It took 3 years for a Michigan federal district court to sentence surgeon, Aria Sabit, MD to almost 20 years in jail for fraud. As the verdict was read, I have no doubt that some of his victims, not patients, would have preferred he go away for much, much longer.
For anyone believing that fraud is somehow the domain of the “uneducated class,” this case is a sterling example of how unethical behavior, along with its opportunity and rationalization can affect even a well-educated orthopedic surgeon. Having no ethical grounding is not limited to any profession, age or level of education. It talks to an absence of training and checks and balances. This case of fraud actually shows that patterns of unethical behavior will readily repeat themselves. Dr. Sabit exemplifies this negative characteristic after prosecutors uncovered two separate cases of fraud under the same banner. Surgeon gets 20-year sentence for fraud: Was it the right charge?
The Physician-Owned Distributorship
The first opportunity Dr. Sabit had to commit fraud was when he was practicing at a hospital out in sunny Ventura, California. He invested in a business in 2010 which is known as a physician-owned distributorship. In and of itself, I suppose it should raise a few ethical flags. The distributorship sells surgical equipment and supplies such as screws and rods used in spinal surgeries. He convinced Apex Medical Technologies to cut him in on the profits. Then Sabit convinced the hospital to purchase his line of products. I suppose it was still ethical, but as many a judge has said, “We’ll let it go for now, but watch it!” It did not take long for Sabit to cross the threshold from questionable to unethical.
Aria Sabit, MD then convinced some patients to have unnecessary surgeries in addition to his cases that were legitimate. In both situations, he “overloaded” patients with Apex Medical Technologies hardware. They gave him kickbacks, to the tune of $440,000 for just an 18-month period. When the case came to light, almost 30 patients in California sued him for malpractice.
The surgeries were so unnecessary and performed so poorly, 71% of those patients were readmitted for corrective procedures. Here is the truly sad part: several died from complications. His whistle-blowing colleagues were too late to report him. Late in 2010 the hospital revoked his privileges and by early winter of 2011 he moved to the Detroit area to start anew.
On to Detroit
His relationship with Apex Medical Technologies started to decline with the move to Detroit because the new hospital already had established suppliers. Therefore, his kickbacks for using Apex Medical Technologies products dropped off to nothing. Undeterred, he figured out a new way to defraud patients. He influenced patients to have spinal fusion surgery with metal instrumentation. This is an expensive procedure.
However, something seemed wrong to his fellow surgeons in Detroit as well. When they convinced the new hospital to do diagnostic imaging of Aria Sabit’s patient’s the images showed that he never installed the hardware, just bone material. The spines never fused. The hospital and medical community became outraged and reported it to the police.
He was arrested on November 24, 2014. He pleaded guilty to fraud, conspiracy, and for good measure, one count of illegally distributing a controlled substance.
In all, and using extremely unethical surgical procedures, this father of three was able to steal more than $11 million from Medicare, Medicaid, and private insurers. He (his lawyers) argued with the judge that he should have a short sentence. The judge disagreed and gave him nearly 20 years.
Though there were all kinds of warnings about Aria Sabit’s unethical behavior and numerous malpractice charges in California, he nevertheless went on to practice in Detroit without ethical trainings or reviews. Here is a simple enough question: Why not?
He is currently serving his sentence.
Though I have raised the issue for the need of ethical training, it is not the prime question in this scandal. Much larger issues loom, beginning with oversight. Why was there no oversight at least in Detroit, after it was seen that Sabit behaved so unethically in California? Why were they so protective of him? Then there is the issue of charges.
In California, the man was essentially running a “surgery mill,” with the object to kickback as much money as possible for unnecessary surgeries and equipment. His actions directly, or indirectly contributed to patient deaths. Why were there no severe consequences?
In Detroit, he had no compunction about cutting corners (though it’s much too gentle a phrase) which would then put patients’ lives at risk. At what point should more severe charges have been imposed? Ultimately, this ne’er-do-well surgeon cared nothing about his patients. He cared not about their pain or their lives. The question on the (operating) table: should the charges have taken a criminal turn up to, and including, manslaughter? Surgeon gets 20-year sentence for fraud: Was it the right charge?
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