New Jersey insurance fraud officials are investigating a Fort Lee pain treatment center linked to two patient deaths, said a spokesman for state Attorney General Peter C. Harvey.
The spokesman, John Hagerty, declined to elaborate, but a source close to the investigation said the state will try “to determine the nature and cause” of the deaths. Investigators are also examining the Fort Lee Surgery Center’s records, patient charts and billing practices “to see whether the treatments provided to a large number of patients were medically necessary.”
The New Jersey Board of Medical Examiners, the state Department of Health and some insurance companies have joined the Office of the Insurance Fraud Prosecutor in what the source called a “multi- pronged, multi-focused” investigation.
At the same time, the family of one of the center’s patients – a 47-year-old New Brunswick man who was paralyzed in March after doctors gave him an injection for neck and back pain – sued the center Tuesday, claiming negligence.
“He went to Englewood Hospital as a quadriplegic, after having walked into the Fort Lee Surgery Center,” the family’s lawyer, Roy J. Konray of Rahway, said of Stephen A. Cromedy. “He left [Fort Lee] on a stretcher, unable to move his arms or legs, and able to just blink his eyes.”
Cromedy died two weeks later.
State Health Department officials closed the center, at 1608 Lemoine Ave., in April following Cromedy’s death. The center was cited for not notifying the state of the incident and for code violations, including sanitation and supervision. At the time, Deputy Health Commissioner Marilyn Dahl said the center presented “a life-threatening emergency, and an ongoing and immediate risk of harm to the public.”
In 2002, health officials cited the center for waiting five hours to call an ambulance after a North Bergen man turned blue and unresponsive.
Like Cromedy, that patient also had received a cervical epidural – a needle injection of steroids in the neck.
In such a treatment, “death is essentially unheard of,” said Dr. James Rathmell, an anesthesiologist and authority on cervical epidural procedures. At worst, patients face a remote risk of minor injury from the procedure, said Rathmell, director of the Center for Pain Medicine at the Fletcher Allen Health Care main hospital at the University of Vermont in Burlington.
Two owners studied
The state’s investigation is focusing on two of the five owners listed on the center’s licensing application: Dr. Ulises Sabato, an Englewood neurologist, and Dr. Sri Kantha, a Madison anesthesiologist, the source said.
State fraud investigators are examining the number of diagnostic tests such as MRIs and EMGs – electromyograms, which measure muscle nerve function – to see if the center “generated other tests and billings for procedures never performed,” the source said.
“We’re looking at potential false billings to the Medicaid program and to insurance companies,” the source said.
Auto insurer Allstate New Jersey is cooperating with the state’s investigation, said a spokesman, Manuel Goncalves.
“We are very, very familiar with the Fort Lee Surgery Center, Dr. Kantha and Dr. Sabato,” Goncalves said.
“Over the past several years, Allstate New Jersey has identified significant diagnostic testing abuses in New Jersey,” he said. Those cases involved abuses of the auto insurer’s personal injury protection coverage.
“This case is no different,” Goncalves said.
The Fort Lee Center reflects a pattern in North Jersey in which attorneys, chiropractors or physicians refer patients, particularly auto accident victims, usually to a handful of non-board-certified neurologists who order unnecessary numbers of expensive tests and procedures, according to a doctor who reviews nearly 1,000 such cases in the state each year at the request of insurance companies.
“This then leads to a cycle of treatment, referrals and testing … and concludes with tremendous expenses and certifications of permanent injury with which the attorney can press his lawsuit,” he said.
Each cycle of testing, treatment and referrals can end up costing $10,000 to $50,000 per patient, he said.
Thousands treated
The center is also known as the Fort Lee Surgery and Medical Center and the Fort Lee Institute for Minimally Invasive Spine Surgery and Interventional Pain Management. In an interview this spring, Sabato said the center has treated “tens of thousands of people.”
Sabato and Kantha could not be reached for comment Tuesday. Steven R. Antico of Hackensack, a lawyer who represents the center, said he had not heard about the state’s investigation. He had no comment on the Cromedy family’s lawsuit.
That lawsuit, filed in state Superior Court in Hackensack, charges that “combined negligence” caused Cromedy “extreme disability, pain, fear and anguish before dying,” as well as his death.
Cromedy, a machinist and grandfather, sought treatment in March for lingering neck and back pain from an auto accident in 2004, Konray said.
But the injection, allegedly administered by Kantha, left Cromedy totally paralyzed. He was taken to Englewood Hospital and Medical Center, where he spent about two weeks on a respirator at Englewood and died there of a pulmonary embolism, or blood clot, Konray said.
According to the lawsuit, the center also broke “many promises” to correct “dirty and unsanitary conditions” cited by several state health inspections between 1998 and 2005.
The center’s medical director, who is not named, is not certified by the American Board of Medical Specialists, as required by state law, the suit charges. Kantha is described by the center’s Web site as “world renowned,” but he “is not board-certified in pain medicine, anesthesiology or any other specialty,” the suit says. The center also failed to have a board-certified physician to review credentials of the doctors who worked there, it says.
“The closer I look, the more I see a trail littered with broken promises and dead bodies,” Konray said. “This is shocking because they have been so consistently cited by the state for violations. … So this is not an isolated incident.”
Doctors at the center are also being sued by the family of Ericberto Ortiz, a 28-year-old North Bergen man injured in an auto accident, who also died at Englewood Hospital following pain treatment at the center.
In another pending suit against the center and Kantha, Angela Levi claims that she was fired as a surgical technician there for refusing to take patient X-rays, a job she was not licensed to perform.
Attorneys for the doctors deny claims in both lawsuits.
Although the surgery rooms are closed, doctors’ offices in the same building remain open. The surgery center is working on a plan of correction before the state will allow it to reopen, Jennifer Sciortino, a spokeswoman for the state Department of Health, said Tuesday.
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Staff Writer Ben Lesser and Librarian Leonard Iannaccone contributed to this article.
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