I had never heard of the phrase “serial malpracticer.” It seems to apply to Dr. Spyros Panos, an orthopaedic surgeon who surrendered his medical license six years ago. An arbitrator awarded $140 million to resolve 255 medical malpractice lawsuits in New York. Dr. Panos refused consent to settle. His carrier, MLMIC, overrode him. It’s not clear that the carrier has (or will allocate) sufficient funds to pay all of these claims. More on that shortly.
Along the way, Panos already served one prison term and new criminal charges are pending. He pleaded guilty to healthcare fraud in US District Court in NY. He served 2 ½ years of a 4 ½ year sentence. Last year he was charged with wire fraud, healthcare fraud, and aggravated identity theft.
Within months of release from prison, Panos submitted credentialing information to peer review companies using the name of another licensed orthopaedic surgeon. Panos and a family member had set up bank accounts in Hong Kong to perform peer review for worker’s compensation claims. Such reviews can only be performed by a licensed physician. Since Panos had surrendered his license, he piggy-backed off another. He earned $600k in this venture.
There were three categories of plaintiffs. Those who did not need surgery but received it anyway. Those who had a genuine problem but were inadequately treated “so he could do a second or third surgery on them.” And those on whom Panos “just malpracticed because he was in a rush or just lacked the skill.”
One settlement was $1.4 million for a woman who suffered a pulmonary embolism. Hard to know whether this was a patient who never needed surgery. Or whether that patient did not have adequate deep venous thrombosis prophylaxis. Or none of the above.
When approved by the court, the awards to individual plaintiffs will range from $15,500 to $3.8 million.
What is shocking is how long it took for this practitioner to be ousted. If there was this much malpractice going on, didn’t anyone notice? Hospital administrators? Anesthesiologists? Colleagues?
Most orthopaedic surgeons will be sued at least one time in their career. The same is true for all surgeons. Still, for most of these physicians, being sued is a snapshot -and not a movie- of their career. This is true whether or not the doctor is found liable. Most allegations of malpractice are outliers; meaning that same doctor typically practices at or above the standard of care on virtually every patient every day.
But every so often, there’s a bad apple. A serial malpracticer. Collectively, we ignore such bad apples at our peril.
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ABOUT THE AUTHOR
Jeffrey Segal, MD, JD
Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.
Dr. Segal received his M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.
Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.
If you have a medico-legal question, write to Medical Justice at infonews@medicaljustice.com.com.
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Turns out that people like this attack those who confront them. They often bring a lot of money to institutions where they work, so there’s a conflict of interest that gives them longevity they do not deserve.
Examples: I have worked at universities where various surgeons brought in enormous quantities of money, much of it to the hospitals. In the case of at least two such universities (and three surgeons), the practices were unethical (2 cases) or psychotic (1 case). Never were these surgeons investigated, not even reprimanded. In one case, a surgeon had done numerous craniotomies, having intentionally misled patients, and therefore provably having done them without informed consent. What happened? The person who brought him to the attention of the chief of staff was the one who was reprimanded for having “brought patients into this [issue].”
Bottom line is that it is often true that no good deed goes unpunished.
Unless there’s a negative feedback loop that reaches the hospital and chiefs of staff’s offices, they have no incentive to rein in malpractice. If anesthesiologists balk at putting their patients to sleep, the hospitals put the squeeze on them by threatening to fire them (they often work directly for the hospital) and replace them with more compliant folks.
It’s not a pretty picture.
This case certainly seems to be egregious. However, what we do not know was whether there was also a pile on effect, such that once it was known he was being sued there were a ton of other suits brought. Was this guy unlucky initially, or was he a bad practitioner? Clearly later on he did nefarious things to earn money, most likely for his defense.
In such cases it can be difficult to get physicians removed from the staff. In one instance I know of, a surgeon had to be supervised by another surgeon whenever he operated as a condition of retaining privileges and one surgeon stepped up to do so, despite risk to his malpractice, mainly to protect patients from the onslaught. Primum non nocere.
We had one in our town who despite having numerous complaints brought against him to the board of medicine without hardly a quarter going by without some sort of sanction managed to continue practicing for over 20 years! Since he was a cosmetic and ENT surgeon, his patients tended not to die but be maimed, unnecessarily operated upon or overcharged mostly and i think he had great lawyers. Eventually even when he lost his license he continued to practice out of his house and send patients to a clinic in another country. It took a police sting to finally convict and imprison him.