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8-inch Forceps Left Inside Woman
RETAINED OBJECT Part of the patient's small intestine looped through the handle of the forceps.

A stray surgical sponge might be difficult to spot, but how do you miss an 8-inch forceps? That thought must have crossed the mind of Mary Harber when she sued the surgeon who allegedly left the tool in her abdomen during surgery to remove a benign tumor.

Last spring, Ms. Harber, 52, had the tumor removed from her abdomen at Shasta Regional Medical Center in Redding, Calif., which is also named in the lawsuit. Richard Mooney, MD, an obstetrician-gynecologist, performed the surgery and allegedly left the forceps behind.

After leaving the hospital on April 19, 2017, Ms. Harber experienced pain in her back, kidney and abdomen. On May 1, she went to the emergency room at Banner Lassen Medical Center, where an X-ray revealed the forceps. Ms. Harber reportedly underwent follow-up surgery to remove the forceps and 18-inches of her small intestine, which had looped around the tool's handle.

Ms. Harber, who claims she will require additional follow-up care, is seeking an undisclosed amount for medical and incidental expenses and loss of past and future earnings. She's also seeking damages for the loss of comfort and support to her husband.

Shasta Regional did not respond to a request for comment. A representative at Dr. Mooney's office declined to comment.

Daniel Cook

Did Surgeon Discriminate Against HIV Patient?
VIOLATION A judge said Dr. Emmanuel Asare's refusal to treat a patient based solely on HIV history went against the Americans with Disabilities Act.

A New York surgeon was in violation of the U.S. Americans with Disabilities Act (ADA) and the New York City Human Rights Law when he refused to perform breast reduction surgery on a man after learning he was HIV positive, court records show.

U.S. District Judge Analisa Torres issued the summary judgment order last week and sided with federal prosecutors and former patient Mark Milano, who brought a discrimination suit against Emmanuel Asare, MD, a former surgeon with Advanced Cosmetic Surgery of New York, which was also named in the suit.

The lawsuit concerned an incident in July 2014 when Mr. Milano went for a consultation for a gynocomastia procedure at Dr. Asare's office. During the consultation, Mr. Milano told the doctor that he had HIV, resulting in Dr. Asare declining to perform the surgery, court records show.

Before dismissing Mr. Milano, Dr. Asare allegedly also cancelled surgeries on 2 other patients after he suspected they might be HIV positive, court records show.

Mr. Milano filed a complaint about Dr. Asare with the U.S. Department of Justice, prompting federal prosecutors to investigate both Dr. Asare and Advanced Cosmetic Surgery of New York.

During the investigation, prosecutors asked Dr. Asare about his policy regarding HIV-positive patients, to which the doctor reportedly replied, "Any condition that a patient has that to the best of my knowledge will potentially have any negative effect on the outcome of the surgery or recovery process will disqualify the patient," the order said.

Dr. Asare went on to include a history of HIV, along with obesity, a history of DVT and a recent heart attack as conditions that would disqualify a patient. According to the order he added, "I have some qualifying and disqualifying criteria based on my comfort level and how much risk or stress I am willing to take! I think that is my right as a cosmetic surgeon!"

Prosecutors filed a complaint against Dr. Asare in 2015 based on violation of the ADA. Mr. Milano intervened shortly thereafter, accusing Dr. Asare of violating the ADA and the Human Rights Law, the order said.

Judge Torres's decision rested on Dr. Asare's admission that he had rejected the patients based on the fact that they were taking antiretroviral drugs, without investigating each patient's case further.

"Defendant's blanket refusal without individualized inquiry is insufficient to pass muster under the ADA," the judge wrote.

Anna Merriman

Anesthesiology Group Admits Submitting $3.4 Million in False Claims

A group of anesthesiologists in Irving, Tex. took $3.4 million from insurance companies for treatment they never gave, court records show.

For years, the group, Limbic Partners, submitted false claims of anesthesia treatment that was either never given at all or administered by a non-credentialed provider. Limbic sometimes instructed its billing company "to substitute credentialed anesthesiologists to claims when the providing anesthesiologist was not credentialed with the patient's insurance company," court records show.

Many of the claims for reimbursement "were impossible to perform" since the anesthesia provider was "performing a procedure at another facility at the same time."

Though no providers were charged individually, Limbic was founded by anesthesiologists Herbert Cleighton Brown, MD, Brian David Rudman, MD, and Maulik Paresh Parikh, MD. Limbic Partners has agreed to pay back $933,251 of the falsely claimed reimbursements, having already repaid $133,000. Limbic's attorneys Daniel K. Hagood, Brian D. Poe and Robert L. Webster declined to comment.

Joe Madsen

InstaPoll: Are Add-on Cases a Problem?
Trying to wedge add-on cases into an already packed schedule can bring inefficiency to your operations and inconvenience to you and your staff. Tell us in this week's InstaPoll how big of a problem add-ons are at your facility.

Only 15% of the 347 respondents to last week's poll charge patients who cancel less than 24 hours before their scheduled procedure. The results:

Do you charge patients who cancel surgery at the last minute?

  • yes 15%
  • no 85%

Dan O'Connor

News & Notes
  • Compounding pharmacy recalling drugs over sterility concerns PharMedium Services is voluntarily recalling more than 25,000 units of its compounded medications due to a lack of assurance of sterility. The recalled drugs include fentanyl, morphine, midazolam and bupivacaine. You can review the specific lot numbers affected here. To date, PharMedium says it hasn't received any reports of complaints related to the products, but is issuing the recall out of an "abundance of caution."
  • Inpatient spine surgery safer? Inpatient surgery may be safer for spine surgery patients than outpatient surgery, according to a study published in The Spine Journal. The study examined the outcomes of anterior cervical discectomy and fusion in outpatients versus inpatients. Researchers found that 1 year after surgery, 5.5% of outpatients needed another operation while only 4.1% of inpatients required another procedure.
  • Program helps older people avoid surgical complications A program that helps medical professionals identify individual risks in patients over 65 in order to help them make decisions about whether to go ahead with their elective surgeries and how to prepare for their procedures to avoid complications resulted in shorter hospital stays and lower readmission rates, according to a study published in JAMA Surgery. The program, developed at Duke Health, is called the Perioperative Optimization of Senior Health (POSH) program was developed at Duke Health.