On May 22, 2002, Shirley went to Tenet Healthcare’s Redding Medical Center (RMC) for a scheduled cataract surgery on her eyes. She had no chest pain, no shortness of breath, no history of high cholesterol or heart disease and nobody in her family had ever had heart problems. In short, she had no symptoms. As part of her pre op clearance, she was seen by Dr. Chae Moon. An hour later, she was told that she needed heart bypass surgery and would die if she left the hospital.
When 40 FBI agents raided Redding Medical Center (RMC) and the offices of a prominent group of cardiologists and thoracic surgeons. The raid made headlines across the country. And the accusations were devastating to people all over Northern California. The government believed people were being operated on unnecessarily for the sake of profits. Within days, hundreds of people reached out to their primary care doctors and lawyers - all asking the same question.
Was my heart surgery unnecessary?
The accusations against Tenet were not the first time the for profit health care company had been accused of putting profits ahead of patient care. Nor was it the first time the main stream media had investigated its business practices. Among others, 60 Minutes promptly dispatched one of their producers to Redding to investigate. There, she met Russ Reiner and Bob Simpson, two long standing attorneys in the community with an outstanding history and reputation for protecting everyday Americans. Reiner and Simpson and another local lawyer Dugan Barr, were fielding inquiries faster than they could return calls.
The producer explained to Reiner and Simpson that Tenet had been accused of putting profits before patient care before and suggested they contact a group of lawyers out of Texas. Within days, Reiner and Simpson were in Houston meeting with Jim Moriarty, Kevin Leyendecker, Steve Hackerman and Richard Frankel.
The James R Moriarty PC and Hackerman Frankel firms, along with Tommy Fibich, Pat Green and Chuck Dorr, had previously prosecuted a knock down drag out fight against Tenet on behalf of hundreds of former patients and they gladly shared their experiences with Reiner and Simpson. As the men left dinner that evening, they shook hands and agreed to join together to investigate whether what the FBI was alleging was true.
Over the next twelve months, nearly twenty five hundred former patients contacted Reiner and Simpson wanting to know whether the angiograms and heart surgeries they were put through at RMC were unnecessary. Leyendecker traveled to Redding week in and week out during this period, working closely with Reiner, Simpson and their team of nurses to evaluate the patients' medical records, interview the clients and coordinate with a team of board certified cardiologists and heart surgeons. The medical team assembled by the lawyers was literally a who's who of heart doctors from around the country. Surgeons like Hartzll Shaff of the Mayo Clinic reviewed cases for the lawyers. While Leyendecker was travelling to California, Frankel was busy in Houston reviewing medical records and interacting with cardiologists and surgeons working in Houston's world renown medical center. Their task was simple and straightforward. Answer the question on everyone's mind.
When the dust settled from the reviews and client meetings, the group determined that 450 of the patients that contacted them had been operated on unnecessarily. The inescapable conclusion was devastating to those involved and the attorneys conducted hundreds of one on one meetings to deliver the news to their clients.
With the clients in place, the stage was set for what would become one of the largest medical fraud cases in US history.
While the defendants were lining up National blue chip firms like Gibson, Dunn & Crutcher and Latham & Watkins to defend their conduct, Hackerman, who had been coordinating with the other members of the team throughout the review process, spent months drafting a legal complaint that would need to stand up to the onslaught of legal challenges to follow. Its one thing to allege a doctor was negligent, it is quite another to allege that a doctor had essentially been bribed by a health care corporation to operate on people unnecessarily for the sake of profits. The onslaught of legal challenges arrived soon after the complaint was filed. Over the next 18 months, Hackerman, Frankel, Leyendecker, Simpson, Reiner and others conducted dozens of depositions and interviews of witnesses and fought one legal challenge after another in an attempt to prevent Tenet and the doctors from derailing the case. While that group of lawyers was fighting the battle at the courthouse, Moriarty was fighting the battle of public opinion. He formed a relationship with United States Senator Charles Grassley. Grassley launched in investigation of Tenet's practices as Moriarty worked closely with the Senator's staff from behind the scenes.
Ultimately, the pressure brought to bear led Tenet to settle the claims brought by the group's clients and others that had been filed.
Although the fight had been taken out of Tenet, the group of cardiologists and surgeons that performed the procedures were still denying they had done anything wrong. One by one though, the eight doctors involved agreed to settle the claims brought against them until just one surgeon defendant remained. That surgeon was adamant he had done nothing wrong and was refusing to settle. As Reiner and Simpson were negotiating and finalizing settlements with the other seven doctors, Hackerman, Frankel and Leyendecker prepared to do battle with the lone holdout. The trio flew to Denver and cross-examined the doctor for three days over the details of each of his former patients surgeries who'd filed suit against him. Not long thereafter, the surgeon relented and agreed to settle with his former patients.
About two years after the crusade on behalf of their individual clients reached a successful completion, Tenet paid the United State's government $900 million for manipulating the Medicare system in connection with its hospital operations. Today, that settlement remains one of the largest ever from a profit hospital system.
In her book Money Driven Medicine, Maggie Mahar explores the many reasons health care costs have soared in the US. It examines two cases Moriarty Leyendecker brought against Tenant Healthcare and NME involving bribed doctors performing unnecessary heart surgeries and psychiatrists sucking insurance monies dry by admitting teens into psych wards.
Her book spawned a documentary titled Money Driven Medicine, which reveals how a profit-hungry medical-industrial complex has turned health care into a system that squanders millions of dollars on unnecessary tests, unproven and sometimes unwanted procedures and overpriced prescription drugs.