July 3, 2015

ARE YOU SURPRISED WHEN JIFFY-LUBE TELLS YOU THAT YOU NEED A NEW FILTER?:

Whistle-blower: How doctor uncovered nightmare (Laura Berman, 6/10/15, The Detroit News)

From the blue yarns tucked in a woven basket to the earth-tone carpeting and the solidity of the stone fireplace, every detail of the Crittenton Hospital Cancer Center's waiting room helps anxious patients feel embraced by warmth and comfort. Even the vaulted ceiling, crafted of gleaming cherry wood, suggests a religious sanctuary, not a medical clinic.

Two years ago, before St. John Health System acquired it, this was the foyer to Dr. Farid Fata's clinic, a tasteful yet grand reception area linking his private clinic to the hospital. It was an arrangement that lent Fata seemingly special status and enhanced his reputation with patients.

Yet at 10 a.m. on July 1, 2013, Monica Flagg felt dread as she entered this space, a full year after a routine urine test showed an M protein spike that led her physician to refer her to Fata, a well-known oncologist and hematologist. She was 51, the executive director of a state-licensed nonprofit -- a competent woman facing the stress of a life-threatening illness.

She would wait close to two hours before being called for this, her first chemotherapy session.

A nurse opened the door for her. "Monica."

Inside the clinic, the designer surroundings faded as human chaos seeped in. The infusion nurses argued among themselves, uncertain about whether to deliver the treatment by injection or a slow drip. In the end, Flagg was given a single shot. By the time she returned home, she was exhausted and upset.

Later that day, she and her husband Stephen retreated to the deck outside their Rochester home, trying to relax. When a few raindrops splattered, she went upstairs to close the bedroom window. Turning back around, Flagg stumbled and fell on an open suitcase she had been unpacking.

Almost two years later, she still recalls the crunch of bone and her own anguish as she began to cry.

That sweltering Fourth of July week, Dr. Soe Maunglay, then 41, a Burmese-born oncologist newly settled in southeastern Michigan, was making hospital rounds for Fata, his employer. Soft-spoken and meticulous, Maunglay was wearing a suit jacket rather than a white lab coat, a habit he'd adopted from a Mayo Clinic-trained mentor.

An accident of timing, personal history, and incredible luck -- good and bad -- was about to unfold in Flagg's hospital room. The result would save lives and unleash a federal investigation into a long-esteemed physician, collapsing his elaborate medical empire, even as details about who uncovered the doctor's web of deceit, fraud and suffering remained unexplained.

Next month, before Fata is sentenced in a Detroit federal courtroom, Fata victims will describe the toll of being prescribed toxic medication and testing they didn't need. They will explain how their misplaced trust in a doctor they once revered tore apart their families, cost them the power to make choices about living or dying, and created lingering mental anguish and illness.

But it was Flagg's stumble over a suitcase, and Soe Maunglay's determined follow-through over the next weeks, that precipitated Fata's own fall.

Making Fata's rounds that July day, Maunglay checked for the first time on Flagg, hospitalized with two fractures in her left leg. Because Maunglay is a cancer doctor, he paid heed to her multiple myeloma diagnosis, the Velcade injection, and the medical record before him. It all triggered an internal alarm. .

"Who told you that you have cancer?" he asked her.

Fata's Michigan Hematology and Oncology Inc. (MHO) was the state's largest private cancer practice in 2013, with clinics in seven cities, its own pharmacy and diagnostic center, and 1,700 patients, virtually all of them assigned to Fata, the tireless physician. Those who needed proof of Fata's dedication could look to the doctor's work ethic -- he often labored past midnight -- or to the Swan for Life Foundation, a charity Fata established to help cancer patients and their families.

Today, MHO is gone and Fata is behind bars, awaiting sentencing for at least $34 million in fraudulent Medicare billings and a kickback scheme with a hospice. The criminal counts only hint at the human suffering behind the financial damages and raise questions about how Fata's schemes could go undetected so long, despite his many contacts, doctors, and huge roster of patients. As Brian McKeen, the malpractice lawyer now representing Flagg, says with outrage: "The one place a person should be safe is a hospital or doctor's office. [...]

Maunglay was stunned by what the hospital chart suggested. A cancer-free patient being given chemotherapy wasn't negligence; it was an atrocity. "It's oh my God, if he can do this to a person who has nothing. ..." he said one recent Saturday afternoon. "For me, one case like this was enough. How could a doctor do this? My father died of cancer. For most of us" -- he waved his arms -- "cancer is personal."

As a cancer specialist, he had a special understanding of the horror he was witnessing, its cruelty. Fata's choice of myeloma, a cancer of the plasma cells in bone marrow, bespoke a certain shrewdness, because of the subjectivity of diagnosis. It was a clever niche for false doctoring. "You cannot fake lung cancer," he says. "You cannot fake a tumor ..." But with this disease, a malevolent doctor could plausibly use the treatment itself as a smokescreen to obscure future questions.

Myeloma's early "smoldering" stage is signaled by relatively minor changes in blood chemistry. Maunglay and Dr. Craig Cole, an assistant professor of medicine at the University of Michigan and myeloma specialist, say someone with an elevated M protein level is properly monitored through blood and urine testing. Flagg's was high enough to qualify as MGUS -- an entry-level condition that can be precancerous, but often is not.

Flagg was instead diagnosed for the more serious smoldering myeloma and singled out for Fata's brand of aggressive, unorthodox -- and very expensive -- treatment: she was subjected to three bone marrow biopsies and prescribed monthly intravenous immunoglobin injections (IVIG) that cost $4,000 each. Flagg despaired before every test, even fighting the diagnosis. "People would ask me how I was feeling. I felt fine. I had no symptoms!" she said.

Posted by at July 3, 2015 5:14 PM
  

blog comments powered by Disqus
« A MORE AMERICAN POLICY...: | Main | DELTA DAWN: »