San Diego hospital administrator arrested in Tenet investigation

pickledpepperRN · Sep 24, 2003

Friday, September 12, 2003

Neurosurgery chief Chambi suspended

Western Medical Center takes action against doctor with long history of malpractice suits.

By CHRIS KNAP, BERNARD WOLFSON, and WILLIAM HEISEL, THE ORANGE COUNTY REGISTER

The chief of neurosurgery at Western Medical Center Santa Ana, a major center for head trauma in Orange County, has been suspended from clinical practice by top officials at his hospital.

The exact reason for the Wednesday night action by the hospital's Medical Executive Committee was not made public Thursday. Dr. Israel Chambi Venero has been accused repeatedly of malpractice, unnecessary surgery and incompetence - all of which were detailed in an Orange County Register investigation in May.

Hospital spokesman David Langness said the results of the hospital's investigation will be sent to the Medical Board of California, as required by state law.

Chambi's suspension comes at a time when the hospital's parent company, Tenet Healthcare, is under investigation by multiple federal agencies examining allegations of illegal kickbacks to doctors and unnecessary operations by high-volume surgeons. Last week, the U.S. Senate Committee on Finance said it, too, is investigating Tenet, and it told the company to hand over any documents regarding its relationship with Chambi.

After a full investigation, the Medical Staff Executive Committee (MEC) of Western Medical Center Santa Ana voted to summarily suspend Dr. Israel Chambi's clinical privileges effective September 10, 2003. The summary suspension shall remain in effect until Dr. Chambi fully meets numerous conditions set forth by the MEC

Chambi would not comment. His attorney, Michael Zuk, said he was surprised by the hospital's action.

"That's the first I've heard of it," Zuk said. "Dr. Chambi has gotten nothing from the hospital."

The hospital committee set out conditions that could allow Chambi to return eventually. However, one medical expert said the conditions can be so onerous - involving extensive medical and ethical retraining - that doctors seldom come back.

Western Medical Center has hired a professional search firm to find another neurosurgeon for the hospital. In the meantime, trauma coverage at the hospital is being handled by other doctors.

In the Register's stories, patients and their families described how Chambi persuaded them or their loved ones to undergo brain or spinal surgery that left them severely disabled. In some cases, other doctors reviewed the records and suggested surgeries should not have been performed.

Chambi has been sued 36 times for malpractice or wrongful death since 1992. He won most of the lawsuits. But 10 patients obtained verdicts or settlements totaling $3 million. Four cases are pending. Chambi also lost his teaching post at UCI after doctors there accused him of incompetence and poor judgment.

But Western Medical Center, the flagship Orange County hospital for the Tenet Healthcare chain, made Chambi chief of neurosurgery in 1998.

On Thursday, former Chambi patients and other neurosurgeons applauded the action by the hospital but said it came much too late.

"It should have been done a long time ago," said Tim Kling of Fullerton, whose mother, Frances, suffered permanent brain damage after an operation by Chambi. "Too many people suffered because of him."

A Register analysis of public records found that Western Medical billed $38 million for neurosurgeries in 2000 and had the highest per-patient charges in Southern California.

"The action by the hospital's medical executive committee is certainly appropriate in the context of the numerous well-documented deficiencies of Dr. Chambi over several years," said Dr. James Doty, a San Francisco neurosurgeon who has reviewed a number of Chambi's cases and is scheduled to testify against him in a trial this year.

"It is unfortunate that the peer-review system requires a major investigation by a news organization before such action is instituted," Doty said. "The delay only confirms my belief that major financial producers for a hospital are not closely scrutinized."

A letter to Trevor Fetter, Tenet's acting CEO, from Sen. Charles Grassley, R-Iowa, chairman of the Senate Finance Committee, shows scrutiny is coming. He asked for documents pertaining to Chambi's compensation; office space, equipment or services provided to him by Tenet; and any reports or audits of him, including anything "regarding unnecessary medical surgeries and procedures at Western Medical Center."

The committee has oversight for Medicare and Medicaid. The federal government warned Tenet last week that Redding Medical Center could be kicked out of Medicare.

"The investigation itself, though focused primarily on the Redding facility, is really a broad-brush look at Tenet and its corporate governance practices," said Jill Gerber, Grassley's spokeswoman. "The situation with Dr. Chambi presents another hospital under Tenet's control where similar allegations have been made.

"Senator Grassley is particularly concerned about the type of peer review Tenet is doing or not doing and whether the company is prohibiting the peer review of these doctors with the goal of keeping them in place and keeping their high billing practices for the company."

Langness, the spokesman for Tenet, said the company follows the law with regard to physician payments.

"We have a team of attorneys who make sure any payments to physicians are within the law," Langness said.

Added Zuk, the attorney for Chambi: "The U.S. Senate is fishing for financial inducements, but Dr. Chambi doesn't have any. They never gave him a penny. They are looking for stuff like that, but none of it exists."

Zuk also said he received a notice from the Medical Board dated Sept. 2 saying that its investigation of Chambi was completed and that there would be no further action.

But Candace Cohen, a spokeswoman for the board, said Thursday that Chambi remains under investigation and that the board will scrutinize closely what it's sent by Western Medical Center's doctors.

"If information is brought to our attention that a physician is an imminent danger to the public, we will seek an interim suspension of his license."

CONTACT US: (714) 796-2240 or [email protected]

http://www2.ocregister.com/ocrweb/ocr/article.do?id=56732&section=NEWS&subsection=NEWS&year=2003&month=9&day=12

pickledpepperRN · Sep 24, 2003

Saturday, September 13, 2003

Chambi shifts surgery list to St. Jude

Neurosurgeon's privileges at Western Medical Center-Santa Ana were suspended Wednesday.

By CHRIS KNAP, BERNARD J. WOLFSON and WILLIAM HEISEL, The Orange County Register

The beleaguered neurosurgeon suspended from Western Medical Center-Santa Ana on Wednesday has begun shifting his patients to St. Jude Medical Center in Fullerton.

Dr. Israel Chambi Venero, who was chief of neurosurgery at Western Medical, began moving his surgeries Thursday, saying he had a business dispute with Tenet Healthcare, owner of Western Medical, patients said.

"Dr. Chambi does have full privileges at St. Jude," said Chambi's lawyer, Michael Zuk. "He is on staff there and will continue to provide excellent patient care with compassion to everyone he takes care of."

St. Jude spokeswoman Dru Ann Copping said Chambi performed two operations there this week and has done 14 surgeries since the beginning of the year. At Western Medical, Chambi performed 400 operations per year. Western Medical suspended Chambi's privileges Wednesday night. The hospital would not disclose the details of its investigation. However, Chambi and Western currently face five lawsuits that accuse Chambi of malpractice, unnecessary surgery, incompetence and sexual harassment, and Western Medical of failing to monitor and discipline Chambi.

St. Jude is investigating the circumstances of Chambi's suspension, Copping said. "We will request that Dr. Chambi and Western Medical Center share that information with us, and we will review that information when we get it," she said. "But he will continue to have privileges until that time."

Copping said St. Jude conducted a thorough investigation of Chambi earlier this year after an Orange County Register investigation detailing 10 years of allegations against Chambi. He has been sued for malpractice or wrongful death 36 times and lost a teaching post at UCI Medical Center in 1995 over allegations of incompetence. "We meticulously reviewed his work here and found absolutely no evidence of poor quality medical care," Copping said. Whether Chambi continues to operate at St. Jude "is up to his patients," Copping said.

Phyllis Mumford of Tustin was scheduled for a back operation Monday at Western Medical, but Chambi called her Thursday and told her he was leaving Western and would perform her surgery at St. Jude. "He said he would not be working at Western Med anymore," Mumford recalled. "I asked him why and he said he had some differences with Tenet's business methods."

Then Mumford's daughter read in the Register that Chambi had been suspended. "My daughter woke me up at 6:15 and said, 'You are not going to have surgery Monday. I won't let you,' " Mumford said. "It really disturbs me that they keep this stuff secret."

Copping said St. Jude also learned of Chambi's suspension from Friday's Register. Dr. William Norcross, the director of a Medical Board program for rehabilitating doctors in trouble, said that was unacceptable; there should be no lag between the time a doctor is suspended by one hospital and the time another hospital finds out. "Hospitals, unfortunately, do not have a safety mentality," he said. "Patient safety should be the first thing on their mind. Instead, they usually try to cover things up and remediate them internally."

Chambi's problems at Western Medical, Tenet's Orange County flagship, are the latest in a long string of disclosures that have hammered the stock price of the second largest U.S. for-profit hospital chain.

Tenet, the largest hospital operator in Orange County, is under federal investigation for alleged unnecessary surgeries, illegal payments to doctors and improper billings to Medicare. Last week, the U.S. Senate's Committee on Finance said it was investigating Tenet's corporate practices and demanded all communications, contracts and other records of Tenet's relationship with Chambi.

In a Sept. 5 letter to acting Tenet CEO Trevor Fetter, Sen. Charles Grassley, R-Iowa, chairman of the U.S. Senate Committee on Finance, harshly rebuked the company's behavior, past and present. "In the annals of corporate fraud," he wrote, "Tenet more than holds its own among the worst corporate wrongdoers."

On Wall Street, which is mostly concerned with Tenet's depressed stock price, some analysts wondered Friday whether the company can ever recover from its loss of reputation and the accumulating weight of civil and criminal investigations.

"There might not be another Redding out there, but certainly that culture permeates the company," said John Ransom, a stock analyst with Raymond James & Associates, referring to Tenet's agreement in August to pay millions in fines to resolve accusations over unnecessary cardiac procedures at a Redding hospital. "So, as discovery is done and documents are uncovered, you've got to think we're not done with the bombshells."

CONTACT US: (714) 796-2240 or [email protected]

http://www2.ocregister.com/ocrweb/ocr/article.do?id=56866&section=LOCAL&subsection=LOCAL&year=2003&month=9&day=13

pickledpepperRN · Sep 24, 2003

Peer committee suspends doctor at Tenet hospital

Story posted September 15, 2003 4:45 PM ET

The peer-review committee at a Tenet Healthcare Corp. hospital suspended the privileges of a physician who has drawn the interest of congressional investigators, a spokesman for the Santa Barbara, Calif., company said. The committee at Western Medical Center-Santa Ana (Calif.) suspended Israel Chambi from practicing at the hospital until he meets certain conditions, said David Langness, a spokesman for Tenet's California operations. The conditions have not been made public. The Senate Finance Committee requested documents about Chambi from Tenet in a letter earlier this month. The letter primarily seeks documents related to Tenet's Redding (Calif.) Medical Center. Tenet did not have a say in the decision to suspend Chambi and knows little about it, since privacy regulations preclude the committee from divulging more information, Langness said. Michael Zuk, a Los Angeles attorney representing Chambi, declined to comment. Tenet has owned the hospital since it bought OrNda HealthCorp in 1997, Langness said. Tenet owns or operates 112 hospitals. -- by Vince Galloro

http://www.modernhealthcare.com/news.cms?newsId=1490&potId=MN

pickledpepperRN · Sep 25, 2003

http://www.latimes.com/business/la-fi-tenet25sep25,1,7763266,print.story?coll=la-headlines-business

Hospital Administrator Arrested in Tenet Investigation

Prosecutors charge Mina Nazaryan of San Diego center with obstruction of justice.

By Ronald D. White

Times Staff Writer

September 25, 2003

The message was left on Dr. Hamid Mani's phone line shortly before 7 p.m. Friday.

"Please help me for God's sake, so I don't go to jail," the caller pleaded. "Do whatever you can in your power that I don't go to jail."

The desperate call was made by Mina Nazaryan, an associate administrator at Tenet Healthcare Corp.'s Alvarado Hospital Medical Center in San Diego, according to a government complaint made public Wednesday.

Federal prosecutors allege that Nazaryan, 40, was trying to cover her tracks in a scheme that paid illegal kickbacks to medical clinics that funneled patients to Alvarado Hospital. The U.S. attorney's office in San Diego charged her Tuesday with one count each of obstruction of justice and tampering with witness testimony.

Nazaryan's attorney, Jane Hahn, said her client was innocent. Nazaryan surrendered to authorities Tuesday and remained Wednesday at the Metropolitan Correctional Center. A bail hearing was scheduled for today.

The arrest is the latest twist in a federal investigation into physician relocation payments by Alvarado. Such payments are intended to cover costs for doctors who move to areas where there is a shortage of physicians.

Santa Barbara-based Tenet, the nation's second-largest hospital chain, said Wednesday that it expects Nazaryan to be added to a grand jury indictment that was returned in July against Alvarado's administrator, Barry Weinbaum, the hospital and a related Tenet subsidiary. All of the parties have pleaded not guilty to charges of paying illegal kickbacks.

The indictment alleges that the hospital paid $10 million in relocation costs from 1992 to 2002.

Of that money, the new complaint says, $1.1 million went to three doctors affiliated with California Retina Associates, an eye-care practice operated by Dr. Hamid Mani and his sister, Dr. Nasrin Mani.

The Manis were served with subpoenas last month. The doctors told investigators that Nazaryan "had assisted them in obtaining the relocation agreements," including one for their physician brother, Parvin, according to the complaint filed Tuesday.

Nazaryan demanded money in return for her help, the Manis told investigators. Nazaryan "made it clear that flowers and gifts were not enough," according to the complaint, and warned her fellow immigrants that relocation payments "could stop at anytime."

In all, the Manis said they paid Nazaryan about $80,000, including $53,300 in 18 checks between February 1998 and December 2002.

Nazaryan learned last month that the family had been contacted by investigators, according to the complaint, and in response, she showed up at their home with a suitcase laden with jewelry and silver plates, telling the Manis that they could say the checks were used to buy the items from her.

When the Manis refused, prosecutors allege, Nazaryan suggested that they tell authorities the checks to her were for the Persian rugs and paintings in their home. The Manis then indicated that they would go along with the ruse, but Nazaryan continued to contact the family.

On Friday evening, the complaint says, Nazaryan telephoned the Manis and again suggested that they tell authorities the checks to her were for the paintings. Twelve minutes later, Nazaryan left the plaintive message.

Hahn, Nazaryan's lawyer, said her client was "stunned by the allegations made by the Manis." Hahn added that Nazaryan has known the Manis since they all lived in Iran nearly two decades ago.

Tenet, which operates about 40 hospitals in the state, did not comment specifically about the new complaint. Previously, the company has said its corporate policy on relocation agreements "is entirely appropriate under the law."

Tenet is the subject of several government investigations for its business practices, including the way it billed for certain Medicare reimbursements.

On Wednesday, its shares rose 18 cents to $14.88 on the New York Stock Exchange.

oramar · Sep 25, 2003

If you had any doubt that many of these high level managment types are about nothing but money, here is the proof.

pickledpepperRN · Sep 26, 2003

Originally posted by oramar
If you had any doubt that many of these high level managment types are about nothing but money, here is the proof.

And now:

http://www.kpmginsiders.com/display_reuters.asp?cs_id=79847

Tenet General Counsel Leaving Company

CHICAGO, Sept. 26 (Reuters) - Tenet Healthcare Corp., embroiled in government investigations, on Friday said Christi Sulzbach will leave her positions as general counsel and chief corporate officer on Nov. 1.

In a news release, Sulzbach said she had "become a focal point for some Tenet critics" and that it was "in the best interest of the company for me to leave at this time."

The nation's second largest hospital chain, which earlier this week said one of its hospital administrators under investigation had surrendered under an arrest warrant, said Gary Robinson and Rod Stone, both deputy general counsels, will supervise Tenant's legal functions until a replacement is found.

The company, based in Santa Barbara, California, said the position of chief corporate officer will be eliminated.

pickledpepperRN · Sep 26, 2003

Never been to this hospital. I think it is close to Disneyland.

Fullerton, Calif., Hospital Probes Malpractice Charges against Neurosurgeon

September 23, 2003 7:14pm

Knight-Ridder / Tribune Business News

Sep. 20--A neurosurgeon fighting charges of malpractice and unnecessary surgery has agreed to stop admitting patients at St. Jude Hospital in Fullerton while the hospital investigates the suspension of his privileges at Western Medical Center in Santa Ana, officials confirmed Friday.

Dr. Israel Chambi Venero said in a written statement that he is confident the medical executives at St. Jude will find the charges leveled by Western Medical "unsubstantiated and untrue" and that he will soon be back to surgery.

Chambi accused Western Medical's parent company, embattled hospital chain Tenet Healthcare, of jettisoning him in an effort to scrub away its own sins.

Multiple federal agencies are investigating Tenet for allegedly overcharging Medicare, paying illegal inducements to doctors and allowing doctors at some hospitals to do unnecessary surgeries.

"Tenet has made me into a sacrificial lamb in order to escape any further bad publicity and attempt to rehabilitate the company's tarnished image," Chambi said in the statement. "I have done nothing in my professional career except care for people in need and help restore them to health."

Tenet officials were unavailable for a response late Friday.

Chambi was the subject of an Orange County Register investigation in May that detailed 10 years of patient complaints, including allegations of malpractice, unnecessary surgery and wrongful death. Chambi has been sued 36 times for malpractice; 10 patients have won verdicts or settlements totaling more than $3 million.

Officials at Western Medical and Tenet had denied there were any problems with Chambi's practice. Then on the night of Sept. 10, the hospital's Medical Executive Committee suspended him.

The hospital has declined to release the findings of its Medical Executive Committee but said it would forward the report to the Medical Board of California. Pending lawsuits accuse Chambi of malpractice, unnecessary surgery, sexual harassment and performing invasive operations without the patient's permission.

After he lost his privileges at Western Medical, Chambi began shifting his surgeries to St. Jude, where he has held staff privileges for nine years.

The incident has echoes of a previous dispute in which Chambi was suspended from practicing at UCI Medical Center in 1995 and moved his surgeries to St. Jude.

Chambi fought that suspension and won restoration of his privileges, but UCI administrators took away his medical professorship and he left UCI a few weeks later, court records show.

St. Jude was named in a malpractice case in 1996 by a patient Chambi operated on during that time. Chambi and St. Jude won the case.

In the last week, patients have told the Register that Chambi characterized his departure from Western Medical Center as a business dispute with Tenet. Patients also said that nurses at his Santa Ana office denied that he had lost his clinical privileges.

At least one patient canceled surgery that had been moved to St. Jude. The hospital said he has operated there two times this week, compared with the eight surgeries a week he averaged at Western Medical.

St. Jude's Medical Executive Committee met in confidential session Wednesday night to discuss what to do about Chambi, the hospital confirmed.

Hospital spokeswoman Dru Ann Copping said Chambi agreed not to admit any more patients or work on-call surgical duties until St. Jude's peer-review committee can examine the reasons for Western Medical's suspension and conduct its own review. Western Medical officials said they expected to cooperate with St. Jude in that effort.

Chambi will be allowed to assist other surgeons if they request his help.

He added: "I look forward to a full resolution of this matter and hope that St. Jude is quickly able to come to the conclusion that my surgical skills and practice are needed by hundreds of Orange County families each year."

Chambi remains under investigation by the state Medical Board and is fighting at least five lawsuits in Orange County Superior Court.