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Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/16/2011 4:13 PM (GMT -6)   
The following article was in the Las Vegas Review Journal and is now on the air. Myself and my predacessor at the Las Vegas chapter of UsTOO are being interviewed by local television and the papers. Please read the following and I have a question:

www.lvrj.com/news/medical-board-suspends-las-vegas-physician-s-license-118035174.html?viewAllComments=y&c=y

The keyword:
endocavity needle guides

I need to know if any of you have your bills and can identify what is charged for the above disposable device. Any diagrams also would be helpful on how the device is used. Mine are not detailed on this product.

My official statement as UsTOO Las Vegas Chapter President:

"We are deeply disappointed by these charges against Dr. Michael Kaplan. In the past Dr. Kaplan has supported our group and has appeared as a guest speaker on the procedures for diagnosing prostate cancer. Additionally, we have several patients that are members at our group who now must go through a battery of tests and the worry associated with this information that will certainly compound the worries that come with a prostate cancer diagnosis."

UGH!

I am not a very happy Prez... More media coming I'm sure.

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Post Edited (TC-LasVegas) : 3/16/2011 4:47:44 PM (GMT-6)


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 3/16/2011 4:43 PM (GMT -6)   
Wow:
 
It also sounds like he was sued quite a few times. That is BAD medicine, although I assume even good doctors have their share of lawsuits.
 
Mel

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/16/2011 4:46 PM (GMT -6)   
Mel,
I am dumbfounded. This is appalling if true. I have to reserve judgement because we depend on doctor participation at our group. These could be false charges, still.

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 3/16/2011 5:02 PM (GMT -6)   
My biopsy was done with a sealed, numbered kit (the nurse opened it in front of me) that came from Bostwick. After the biopsy she bundled all the materials into the original box and chunked them in the BioHazard bin, and packed the samples in a kit (still provided by Bostwick).
 
I thought there was an inordinate amount of show and tell, but I guess now I'm happy they did all of that in front of me.
 
I don't have a line item bill, so can't help with that.
 
Scary though. Real scary.

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 3/16/2011 6:53 PM (GMT -6)   
Tony,  From the Cone instruments web site: GE Ultasound Endocavity Needle Guide, Box of 24, $250.00.  Try this link: http://www.coneinstruments.com/ge-ultrasound-endocavity-needle-guide/p/934473/.  
 
Carlos
Dx 2/2008, age 71, PSA 9.1, G8,T1c. daVinci surgery 5/2008, G8(5+3), pT2c. LFPF, good QOL. PSA <0.1 for 2 yrs. PSA rose to .2 at 30 months, Completed SRT 2/2011. PSA 0.1 at 3 wks post SRT.

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 3/16/2011 7:05 PM (GMT -6)   
Amazing. I do not have an itemized bill for my biopsy either but this is appalling if found to be true. One would like to believe that they can trust their medical providers to deliver on the Hippocratic oath.

Don
Diagnosed 04/10/08 Age 58
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
IGRT/IMRT with adjuvant HT (lupron) 2yrs
PSA:
02/08 21.5
07/08 0.82
10/08 .642
09/09 0.32
03/10 0.32
06/10 0.32
07/10 0.10

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/16/2011 8:00 PM (GMT -6)   
More follow up...

www.8newsnow.com/story/14265683/doctors-license-suspended-for-re-using-medical-devices

In this segment, Lew Musgrove is the former CEO for UsTOO International and he was also the President of our group for 15 years until I took over a year and a half ago.

As I stated, I will keep our group neutral and place importance of supporting our affected members...

(special thanks to Mike Scott for helping with the media handling. His guidance has helped me a great deal)

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Post Edited (TC-LasVegas) : 3/16/2011 7:06:19 PM (GMT-6)


davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 3/16/2011 11:55 PM (GMT -6)   
how do they know? did a nurse snitch on him or something? Even more curious they would know that it only happened for a short period of time. I guess they can tell how many of those he buys and how many biopsies he does.

Can't believe someone bled to death after an operation like mine. Glad I didn't read that before my surgery.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 3/17/2011 7:38 AM (GMT -6)   
Would love to hear the testimonies on this in a court of law. What would the logic be from the doctors perspective, assuming this is truthful and reality of the situation? I like the original Hippo-Oath it was fatter, humbler, and had nicer teeth on it, compare the original Oath to todays versions, some morphing has happened. I hope this current incidence is not someone whom forgot to remember the Oath, and wrote his own. As Desi Arnaz would have said....(Lucy)...you have some esplaining to do????
Dx-2002 total urinary blockage from PCa, higher end stats...I think I must have been abducted by aliens probably near Area 51 and Roswell cause this disease is to alien to believe.(LOL) So I zapped at it.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/17/2011 10:16 AM (GMT -6)   
Carlos, thanks for that. But I still wonder how much one of these is billed at in the billing. Ten bucks each cost? And on the bill 100 bucks each? Something like that if anyone has it on the bill.

Here is another follow up article in the LVRJ as of this morning.

www.lvrj.com/news/patients-of-suspended-doctor-advised-to-speak-with-personal-physicians-118104909.html

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 3/17/2011 7:35 PM (GMT -6)   
This is unbelievable. There is no excuse for something like this other than unbridled greed. A ten dollar device paid for by the patient and used five times he nets $40.

Don
Diagnosed 04/10/08 Age 58
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
IGRT/IMRT with adjuvant HT (lupron) 2yrs
PSA:
02/08 21.5
07/08 0.82
10/08 .642
09/09 0.32
03/10 0.32
06/10 0.32
07/10 0.10
09/10 1.00
03/11 2.38

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 3/17/2011 7:45 PM (GMT -6)   
Don,
 
I'm sure that if a less-than-ethical doctor reuses the equipment, he likely also bills it again to each patient, so the gain would be much more than $40.
 
 
Tony,
 
I like the idea that everything used for me (except the drape sheets and the lube) came out of the sealed kit even more now. Probably costs extra to do it that way, and except for hearing such stories, we wouldn't appreciate those extra costs. Since my kit was part of a lump sum fee, I can't break out the parts.
 
Whole discussion makes you want to hope he was maliciously set up by a disgruntled employee.

don826
Veteran Member


Date Joined May 2008
Total Posts : 1010
   Posted 3/17/2011 8:04 PM (GMT -6)   
142,

You are correct but he gets that anyway. All he has avoided is the cost of four more devices at $10.00 each. Just baffling.

Don
Diagnosed 04/10/08 Age 58
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
IGRT/IMRT with adjuvant HT (lupron) 2yrs
PSA:
02/08 21.5
07/08 0.82
10/08 .642
09/09 0.32
03/10 0.32
06/10 0.32
07/10 0.10
09/10 1.00
03/11 2.38

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/18/2011 12:10 AM (GMT -6)   
Thank you everybody for your contributions. It was helpful.

Today I spoke to all major news channels, the local press, and to a bunch of this doctors patients. I will post them if you like.

Here is an interesting twist. This doctor has a great reputation in Las vegas. And the patients that were there were quick to point out that they are baffled by these things. And I am not talking about blind patients. Some of these guys knew as much as anyone here. And for our chapter, it was this doctor that asked my predecessor to start the group...

I dunno, I feel as though we need more of the final information before being judgmental.

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3742
   Posted 3/18/2011 8:07 AM (GMT -6)   
I'm doing my taxes now and have records for all the items I purchased while doing my business. I'd assume any reputable office can do the same.
With a court order, it should be no more than a simple 2 hour investigation to match the number of biopsies performed and the number of kits purchased. The compnay that sells the kits knows when and how many they shipped, and the billing department knows how many were charged.

There is also the possibility that while kits were being reused, the new kits were being sold 'off the books' to other doctors in the area at reduced cost. That investigation will add another 3 hours of research time. Check the record of the golf buddies.

The financial incentive to cheat is too high. Reuse a kit; charge insurance or the patient full price; sell the replacement kit to another doc. This sounds a bit like the recent Russian Medicare fraud operations.

By the way, when I had my biopsy, all the goodies were opened beforehand and laid out on the work table with a drape over them. I never considered that they might be new or used. Like everyone else on the table before me all I was concerned about was getting through the procedure and receiving good results.

Jeff
Age: 58, Mar 35 yrs, 56 dx, PSA: 4/09 17.8 6/09 23.2
Biopsy: 6/09 7 of 12 Pos, 20-70%, Gleason 4+3 Bone, CT Neg
DaVinci RP: 7/09, U of Roch Med Ctr
Path Rpt: Glsn 3+4, pT3aNOMx, 56g, Tumor 2.5x1.8 cm both lobes and apex
EPE present, PNI extensive, Sem Ves, Vas def clear, Lymph 0/13
Incont: 200ml/day ED: Trimix
Post Surg PSA: 10/09 .04, 4/10 .04, 7/10 <0.01, 12/10 <0.01
AdVance Sling 1/10/11 Dry

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 3/18/2011 10:31 AM (GMT -6)   
I have to agree (already did) with Tony that there might be something else here - bad blood with an employee, etc.
 
Also, the accounting trail is a good point.
 
But I have to ask about the idiocy of risking a career and personal fortune over such a minimal amount of money (at least in comparison to the overall money involved in a medical practice). When I've see good doctors close up shop and retire, it is often because of the risks of legal actions and the long term impact on their personal lives.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/18/2011 10:58 AM (GMT -6)   
This doctor is prominent in the community and had a positive reputation in the community for over 20 years. It's kinda hard to believe that he did it ten bucks at a time. But if you read the article it is just the last 4 months that he switched to the disposable version of the tool. Prior he was using the steel version that can be reused. Maybe a misunderstanding? He did not deny anything to the investigators so a cover up was not present.

Wow, what a busy day. I know our local paper, the Review Journal, is writing a story for the Sunday edition that will include our group. The reporter was present during the entire meeting and said he was impressed by our group. He has written on other groups before so I thought that was a nice comment...

I can't wait for the Sunday paper...(online or otherwise)

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/18/2011 11:04 AM (GMT -6)   
I can only speak for the legal system here in SC, but we live in state that has a strong enforcement of old school "breech of trust" laws. If this doctor was doing all this, he could be indicted on breech of trust, one count for each occurance, and depending on the value of the stuff he's "re-selling", would have additional charges of either petty or grand larceny. In my opinion, its beyond money and greed, it speaks volumes of major ethical and character flaws.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 2/11 1.24
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10,

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/18/2011 11:47 AM (GMT -6)   
David the laws are even stricter here than anywhere in the country, so I'm told..

Amazingly, we just had one of the biggest medical headlines in the country come to a close in the Dipak Desai case mentioned in the article. He was admitted into the state hospital after being declared unfit for trial after reusing needles at an endoscopy clinic.

I am not certain if this will end up in criminal court, I think that is still out there. I will say that his license was suspended and not revoked ~ at least as yet. I guess we'll have to wait for more data and that's what I am cautioning everybody about.

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/18/2011 12:22 PM (GMT -6)   
In this state, he would be up on criminal charges immediately, and would probably lose his license and credentials as well.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 2/11 1.24
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10,

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/18/2011 12:25 PM (GMT -6)   
I would hope there is due process involved, David. i would hate to live where law is executed on knee jerk reactions.

The investigation is ongoing. I am certain if criminal charges are necessary they will be applied when the entire case in analyzed and not a moment sooner. The license was suspended in hours seemingly while the investigation continues so he stopped seeing patients.

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/18/2011 12:50 PM (GMT -6)   
Tony, of course there would be due process, I am working on the assumption that all these allegations were found to be true.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 2/11 1.24
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10,

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3892
   Posted 3/18/2011 1:22 PM (GMT -6)   
According to his website, Kaplan is a board-certified urologist with subspecialty training in urologic oncology. He attended the Baylor College of Medicine in Houston and completed both his internship and residency at Letterman Army Medical Center Presidio of San Francisco.

Kaplan has been a defendant in at least nine medical malpractice cases since 1995, the most recent coming in 2007, according to District Court records.

In that case, a woman sued the doctor after her husband bled to death following a 2006 operation to remove his prostate.

According to the lawsuit, a robot Kaplan used to help in the procedure mistakenly cut an artery and vein, causing massive loss. The case was dismissed two years later after an apparent settlement.

In a 2002 case, a woman sued Kaplan after he operated on the wrong side during a 2001 surgery to fix an obstructed ureter, which connects the kidney to the bladder. During a follow-up surgery two weeks later, he mistakenly punctured the woman's bowel, she alleged.

The woman settled her lawsuit against Kaplan for a total of $1.25 million, according to medical board records.
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