Dive Brief:

• The Department of Justice has joined and unsealed a civil complaint against the University of Pittsburgh Medical Center, University of Pittsburgh Physicians medical group and cardiac surgeon James Luketich, who also chairs UPMC's cardiothoracic surgery department.
• Filed under the False Claims Act, the suit contends that Luketich regularly performed as many as three surgeries simultaneously. In addition to violating laws barring concurrent surgeries for payment from Medicare or other federal programs, the suit claims Luketich's practices violated patient standard of care by keeping him from fully participating in the most critical aspects of each procedure. It also claims patients were subjected to additional hours of medically unnecessary anesthesia while being watched by unsupervised residents — and even multiple surgeries.
• The suit was originally filed under seal in U.S. District Court in Pennsylvania in 2019, court records show, and alleges that the conduct dates back years. The whistleblower in the case is cardiothoracic surgeon Jonathan D'Cunha, who currently practices at the Mayo Clinic in Arizona but worked at UPMC between 2012 and 2019.

Dive Insight:

Healthcare continues to gobble up the lion's share of False Claims Act activity at the DOJ. Of the $2.2 billion the agency recovered in the last fiscal year, $1.8 billion related to healthcare fraud, covering wrongdoing by hospitals, doctors, drugmakers and devicemakers.

The latest lawsuit accuses Luketich, his medical group and UPMC of engaging in cardiac procedures made dangerous by being conducted simultaneously, dragging them out for hours or even days more than necessary. The alleged practice dates back to at least 2015, according to the suit.

Patients were also admitted to UPMC in order to accommodate Luketich's schedule, leading them to not only have to be operated again at a future occasion, but also to unnecessary bills, according to the suit.

It also contends that as a result of Luketich performing drawn-out procedures, several patients developed pressure ulcers or compartment syndrome, which is caused by internal pressure buildup due to internal bleeding or tissue swelling. At least two of Luketich's patients also had to undergo amputations.

"Defendants have … regularly sacrificed patient health in order to increase surgical volume in the CT Department, to ensure that Luketich — and only Luketich — performs certain portions of surgical procedures, and to maximize profit," the suit says.

Moreover, the litigation accuses UPMC of ignoring or minimizing complaints by employees and staff regarding Luketich, and says it "protected him from meaningful sanction; refused to curtail his surgical practices; and continued to allow (him) to skirt the rules and endanger patients."

Luketich and the other defendants have yet to file a formal response to the lawsuit.

"The laws prohibiting 'concurrent surgeries' are in place for a reason: to protect patients and ensure they receive appropriate and focused medical care," Acting U.S. Attorney Stephen Kaufman said in a statement. "Our office will take decisive action against any medical providers who violate those laws, and risk harm to Medicare and Medicaid beneficiaries."

DOJ has been fairly active in False Claims Act lawsuits against large hospitals and healthcare systems as of late. It obtained a $90 million settlement against Sutter Health, as well as a $21 million settlement against a Cleveland Clinic-owned hospital system in Ohio.