U.S. sues Satilla Regional Medical Center over fraudulent claims to health care programs

Complaint Alleges Hospital Allowed Untrained Physician to Perform Endovascular Procedures and Endangered Lives of Patients

The United States has filed a complaint under the False Claims Act against Dr. Najam Azmat and the Satilla Regional Medical Center in Waycross, Ga., the Justice Department announced today.  The complaint, filed in U.S. District Court for the Southern District of Georgia, alleges that the defendants submitted false or fraudulent claims to federal health care programs, such as Medicare.  Specifically, the United States contends that certain operative procedures performed by Dr. Azmat at Satilla, and hospital services provided by Satilla in connection with those procedures, were not reasonable and necessary, were incompatible with standards of acceptable medical practice, and were of no medical value.  The United States further alleges that the defendants' misconduct endangered the lives of federal health care program beneficiaries.

The government's complaint alleges that in the Spring of 2005, Satilla recruited Dr. Azmat, a general surgeon by training, to relocate to Waycross and join the hospital's medical staff.  Shortly after Dr. Azmat came aboard, Satilla allowed him to begin performing endovascular procedures – highly specialized operative procedures that require formal training – in Satilla's Heart Center cath lab.  Satilla did so despite the fact that Dr. Azmat lacked training to perform such procedures, was not qualified or competent to perform such procedures, had never performed such procedures before at any of the hospitals where he had been on staff, and did not even have privileges at Satilla to perform such procedures. 

The complaint further alleges that it was obvious to the cath lab nursing staff that Dr. Azmat was not qualified or competent to perform endovascular procedures.  The nurses repeatedly voiced their concerns to Satilla's management, but the hospital took no formal action for at least five months, during which patients were seriously injured and one patient died from hemorrhagic shock following an endovascular procedure during which Dr. Azmat perforated her renal artery.  The complaint also states that not only did Satilla's management ignore its nurses' concerns for several months, but it also performed no formal oversight of Dr. Azmat, categorically excluding all of his endovascular procedures from Satilla's peer review process.

"When health care providers cut corners by allowing unqualified doctors to perform complicated medical procedures, patients suffer," said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice.  "Here, we allege individuals were endangered because of these defendants.  The seriousness of this case illustrates why we remain committed to protecting patient safety and the integrity of our federal health care programs by aggressively enforcing our health care fraud laws."

"The filing of this complaint is but one example of the willingness of the Department of Justice to take action to protect the health and safety of the American people.  The United States Attorney's Office will take the necessary legal actions to comply with our vigorous enforcement responsibilities under the False Claims Act," said Edward Tarver, U.S. Attorney for the Southern District of Georgia

This lawsuit was originally filed by Lana Rogers, a nurse who formerly worked in Satilla's Heart Center.  Under the qui tam, or whistleblower, provisions of the False Claims Act, a private citizen can file an action on behalf of the United States and receive a portion of any recovery.  In April of this year, the United States intervened in the lawsuit, and today filed its own complaint.  Under the False Claims Act, the government may recover up to three times the amount of its losses, plus civil penalties based on the number of false claims filed

The suit is entitled United States ex rel. Lana Rogers v. Najam Azmat, M.D. and  Satilla Health Services Inc., dba Satilla Regional Medical Center.  

The United States' intervention is part of the government's emphasis on combating health care fraud.  One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover approximately $3 billion since January 2009 in cases involving fraud against federal health care programs.  The Justice Department's total recoveries in False Claims Act cases since January 2009 have topped $4 billion

SOURCE U.S. Department of Justice