Newsday: Spinal surgery lasted 16 minutes at NUMC, lawsuit alleging fraud contends

By: Robert Brodsky

A Rockland County resident involved in a fender bender in Queens in 2022 sought treatment years later at Nassau University Medical Center, where he received a highly complex spinal fusion surgery that nursing notes show took 16 minutes for doctors to perform, according to a lawsuit alleging the treatment was unnecessary and impossible to perform during that short period of time and that the crash was staged.

The complaint, filed on July 21 in state Supreme Court in Manhattan, claims to show other mathematical and medical near-impossibilities: a lumbar procedure on another passenger in the vehicle to remove part of a herniated disc that took four minutes to complete, and a shoulder surgery that involved six separate procedures that lasted 16 minutes. 

'Pre-planned medical treatment'

The suit, known as a third-party action, makes allegations of fraud and names Total Orthopedics & Sports Medicine, which has run NUMC's orthopedics department since 2007; two of the company's Brooklyn-based surgeons; and physicians from Dix Hills and Staten Island. 

In a statement supplied by its attorneys, Total Ortho denied the allegations in the complaint.

The attorneys note that the anesthesia records for the spinal surgery at NUMC indicate that the procedure lasted 1 hour and 42 minutes, while the intraoperative neuromonitoring report shows the surgery lasted 1 hour and 41 minutes.

"In short, the 16 minutes figure is the product of misapplying the latest alleged start time and the earliest possible end time from a file containing multiple records," attorneys for Garfunkel Wild wrote in a letter to Newsday late Wednesday. 

None of the other defendants, several of whom have been previously named in other suits alleging fraud schemes or performing unnecessary surgeries on motorists in alleged staged accidents, responded to requests for comment from Newsday.

The allegations come as NUMC's board of directors continues an investigatory review of surgical cases performed by doctors from Total Ortho and plan to reduce their oversized role at the East Meadow public safety net hospital.

The complaint stems from a May 2, 2022, accident on South Conduit Avenue in southeast Queens in which Richard Kelly, driving a truck owned by Werner Industries of New Jersey, was attempting to make a wide right turn and allegedly struck the front driver's side of a vehicle operated by Charles Philippe, of New City in Rockland County, records show.

Police arrived on the scene and reported that both vehicles were drivable and that neither the two drivers nor Philippe's passenger, Jean Clark Richard, also of New City, suffered any injuries, the suit states.

Nonetheless, attorneys for Werner Industries, which filed the complaint, note that Philippe and Richard sought physical therapy treatment in Hempstead — more than an hour from their homes — the day after the accident.

"Both plaintiffs — Philippe and [Richard] — denied any injuries whatsoever at the accident scene and made no requests for medical assistance," the complaint states. "Regardless, both Philippe and [Richard] began a course of pre-planned medical treatment designed to fabricate injuries facially supporting needless medical procedures and surgeries, all occurring counties away from their residences."

The Manhattan-based Liakas law firm represents Philippe and Richard and in 2023 sued Kelly and Werner Industries for injuries incurred in the initial crash. That suit is ongoing.

In a statement Monday, Hank Sheinkopf, a spokesperson for the law firm, said Philippe and Richard declined to comment on the allegations in the new complaint.

"Liakas Law has no involvement in the allegations against these physicians," Sheinkopf said. "The firm is not named in the matter, nor has it been accused of any wrongdoing. Any suggestion otherwise would be inaccurate and misleading."

Physical therapy and surgeries

In the months following the accident, Philippe and Richard made the roughly 100-mile round-trip drive to Long Island for physical therapy about 10-12 times per month, the suit contends.

The pair also visited Island-based acupuncture, neurology, rehabilitation and diagnostic facilities, the complaint states.

Ultimately, Philippe underwent a complex arthroscopic left shoulder surgery in July 2022 at a Brooklyn surgical center, records show.

Two years later, Total Ortho doctors at NUMC performed spinal decompression surgery and fusion on Philippe, even as two earlier MRIs showed no evidence of disc bulges or herniations, the complaint states.

The length of each procedure, according to nurse's operative notes included in the lawsuit: 16 minutes. 

Richard, meanwhile, had spinal, knee and lumbar surgeries, the latter of which, records show, took only four minutes to complete.

The bill for the $10,000 spinal surgery, meanwhile, indicates that it was paid by Richard's attorney.

The complaint alleges the surgeries were performed not with the goal of repairing any purported injury "but instead maximizing billing, inflating the damages of the underlying lawsuit, and defrauding [Werner Industries]."

Total Ortho doctors have been named in at least four federal Racketeer Influenced and Corrupt Organizations lawsuits, including one alleging they conspired with Freeport residents, a Manhattan law firm and a vast network of other medical providers to collect millions in insurance payouts for fraudulent accident claims.

 Attorneys for Total Ortho contend that many of the previous RICO actions against the company have been "dismissed of failed to survive dispositive motions." 

Attorneys representing insurance companies in the RICO cases allege that Total Ortho surgeons often see patients — typically litigants in lawsuits stemming from alleged accidents in Brooklyn and across the five boroughs — and then direct them to spinal surgery at NUMC, which they or their colleagues later perform.

 Those often expensive surgeries are typically performed on individuals without insurance, so the costs of the procedures are absorbed by the hospital, which is $1.4 billion in debt, records show. 

No one has been criminally charged in connection with the cases, but the Brooklyn District Attorney's Office has opened a criminal investigation connected to the RICO complaints, court records show.