What Were They Thinking? Chapter 952.

Medical Justice provides consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a consultation – or use the tool shared below.

“Can Medical Justice solve my problem?” Click here to review recent consultations…

all. Here’s a sample of typical recent consultation discussions…

• Former employee stole patient list. Now a competitor…
• Patient suing doctor in small claims court…
• Just received board complaint…
• Allegations of sexual harassment by employee…
• Patient filed police complaint doctor inappropriately touched her…
• DEA showed up to my office…
• Patient “extorting” me. “Pay me or I’ll slam you online.”
• My carrier wants me to settle. My case is fully defensible…
• My patient is demanding an unwarranted refund…
• How do I safely terminate doctor-patient relationship?
• How to avoid reporting to Data Bank…
• I want my day in court. But don’t want to risk my nest egg…
• Hospital wants to fire me…
• Sham peer review inappropriately limiting privileges…
• Can I safely use stem cells in my practice?
• Patient’s results are not what was expected…
• Just received request for medical records from an attorney…
• Just received notice of intent to sue…
• Just received summons for meritless case…
• Safely responding to negative online reviews…

We challenge you to supply us with a medico-legal obstacle we haven’t seen before. Know you are in good hands. Schedule your consultation below – or click here to visit our booking page.

 

Yes, it’s true, in the United States criminal justice system, one is presumed innocent until proven guilty beyond a reasonable doubt.  

If the allegations in a recent US Department of Justice press release are true, two physicians will have a hard time staying out of prison. 

From in or about January 2013, up to and including in or about April 2018, the defendants engaged in an extensive fraud scheme through which the defendants defrauded businesses and insurance companies by staging trip-and-fall accidents and filing fraudulent lawsuits arising from those staged trip-and-fall accidents.  In or about 2015, certain members of the fraud scheme split from the original conspiracy and formed a separate conspiracy that operated in substantially the same manner.  GEORGE CONSTANTINE was the primary attorney who filed fraudulent lawsuits in the original conspiracy starting in 2013.  MARC ELEFANT was the primary attorney who filed fraudulent lawsuits in the separate conspiracy, formed in or about 2015. 

What was the alleged scheme? 

Fraud scheme participants recruited individuals (the “Patients”) to stage or falsely claim to have suffered trip-and-fall accidents at particular locations throughout the New York City area (the “Accident Sites”).  In the course of the fraud scheme, scheme participants recruited more than 400 Patients.  In the beginning, scheme participants would instruct Patients to claim they had tripped and fallen at a particular location, when in fact the Patients had suffered no such accidents.  Eventually, at the direction of the lawyers who filed fraudulent lawsuits on behalf of the Patients, scheme participants began to instruct Patients to stage trip-and-fall accidents, i.e., to go to a location and deliberately fall.  Common Accident Sites used during the fraud scheme included cellar doors, cracks in concrete sidewalks, and purported “potholes.” 

Specific attorneys filed scores of lawsuits. 

After the staged trip-and-fall accidents, Patients were referred to specific attorneys, including GEORGE CONSTANTINE and MARC ELEFANT, who would file personal injury lawsuits (the “Fraudulent Lawsuits”) against the owners of the Accident Sites and/or insurance companies of the owners of the accident sites (the “Victims”).  The Fraudulent Lawsuits did not disclose that the Patients had deliberately fallen at the accident sites or, in some cases, had not fallen at all.  During the course of the fraud scheme, the defendants, together with others known and unknown, attempted to defraud the Victims of more than $31,000,000. 

Weren’t doctors also allegedly involved? 

Yep. 

The Patients were also instructed to receive ongoing chiropractic and medical treatment from certain chiropractors and doctors, including ANDREW DOWD and SADY RIBEIRO.  The fraud scheme participants advised the Patients that if they intended to continue with their lawsuits, they were required to undergo surgery.  As an incentive to getting surgery, the recruited Patients were offered a payment of typically between $1,000 and $1,500 after they completed surgery (“Post-Surgery Payments”).  Patients generally were told to undergo two surgeries. 

These patients chose to undergo surgery – surgery they did not need – to collect a modest check or even a meal. 

Doctors in the fraud scheme, including DOWD and RIBEIRO, were expected to, and in fact did, conduct these surgeries regardless of the legitimate medical needs of the Patients.  For example, in a March 2016 email, before DOWD examined the shoulder of a particular Patient who had staged a trip-and-fall accident (“Patient-2”), one of the scheme organizers asked DOWD to “write us an additional report today stating that [Patient-2’s] Lt. shoulder has worsened [so that I can] book this surgery for you.”  DOWD provided the requested report and recommended that Patient-2 undergo arthroscopic surgery.  

Likewise, in an August 2015 email from RIBEIRO to the owner of a litigation funding company, in which RIBEIRO described the services that he performed, RIBEIRO wrote, “I will play very honest ‘game’ with you . . . I see the patient and I generate a very good dictation that justifies the treatment-there is a cost for that and I hope a profit.” 

Members of the fraud scheme often recruited individuals who were extremely poor as Patients – individuals desperate enough to submit to surgeries in exchange for the small Post-Surgery Payments.  For example, it was common for Patients to ask for food when they would appear for their intake meetings with the lawyers.  Many of the Patients did not have sufficient clothing to keep them warm during the wintertime and had poor-quality shoes.  Members of the fraud scheme also recruited Patients who were drug addicts.  It was also common for scheme participants to recruit Patients from homeless shelters in New York City. 

Wait, there’s more. Did the patients even collect anything from their slip and fall lawsuits? Wasn’t that the teaser to persuade patients to even stage their accidents? Well no, the patients were often left high and dry. 

The Patients’ legal and medical fees were usually paid for by litigation funding companies (the “Funding Companies”), even if the Patient maintained medical coverage through an insurance company or a government-subsidized program.  The Funding Companies also paid the fraud scheme organizers and participants referral fees, typically $1,000 to $2,500, for each Patient who signed a funding agreement.  In exchange for funding Patients’ medical and legal costs, the Funding Companies charged the Patients high-interest rates, sometimes up to 50% on medical loans and up to 100% on personal loans.  The interest rates were so high that oftentimes the majority (if not all) of the proceeds that were awarded in the Fraudulent Lawsuits were paid to the Funding Companies, CONSTANTINE, ELEFANT, DOWD, RIBEIRO, and others, with the Patients receiving a much smaller percentage of the remaining recovery. 

What is the potential liability if convicted? 

GEORGE CONSTANTINE, 58, and MARC ELEFANT, 49, are New York-licensed attorneys who represented hundreds of Patients and filed Fraudulent Lawsuits on their behalf as part of the fraud scheme. 

ANDREW DOWD, 45, is a New York-licensed orthopedic surgeon who performed hundreds of knee and shoulder surgeries on Patients as part of the fraud scheme, earning approximately $9,500 per surgery. 

SADY RIBEIRO, 51, is a New York-licensed pain management doctor and surgeon who performed back surgeries, among other medical procedures, on Patients.  RIBEIRO paid participants cash kickbacks in exchange for patient referrals and treated nearly 200 Patients during the fraud scheme. 

GEORGE CONSTANTINE, MARC ELEFANT, ANDREW DOWD, and SADY RIBEIRO are each charged with conspiracy to commit mail and wire fraud, which carries a maximum sentence of 20 years in prison, mail fraud, which carries a maximum sentence of 20 years in prison, and wire fraud, which carries a maximum sentence of 20 years in prison.  DOWD and RIBEIRO are also charged with one additional count each of conspiracy to commit mail and wire fraud, mail fraud, and wire fraud.  

A Google review of Dr. Ribeiro from three years ago stated: 

I never met such a rude, incompetent secretary and such an arrogant little man. Who is supposed to make patients feel better. Not leave the office crying. sitting on the bench out front to cry and cry because how rude and callous the two are. I guess it explained why i was the only patient in the whole office. Such an arrogant little man. May God warm his soul and hers because she is so ugly on the inside. 

An earlier review of Dr. Dowd stated: 

A total douchbag of a doctor. Went to see him for a possible CMC arthritis. He didn’t even bother looking at my finger! I waited 20 minutes, the receptionist was nice. When I was called in, he looked at me and brushed me off. Said it was a problem not worth treating!! Unbelievable! 

Perhaps both physicians were distracted by more entrepreneurial activities. 

What do you think?

Medical Justice provides consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a consultation – or use the tool shared below.

“Can Medical Justice solve my problem?” Click here to review recent consultations…

all. Here’s a sample of typical recent consultation discussions…

• Former employee stole patient list. Now a competitor…
• Patient suing doctor in small claims court…
• Just received board complaint…
• Allegations of sexual harassment by employee…
• Patient filed police complaint doctor inappropriately touched her…
• DEA showed up to my office…
• Patient “extorting” me. “Pay me or I’ll slam you online.”
• My carrier wants me to settle. My case is fully defensible…
• My patient is demanding an unwarranted refund…
• How do I safely terminate doctor-patient relationship?
• How to avoid reporting to Data Bank…
• I want my day in court. But don’t want to risk my nest egg…
• Hospital wants to fire me…
• Sham peer review inappropriately limiting privileges…
• Can I safely use stem cells in my practice?
• Patient’s results are not what was expected…
• Just received request for medical records from an attorney…
• Just received notice of intent to sue…
• Just received summons for meritless case…
• Safely responding to negative online reviews…

We challenge you to supply us with a medico-legal obstacle we haven’t seen before. Know you are in good hands. Schedule your consultation below – or click here to visit our booking page.

 

Learn how Medical Justice can protect you from medico-legal mayhem… 

Jeffrey Segal, MD, JD

Chief Executive Officer and Founder

Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. 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 was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.

Dr. Segal holds a 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.

In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.

Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. Byrd Adatto was selected as a Best Law Firm in the 2021 edition of the “Best Law Firms” list by U.S. News – Best Lawyers. With decades of combined 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.