In a whistleblower grievance in Miami court docket, he claims that it was solely months into his job on the Boynton Beach hospital when he found fraudulent billing to the tune of thousands and thousands of {dollars}, extreme understaffing within the intensive care unit, and violations of medical requirements that he says triggered affected person hurt.
Calcaterra voiced his issues repeatedly to the hospital administration and prime executives, however his grievances had been largely ignored, in response to the lawsuit. He says he was fired a yr after his hiring in retaliation for bringing the hospital’s dysfunction to mild.
“Defendants retaliated in opposition to Calcaterra by harassing, isolating, and terminating him from all positions solely on account of his protected exercise,” the grievance alleges.
The lawsuit was filed in Miami-Dade County Court in opposition to Bethesda Health Physician Group and Baptist Health South Florida, a nonprofit hospital firm. It lists counts for employment retaliation below the Florida Private Whistleblower Act and the False Claims Act, a federal legislation that protects whistleblowers and gives compensation in the event that they uncover fraud in opposition to a authorities entity or program.
Baptist Health South Florida is one of many largest healthcare organizations within the area, working 12 South Florida hospitals and greater than 100 outpatient and pressing care services. It acquired Bethesda East hospital as a part of a 2017 merger with Bethesda Health, which has been working in Palm Beach County since 1959.
When reached by New Times, Baptist Health South Florida stated it had not been served within the case and doesn’t touch upon pending litigation.
Withholding Treatment?
In July 2020, an uninsured 48-year-old Black affected person opted to not have surgical procedure to handle his coronary heart situation after one in every of Bethesda East’s medical doctors informed him and his spouse the operation was not definitely worth the danger, the lawsuit alleges. According to the grievance, two different physicians had been so involved by their colleague’s recommendation that they sought a second opinion from Calcaterra.
Upon analyzing the affected person, Calcaterra discovered the person had a life-threatening aortic dissection, a situation that would end in a deadly rupture of the aorta if not surgically repaired instantly.
“Incredibly, the treating doctor didn’t doc these particulars within the affected person’s chart, however did doc within the medical data that the affected person had ‘refused the operation,'” the lawsuit states.Â
Calcaterra believed that the affected person was prone to a rupture inside a matter of days and wanted an emergency operation. After consulting with Calcaterra, the grievance claims, the person elected to maneuver ahead with the surgical procedure.
The surgeon says the incident was a part of a “sample at Bethesda hospital” whereby the ability would “withhold therapy together with wanted operations to the uninsured to keep away from the expenditure of assets for which there can be no compensation or compensation at a charge far lower than an insured or Medicare affected person would generate.”
“This was confirmed when Dr. Calcaterra introduced this near-tragic incident to the eye of the director of defendant’s danger administration workplace, who said that the hospital administration had been unwilling to handle such points… for years,” the lawsuit alleges.
“We Take Care of Each Other”
Calcaterra claims to have witnessed a number of types of fraudulent billing practices whereas working because the hospital’s head of cardiac surgical procedure. Among different alleged misconduct, Calcaterra says he observed the hospital systematically conducting pointless post-surgical affected person consultations to inflate invoices.
Within a month of his hiring, Calcaterra says he requested one other physician at Bethesda East why he had ordered so many specialist consults on a affected person. The physician allegedly responded, “We deal with many uninsured sufferers right here, and we now have to compensate for the work we do without cost, so we deal with one another.”
Calcaterra reported the follow, often called “overutilization,” to the hospital’s assistant vice chairman, chief medical officer, and chief working officer, however the concern was swept below the rug, in response to the lawsuit. Just a few weeks after Calcaterra met with the chief working officer to report the problem, she “was abruptly fired,” the lawsuit alleges.
Calcaterra says he additionally discovered that the hospital was misclassifying medical providers as “essential care time” to inflate billing. The facility allegedly disregarded the Centers for Medicare and Medicaid Services pointers for outlining and coding essential care.
“These illegal practices associated to billing of ‘essential care time’ account for tens of thousands and thousands of {dollars} per yr of fraudulent billing on the totally different Baptist Hospitals,” the lawsuit asserts. “Calcaterra, in individual, together with one in every of his essential care doctor colleague[s]… reported verbally and in writing these information to the Bethesda chain of command.”
Lax Care Claims
The physician, who accomplished his cardiothoracic surgical procedure fellowship in 2007 on the University of Miami’s Miller School of Medicine, recounts within the lawsuit how Bethesda East allegedly dragged its ft in hiring extra doctor assistants (PAs) to assist out in working rooms and the intensive care unit. He says he expressed his issues a number of instances in the course of the summer season of 2020, telling the administration the shortage of ICU protection put sufferers’ lives in danger.
In an August 2020 e mail, Calcaterra reached out to the hospital in regards to the understaffing, noting that hospital workers had been reluctant to talk up for concern of retaliation, he says. Then in November of that yr, not lengthy earlier than he was fired, he emailed administration about an incident through which the hospital allegedly had a “lack of any personnel” to take care of a affected person in misery within the intensive care unit.
Though Calcaterra labored at Bethesda East on the onset of COVID-19 pandemic, throughout which South Florida hospitals struggled to keep up ample personnel, he presents proof that allegedly exhibits the hospital had financially motivated misgivings about hiring extra doctor assistants. The lawsuit claims that in response to Calcaterra’s issues, the president of Bethesda Physicians Group as soon as wrote that the hospital was “being requested to spend an terrible lot of cash right here,” whereas questioning why an already-hired doctor assistant wouldn’t suffice.
While an govt at Baptist Health South Florida acknowledged “important protection points and problem managing the workload,” she did little to resolve the scenario and failed to research the ICU understaffing, Calcaterra argues.
“The many issues I’ve introduced up by means of the months about issues with operations, processes, and high quality of care haven’t been addressed and acknowledged,” Calcaterra wrote in a grievance cited within the case.
A “lack of primary tools wanted for sufficient medical care,” together with emergency dialysis, together with an lack of ability to rapidly course of coagulation lab outcomes, prompted yet one more grievance from Calcaterra, in response to the lawsuit. He claims that when he parted methods with the hospital, the lab concern nonetheless had not been addressed.
During his tenure on the hospital, he claims, he needed to handle missteps within the hospital’s dealing with of central line catheters, its use of intravenous anti-arrhythmia medicine, and its purported “follow of reserving after which canceling instances,” all of which he claims put sufferers in danger.
In one of many extra alarming alleged mishaps cited within the grievance, Calcaterra claims the hospital allowed a common surgeon to hold out a pacemaker surgical procedure regardless of an absence of {qualifications} to carry out the operation. “The pacemaker was improperly implanted, and opposite to any medical justification,” the physician says, noting that the affected person wound up dying.
Calcaterra claims his employment was terminated round January 2021 in retaliation for his complaints in regards to the hospital’s “illegal exercise.”
The physician, a University of Rome medical faculty graduate, says he is entitled to job reinstatement, backpay, and different monetary damages. He is represented by Gary Costales in Miami and Tina Glandian of Geragos & Geragos in New York.
“There seems to be a follow or modus operandi of a cover-up… No investigation has taken place to the most effective of our information, and we look ahead to investigators uncovering the reality and substantiating our consumer’s claims,” Geragos & Geragos spokesperson Holly Baird stated in a press release.