On Monday, the FBI posted on X, formerly known as Twitter, saying that the doctors had "gambled with their patients' care during complicated open-heart-surgeries no less, compromising quality care over quantity and then falsely billed Medicare for reimbursement of services they improperly delegated."
According to U.S. Attorney Alamdar S. Hamdani, Baylor St. Luke's Medical Center (BSLMC), Baylor College of Medicine (BCM), and Surgical Associates of Texas P.A. (SAT) have jointly agreed to pay $15 million to resolve the claims.
The settlement resolved allegations from June 3, 2013, to Dec. 21, 2020. The civil lawsuit alleges three surgeons, 71-year-old Dr. Joseph Coselli, 63-year-old Dr. Joseph Lamelas, and 77-year-old Dr. David Ott, violated Medicare teaching physician and informed consent regulations.
According to the U.S. Attorney's Office, the investigation began on Aug. 7, 2019, when the whistleblower alleged that Coselli, Lamelas, and Ott regularly ran two operating rooms at once and delegated key aspects of extremely complicated heart surgeries to unqualified medical residents at St. Luke's.
The sealed qui tam lawsuit alleges that the heart surgeries at hand are some of the most complicated operations performed at any hospital, including coronary artery bypass grafts, valve repairs, and aortic repair procedures.
The U.S. Attorney's Office said these surgeries typically involve opening a patients' chest and placing the patient on the bypass machine for some portion of time.
The lawsuit alleges that the surgeons ran two operating rooms at once and failed to attend the surgical timeout, which is a critical moment when the entire team would pause and identify key risks to prevent surgical errors.
"Patients entrusted these surgeons with their lives - submitting to operations where one missed cut is the difference between life and death," said Hamdani. "Allegedly, the patients were unaware their doctor was leaving for another operating room. This settlement reaffirms the importance of Medicare requirements governing surgeon presence and ensuring that no physician - no matter how prominent or successful - can skirt around the rules."
The doctors are accused of hiding this information by falsely attesting on medical records they were physically present for the "entire" operation.
"The complete disregard for patient safety exhibited by these three doctors put patients at risk and violated Medicare regulations for their own convenience and greed," said Special Agent in Charge Jason E. Meadows of the Department of Health and Human Services Office of Inspector General. "This record settlement demonstrates our steadfast commitment to protecting Medicare beneficiaries and working with our law enforcement partners to utilize all the tools in our arsenal to hold accountable those who steal from Medicare and other federal health care programs."
Baylor St. Luke's Medical Center sent Eyewitness News the following statement:
Baylor St. Luke's Medical Center has reached an agreement with the Department of Justice (DOJ) to resolve a documentation and billing matter involving compliance and billing requirements set forth by the Centers for Medicare and Medicaid Services (CMS). The DOJ claims are strictly allegations and the settlement by Baylor St. Luke's is not an admission of liability. Baylor St. Luke's remains committed to complying with all CMS regulations. Baylor St. Luke's is a world-renowned academic medical center that cares for patients from throughout the world with the most complex conditions. The hospital provides its patients with safe, high-quality care and remains committed to compliance with all applicable regulations.
The $15 million recovery is the largest settlement to date involving concurrent surgeries. The whistleblower will receive $3,075,000 due to the False Claims Act, which entitles the private whistleblower who commences the suit to a portion of the recovery.
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