Doctor falsifies cancer diagnoses to defraud millions | Medical Error Action Group

Doctor falsifies cancer diagnoses to defraud millions | Medical Error Action Group: "Detroit, MI

An American oncologist faces up to 175 years in prison for a scam in which he reaped millions of dollars by putting patients on chemotherapy drugs they didn’t need, in order to defraud public and private insurers.

Dr Farid FATA, 49, pleaded guilty to 13 counts of healthcare fraud, one count of conspiring to receive kickbacks and one count of money laundering as the owner of a cancer treatment clinic and a diagnostic testing facility.

“Dr FATA…  admitted he put greed before the health and safety of his patients, putting them through unnecessary chemotherapy and other treatments just so that he could collect additional millions from MEDICARE,” said US Assistant Attorney- General Leslie CALDWELL.

“The mere thought of what he did is chilling.”

The US Federal Bureau of Investigation said FATA was swiftly arrested after agents were alerted to the scam in mid-2013.

FATA submitted approximately $225 million in claims to MEDICARE – the US federal-funded program in the US that provides health insurance to the disabled and people over 65 – between August 2007 and July 2013.

The claims included about $109 million for chemotherapy and other cancer treatments.

MEDICARE paid the fraudster $91 million, of which over $48 million was for chemotherapy and other cancer treatments.

Employees of FATA’s Michigan Hematology Oncology Clinic (MHO), which had six offices in the Detroit area, gave damning evidence of dangerous prescribing practices."



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"Similar low values are observed in patients with sympathectomy and in patients with tetraplegia"

Information about surgery for sweaty hands: "Patients with progressive autonomic dysfunction (including diabetes) have little or no increase in plasma noradrenaline and this correlates with their orthostatic intolerance (Bannister, Sever and Gross, 1977). In patients with pure autonomic failure, basal levels of noradrenaline are lower than in normal subjects (Polinsky, 1988). Similar low values are observed in patients with sympathectomy and in patients with tetraplegia. (p.51)

The finger wrinkling response is abolished by upper thoracic sympathectomy. The test is also abnormal in some patients with diabetic autonomic dysfunction, the Guillan-Barre syndrome and other peripheral sympathetic dysfunction in limbs. (p.46)

Other causes of autonomic dysfunction without neurological signs include medications, acute autonomic failure, endocrine disease, surgical sympathectomy . (p.100)

Anhidrosis is the usual effect of destruction of sympathetic supply to the face. However about 35% of patients with sympathetic devervation of the face, acessory fibres (reaching the face through the trigeminal system) become hyperactive and hyperhidrosis occurs, occasionally causing the interesting phenomenon of alternating hyperhidrosis and Horner's Syndrome (Ottomo and Heimburger, 1980). (p.159)

Disorders of the Autonomic Nervous System
By David Robertson, Italo Biaggioni
Edition: illustrated
Published by Informa Health Care, 1995
ISBN 3718651467, 9783718651467"



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"the standards for the evidence are often low and tainted by commercial or personal interests"

In the eyes of doctors and the public, evidence-based medicine is the gold standard of clinic practice. If it’s based on evidence from trials and laboratories, it must be right.

However, evidence-based medicine has its critics, as a bilious outbreak of comment and letters in the BMJ demonstrated recently. Early last month a Glasgow GP, Des Spence, said that the system of EBM had been corrupted. “If we don’t tackle the flaws of EBM there will be a disaster, but I fear it will take a disaster before anyone will listen,” he wrote. 

How could anyone fault the notion of treatment based on scientifically validated evidence? No one. But the critics of EBM argue heatedly that the standards for the evidence are often low and tainted by commercial or personal interests. Dr Spence accuses drug companies of
manipulating the gold standard to their own benefit. “Today EBM is a loaded gun at clinicians’ heads. ‘You better do as the evidence says,’ it hisses, leaving no room for discretion or judgment. EBM is now the problem, fueling overdiagnosis and overtreatment.”
A number of letters pointed out that, while EBM had its flaws, doctors still need to exercise their clinical judgement. They write the prescriptions, not the drug companies.
Dr Spence was supported by Dr Miran Epstein, a medical ethicist at The London School of Medicine. He writes that “EBM “does not regard polluted information, whether it involves misconduct or not, as a sufficient condition for rendering disclosure inadequate. Thus, it lets informed consent degenerate into a legal fiction and the principle of autonomy into a cynical farce. Worst of all, it is perfectly ethical: being the codified expression of the collective conscience of our medicine, it naturally purports to be moral.” 

And he was supported by lawyer and ethicist Charles Foster, writing in the Practical Ethics blog. He believes that the editors of journals need the help of a regulator to sift the wheat from the chaff. “Journals can’t do it all. We need a cynical, skeptical, well-funded, well-staffed and ideologically very left-wing regulator. With huge teeth.” 

Evidence-based medicine comes under attack
by Michael Cook | 8 Feb 2014 |
tags: commercialization, evidence-based medicine
http://www.bioedge.org/index.php/bioethics/bioethics_article/10841 

Publication bias distorting evidence base, systematic reviews and clinical guidelines

For decades, the systematic review of published randomised controlled trials has been considered the gold standard in medical research, and this was what the original Cochrane reviewers did.

By combining data from all published trials on a particular subject, researchers are able to see effects in much larger numbers of people than would typically be included in a single trial, in theory making their conclusions more powerful.

In theory. The problem in reality is a small thing called publication bias.

Some trials are simply more likely to be published than others, potentially skewing the results of this kind of meta-analysis.

MJA InSIght, Monday, 14 October, 2013

Jane McCredie: Sharing evidence

"the most dangerous pseudoscience is not produced by amateurish cranks, but by a minority of qualified scientists and doctors"

"Their pseudoscience is promoted as science by think tanks and sections of the media, with serious consequences."

"Why do a minority of scientists produce pseudoscience? Clearly some pseudoscience is strongly associated with ideological beliefs, and motivated reasoning can overwhelm data, logic and years of training. Perhaps some scientists get complacent, expecting their hunches to always be correct.

But perhaps there’s another reason that’s closer to home. Is part of the problem how we educate prospective scientists?

Hypothesis

Pseudoscience mimics aspects of science while fundamentally denying the scientific method. A useful definition of the scientific method is:

principles and procedures for the systematic pursuit of knowledge involving the recognition and formulation of a problem, the collection of data through observation and experiment, and the formulation and testing of hypotheses.

A key phrase is “testing of hypotheses”. We test hypotheses because they can be wrong.

Hypothesis testing is the first victim of pseudoscience. The conclusions are already known, and the data and analyses are (consciously or unconsciously) chosen to reach the desired conclusion.

Unfortunately, high school and undergraduate science students may have limited exposure to hypothesis testing. A student laboratory exercise may repeat an experiment from decades ago, which has been simplified for teaching, and whose conclusions are well known.

Such an exercise teaches technical skills at the expense of hypothesis testing. Should we expect students to “get” hypothesis testing without real experience? No, and without real experience of hypothesis testing we may undermine years of education."

http://theconversation.com/scientists-can-learn-from-pseudoscience-thats-a-fact-17376

"the pharma giant used fictitious patient quotes to promote its fluticasone product"

"GLAXOSMITHKLINE is among three companies to be fined for breaches of Medicines Australia’s Code of Conduct after the pharma giant used fictitious patient quotes to promote its fluticasone product, Seretide.

MA said in its July–September quarterly report that the Code of Conduct committee dealt with allegations by Mundipharma that GSK’s promotional material on Seretide was false and misleading.

The committee said that while publishing fictitious patient quotes is itself a breach of the code, GSK had exacerbated its breach by placing the statements in quote marks beside the image of a young woman. 

“GSK had agreed during intercompany dialogue to make clear that the statements were not from real patients,” the committee said."

Medical Observer, 

False claims: Pharma companies fined

Warwick Stanley  3rd Nov 2014