Ten years ago, Bill Reynolds and Mark Sersansie discovered a nefarious medical fraud scheme in California that centered around doctors receiving kickbacks and surgeries being performed using fake hardware. In the scheme, middlemen were given money to track down patients who had back problems from work-related injuries. Doctors were then paid kickbacks to perform spinal surgeries at designated hospitals.
Many of the patients are still suffering from debilitating problems because of this scam, ranging from not wanting to live anymore to living every day in excruciating pain. Many later learned they did not even need surgery.
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Alex Ferrer (who used to be a police officer, then a lawyer and is now a judge) is the host of the TV show “Whistleblower.” He filmed Reynolds and Sersansie for his show as they visited the patients who were victims of the scam. They also visited and filmed the southern California hospitals where the botched surgeries took place. The show’s episode is called “The Billion Dollar Back Surgery Scam: Patients in Pain and Peril,” which aired on Friday, June 21.
Sersansie worked in sales for a California medical supply company and Reynolds is a medical fraud investigator. By the end of their investigation, they discovered that hospitals weren’t just overbilling for the spinal hardware used in surgeries, but they were also implanting, in many cases, fake hardware into the backs of their unaware patients.
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Reynolds said some of the invoices for the fraudulent hardware ranged from $350,000 to $475,000. According to attorney Justin Berger, once in the body, the hardware, which had counterfeit screws mixed in with FDA approved screws, could leak poisonous materials into the body and lead to serious infections. Berger explained:
“Those screws go into patients’ … bones … little pieces of those threads can break off in people’s bodies and end up in their tissue. It can cause serious complications.”1
Berger represents the patients who were interviewed by “Whistleblower,” Reynolds and Sersansie, and many others who have sued because of the scam. The consensus among all involved is the doctors, driven by greed and money, were aware they were operating with unsafe hardware. Reynolds added:
“It’s important to blow the whistle on this. Somebody has to step forward and bring the attention to the magnitude of this problem.”1
Making matters worse, the only way to conclusively tell if a patient has been implanted with the toxic hardware is to perform surgery to take the screws out and check them because the lot numbers were not tracked properly. It is estimated that hundreds, if not thousands, of patients are implanted with the phony hardware.
The Department of Justice performed a criminal investigation, called “Operation Spinal Cap,” into the scheme, which involved $40 million in corrupt kickbacks paid out to doctors and other medical professionals for referring thousands of people for surgeries at California hospitals. The claims related to this scam spans over fifteen years, and all together total more than $950 million.
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Out of all of the players in this deplorable scam, one of the most alarming convictions was California State Senator Ron Calderon, who was convicted of accepting bribes in exchange for influencing California lawmakers to keep open the lucrative loophole that allowed for the inflated hardware reimbursements. He was sentenced to 42 months in prison and served less than two years. No one has been criminally charged with knowledge of the implantation of counterfeit spinal hardware.
Michael Drobot is also one of the ringleaders of the scam. He is currently serving five years in federal prison and must give up $10 million. He is the former owner of Pacific Hospital in Long Beach. Paul Randall is another central figure in the scam. He cooperated with the federal investigation and spent less than a year in jail and has now been released.
