Metro

Spotlight Follow-up

Doctor faces lawsuits over double-booked surgeries

Dr. David B. Samadi, a urologist who is one of the nation’s highest-paid surgeons, is the chief of urology at Lenox Hill Hospital in Manhattan.
John Tlumacki/Globe staff/File 2017
Dr. David B. Samadi, a urologist who is one of the nation’s highest-paid surgeons, is the chief of urology at Lenox Hill Hospital in Manhattan.

One of the most prominent surgeons caught up in the controversy over double-booked surgeries was hit with two lawsuits Friday that accuse him of injuring and defrauding patients by allowing unsupervised medical residents to perform his operations.

The lawsuits allege that Dr. David B. Samadi, a urologist who is one of the nation’s highest-paid surgeons, permitted the doctors in training to perform his prostate surgeries while he worked on simultaneous operations in another room at Lenox Hill Hospital in Manhattan.

As a result, the suit alleges, the two patients endured “excessively prolonged” general anesthesia to conceal the fact that Samadi was not performing the surgeries, and the patients sustained “serious physical injuries” after being subjected to surgery by unsupervised, inexperienced residents.

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“We don’t want this to happen to somebody else,” said George Markelson, who sued on behalf of his deceased father, Stephen Markelson, who was operated on by Samadi in 2013. “We were led to believe that our father was in good hands with a top surgeon performing the operation and we were furious to find out years later that he had another operation at the same time. This just shouldn’t go on.”

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Peter Nadler, who underwent prostate surgery in 2015, filed the second suit after he suffered complications, including urinary problems and loss of libido.

The lawsuits, each seeking $7 million in damages, come after a March investigation by the Spotlight Team revealed that urology residents do the vast majority of Samadi’s nonrobotic surgeries, including two-hour operations to trim away excess prostate tissues blocking urine flow.

Samadi, the chief of urology at Lenox Hill, could not immediately be reached for comment. A woman who answered the phone at Samadi’s office referred all questions to hospital officials. The officials also could not immediately be reached for comment.

A spokesman said the hospital had not been served with the lawsuit and declined comment.

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The suits also name Lenox Hill Hospital and its parent company, Northwell Health, as defendants, accusing them of “an extensive pattern of fraudulent conduct in which they misled patients, made misrepresentations to patients, and defrauded patients . . . and conspired to fraudulently bill such patients for more than 1,000 urologic surgeries performed entirely by unsupervised second and third year residents.”

The controversy over Samadi’s surgical practices is part of a larger national debate on the safety and ethics of surgeons running more than one operating room at a time, sparked by a 2015 Spotlight report on a dispute at Massachusetts General Hospital.

Although it is not uncommon for surgeons’ operations to overlap by a few minutes, the fight at Mass. General centered on a handful of orthopedic surgeons whose operations sometimes overlapped for hours, requiring them at times to shuttle between rooms. Some patients complained that they were not informed that they would be sharing their surgeon with another patient. Mass. General has said it had no evidence that any patients have been harmed and the hospital now requires surgeons to “discuss overlapping surgery with patients in advance of planned procedures.”

Since the Globe report, several researchers have found no significant difference in complication rates for surgical patients when operations run concurrently. However, earlier this month, a major Canadian study found that patients whose hip surgeries were performed by surgeons overseeing two operations at once were nearly twice as likely to suffer serious complications as those whose doctors focused on one patient at a time.

In Samadi’s case, the Globe reported in October that federal prosecutors had launched an investigation into his billing practices. Federal law prohibits surgeons at teaching hospitals from billing Medicare for two simultaneous operations unless the doctor was present for all “critical parts.”

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Northwell Health said it continues to cooperate with any state or federal investigations that are brought to its attention.

Lenox Hill officials previously confirmed that Samadi uses two operating rooms at once, but said he was present for the entirety of “major surgeries,” that he performs all robotic surgeries himself, and that his “primary concern and priority has always been the well-being of his patients.”

Samadi, a star surgeon who used to be a regular medical expert on Fox News, earned $6.7 million in 2015 as a specialist in robotic prostate surgery, according to hospital tax filings. Lenox Hill even built a luxurious wing for his patients where they are served gourmet meals.

But Lenox Hill data obtained by the Spotlight Team showed Samadi overlapped one case with another at some point in about 70 percent of his approximately 2,200 operations between mid-2013 and mid-2016. Hundreds of times, one operation overlapped completely with another — including Stephen Markelson’s surgery.

Markelson was a frail 79-year-old who had blood in his urine and an enlarged prostate when he agreed to have surgery performed by Samadi. But Samadi was busy with a robotic surgery that completely overlapped with Markelson’s, and a resident allegedly started and then had to halt Markelson’s surgery, according to interviews with medical personnel who were briefed on the case and spoke with state regulators.

Markelson was discharged, but medical records show he returned to the hospital days later with a massive amount of blood in his urine and had the operation redone by a different surgeon, according to patient records and an interview with a medical staffer. Markelson died several months after the prostate operations of unrelated causes.

During Peter Nadler’s surgery, which lasted more than two hours, Samadi had another operating room going for all but about 25 minutes. Nadler suffered from urinary problems and a diminished libido after his June 2015 operation for an enlarged prostate.

“It’s really fraud,” Nadler said in an interview with the Globe.

His wife, Lorraine, added: “It’s the dirty little secret in the medical field. It’s a sacred thing to hire someone to cut into your body, and never in a million years did we think that someone else would do the job. And now my husband is suffering. It’s dishonest and disgraceful.”

Joe Lanni, a New York-based lawyer representing both Markelson and Nadler, said patients have the right to be informed that someone other than their surgeon is operating on them.

“My clients also want the public to know that the practice of concurrent surgeries can harm patients,” he said.

Jenn Abelson can be reached at jenn.abelson@globe.com.