June 25, 2013

162017_132140396847214_292624_nSome say that medicine is a cut-throat business. A hospital on the west side of Chicago applied that adage literally.

According to the FBI, a Chicago for-profit hospital was able to bill as much as $160,000 for patients who received unnecessary tracheotomies due to a pulmonologist on the hospital staff who would intentionally heavily sedate patients so that they could not breathe on their own and therefore required a tracheotomy (a tracheotomy is a surgical procedure that opens up the windpipe that is typically performed in emergency situations – a tracheostomy refers to the opening itself while a tracheotomy is the actual operation).

A tracheotomy may be necessary if a patient is not getting enough air into his lungs due to swelling of the trachea, a serious injury to the neck, nose, or mouth, a large foreign object in the trachea, a tumor, or paralysis of the muscles of the throat that do not allow the patient to breathe on his own, or if the patient is in a coma or is dependent on a ventilator to breathe.

The FBI alleges that the owner of the Chicago hospital stated in a recorded conversation that tracheotomies performed at the hospital were the hospital’s “biggest money maker.” The FBI further alleges that a hospital pulmonologist ordered an ICU nurse to “snow the patient,” meaning the level of sedation would be so deep that only the white portion of the eyes would be visible. The same hospital pulmonologist allegedly stated that the hospital’s owner requested that he “provide two more tracheotomy cases for the hospital soon,” before inspectors could return to the hospital after their initial investigation.

A hospital surgeon performed 28 tracheotomies on Medicare patients at the hospital between early 2010 and January 2013. Five of those patients died within two weeks of their tracheotomies, which is a death rate three times higher than in the rest of Illinois.The FBI affidavit contains an allegation that tracheotomy patients were lucrative for doctors as well as the hospital: the physician could bill $160 each time he visited a tracheotomy patient at the hospital, versus $32 for seeing a ventilator patient in a nursing home.

The hospital where the allegedly unnecessary tracheotomies were performed reported an increase in profits from $1.3 million in 2011 to $9.4 million for the year that ended on June 30, 2012. The hospital is located in one of the poorest sections of Chicago and has reported that less than half of its beds have been occupied in recent years. The hospital’s owner, the hospital’s chief financial officer, and five of its physicians were criminally charged in April 2013 with Medicare fraud, alleging that they provided or received kickbacks in exchange for patient referrals. The owner posted $10 million in cash in order to be released from custody after his arrest in April.


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