, but said the lawyer would not
listen.
People are listening now. Last Wednesday, dozens of federal agents raided the
offices of Dr. Moon and another doctor, Fidel Realyvasquez Jr., and of the
Redding Medical Center, the hospital at which they practice. The F.B.I.,
according to an affidavit, was gathering records as part of an investigation of
accusations that the two doctors performed hundreds of unnecessary invasive
procedures like catheterizations and open-heart surgeries, at risk to patients'
life and health, to make money from Medicare.
The accusations have caused many people here to question the treatment they or
their loved ones received. The accusations raise questions about the role of
the profit motive in health care and are threatening the reputation of Redding
Medical Center and its owner, Tenet Healthcare, one of the nation's largest
hospital companies.
The incident shows "why the market isn't an appropriate vehicle for health
care," said Rose Ann DeMoro, executive director of the California Nurses
Association, which has often tangled with Tenet.
The Redding Medical Center, with 238 beds, is one of the most profitable of
Tenet's 113 hospitals, largely on the basis of its high-volume cardiac
practice, which it advertises heavily. Figures compiled by Dartmouth show that
the Redding region leads California in the number of coronary bypass surgeries
performed per 1,000 Medicare enrollees. Doctors here say most of those are done
at Redding Medical Center, which draws patients from a wide area of Northern
California.
In an affidavit issued last week, the F.B.I. said that, according to a few
other Redding cardiologists and doctors it interviewed but did not name, 25 to
50 percent of the procedures that Dr. Moon and Dr. Realyvasquez performed might
not have been necessary. The affidavit said that Dr. Moon, director of
cardiology at the Redding Medical Center, performed four to five times as many
catheter procedures as his peers in California. According to the affidavit, he
would tell patients that they would die without emergency surgery, which would
then usually be performed by Dr. Realyvasquez, the chairman of cardiac surgery.
The two doctors have not been charged with any wrongdoing. Malcolm S. Segal,
the lawyer for Dr. Realyvasquez, said his client is "very well respected,"
adding, "The accusations are just frankly wrong." John W. Reese Jr., the lawyer
for Dr. Moon, said it was inappropriate to comment while an investigation was
under way.
The charges seem to have split this small city well north of San Francisco,
with some former patients saying they were harmed and others saying the doctors
saved their lives or those of family members. About 100 people, many of them
staff members of the hospital or patients, held a candlelight vigil in support
of the doctors on Friday night outside the hospital.
"He's very brusque, rather abrupt, but he's extremely caring," said Reva
Richard, 75, of Dr. Moon, whose diagnoses led to open-heart surgery for her,
her husband and her father. As for the accusations that he performs too many
procedures, she said, "Well, yes, because he works twice as hard as other
doctors."
Dr. Bruce Bartlow, a critical-care doctor at Redding Medical Center and head of
its medical ethics committee, said, "I've not found them at all excessive." He
said he had brought his father from Chicago to be diagnosed and operated on by
the two doctors. Dr. Bartlow said one reason more procedures were performed
here than elsewhere was that there are no health maintenance organizations that
might disallow certain procedures. He said medical decisions are to some extent
judgment calls and the practice of medicine could be chilled if doctors fear
the F.B.I. will second-guess them.
He said he once told Dr. Moon that he might die from overwork. Dr. Moon, he
said, replied that if that happened, "I will have taken care of more people
with heart disease than anyone in the world."
But Dr. Teresa Tioran, a cardiologist who practices in the area, said there is
a feeling among her peers that Dr. Moon does too much — as many as 12
catheter procedures a day — and recommends needless surgery. "If I do three
or four caths in one day, it takes all day," she said.
One reason he is so fast, detractors say, is that he spends little time talking
to patients. Roy Duggins Jr., a pastor in Red Bluff, 30 miles south of here,
said he tried in vain for 10 days to talk to Dr. Moon or Dr. Realyvasquez to
tell them that his father's condition seemed to be worsening after his surgery.
"He gave me the riot act for even daring to question him," Mr. Duggins said.
The Rev. John Corapi, whose complaints to the F.B.I. appear to have set off the
investigation, said he went to Dr. Moon for a checkup in May because his father
had had heart problems. He did fine on a treadmill test, but Dr. Moon then
recommended other tests including a catheterization.
"The doctor looked ominously over me when I'm still on the cath table and said:
`I'm sorry there's nothing I can do for you. You need immediate multiple-bypass
surgery,' " Father Corapi, 55, recalled in an interview. "Then he left the
room."
The doctor tried to schedule the operation immediately but could not. So Father
Corapi, a Catholic priest, decided to have the operation in Las Vegas, where he
had a friend in medicine. But several cardiologists there, after looking at his
test results, found little wrong with him.
Tenet officials say the doctors continue to practice at Redding, though other
physicians will now have to review any proposed procedures.
Tenet officials said that the investigation is of the two doctors, not the
hospital or any other part of Tenet. The doctors do not work directly for the
hospital and are responsible for their own decisions, they said.
But two Redding personal-injury lawyers, Dugan Barr and Robert Simpson, said
the hospital could be responsible because it heavily advertises the services of
the cardiologists. Moreover, they say, the F.B.I. affidavit says that several
doctors in town warned top executives of Redding Medical Center as early as
1997 about the number of cardiac procedures but that nothing appears to have
been done. Plaintiffs' lawyers say they are being inundated with calls from
patients of the two doctors.
Alfred F. Shields, who lives east of town, sued Dr. Realyvasquez earlier this
year for leaving a surgical needle in him after valve-replacement surgery in
2000. Now, he is wondering whether the surgery was even needed, his lawyer
said.
Mr. Shields, who was 71 at the time of his surgery, had had a heart murmur for
more than 30 years that caused him little problem, the lawyer, David S. Rand of
Mill Valley, Calif., said. But after a periodic visit to Dr. Moon, Mr. Shields
was rushed into emergency surgery.
Mr. Duggins thinks that his father, who died in 1996, had been rushed into
surgery in 1994. "They made it sound as if he would die in a week or so if they
did not do it that night," he said. Mr. Duggins added "I would like to get my
dad's report now."
http://www.1800theeagle.com/Redding_Heart_Surgery/
Tenet Healthcare : Heart Surgery Patients
Unnecessary Heart Procedure?
Tenet Healthcare: MODESTO, CALIFORNIA: Doctors Medical Center
Tenet Healthcare is under investigation again. This time the investigation is
being led by the officials of Blue Cross Blue Shield. According to an
independent review of Doctors Medical Center in Modesto, California requested
by Blue Cross, 13 coronary artery bypass grafts out of 23 reviewed were deemed
unnecessary; a 56% rate of failure to meet requirements.
Officials at Doctors Medical Center have said over 1,900 bypass surgeries have
been completed in a little over a three-year period. Patients undergoing such
procedures require long recovery time and endure major pain after undergoing
the bypass.
Over the last year, Tenet Healthcare has faced allegations of fraud,
illegitimate billings to Medicare, price-gouging and the unnecessary heart
surgeries at Redding Medical (see below).
** WE ARE NO LONGER ACCEPTING NEW TENET HEALTHCARE CASES. **
Tenet Healthcare: REDDING, CALIFORNIA: Redding Medical Center
Federal authorities say there is reason to believe that since 1995, as many as
25% to 50% of the heart surgeries performed by Dr. Chae Hyun Moon and Dr. Fidel
Realyvasquez, Jr at the Redding Medical Center were unnecessary. These
surgeries included artery bypass, heart valve replacements, procedures and
probes.
Tenet Healthcare has since agreed to pay the federal government $54 Million to
settle fraud charges that doctors performed unnecessary heart procedures and
operations at Redding Medical Center between 1997 and 2002.
The F.B.I.’s investigation stemmed from reports that the two doctors
recommended costly surgeries for healthy patients and then proceeded to bill
Medicare. According to news reports, Medicare records indicate that 167 of the
patients the pair treated during a 3-1/2–year period died. The period of
questionable surgeries extended through July 2002. It is unclear whether the
death toll is unusual based on the volume and types of procedures Dr. Moon and
Dr. Realyvasquez performed.
** WE ARE NO LONGER ACCEPTING NEW TENET HEALTHCARE CASES. **
http://www.whale.to/a/koren4.html
Dr. Tedd Koren's April 2002 Newsletter Having a Bypass or 4?
Why are 800,000 people each year lining up or rather lying down for this
operation (coronary artery bypass graft or CABG) which is dangerous, useless
and needless in most of the recipients?
Perhaps they would not be so enthusiastic if they knew that the statistics
showing coronary artery bypass surgery was "safe" were wrong? MDs thought that
1% to 5% of patients who had this surgery had neurological complications (like
stroke) [Roach GW, Kanchuger M, Mangano CM et al. Adverse cerebral outcomes
after coronary bypass surgery. N Engl J Med. 1996;335:1857-1863]. Is 1-5% safe?
But very many patients would complain of feeling "not quite right"
intellectually afterwards. Their doctors pooh-poohed it.
Finally some bright guys, using pre-operative and post-operative
neuropsychological testing, have "convincingly demonstrated" that measurable
cognitive dysfunction is very common with an incidence of up to 80%-90% at
hospital discharge. [Diegeler A, Hirsch R, Schneider F, et al, Neuromonitoring
and neurocognitive outcome in off-pump versus conventional coronary bypass
operation. Ann Thorac Surg. 2000;69:1162-1166.] (It might be the heart-lung
machine they are hooked on to.) They find this out after the operation has been
in vogue for 35 years.
Whoa! That's almost as bad underreporting as vaccination injury. Why weren't
surgeons seeing more damage in an operation that was putting oh, a cool half
million a year (each) into their pockets? You'd think if they were making that
much money they could afford better glasses. Coronary Artery Bypass? I don't
think so - while I can still think.
Cognitive Dysfunction After Orthopedic Surgery?
It's not just heart surgery; cognitive dysfunction is present after all kinds
of surgery. For example, the International Study of Postoperative Cognitive
Dysfunction found that 26% of patients older than 60 years who underwent major
abdominal or orthopedic surgery had cognitive dysfunction 1 week after surgery.
(Moller JT Cluitmans P, Rasmussen LS, et al. Long term postoperative cognitive
dysfunction in the elderly ISPOCD1 study: International Study of Postoperative
Cognitive Dysfunction. Lancet. 1998;351:857-861.)From Mark DB and Newman MF.
Protecting the brain in coronary artery bypass graft surgery. JAMA.
2002;287(11):1448-1450.
Special Sale: Vaccination Court Brief by Harris Coulter, Ph.D. is on sale for
half price for a limited time. This brief was written as a court brief
defending parents' rights for refusing mandatory vaccination, revealing that
the medical community itself is confused about vaccination, that it is an
unscientific and dangerous procedure. It's perfect if you ever wanted to debate
the subject with a pediatrician or health official. It's got information they
cannot refute. It is a masterpiece. Dr. Coulter charged $5,000 to research and
write this 80-page brief (heavily documented). Normally $40.00, it's only half
price ($20.00) for this month (offer expires April 30, 2002).
Order Online at www.korenpublications.com or Call 800-537-3001!
That wonder drug - Cholesterol
We need cholesterol. Cholesterol is an essential part of all cell membranes and
half the dry weight of your brain is cholesterol. New research reveals that
your brain makes cholesterol. It's true, specialized brain cells called glial
cells make it. Cholesterol appears to have a role in regulating where and when
brain cells connect or synapse. (From Science News. 2001;160:309.)
Is low cholesterol is dangerous? Low cholesterol has been linked to suicide,
increased deaths from all causes (including cancer) and physical and mental
problems. In fact, studies indicate that certain age groups (such as the
elderly) benefit from high cholesterol.
Smallpox vaccine is great for getting smallpox
If every American got the smallpox vaccine at least 71,000 would die from the
shot and millions would be damaged, many permanently, according to estimates.
No thanks, I'll take my chances with the disease, thank you. England's severe
smallpox epidemics occurred after there was widespread smallpox vaccination.
Here's a bit of history they didn't give you in public school health class.
(Why should they? It's a government run, gov't controlled institution). In
Leicester, England, because of terrible reactions to the smallpox vaccine, most
everyone refused the shots: "Poor and rich alike, the workers and even the
municipal authorities began to refuse vaccination for their children…instead
of 95%, the vaccinations reached only 5%! As this ominous decrease of
vaccination went on the doctors again and again prophesied
that…small-pox…would run through the town like wildfire and decimate the
population. Yet it has been introduced again and again, but it has never
spread; and from that day to this no town in the kingdom of approximately equal
population has had such a very low small-pox mortality as this almost
completely unvaccinated and-as the doctors say-unprotected population!"-----By
Alfred Russel Wallace http://www.whale.to/a/wallace.html
Personal resistance is the main factor in whether or not someone will get sick.
The Journal of the AMA (Feb. 7, 2001;285:5) reprinted an editorial from 100
years prior (JAMA Feb 2, 1901:36:327-328) with this revealing statement: Dr.
Osler calls attention to the fact that sanity science, or hygiene, is one of
the bright spots of the century. A knowledge of the conditions of disease, and
the means of transmission together with the culmination of the art of
preventive measures, has made smallpox, as a dangerous disease, a thing of the
past.
Conflicts of interests in the American Government? I'm shocked, shocked!
A study found that more than half of the members of the FDA advisory committees
"have financial relationships with pharmaceutical companies that have an
interest in FDA decisions." DeAngelis CD. Conflicts of interest and the public
trust. JAMA. 2000;284:2237-2238.
"If you think science is neatly split between research in independent
university labs and in companies that produce products for profit, you're about
20 years behind… Sheldon Krimsky [of] Tufts University…predicts that a
private company will probably buy an entire university some day; in the
meantime, it's one professor at a time." Tinker Ready "Science for Sale" Utne
Reader. November/December 1999:60-62.