July 27, 2016
Medicare's hospital ratings
pack surprises, controversy
By Paul Sisson
SDUT
July 27, 2016
Medicare on Wednesday handed out its first-ever set
of overall ratings for hospital quality, bestowing a full
five stars on only 3 percent of facilities nationwide
while scoring many well-known institutions lower than
the public might expect.
For example, the vaunted Mayo Clinic in Rochester,
Minn., received five stars, but its equally prestigious
peers the Cleveland Clinic, Massachusetts General
Hospital, Cedars-Sinai Medical Center and Stanford
Health Care got four. Another nationally known
hospital, the Ronald Reagan
UCLA Medical Center,
earned only three stars.
Locally, Scripps Memorial
Hospital and Scripps Green
Hospital, both in La Jolla,
were the only two facilities
to get the top rating.
Kaiser Permanente and
UC San Diego Medical Center
earned only three.
Paradise Valley Hospital in National City
and Alvarado Hospital Medical Center
in San Diego got four stars apiece despite
being much smaller players
in the San Diego County market.
Among the nation’s 120 five-star hospitals are names
most likely unknown outside of their communities.
Anyone familiar with Moses H. Cone Memorial Hospital
in Greensboro, N.C.? How about Santa Barbara
Cottage Hospital? Or Scheneck Medical Center in
Seymour, Ind.?
All three fared better in Medicare’s ratings than major
teaching and research facilities with reputations
strong enough to attract an international patient
base...
San Diego Education Report
|
Official defends County Harbor-UCLA Medical Center
after incidents
By Deborah Schoch, CHCF Center for Health Reporting
DailyBreeze.com
04/03/2012
Los Angeles County's health services director said Tuesday that he was concerned
about recent patient care problems at County Harbor-UCLA Medical Center, but believes
the hospital is working to prevent such incidents from happening again.
"When mistakes happen, we are accountable and immediately work to correct the
processes that enabled them," said the director, Dr. Mitchell Katz, in a statement
responding to an article in the Daily Breeze. "The two cases cited in the article are
troubling and not indicative of the medical care received by tens of thousands of
individuals who seek care each year at Harbor-UCLA."
The Daily Breeze reported Sunday that a psychiatric patient died and a surgical patient
was injured amid mistakes last summer at the county-run trauma center near Torrance.
The news has stirred concern among community leaders about the quality of care at
Harbor-UCLA, the only Level I trauma center south of the Santa Monica Freeway and a
key safety net hospital for the county's low-income and uninsured patients.
Katz, who became director of health services in January 2011, said he regretted
any harm caused to patients at county-run hospitals overseen by his department.
"A hospital should be a place of safe refuge and healing, not harm," Katz said.
County Supervisor Mark Ridley-Thomas, whose district includes Harbor-UCLA,
expressed confidence in Katz and in the hospital's new chief executive officer, Delvecchio
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Finley.
"There's new leadership at that hospital, and it is very focused on making sure that
patient care is at its highest possible level," Ridley-Thomas said Tuesday.
Harbor-UCLA's medical chief of staff, Dr. Janine Vintch, released a statement praising
the quality and dedication of the hospital's staff.
"These two cases, while tragic, are not representative of all care at the hospital as the
article painted," Vintch said. She said the article oversimplified the challenge of caring
for psychiatric patients. "Periodically, we have a bad outcome as all hospitals do. It is a
part of the job that makes being a physician so difficult."
But some expressed worry that recent problems at Harbor-UCLA signal that the county
hospital system is too large and complex to be managed by the county Board of
Supervisors.
"This is about life-and-death situations. When are they going to understand that they
need a different type of governance?" said Lark Galloway-Gilliam, executive director of
Los Angeles-based Community Health Councils, a health policy and advocacy group for
low-income and uninsured residents.
The death of the psychiatric patient, who refused food and water for 16 days, was
among patient care problems that were chronicled in a Medicare report following a Sept.
13, 2011, inspection of the hospital. The report, which had not been publicized, was
obtained by the Breeze in March under the federal Freedom of Information Act.
The survey was one of three inspections Medicare conducted at Harbor-UCLA in less
than two years. The results prompted the Centers for Medicare and Medicaid Services
to threaten to cut off the hospital's Medicare funding. That move could close the hospital.
Harbor-UCLA responded by instituting new policies and making other changes. After a
successful Jan. 12 follow-up survey, Medicare sent a March 8 letter to Finley stating that
the hospital's Medicare status had been restored.
Following the patient's death, Harbor-UCLA created new guidelines for the treatment of
patients who refuse to eat or drink. The policy is now in effect at all hospitals overseen
by the Department of Health Services, county staff said.
Those hospitals contain a total of 142 in-patient psychiatric beds: 38 adult beds at
Harbor-UCLA, 32 adult beds at Olive-UCLA Medical Center and 62 adult beds and 10
adolescent beds at County-USC Medical Center.
Harbor-UCLA has also changed its pre-surgery and anesthesiology guidelines after a
patient undergoing elective knee replacement surgery last August nearly bled to death.
No blood had been typed and cross-matched in advance, delaying a blood transfusion,
according to the Sept. 13, 2011, inspection report.
Dr. Judith Kraft, medical director at the close-by Wilmington Community Clinic, said she
was puzzled by the newspaper's account of the surgery and thought that typing and
matching blood before surgery is routine.
"It was surprising. I felt that there was probably something in place to prevent that. How it
got missed, I don't know," she said.
Dr. Marshall T.
Morgan
Dr. Marshall T. Morgan is
chief of the medical staff at
UCLA Medical Center and
director of the Emergency
Medicine Center in the
David Geffen School of
Medicine. He holds the rank
of professor in the
Department of Medicine. As
chief of staff, he
exercises oversight of
the quality of physician
practice and medical
care in the medical
center. As director of the
Emergency Medicine
Center, he oversees the
emergency medicine
practice group and the
academic programs in
emergency medicine. Dr.
Morgan received his M.D.
from the Pritzker School of
Medicine of the University of
Chicago, and his
postgraduate medical
training at Harbor-UCLA
Medical Center. He joined
the faculty of the UCLA
School of Medicine in 1974.
He is a fellow of both the
American College of
Physicians and the
American College of
Emergency Physicians, and
is a member of the Alpha
Omega Alpha honor
medical society.
[May 2012]
Gary Gitnick, MD
Specialty
Gastroenterology
Ronald Reagan UCLA Medical
Center
100 UCLA Medical Plaza Ste 265
Los Angeles, CA 90095
EDUCATION
Residency
Internal Medicine, Mayo
Graduate School of Medicine,
1964 - 1969
Internship
Internal Medicine, Johns
Hopkins Hospital, 1963 - 1964
Medical Degree
MD, University of Chicago
Pritzker School of Medicine, 1963
AFFILIATION
Department Affiliation
Chief, Digestive Diseases /
Gastroenterology
Physician, Hepatology, UCLA
Center for Esophageal Disorders
Dr. Gitnick is Professor of
Medicine and Chief of the
Division of Digestive Diseases
at the University of California,
Los Angeles School of Medicine.
He heads the largest
gastroenterology division in the
world with 80 full-time faculty
members, 99 employees and a
multimillion dollar budget. He
received his Bachelor of Science
and Doctor of Medicine degrees
at the University of Chicago, after
which he completed an
internship at Johns Hopkins
University Hospital. From there
he completed Internal Medicine
and Gastroenterology
subspecialty training at the Mayo
Clinic and also spent three years
as a Research Associate at the
National Institutes of Health.
He joined the faculty at the
University of California, Los
Angeles in 1969.
He was Chief of Staff of
the UCLA Medical Center
and was Medical Director
of the UCLA Health Care
Programs.
Dr. Gitnick has produced over
300 publications and is the
author or editor of 64 books
including the textbooks
"Principles and Practices of
Gastroenterology and
Hepatology" and "Diseases of
the Liver and Biliary Tract."
Dr. Gitnick is past President of
the Medical Board of California
and remains on its executive
committee. Dr. Gitnick is
Chairman of the Board of
Trustees of the Health
Professions Education
Foundation which has
developed the California Health
Corps, which enables doctors,
nurses and allied health workers
to provide care to underserved
populations in exchange for
educational loan repayment.
He is the founder and Chair of
the Board of Governors of the
Fullfillment Fund, a 30-year-old
nonprofit organization that
provides college access
programs, mentoring and
college scholarships to over
2000 students each year.
UCLA Health System and Medical School
UCLA physicians control 40% of the DOMHC
CLINICAL ADVISORY PANEL
Membership (as of January 1, 2005)
All members of the Clinical Advisory Panel
are appointed by the Director, Department of Managed Health Care
PANEL MEMBERS ORGANIZATION
Dr. John F. Alksne
Neurosurgeon
University of California, San Diego School of Medicine;
UCSD Medical Center (Professor; practicing physician)
Dr. Herbert A. Berkoff
Cardiovascular surgeon
University of California, Davis School of Medicine
(Professor Emeritus)
Dr. Mark S. Grossman
Pediatrician/Internist
University of California, Los Angeles School of Medicine,
UCLA, Community Physicians Network
(Clinical assistant professor; practicing physician)
Dr. Bernadette C. Loftus
Otolaryngology
Stanford University School of Medicine; Physician-inChief, Kaiser Permanente
Santa Clara Medical Center
(Clinical assistant professor; practicing physician)
Dr. Edward W. Salvage, Jr.
Obstetrics/Gynecology
Charles R. Drew University of Medicine & Science/UCLA
Center for Health Science King/Drew Medical Center
(Professor; practicing physician)
Yelp reviews of UCLA
Medical Center
I feel compelled to review the
UCLA ER/UCLA Health
System billing office after
reading other Yelpers
experiences. Thank you to the
Yelper who alerted me to the
non profit advocacy group
Just Health. After simply
cc'ing correspondence to
Just Health I was
miraculously able to
resolve a typically
frustrating billing error
with UCLA in record time!
Just Health
My billing nightmare was
resolved - but not by trying to
talk to anyone in the billing
department directly. Here's
what happened - After
posting my complaints on
yelp, someone from UCLA
contacted me through yelp
and hooked me up with the
nicest Patient Coordinator or
Advocate (I can't remember
his exact title) in the world,
and my problem was resolved
very quickly. That said, be
forewarned - if you are going
to UCLA for ANYTHING at all,
make sure you get a quote in
writing that is put into your
file. UCLA does not accept
my insurance so I have to
negotiate a "cash price'. If
your insurance covers
everything you MAY not have
the hassles I have. I do not
want to give out the names of
the people at UCLA who
helped me, because I don't
have there permission to do
so, but there are people there
who can help you.
A rep from UCLA promptly
followed up on my previous
post. We had a long back and
forth over email where I
detailed all of my issues.
Then she put me in contact
with a billing rep, so I
forwarded the email chain to
the billing rep, and then I
never heard back. I sent a
follow-up email today, and the
billing rep was clueless as to
what my issue was--clearly
demonstrating that she didn;t
take the time to read the email
chain. It's nearly a year since
my visit, and I still have not
recieved a proper invoice for
services rendered, even after
a month of conversations with
staff requesting exactly that.
41% of California hospitals graded C or lower on
patient safety
The Leapfrog Group issues a national report card aimed at prodding hospitals to
end thousands of preventable injuries and deaths.
By Chad Terhune, Los Angeles Times
June 6, 2012
More than 40% of California hospitals received a grade of C or lower on patient
safety in a new national report card aimed at prodding hospitals to do more to
end thousands of preventable injuries and deaths.
The Leapfrog Group, an employer-backed nonprofit group focused on
healthcare quality, said it issued these first-ever scores Wednesday so
consumers and employers can be aware of poorly performing hospitals before
using them. The ratings are available online at http://www.hospitalsafetyscore.
org.
Nationwide, 47% of the 2,652 hospitals that were graded received
a C or below, including some big-name institutions such as
Ronald Reagan UCLA Medical Center.
[In November 2012, Ronald Regan UCLA Medical
Center received an“F” for patient safety from the
Leapfrog Group, a healthcare buyers organization
that publishes an annual “Hospital Safety Score.”]
A landmark report from the Institute of Medicine in 1999 said hospital errors
caused up to 98,000 deaths and more than 1 million injuries each year. In
response, hospitals nationwide embarked on a series of patient-safety initiatives
focused on electronic medical records, checklists, hand washing and other
strategies.
Despite all that, hospitals have made little progress at protecting patients from
harm, said Leah Binder, Leapfrog's president and chief executive. The
Washington-based group estimates that 180,000 Americans die annually from
hospital accidents, errors and infections.
"If an airline was crashing and killing 400 people every day, we would have made
a lot of progress in the last decade," Binder said. "Without public pressure this
won't become a top priority for hospital leaders."
Binder said her group was inspired to issue letter grades after seeing how
effective and consumer-friendly such ratings have been for restaurant health
inspections. The group worked with leading patient-safety experts and analyzed
26 hospital measures looking at infections, medication errors and other relevant
data.
In California, Leapfrog graded 264 hospitals and gave a C or lower to 41% of
them. It handed out A's to 97 facilities, Bs to 58 and Cs to 83. An additional 26
hospitals ranked even lower. Leapfrog didn't issue a letter grade for them and
said it will give those lowest performers until November to show improvement
before issuing them a D or F.
Ronald Reagan UCLA Medical Center was one of those hospitals falling below a
C. A spokeswoman for UCLA Health System said that its Santa Monica hospital
earned an A and that it's "committed to providing the highest level of quality care
and patient safety to each and every individual we treat."
Northridge Hospital Medical Center, owned by nonprofit hospital chain Dignity
Health, was another facility that was graded below a C. A spokeswoman said the
hospital has implemented "many initiatives to ensure the safety of patient care."
The California Hospital Assn. commended Leapfrog for making safety
information more accessible to patients and said its members are making
significant strides at eliminating preventable errors.
"There have been improvements and everyone would like to see a faster pace,"
said David Perrott, the hospital group's chief medical officer. "We believe in
transparency, but this is not the end-all, be-all assessment for hospitals."
Some of Southern California's large safety-net hospitals scored well. Both L.A.
County/USC Medical Center and White Memorial Medical Center earned a B.
Cedars-Sinai Medical Center received an A, and 30 Kaiser Permanente hospitals
that were graded all earned an A or B.
David Hopkins, a senior advisor at the Pacific Business Group on Health, a
nonprofit business coalition in San Francisco that works with employers, said
health plans should be providing these safety scores to all of their customers
when they're choosing a hospital.
"I think this is a huge breakthrough for consumers," he said.
Leapfrog's Binder said consumers should look beyond hospital advertising that
touts the latest accolades or new medical wing.
"There are some hospitals with a reputation for having excellent quality of care
and the latest technology, but they may not have done well on the hospital safety
score."
David T. Feinberg, M.D.,
M.B.A.
Dr. David T. Feinberg is
the President of UCLA
Health System
and
Chief Executive Officer for
the UCLA Hospital System
Associate Vice Chancellor,
UCLA Health Sciences
Dr. David T. Feinberg was
appointed President of
UCLA Health System
effective July 1, 2011. As
President, Dr. Feinberg
oversees all aspects of
UCLA Health System,
which includes the
campuses of UCLA
Hospital System -- Ronald
Reagan UCLA Medical
Center, Stewart and Lynda
Resnick Neuropsychiatric
Hospital and Mattel
Children's Hospital UCLA
in Westwood and UCLA
Medical Center, Santa
Monica - as well as the
UCLA Faculty Practice
Group. More than 80,000
patients are treated each
year in UCLA hospitals,
which are consistently
ranked among the top in
the nation by U.S.News &
World Report, and 1.5
million are seen in the
more than 80
community-based clinics of
the UCLA Faculty Practice
Group.
In addition to his role as
President, Dr. Feinberg
has been CEO and
Associate Vice Chancellor
since 2007, after having
served as Medical Director
of the Resnick
Neuropsychiatric Hospital
and head of the NPH
Faculty Practice Group.
Dr. Feinberg also is a
Clinical Professor of
Psychiatry on the faculty of
the David Geffen School of
Medicine at UCLA.
Along with his commitment
to upholding the highest
clinical standards for
patient care and safety,
Dr. Feinberg's primary
goal is to ensure patient
satisfaction. Under his
leadership, patient
satisfaction has increased
dramatically, and stands in
the 99th percentile in many
areas, according to
independent national
surveys.
Dr. Feinberg also serves
on the boards of many
important companies and
institutions, including OSI
Systems, Inc., Douglas
Emmett, Inc., the RAND
Health Board of Directors
and Sound Body Sound
Mind Board of Directors.
June 2012
Patricia Kapur, M.D.
Chief Executive Officer,
UCLA Faculty Practice
Group
Executive Vice
President, UCLA Health
System
As CEO of the Faculty Practice
Group, Dr. Patricia Kapur will
provide oversight of all FPG
activities and spearhead the
FPG's strategic development and
growth during a time when the
nation's health care delivery
system will be undergoing
tremendous change. Specific
functions and management
responsibilities she will oversee
include: ambulatory clinical
operations, oversight of the
Community Physician Network
as well as the UCLA-Santa
Monica Bay Physicians, clinical
services agreements for UCLA
physicians with other regional
sites, contracting and
contract-management, physician
billing and other physician support
activities, risk-management, legal
matters, and IT priorities.
During Dr. Kapur's
distinguished career, she has
held many important positions
in UCLA Health Sciences and in
the larger academic medical
community. Most recently, Dr.
Kapur co-chaired the clinical
component of the UCLA Health
System's Strategic Planning
Initiative. She has served as
Director of Perioperative
Services since 1997 and as
Chair of the UCLA Medical Staff
Operating Rooms Committee.
She is also a member of the
Ronald Reagan UCLA Medical
Center Medical Staff Executive
Committee and the Santa
Monica-UCLA Medical Center
and Orthopaedic Hospital
Medical Staff Surgery
Committee, and is currently
serving on the UCLA Health
System Strategy and Services
Council.
Outside UCLA, Dr. Kapur has
served as President of the
American Board of
Anesthesiology, President of
the Foundation of Anesthesia
Education and Research, as a
member of the editorial board
and section editor of
Anesthesia & Analgesia, and as
Chair of the Board of Trustees
of the International Anesthesia
Research Society. She is a
member of the governing
Council's of the Association of
University Anesthesiologists,
the Society of Academic
Anesthesiology Associations,
and the Association of
Academic Anesthesiology
Chairs. Dr. Kapur currently
serves on the Board of
Directors and the Executive
Committee of the Anesthesia
Patient Safety Foundation,
which was lauded by the
Institute of Medicine for
significantly changing the
culture of safety and improving
outcomes in anesthesiology
care across the United States.
A graduate of Oberlin College
and the University of
Pennsylvania medical school,
Dr. Kapur completed her
residency training at Stanford
University Hospital before
coming to UCLA's department
of anesthesiology in 1979 as a
research fellow. She has held
numerous visiting
professorships and now holds
the Ronald L Katz, M.D.,
Endowed Chair of
Anesthesiology.
June 2012
UCLA and Kaiser Permanente
...Todd Sachs, MD, FACS, Assistant Area Medical Director for the Kaiser
Permanente West Los Angeles Medical Center, has participated in each of the
Surgery Access Days since he spearheaded the program here in late 2009.
...The Surgery Access Day is now a key component of the Westside-South Bay
Specialty Care Coalition—a partnership between Kaiser Permanente West
Los Angeles, Venice Family Clinic, South Bay Family Health Center, Westside
Family Health Center, COPE Health Solutions, Harbor-UCLA Medical Center,
UCLA Health System, Little Company of Mary, and Saint John’s Health Center.
Medical Records
Right to Inspect and Copy. With certain exceptions, you have the right to
inspect and/or receive a copy of your medical information.
To inspect and/or to receive a copy of your medical information, you must
submit your request in writing to:
Health Information Management Services
UCLA Health System
10833 Le Conte Avenue
Room CHS-BH265
Los Angeles, CA 90095-7305
If you request a copy of the information, there is a fee for these services.
We may deny your request to inspect and/or to receive a copy in certain limited
circumstances. If you are denied access to medical information, in most cases,
you may have the denial reviewed. Another licensed health care professional
chosen by UCLA Health System will review your request and the denial. The
person conducting the review will not be the person who denied your request.
We will comply with the outcome of the review.
Right to Request an Amendment or Addendum. If you feel that medical
information we have about you is incorrect or incomplete, you may ask us to
amend the information or add an addendum (addition to the record). You have
the right to request an amendment or addendum for as long as the information
is kept by or for UCLA Health System.
Amendment. To request an amendment, your request must be made in writing
and submitted to:
Health Information Management Services
UCLA Health System
10833 Le Conte Ave
Room CHS BH265
Los Angeles, CA 90095-7305
(310) 825-6022
In addition, you must provide a reason that supports your request. We may
deny your request for an amendment if it is not in writing or does not include a
reason to support the request. In addition, we may deny your request if you
ask us to amend information that:
Was not created by UCLA Health System
Is not part of the medical information kept by or for UCLA Health System;
Is not part of the information which you would be permitted to inspect and copy;
or
Is accurate and complete in the record.
Addendum. To submit an addendum, the addendum must be made in writing
and submitted to:
Health Information Management Services
UCLA Health System
10833 Le Conte Ave
Room CHS BH265
Los Angeles, CA 90095-7305
(310) 825-6022
An addendum must not be longer than 250 words per alleged incomplete or
incorrect item in your record.
San Diego Education Report
|
San Diego
Education Report
UCLA Faculty
Association
MAY 24, 2012
Lawsuit:
Urban Wildlands Group Takes
Aim at UCLA Over Proposed
Archery Facility
Readers of this blog may recall
an earlier post about a
proposed UCLA archery facility
to be located south of the
Child Care Center along
Veteran Avenue. Concerns
have been raised about the
proposal on ecological and
other grounds.
Readers who have been
following the UCLA hotel issue
will know that UCLA was not
forthcoming in response to
Public Records Act requests by
the Faculty Association and
other groups and did not
provide the requested
information on a timely basis.
The original post regarding the
archery facility is at:
http://uclafacultyassociation.blogspot.com/2012/01/shooting-ar
rows.html
The Urban Wildlands Group
has filed a lawsuit against the
Regents regarding similar
stonewalling by UCLA
regarding documents it
requested related to the
archery facility.
More scrutiny for UCLA's School of Medicine
In the wake of a whistleblower lawsuit, a new study raises a
red flag about universities' financial ties to industry.
The $10-million, mid-trial settlement
this week between the UC system
and the former head of orthopedic
surgery at UCLA has prompted a
consumer group to seek an
independent investigation by
California Atty. Gen. Kamala Harris
or Gov. Jerry Brown.
By Chad Terhune
Los Angeles Times
April 25, 2014
In the wake of a $10-million payout
to a whistleblower, UCLA's School
of Medicine is drawing more
scrutiny over its financial ties to
industry and the possibility that
they compromised patient care.
A new study in this month's
Journal of the American
Medical Assn. raised a red flag
generally about university officials
such as Eugene Washington,
the dean of UCLA's medical
school who also serves on
the board of healthcare
giant Johnson & Johnson.
The world's biggest medical-products maker paid Washington
more than $260,000 in cash and stock last year as a company
director...
In a 2012 lawsuit against UCLA and UC regents,
Dr. Robert Pedowitz, 54, alleged that they failed to
act on his complaints about widespread conflicts
of interest among the medical school faculty and
that they later retaliated against him for raising those
concerns as a whistleblower.
As department chairman, Pedowitz testified, he became
concerned about colleagues who had financial ties to
medical-device makers or other companies that could
unduly influence their care of patients or research into new treatments.
University officials said they thoroughly investigated Pedowitz's claims and found no
wrongdoing and no evidence that patient care was jeopardized. UC regents said they
agreed to settle to avoid the time and expense of further litigation.
In a statement Friday, UCLA said Washington's work as a J&J director did not
compromise the "integrity of operations" at UCLA, and that his outside activities
complied with university policies.
"Dr. Washington has absolutely no oversight of purchasing decisions involving devices
or supplies," UCLA said. "Dr. Washington's board service provides significant benefits
to both UCLA and the wider field of medicine. As the only physician on the board, Dr.
Washington provides a frontline perspective on patient care and the needs of doctors."
Such ties between healthcare companies and physicians have drawn increasing
attention from government officials and patient advocates. Taking effect this fall is a
provision of the federal Affordable Care Act that requires public disclosure of financial
relationships between medical companies and doctors.
Consumer Watchdog, a Santa Monica advocacy group that asked for the state
investigation, said the troubling nature of Pedowitz's allegations and the large
settlement amount warrant further inquiry.
"It is apparent that UCLA's policies governing financial conflicts are either inadequate or
unenforced," Jamie Court, president of Consumer Watchdog, wrote in a letter sent to
state officials Thursday.
"Are the same failures happening at other hospitals in the UC system? Your
independent investigation is needed to ensure that patients are not harmed," he wrote.
Consumer Watchdog said the investigation also should determine whether oversight of
UC's relationships with medical companies should be taken away from university
administrators such as Washington and given instead to an independent monitor.
A spokesman for the attorney general said Harris is reviewing the consumer group's
request. He would not comment further.
Responding to the letter, UCLA said its "current policies and procedures represent best
practices that have continued to become stronger and more rigorous in recent years....
We are always looking for ways to improve further."
In an interview last week, the chief compliance officer of the UCLA Health System said
Washington encouraged her to investigate Pedowitz's claims fully. Washington testified
at Pedowitz's trial, and his handling of the surgeon's allegations came up regularly.
The compliance officer, Marti Arvin, said industry relationships are unavoidable at
universities and that patients benefit from that collaboration.
"Having those relationships with industry is a component of allowing us to meet our
mission of leading-edge patient care, education and research," Arvin said.
Washington was reelected to J&J's board Thursday. The company said "we see
absolutely no financial conflict of interest with Dr. Washington serving on our board."
He wasn't alone among academic medical center officials who served on the boards of
major pharmaceutical companies in 2012, the year examined by researchers.
For instance, the dean of USC's School of Pharmacy, R. Pete Vanderveen, serves on
the board of Mylan Inc., a major drugmaker based in Canonsburg, Pa.
A spokeswoman for USC said the university has policies in place to manage potential
conflicts. But USC said that's "a moot point in this case because the School of
Pharmacy has no business relationship with Mylan."
The study found that 41 board members at large drug companies held leadership posts
at academic medical centers. Their average compensation for serving as a company
director was $312,564.
"These leaders are wearing two very important hats at the same time," said Gellad, the
study's co-author. "There are a lot of benefits from academic medical centers having
interactions with industry, but we can't ignore the risks."
chad.terhune@latimes.com
News, information and ideas about our education system, courts and health care by Maura Larkins
|
"THE REGENTS IS NOT SUBJECT TO CLAIM-FILING
PROVISIONS OF THE TORT CLAIMS ACT
"California Government Code section 905.6
exempts The Regents of the University of
California from claim-filing provisions of the Tort
Claims Act. A claimant who wishes to file suit
against The Regents may serve OGC as specified
in section 1 above."
A. Eugene Washington, MD, MSc
Dean, David Geffen School of Medicine
UCLA
Vice Chancellor, UCLA Health Sciences
[Maura Larkins' comment:
Mr. Washington's involvement in
kickbacks is particularly worrisome since
he is in charge of one of the country's
premier medical schools, while
promoting, through example, a culture of
pursuing profits at the expense of
patients. See Reprogramming the Ethics
of Medical Students.]
See <a href="http://learningboosters.blogspot.com/search/label/UCLA">all posts re
UCLA.</a><br/><br/>
See <a href="http://thankheaveninsuranceco.blogspot.com/search/label/UCLA%20lawsuits">all posts
on UCLA</a> from Thank Heaven for Insurance Companies blog.<br/><br/>
UCLA is not unique in its desire to protect its reputation by concealing
wrongful actions, protecting wrongdoers and undermining the well-being of
students
Johns Hopkins, UCLA under investigation for their handling of
sexual assault complaints
76 colleges, universities being investigated
Aug 13, 2014
...On Wednesday the U.S. Department of Education released an updated list of
schools being investigated for possible violations of Title IX, a federal law barring
gender discrimination on campus, adding Johns Hopkins University and the University
of California-Los Angeles...
The complaint also alleges that the school violated the Clery Act, a federal law
requiring institutions to notify the student body of incidents on or near campus...
A Question of
Priorities
[See update Mar. 9,
2015 below]
In November 2012,
Ronald Regan UCLA
Medical Center
received an “F” for
patient safety from
the Leapfrog
Group, a healthcare buyers
organization that publishes an
annual “Hospital Safety Score.”
Care providers are forced
to give special treatment to
VIPs—so-called because of
their wealth or relationship to
UC administrators—at the
expense of other patients.
Despite being the
second most
profitable hospital in
the Los Angeles
market, in 2011, UCLA
Medical Center
only dedicated 1.29 percent
of operating expenses for
charity care to low-income
patients. Over 77 percent of
hospitals in the market
dedicated more.
The average general
acute care hospital in
Los Angeles
dedicated over
four times more of
their operating
expenses for charity
care to low-income
patients than UCLA.
At the same time, patient care
dollars are being diverted to
pay for a skyrocketing number
of managers and their
exorbitant salaries.
Between 2008 and 2011, total
UC workforce grew by 2
percent, faculty increased by 2
percent, but the number
of managers and
administrators grew by 9
percent.
Twenty-eight percent of all
new employee positions
were for managers.
And individuals earning
more than $200,000 grew by
44 percent.
At UC Medical Centers,
between 2009 and 2012,
management growth swelled by
38 percent and payroll costs
for managers grew by 50
percent. It is estimated this
added $100 million to the
annual cost of management,
bringing total yearly salary
costs for managers to an
estimated $298 million.
UCLA Medical Center
doubled the number
of its administrators
between 2009 and
2012, adding 430 full-
time managers at a
cost of $62 million.
UCSF Medical Center CEO
Mark Laret received $300,000
in bonus pay in 2011, for
nearly $1.2 million in total
compensation.
UCLA Hospital System
CEO David Feinberg’s
hourly rate grew from
$354 to $431 between
2009 and 2012.
Farewell to A. Eugene Washington
Musical chairs at medical schools?
Duke University hires new medical leader
from UCLA
By John Murawski
Duke University Health System announced the hiring of a
new president and chief executive Tuesday, naming
A. Eugene Washington, a gynecology professor who is
currently dean of the David Geffen School of Medicine
and CEO of the UCLA Health System.
Washington, 64, will assume his new post at Duke on April 1, overseeing the sprawling
academic health care system with a medical school, nursing school, biomedical
research program and three regional hospitals. He will succeed Victor Dzau, who left in
June for a new job as president of the Institute of Medicine of the National Academy of
Sciences.
Washington leaves UCLA in the wake of a conflict-of-interest scandal, following
disclosures that health care conglomerate Johnson & Johnson paid Washington
$260,000 last year as a company director. Washington was re-elected to J&J’s board in
April, the Los Angeles Times reported.
Washington said Tuesday that his job change has nothing to do with the whistleblower
lawsuit against UCLA and that he will remain on J&J’s board. He characterized his Duke
post as a promotion within a highly esteemed institution in the academic world.
“In this job, I’m a dean. In that role, deans will report to me,” Washington said. “The
principal draw at this stage of my career is the opportunity I will have in more
abundance to work across disciplines.”
Duke University will allow Washington to remain on J&J’s board, said Duke spokesman
Michael Schoenfeld. Duke lets its officers and administrators sit on corporate boards
as long as any potential conflicts are disclosed internally...
The UCLA scandal was exposed by a whistleblower lawsuit filed by Robert Pedowitz,
the university’s head of orthopedic surgery, who alleged the University of California
system is rife with ethics conflicts among medical school faculty. The suit, alleging
retaliation by UC, was settled in April with the UC system paying Pedowitz $10 million,
the LA Times reported...
Read more here: http://www.newsobserver.com/2015/01/13/4473396/duke-university-
hires-new-medical.html#storylink=cpy
UCLA Says Farewell to
David Feinberg who got
an "F" for patient safety
a year after an outrageous pay
increase from taxpayers (see left
column)--but you'd never know it
from this glowing article
Dr. David Feinberg was controversial for his extremely successful efforts to
monetize health care and increase profits dramatically, and for his demands for
greater compensation for himself in the face of tuition increases for students (see
second story below). He has overseen UCLA Health System for many years, so
the article at right giving UCLA and "F" for patient safety is a mark against Dr.
Feinberg--especially since it came a year after Feinberg's big pay increase.
UCLA Health CEO Dr. David Feinberg takes top spot at
Geisinger
Written by Molly Gamble
February 23, 2015
Danville, Pa.-based Geisinger Health System has named UCLA Health System
President David Feinberg, MD, as its sixth president and CEO.
Dr. Feinberg, 53, will replace Geisinger's longtime CEO Glenn Steele, MD, PhD. Dr.
Steele has led the system since 2001 and plans to step down from his role in June
2015. He will then continue to work as chairman of Columbia, Md.-based xG Health
Solutions.
Dr. Feinberg, a psychiatrist, has led five-hospital UCLA since 2007. His leadership
style is marked by his focus on patient satisfaction, and he has said visiting patients
in the hospital is his favorite part of the job. When Dr. Feinberg began work at
UCLA, patient satisfaction scores were in the 38th percentile
for a number of quality-related questions. Dr. Feinberg says the
system now ranks in the 99th percentile for a number of measures. Dr.
Feinberg's philosophy and track record caught the attention of Geisinger's board...
Maura Larkins' comment:
Maybe the truly unsatisfied patients were unable to complete
the surveys because they were too sick--see article at right
giving UCLA an "F" in patient safety in 2012
We are not told how much the low scores improved--we are
only told that there are some very high scores now "for a
number of measures."
Many readers probably incorrectly concluded that scores
had gone from 38th to 99th percentile. If he could have made
this claim, I am confident that Dr. Feinberg would have done
so. Instead, he compared apples and oranges.
In fact, we don't know if those high scores actually represent any improvement at
all. Maybe those particular categories were very high when Dr. Feinberg arrived.
UCLA's Millionaire Doctor David Feinberg
By Beth Barrett
LA Weekly
Thursday, March 31, 2011
...Feinberg was plucked three and a half years ago from UCLA's Resnick
Neuropsychiatric Hospital, where he was medical director, to become acting
head of the entire hospital system. When Block became chancellor a month later,
he approved the appointment of his medical school psychiatrist colleague,
Feinberg.
Are public medical executives such as Feinberg hard to replace? Stanford
University easily found another executive when it didn't get Feinberg,
poaching UCLA's hospital system chief operating officer, Amir Dan Rubin,
who was making a mere $547,600 for overseeing operations at UCLA's four
hospitals and outpatient centers.
Rubin's résumé is far weightier than Feinberg's. Previously, Rubin was chief
operating officer at Stony Brook University Hospital, in New York. He oversaw
operations at the Resnick Neuropsychiatric Hospital while Feinberg was medical
director.
Looking at the two men's histories at UCLA, it's hard to
identify what about the hospital system's strengths can be
attributed to Feinberg as opposed to Rubin — or to other
factors altogether. Rubin declined an interview request from the Weekly.
Feinberg is something of a PR wizard, who tries to get to know as many people in
the health care system as possible, and he has proved a popular boss who makes
a point of looking out for the welfare of employees.
"I invite 10 people to lunch once a week randomly from different departments," he
said in an online 2008 interview with Mike Cottrill in Smart Business Los Angeles. "I
attend as many ceremonies as possible, I attend memorial services — any of the
things where the staff is coming together. ... I try to be out of my office as much as
possible because I'm 100 percent about the relationships."
The Weekly filed a California Public Records Act Request on Jan. 31,
seeking Feinberg's performance reviews, calendar and recent
professional emails — all public information.
UCLA has failed to provide most of it. Frances Thompson, UCLA's public
records coordinator, says in an email: "Due to the sensitive nature of Dr.
Feinberg's position, it is difficult to predict when this [request] will be
completed."
But it is known that Feinberg's peers in California — and at many top Pac-
10 schools — are paid significantly less than Feinberg, not just at UC San
Francisco.
At the University of Washington Medical Center, ranked 12th by U.S. News & World
Report, executive director Stephen Zie-niewicz makes just $477,372 per year plus
standard benefits.
He gets no "incentive" bonuses or "retention" bonuses. He is far more experienced
than Feinberg. Before joining UW, Zieniewicz had 24 years of health care
management experience, including stints as chief operating officer at Saint Louis
University Hospital and Tenet Healthcare Corp.
In 2009, UC Davis Medical Center CEO Ann Madden Rice made $584,300; UC
Irvine's associate vice chancellor for health affairs and CEO Terry Belmont earned
$659,000; and UC San Diego's associate vice chancellor and CEO Thomas
Jackiewicz earned $600,000. Feinberg got $210,739 in "incentive" pay, Laret got
$176,739, Rice got $165,415, Belmont got $147,021, and Jackiewicz got $146,039.
Yet aside from Feinberg, none of these highfliers will get $250,000 a year from his
or her nonprofit, public medical centers — or from an affiliated donor community —
simply to stay on the job.
Now, Jerry Brown is about to cut another $1 billion from higher education, and
UCLA will take a major hit...
Patient safety scores
low at Ronald Reagan
UCLA Medical Center
By Katherine Hafner
Daily Bruin
March 9, 2015
Ronald Reagan UCLA Medical
Center's patient safety scores
severely lag behind those of
comparable institutions,
particularly because of
preventable incidents like
foreign objects left inside
patients, according to a
hospital safety group.
In 2012, The Leapfrog Group
gave the center an F rating in
patient safety, which came in
stark contrast to the institution’
s prestige in Southern
California. UCLA has
generally been rated highly in
overall hospital rankings, such
as the health rankings in U.S.
News and World Report.
Leapfrog is a nonprofit group
started in 2000 for employers
to take hospital safety scores
into consideration when
determining health benefits for
their employees. The
organization has collected
hospital data twice a year
since 2012, said Erica Mobley,
a spokewoman for Leapfrog.
The UCLA Medical
Center has since
improved to a C score
in 2014, but continues
to struggle in several
areas.
A high number of foreign
objects left in patients after
surgery, such as towels or
surgical sponges, dragged
down UCLA’s score. The
objects often lead to second
surgeries to remove them or
health risks down the line.
At the UCLA Medical Center,
there were 329 such cases
per 1,000 people discharged,
according to Leapfrog’s 2014
report, which analyzed data
between 2010 and 2013. At
the highest-rated hospital in
the 2014 survey, no objects
were left after surgery, and on
average, hospitals had about
30 such occurrences.
Mobley said the group creates
its hospital safety scores
based on publicly available
information primarily from
Medicare, to which hospitals
have to report to get
reimbursed. There are no
hospital visits involved.
The California Department of
Public Health issued
administrative penalties
against the UCLA Medical
Center in both 2013 and 2014
for two separate instances of
sponges left in patients post-
surgery, requiring UCLA to
pay a total of $125,000 to the
state.
The department’s
investigation found that the
facility’s mistakes caused or
were likely to cause serious
injury or death to the patient,
violated the state’s Health and
Safety Code and placed the
patient at risk for additional
complications.
“One area where they really
seem to have struggled are
with hospital-acquired
conditions,” Mobley said.
“These are often called
‘never’ events. … The most
frightening of those is foreign
objects retained after surgery.
… (The UCLA Medical Center
has) consistently performed
really poorly, one of the lowest
out of 2,500 hospitals
(nationwide).”
The other most concerning
areas of poor performance
are collapsed lungs, pressure
ulcers and infections, for
which the UCLA Medical
Center scored below the
national average, Mobley
said. One of the UCLA
Medical Center’s lowest
scores in Leapfrog’s survey
was rates of various infections
developed in the intensive
care unit or post-surgery.
The center’s patient safety
scores are the lowest among
the University of California
medical centers surveyed.
The UC Irvine Medical Center
and the UC Davis Medical
Center, as well as UCLA’s
Santa Monica and Olive View
facilities, all received A scores.
COPYEDITED-3.3.
patientsafety.edit3.png
Mobley said she would not
consider the Ronald Reagan
UCLA Medical Center, as of
now, to be a high-performing
hospital, based on the
Leapfrog data.
But Dr. Robert Cherry, chief
medical and quality officer for
UCLA Health, said he doesn’t
believe Leapfrog’s scores
reflect how the hospital is
currently operating.
“I think if we really get
distracted by publicly reported
ranking systems, we would
take away our energies from
safety and quality,” Cherry
said. “We are looking forward
to the journey, and we’re
certainly going to see our
scores go up.”
Mobley said the hospital has
improved in its administrative
and communicative
processes, but still struggles
with actual outcomes.
Cherry said the hospital is
focusing on new programs to
improve outcomes under a
new system that deals with
mortality, outcomes, value,
experience, readmissions and
safety, known as MOVERS.
The MOVERS system,
implemented throughout the
past year, includes specific
goals of pain management,
increased nurse
communication, transitioning
care through home health and
improvements in the Code
Blue and rapid response
teams, among other points
across the system, according
to a UCLA report presented at
a 2014 conference.
Officials see the new system
as key to UCLA Health’s goals
in getting a reputation for
reliability and positive
outcomes, he added.
Dr. Bruce Fagel, a medical
malpractice attorney based in
Beverly Hills, said he has
represented clients who
suffered from the areas in
which the UCLA Medical
Center scored low, such as
one woman at a different
hospital who had a towel left
inside her body after surgery.
She had to undergo a second
surgery and continuing health
issues because of the error,
he said.
“The issue of foreign objects
is something where almost no
one can dispute that that
represents negligent
behavior,” Fagel said. “There
are a handful of things that
can just never be accepted.”
For patients who sue for
cases such as a leftover
sponge, the fine against the
hospital in question is often
more than what the patient
may actually receive, Fagel
said. In California, there is a
$250,000 cap to the amount
of non-economic damages
that a plaintiff can receive, but
patients often end up
spending more than $100,000
to take their cases to trial,
leaving them with little
compensation in the end, he
said. Therefore, many
patients choose not to open a
case.
Fagel is currently litigating a
catastrophic injury case
against UCLA in which a child
died on the way to UCLA’s
main facility because the
procedure was conducted in a
separate medical plaza, he
said.
Cherry said he could not
comment on any active cases.
Fagel compared hospital
scores to health scores given
to restaurants. But unlike
restaurants, where consumers
can choose where they want
to eat, patients usually have
to go to certain hospitals
depending on their insurance,
he said. The scores are more
important for the hospital’s
administration to change so
the institution doesn’t look
bad, he said.
“Grades that are listed for
hospitals are an attempt to
give the public some
information reflective of quality
of care being given,” he said.
“But trying to take a
complicated situation and
narrow it down to something
so easily understandable is
hard. … People don’t choose
to go into hospitals.”
Michele Monserratt-Ramos,
an advocate with Californians
for Patient Rights, said she
thinks the scores are
important in allowing patients
to understand how a hospital
such as the UCLA Medical
Center performs in areas like
preventable medical
accidents, such as post-
surgery infections.
Monserratt-Ramos said she
lost her fiance, a UCLA
alumnus, to a case of medical
negligence at a different
hospital and has since
focused her efforts on making
individual doctor and hospital
information public for
consumers.
“UCLA’s scores surprised me,”
she said. “I looked at the
scores and was comparing
them to the hospitals I use,
and there were significant
differences. … I was very
discouraged.”
Cherry said it may be harder
to compare the UCLA Medical
Center – a large teaching
hospital – to different-sized
hospitals.
“It may not be fair to compare
(UCLA) to an inner-city
community hospital, for
example,” he said.
Cherry applied the same idea
about differences to the
Ronald Reagan UCLA Medical
Center and UCLA’s Santa
Monica facility, which received
an A score. He said because
the Santa Monica facility is a
community hospital, it can
implement new programs
more quickly.
After the Department of Public
Health issued penalties
against the Ronald Reagan
UCLA Medical Center, the
administration was required to
provide a plan of correction to
prevent future adverse
events, said department
spokeswoman Corey Egel in
an email statement.
Usually, nurses count
sponges before and after a
surgery to make sure none
are left in the patient’s body,
but this practice leaves room
for error and is outdated
compared to other hospitals,
several sources said.
UCLA officials’ response to
their 2013 penalty primarily
consisted of the SurgiCount
Safety-Sponge System, a bar-
coding system using radio-
frequency identification
technology to help with the
typical sponge count practice,
according to Department of
Public Health documents.
UCLA officials cited the same
SurgiCount initiative in their
formal response to the 2014
penalty.
Cherry said employees now
undergo additional measures
– including SurgiCount – such
as X-raying a patient before
he or she leaves an operating
room to make sure no object
has been left inside the body.
He added that the hospital is
making changes in other
areas where the UCLA
Medical Center scored low,
such as allowing nurses, with
approval from medical staff, to
remove catheters to avoid
infections.
The Daily Bruin is waiting to
receive requested records of
formal patient complaints
against the UCLA Medical
Center.
A. Eugene Washington, MD, MSc
Dean, David Geffen School of Medicine UCLA
Vice Chancellor, UCLA Health Sciences
Maura Larkins' comment from April 2014:
"Mr. Washington's involvement in kickbacks is particularly worrisome since
he is in charge of one of the country's premier medical schools, while
promoting, through example, a culture of pursuing profits at the expense of
patients."
[See Reprogramming the Ethics of Medical Students.]
Eugene Washington, MD, Joins Kaiser Foundation Health Plan, Inc. and Kaiser
Foundation Hospitals Boards of Directors
Duke University's chancellor for Health Affairs and Duke University Health System
CEO is newest board member for leading health system and not-for-profit health plan
OAKLAND, Calif., Jan. 11, 2016
PRNewswire/
A. Eugene Washington, MD, MPH, chancellor for Health Affairs at Duke University
and president and CEO of the Duke University Health System, has been named to
the boards of directors for Kaiser Foundation Health Plan, Inc. and
Kaiser Foundation Hospitals.
"We feel privileged to have Dr. Gene Washington join our boards of directors," said
Chairman and CEO Bernard J. Tyson. "Amongst his many contributions in the health
care industry, Dr. Washington has played an important role in shaping
national health policy..."
Prior to joining Duke University, Dr. Washington served for five years as vice
chancellor of Health Sciences, dean of the David Geffen School of Medicine at the
University of California, Los Angeles, and chief executive officer of the UCLA Health
System. He was also a distinguished professor of Gynecology and Health Policy at
UCLA..
Dr. Eugene Washington goes to Kaiser
Eugene Washington, MD is the former dean of UCLA
Medical School and UCLA vice chancellor who was
scrutinized in 2014 in the wake of a successful $10
million whistle-blower lawsuit brought by a doctor at
UCLA regarding ethics kickbacks and retaliation.
It's pretty clear why Kaiser Permanente is
delighted to have him as a new member of the
Kaiser Foundation Hospitals and Health Plan
boards of directors. He'll fit in well with Kaiser's
culture of pursuing profits (without paying
taxes) at the expense of patients.
Scripps Health chief executive Chris Van
Gorder; his wife, Rosemary; and a therapy dog
walk down a hallway at Scripps Memorial Hospital in La
Jolla in January 2015. photo by Charlie Neuman * U-T
Regents OK $8.5 million for 2 patients suing over
financial conflicts at UCLA
LA Times
July 29, 2016
Chad Terhune
The University of California regents
have agreed to pay nearly $8.5 million
to settle two lawsuits alleging that a
well-known UCLA spine surgeon failed
to disclose his conflicts of interest with
a leading device maker before using
the company’s products in harmful surgeries.
The settlements were approved last week
in separate Los Angeles County Superior
Court cases that focused on the financial ties
among the surgeon, Dr. Jeffrey Wang, UCLA and Medtronic,
the world’s largest medical-device company.
The regents agreed to pay $4.2 million to Jerome Lew, a 52-year-old screenwriter in
Orange County, and $4.25 million to Ralph Weiss, a 61-year-old attorney in
Calabasas. The two patients said their surgeries led to complications, recurring pain
and the need for additional operations.
In both cases, Wang implanted Medtronic’s controversial bone-growth product in an
“off-label” way not specifically approved by the Food and Drug Administration,
according to the lawsuits. Doctors are legally allowed to use medications and devices in
an unapproved manner, if they think it’s the best way to treat patients.
The plaintiffs argued that Wang deceived them by failing to obtain their consent for the
“off-label” use and by not disclosing the tens of thousands of dollars in financial
support he had received from Medtronic over the years. And Lew alleged that
Medtronic promoted off-label use of its products to Wang and UCLA, which generally is
not allowed under federal law.
“I chose UCLA and Dr. Wang for my spine surgery based upon their sterling
reputations,” Weiss said. “I was astonished and offended when I found out about the
conflicts that were never disclosed to me.”
The UC system and Wang, now co-director of the USC Spine Center, denied any
wrongdoing in court documents. Wang, through his attorney, declined to comment.
In a statement, the UCLA Health system said the regents agreed to settle the two cases
“so that UCLA Health and the David Geffen School of Medicine at UCLA could move
forward with their ongoing commitment to excellence in patient care, research,
education and community service.”
Medtronic denied any wrongdoing and said it did not promote off-label use of its
products. The company was dropped as a defendant in the Weiss case and it agreed
to a separate, confidential settlement with Lew.
The device maker said there was no conflict of interest in the Lew case.
“Dr. Wang was not paid for using the Medtronic products used in the surgery and as of
the time of the surgery involving Mr. Lew, he was not a consultant for Medtronic,” the
company said in a statement.
UC and Medtronic had tried to keep emails and other information unearthed by the
lawsuits under seal. But a Superior Court judge denied that request, saying they were
public records involving a state institution.
The cases shine a light on the controversial role industry money continues to play in
research and patient care at academic medical centers.
Nationwide, doctors and universities have come under increasing scrutiny over the
money they receive from drug and device makers. Although the rules for accepting
money vary widely among institutions, Congress in recent years has required all drug
and device companies to publicly disclose their payments.
The total amount companies paid to doctors and teaching hospitals in 2015, according
to the new federal data, was $6.5 billion.
Wang played a role in spurring Congress to impose those rules in 2010. A 2009 U.S.
Senate investigation into industry payments accepted by dozens of doctors across the
country found that Wang failed to report nearly $460,000 he received from Medtronic
and other companies on annual disclosure forms required at UCLA.
From 2004 to 2013, Medtronic paid Wang more than $275,000 for product royalties,
consulting work and lectures, according to the Senate investigation and UCLA records.
During 2014 and 2015, while at USC, Wang received no money from Medtronic but did
collect $1.4 million from other device companies, according to the federal data.
Wang, who joined UCLA in 1997 and was named executive director of its spine center
in 2003, is considered one of the top specialists in his field. A frequent speaker at
international medical conferences, he serves as a board member of the North
American Spine Society and offers second opinions to injured players in the National
Hockey League.
In the past, he has defended industry collaboration as a way to foster medical
advances.
“If surgeons are discouraged from working with private companies to develop surgical
products, the patients we are trying to protect will lose the benefit of improved
treatment options,” Wang wrote in a 2008 letter to UCLA officials who were responding
to the Senate inquiry.
In the two recent lawsuits, the patients alleged that Wang and Medtronic crossed the
line in their effort to experiment with Infuse, a genetically engineered human protein
that helps grow artificial bone.
The FDA cleared Infuse for use in the lower back in 2002, and more than 1 million
patients have had it implanted. However, many Infuse patients have reported problems
and hundreds of people have filed lawsuits as a result. The rate of complications
prompted government investigations, and researchers began to question some of the
data doctors published to support the product’s widespread use.
In Lew’s case, documents submitted as evidence suggested that Medtronic employees
promoted spinal implants for uses that were not cleared at the time by the FDA.
One was a May 2007 email to Wang from Paul McClintock, a district sales manager at
Medtronic. McClintock provided the surgeon prices and information about new, smaller
doses of Infuse that had received FDA approval for use in oral and maxillofacial
procedures – but not the spine.
Nearly a year later, in an April 2008 email to a UCLA official filed in court, McClintock
noted that the spinal cage known as Anatomic Peek was approved for procedures in
the upper, lower and middle back but “many surgeons choose to use it in the cervical
spine,” or neck area.
At the time, Medtronic had a warning against that on the cage’s label. And in July 2008,
the FDA issued an alert about the dangers of implanting Infuse in the neck because of
the risk of excessive bone growth.
Even so, in 2009, Wang implanted Medtronic’s Anatomic Peek cage into Lew’s neck
along with Infuse after he was injured in a car accident, according to court documents.
A Medtronic salesman joined Wang in the operating room at UCLA’s Santa Monica
hospital, medical records show.
Lew said in his lawsuit that he continued to suffer hand and neck pain and developed
new symptoms, such as difficulty swallowing. It took another three years, in 2012,
before Lew found out what devices Wang had implanted and discovered that his
surgeon was being paid by Medtronic, according to his suit.
Robert Vaage, a San Diego attorney representing both plaintiffs, said UCLA was aware
of Wang’s conflict of interest with Medtronic but did nothing to address it because he
“was bringing a lot of business into the university from the number of procedures to the
amount of clinical studies he was doing.”
For his part, Weiss contended in his lawsuit that he wasn’t informed that Infuse would
be used in an unapproved way during one of Wang’s surgeries at UCLA’s Santa
Monica hospital in 2010. During a follow-up surgery by another doctor at UCLA, the
bone-growth product was put in an infected area and without any cage, which are both
potentially harmful usesHe continued to suffer pain and faced more corrective surgery,
according to his complaint.
Lawyers for the UC regents said in court filings that both Lew and Weiss signed
consent forms explaining their surgeries and the risks involved. The UCLA Health
system also said in a statement that it “takes seriously its duty to manage relationships
with industry in a responsible manner.”
The two settlements follow a $10-million payout in 2014 by the university system to one
of Wang’s former bosses, Dr. Robert Pedowitz, former chairman of UCLA’s orthopedic
surgery department.
Before that whistleblower retaliation case was settled, Pedowitz testified that he had
told university administrators that Wang and some of his fellow surgeons were putting
patient care at risk by accepting so much corporate money. He alleged that UCLA
looked the other way because it stood to benefit financially from the doctors’ activities.
UCLA denied Pedowitz's allegations, and officials said they found no wrongdoing by
faculty and no evidence that patient care was jeopardized. But the UC system paid him
anyway, saying it wanted to avoid the "substantial expense and inconvenience" of
further litigation.
Chad Terhune is a senior correspondent with California Healthline, a service of the
California Health Care Foundation published by Kaiser Health News.
cterhune@kff.org
Dr. Jeffrey Wang