Top UM heart surgeon at center of $15 million settlement between Baylor and feds

A $15 million settlement struck between Baylor University and the Justice Department over claims of allowing unqualified medical residents to perform heart surgeries in dual operating rooms run by veteran surgeons has implicated a prominent University of Miami cardiac surgeon who had worked there.

Houston-based Baylor St. Luke’s Medical Center, Baylor College of Medicine and Surgical Associates of Texas P.A. have jointly agreed to pay the settlement to resolve claims that federal prosecutors say transpired from June 2013 to December 2020, according to a Justice Department news release issued this week.

The Baylor College of Medicine physicians accused of wrongdoing at the teaching hospital included Dr. Joseph Coselli, 71, of Houston, and Dr. Joseph Lamelas, 63, of Miami, according to court documents filed in Texas federal court. Since 2019, Lamelas has overseen the University of Miami Health System’s cardiac surgery program and is widely recognized as a pioneer of minimally invasive cardiac surgery.

UM’s medical school could not be reached for comment late Wednesday.

‘Simultaneous overlapping surgeries’

Lamelas, who also served as chief of cardiac surgery at Mount Sinai Medical Center in Miami Beach, is accused of performing “hundreds of simultaneous overlapping surgeries” during his two-year stint at Baylor, according to court records, which were cited in a story published by USA TODAY on Tuesday.

Although physically impossible to do the number of overlapping surgeries, Lamelas still wrote on medical records that he performed the procedures as he was getting paid for each one, USA TODAY reported, citing the documents.

Dr. David Ott, 77, of Houston, is also named in court records as being a part of the misconduct, but he is a cardiothoracic surgeon affiliated with the medical practice group, Surgical Associates of Texas, federal prosecutors said.

Baylor College of Medicine provided a statement to USA TODAY on Tuesday in response to the settlement of the legal dispute.

“Baylor College of Medicine did not engage in conduct that violates any applicable federal law or regulation. It is also important to note that no patients were harmed,” Robert Corrigan Jr, general counsel for Baylor College of Medicine, said in the statement.

“The settlement agreement acknowledged that BCM disputed that any violations of federal law occurred and that the College being a party to the agreement is not an admission of liability by Baylor. The College decided to amicably resolve the dispute prior to a trial on the merits after considering the cost and expense incurred by Baylor to date, and anticipated future costs and expenses, including attorneys’ fees.”

The investigation into the misconduct began on Aug. 7, 2019, when a whistle blower filed a complaint alleging the doctors “engaged in a regular practice of running two operating rooms at once and delegating key aspects of extremely complicated and risky heart surgeries to unqualified medical residents,” according to the Justice Department, which joined the whistle blower’s lawsuit.

“The heart surgeries at issue are some of the most complicated operations performed at any hospital including coronary artery bypass grafts, valve repairs and aortic repair procedures,” according to the Justice Department’s release. “These surgeries typically involve opening a [patient’s] chest and placing the patient on the bypass machine for some portion of time.”

Did not hold surgical ‘timeout’

Teaching physicians have to abide by Medicare regulations on when they can leave the operating room during procedures, prosecutors said. When the surgeons were running the two operating rooms at once, they did not hold a surgical “timeout,” which allows the medical team to discuss risks to prevent surgical errors, they said.

To make it seem as if the teaching physicians were present during the “entire” operation, they would note their presence on medical records, according to court documents. The medical staff also would not tell patients that the surgeon planned on leaving the room to perform another operation.

“Patients entrusted these surgeons with their lives − submitting to operations where one missed cut is the difference between life and death,” U.S. Attorney Alamdar Hamdani said in the Justice Department news release. “Allegedly, the patients were unaware their doctor was leaving for another operating room.

“This settlement reaffirms the importance of Medicare requirements governing surgeon presence and ensuring that no physician − no matter how prominent or successful − can skirt around the rules.”

The $15 million recovery is the largest settlement to date involving “concurrent” surgeries, according to the Justice Department. Under the False Claims Act, the private whistle blower who reported the allegations will receive more than $3 million from the settlement.