Eye Doctor Left Patients Blind, Reaped in Millions from Medicare Fraud

Eye Doctor Left Patients Blind, Reaped in Millions from Medicare Fraud | Pintas & Mullins Law Firm

Two patients have filed lawsuits against the disgraced Florida eye surgeon Salomon Melgen, claiming he left them both blind in one eye. The doctor was arrested in April 2015 for Medicare fraud after receiving more than $100 million from the government program. The medical malpractice lawyers at Pintas & Mullins Law Firm describe malpractice and healthcare fraud lawsuits below.

Melgen, recently released on $18 million bond, is already awaiting trial for Medicare fraud and corruption charges. His schemes involved convincing elderly patients on Medicare to undergo macular degeneration treatments that were not medically necessary, prescribing overpriced drugs, and falsifying records. Medicare paid for all services to these patients, resulting in millions of dollars in profit to Melgen. In 2012 alone, he received $21 million from Medicare, the highest of any doctor in the country.

During the procedures, Melgen would inject the drug Lucentis to treat macular degeneration. The drug costs about $2,000 per dose, despite it being nearly identical to another drug, Avastin, which costs just $50 per dose.

The Worst Kind of Irony

At least 12 people have accused Melgen of medical malpractice. One of these patients, Samuel Belcher, received Avastin injections from Melgen. Belcher developed a severe eye infection (acute endophthalmitis) that caused both eyes to become red, puffy and sticky. Belcher fortunately healed from the infection, but was left with permanent blindness in one eye and extremely limited vision in the other.

Another patient, 85-year-old Louise Constantine, was also left blind in one eye after Melgen injected her with Lucentis. Melgen used the same syringe to inject the drug into both her eyes, leading to a similar infection as Belcher’s.

Federal prosecutors say Melgen would falsely diagnose patients with conditions like age-related macular degeneration (the diagnoses for both Constantine and Belcher), submit false claims to Medicare, and create false entries on patients’ medical charts.

So, in a terrible twist of irony, patients with relatively healthy eyes like Belcher and Constantine were falsely diagnosed with age-related vision loss. Then they were treated using unreasonable and unnecessary procedures, the results of which led to their actual, permanent blindness. All for the greed of a single man, who used the profits to buy a private jet, an estate in the Dominican Republic, and a yacht, among other lavish lifestyle enhancers.

Melgen ran this scheme for more than ten years, totaling more than $190 million in Medicare bills. He is now facing 46 counts of health care fraud, 19 counts of filing fictitious claims, and 11 counts of making false statements related to health care. He is also facing bribery and corruption charges, along with medical negligence claims.

Political Favors to Hide Fraud

The scandal eventually entrapped Senator Bob Menedez, of New Jersey, a longtime friend of Melgen'€™s. Senator Menedez was recently charged with 14 counts of corruption over allegations that he used his senate seat to intervene on behalf of Melgen, in exchange for donations and luxurious gifts. Prosecutors claim the senator took nearly $1 million from Melgen to help him with Medicare billing disputes and immigration applications for Melgen’s extramarital girlfriends.

This is an egregious and rare case, but there are lessons to be learned from it. Although the majority of doctors are compassionate healers with the best interest of their patients in mind, there are some greedy, negligent, or incompetent physicians. That is why it is so important to report incidents of wrongdoing, mistreatment, malpractice, negligence, fraud and abuse. If the doctor acted within the standard of care, and with full professional integrity, the claims would be moot, and no consequential action would be taken against the accuser.

If the claims turn out to be true, the person who exposed the fraud or negligence would be able to take part in the lawsuit and earn compensation from the resulting jury verdict or settlement. Only about 1% of medical errors result in a malpractice claim. Lawsuits are often the only way our system allows injured patients to receive justice.

A very small pool of doctors (about 6%) is responsible for most malpractice claim payouts. These are not frivolous lawsuits against innocent doctors; it is extremely difficult to have these types of cases heard, and 33 states restrict the amount of compensation victims can receive. This makes it extremely difficult to police hospitals and doctors like Melgen.

This is where we come in. Our medical negligence lawyers have been fighting on behalf of injured patients for 30 years. We have a wide network of medical professionals, investigators, and esteemed trial attorneys who will make the best case possible and win you the compensation you deserve. Our network allows us to accept clients nationwide, and we do not charge anything out-of-pocket, so you can focus on your own health and wellbeing. Contact our firm today for a free case review.