A whistleblower's complaint led to a federal investigation of surgeons at Baylor St. Luke's Medical Center and a record $15 million settlement.
According to the feds, three surgeons at Baylor St. Luke's Medical Center -- Dr. Joseph Coselli, 71, of Houston, Dr. Joseph Lamelas, 63, of Miami, Florida, and Dr. David Ott, 77, of Houston -- are accused of regularly leaving operating rooms during complicated and risky heart surgeries and leaving patients in the hands of unqualified medical residents.
“Patients entrusted these surgeons with their lives - submitting to operations where one missed cut is the difference between life and death,” U.S. Attorney Alamdar S. Hamdani said. “Allegedly, the patients were unaware their doctor was leaving for another operating room."
Now, 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 claims they billed Medicare for concurrent heart surgeries.
“Any time any one of us goes under the knife as a vulnerable patient, we implicitly trust that the surgeons and medical professionals have our best interest at heart, especially here in Houston’s world-renowned hospitals,” said Houston Special Agent in Charge Douglas Williams of the FBI. “In this case, doctors gambled with their patients’ care, during complicated open-heart surgeries no less, compromising quality of care over quantity and then falsely billed Medicare for reimbursement of services they improperly delegated."
The investigation began in 2019 when the whistleblower alleged Coselli, Lamelas and Ott were leaving residents to perform portions of complicated coronary artery bypass grafts, valve repairs, and aortic repair procedures. These surgeries typically involve opening a patient's chest and placing them on a bypass machine.
According to the Justice Department, surgeons would leave one surgery and go to another operating room without designating a backup surgeon. At times, the surgeons allegedly hid these activities by falsely attesting on medical records they were physically present for the “entire” operation, the feds said.
“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.
The $15 million recovery is the largest settlement to date involving concurrent surgeries. The whistleblower will receive part of the settlement.
Baylor St. Luke's sent 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."
Baylor College of Medicine, which employs the teaching physicians, said it did not engage in any conduct that violates federal law, but they decided to amicably resolve the dispute to avoid an expensive trial. They go on to say it’s important to note no patients were harmed.
Below is the full statement from Baylor College of Medicine.
“Baylor College of Medicine did not engage in conduct that violates any applicable federal law or regulation. It is also important to note that no patients were harmed. The settlement agreement acknowledged that BCM disputed that any violations of federal law occurred and that the College being a party to the agreement is not an admission of liability by Baylor. The College decided to amicably resolve the dispute prior to a trial on the merits after considering the cost and expense incurred by Baylor to date, and anticipated future costs and expenses, including attorneys’ fees.”
We checked Coselli, Lamelas and Ott's licenses, and according to the Texas Medical Board’s website, as of Monday, they don’t list any malpractice info, criminal history or disciplinary actions.
Two of the three doctors have active licenses in Texas.