Surgeon Double-Sued for Double-Booking Procedures

DOUBLE TROUBLE David B. Samadi, MD, is facing 2 lawsuits for misleading patients about his double-booking practices.

A prominent surgeon is facing two $7 million lawsuits for letting doctors in training perform his double-booked prostate surgeries.

The lawsuits allege that David B. Samadi, MD, the chief of urology at Lenox Hill Hospital in Manhattan, had inexperienced residents perform his surgeries while he simultaneously performed surgery in another room. In order to hide the fact that Dr. Samadi was elsewhere, the patients were put under "prolonged" general anesthesia and suffered serious complications following their procedures, according to the suits.

In 2013, Stephen Markelson went in for a transurethral resection of the prostate he believed Dr. Samadi would perform. The suit alleges, however, that a resident performed Mr. Markelson's surgery while Dr. Samadi performed a robotic-assisted laparoscopy in another room. Mr. Markelson returned to the hospital days after he was discharged with blood in his urine and had to have the operation redone by another surgeon, court records show.

The second plaintiff, Peter Nadler, alleges a resident performed a 2-hour procedure while Dr. Samadi spent all but 25 minutes on another case.

Attorney Joseph Lanni of Jacob Fuchsberg in New York City, who's representing both patients, alleges that both Mr. Markelson and Mr. Nadler were defrauded because they were led to believe that Dr. Samadi would be performing their surgeries.

These lawsuits come after an ongoing investigation by the Boston Globe into Dr. Samadi's use of residents for his non-robotic surgeries.

Dr. Samadi and Lenox Hill Hospital did not respond to requests for comment.

JoEllen McBride

Did Hospital Reuse HIV Patient's Syringe to Administer Anesthesia?

CONTAMINATED The patient argues the hospital staff put him at risk by reusing a needle that had been used on someone who was HIV-positive.

A patient is suing a Chicago hospital, claiming that during his surgery staff members reused a syringe that had been used on an HIV-positive patient.

The patient, who remained anonymous and was only listed as John Doe in the Jan. 17 complaint, says he went to Northwestern Memorial Hospital in Chicago, Ill., in February 2017, for a hernia repair. During his procedure, a staff member at the hospital, who is unnamed in the suit, gave him anesthesia with a used syringe, according to a copy of the lawsuit. The syringe had been used before on a patient who was "known to be HIV-positive," the suit says.

After the incident, hospital staff drew the patient's blood to test it for HIV without telling the patient what happened and without asking for his consent, the suit says. During a scheduled follow-up 10 days later, the surgeon, Charles Hogue, MD, chair of the department of anesthesiology at the hospital, told the patient his syringe had been used before. The surgeon didn't tell the patient that the syringe had been used on someone who was HIV-positive, though he said there was, "no risk" to the patient's health, the suit says.

The patient followed up with the hospital to get more information on any potential health risks, but it wasn't until late March that an infectious disease specialist, Teresa Zembower, MD, associate professor of medicine at Northwestern University Feinberg School of Medicine, told the patient that the syringe had been used on an HIV-positive person. She said the hospital would pay for his blood tests to screen for HIV and hepatitis, the suit says.

The patient sought treatment for exposure to HIV from the University of Chicago after speaking with Dr. Zembower, but was told that it was "too late for antiretroviral medicines to be of any benefit," the suit says.

A hospital spokesperson did not respond to a request for comment.

The patient is suing the hospital for reckless endangerment and medical battery for reusing the syringe, and fraudulent concealment for neglecting to tell him about the incident, the suit said. The hospital is the only defendant named in the suit. None of the doctors or staff involved is named as a defendant.

Anna Merriman

It's Safe to Send Joint Replacement Patients Home Alone

WALKING SOLO Patients who live by themselves can have a great experience after total joint surgery, according to researchers.

Surgeons might hesitate to send joint replacement patients home alone soon after surgery, but new research says positive post-op outcomes aren't dependent on having caregivers around to help out during recovery and rehab.

The study, which was published in the Journal of Bone & Joint Surgery, compared post-op outcomes among 138 older patients who lived on their own and 631 patients who lived with others. About one-third of the patients who lived alone did not have daily or weekly visitors, but nearly 80% lived within 15 minutes of someone they could call for assistance.

There were no significant differences in post-op complications rates, emergency room visits, pain relief scores and satisfaction levels between the 2 groups, according to the researchers. Joint function and quality-of-life scores were also similar at 6 months post-op.

"There has been a growing interest in value-based care across orthopedics," says study lead author Andrew Fleischman, MD, a research fellow at the Rothman Institute in Philadelphia, Pa. "While certain costly interventions have withstood based on their assumption of efficacy, it is up to us to identify which services actually improve outcomes and are cost effective.

Surgeons should set realistic expectations about the post-op period and use their judgment to come up with a recovery plan that patients are comfortable with and confident in completing, according to Dr. Fleischman. "They should be coached to have optimistic expectations," he says. "We no longer operate under the ‘sick' patient model."

Daniel Cook

InstaPoll: How Many Surgical Conferences Will You Attend in 2018?

Tell us in this week's InstaPoll

About 1 in 5 of the 365 respondents to last week's poll have had a patient die in the OR. The results:

Has a same-day surgery patient ever died on your table?

  • yes 21%
  • no 79%

Dan O'Connor

News & Notes

  • Prescription length risk factor for opioid misuse Patients who continually refill opioid prescriptions to manage post-op pain are more likely to experience medication-related harm, according to a study published in BMJ. The review of 568,612 surgical patients who received opioid prescriptions shows each week of post-op opioid use increased risks of dependence, abuse or nonfatal overdose by 44%. The dosage amounts had a much smaller impact on the likelihood of misuse than the duration of the prescriptions, notes the study.
  • Flubbed bowel surgery leaves patient vomiting blood and feces A patient has won a 6-figure payout following a bowel surgery that left him in severe pain, vomiting blood and feces. The surgery, which was supposed to help Graeme Cross, 33, with his Crohn's disease, ended up leaving Mr. Cross unable to work again. It was 9 days post surgery before The James Cook University realized he had a leak in his bowel, a lawsuit alleges.
  • Nerve transplant procedure restores eye sensation Patients who develop neurotrophic keratopathy, a degenerative disease of the corneal epithelium resulting from impaired corneal innervation, may have an end to their suffering in sight. Surgeons at Michigan Medicine are helping these patients with a small-incision, nerve transplant procedure corneal called neurotiziation surgery. The surgery will re-direct the patient's sensory nerves in the forehead or use a nerve graft from somewhere else in the patient's body to implant the new nerve endings around the cornea, surgeons say.