Inaction by regulators as weight loss surgery allegations mount

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Lap-Band billboard

Several patients have died since 2009 after Lap-Band procedures in clinics in Beverly Hills and West Hills affiliated with the 1-800-GET-THIN marketing campaign, according to coroners' reports, lawsuits and other public documents. (Mariah Tauger / Los Angeles Times / October 23, 2012)

Last year, when I asked medical board President Barbara Yaroslavsky (wife of Los Angeles County Supervisor Zev Yaroslavsky) why she wasn't screaming from the rooftops about her agency's problems, she explained that she didn't think it was right to "act independently" from the governor's office, which sets her budget.

In other words, she thought it was more important to be seen as a team player politically than to live up to her responsibilities to the state's surgical patients. That's an explanation, of sorts, but the regulatory approach it describes is inexplicable.

Who else has blood on their hands in connection with these surgery centers?

How about health insurers?

Much of the income collected by the Omidis — Shamaan testified he was told it amounts to $21 million a month — comes from insurance payments. Yet the whistle-blowers' lawsuit is rife with assertions of fraudulent billings. In the wrongful death case, Dr. Shamaan testified that at Julian Omidi's direction he signed 600 fraudulent form letters seeking pre-authorizations for surgeries.

The health insurance industry justifies its existence by maintaining that we need its skill at ferreting out fraud and keeping medical bills reasonable. Lots of good they've done us in this instance.

The insurers aren't shy about telling patients with legitimate conditions that they can't spend an extra day or two in the hospital, but judging from the allegations in the whistle-blower lawsuit and others, not to mention Shamaan's testimony, they may have paid out thousands of dollars, even millions, on inflated or fake claims from clinics affiliated with 1-800-GET-THIN. Think about that the next time your health insurer tries to explain why your premiums are being jacked up, again.

Then there's the accreditation agency known as the Joint Commission, which has given its seal of approval to the Omidis' Beverly Hills and West Hills surgery centers. The Joint Commission is one of the independent organizations to which the California medical board has outsourced the duty to inspect and oversee the non-hospital surgical facilities it inherited after that 2007 court ruling.

When the Joint Commission first accredited the Beverly Hills facility in September 2009 — by then the former Almont Ambulatory Surgery Center was doing business under the name Beverly Hills Surgery Center — the location's accreditation already had been revoked by one competing accreditation organization and its application had been rejected by another.

But the Joint Commission didn't examine a facility's prior accreditation record as part of its approval process. Why not? It pockets an annual fee from its accredited institutions, so perhaps it has an incentive not to be too particular.

The state Legislature finally closed this loophole last year. Henceforth, a revocation by any one accreditation organization will have to be honored by all. But it's proper to ask whether the Joint Commission has adequately performed its oversight function.

In her lawsuit Deuel, who says she based her account on information from people on the scene, describes frenzied efforts at the West Hills clinic to cover up the circumstances of Paula Rojeski's death — defective equipment removed from the facility and spirited into hiding, the place scrubbed down, records falsified.

This all took place, Deuel says, prior to a pre-announced inspection by state and county officials looking into Rojeski's death. But what if there had been an unannounced inspection by regulators, at any time before Rojeski went under the knife last Sept. 8? The conditions described by Deuel might have been discovered on the spot, like those discovered in Beverly Hills by the surprise inspection in 2009.

And Paula Rojeski might be alive today.

Let us now call the roll of the known departed. Willie Brooks, 1974-2009. Ana Renteria, 1976-2010. Laura Lee Faitro, 1959-2010. Tamara Walter, 1958-2010. Paula Rojeski, 1955-2011. According to coroners' reports, lawsuits and other public documents, they all died after undergoing Lap-Band surgery at clinics associated with 1-800-GET-THIN.

The allegations in last week's court filings point to the reasons why this may have happened, and to who looked away and let it happen.

One can only hope that the regulators and all the others who could have acted and failed to do so are haunted by these names to the end of their days. They should act now, before the roll call of victims grows longer.

Michael Hiltzik's column appears Sundays and Wednesdays. Reach him at mhiltzik@latimes.com, read past columns at latimes.com/hiltzik, check out facebook.com/hiltzik and follow @latimeshiltzik on Twitter.
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