Former medical director, cardiologist sues Cape Cod Healthcare claiming 'unethical practices'

EDITOR'S NOTE: A correction was made on Dec. 12, 2022, to a caption of a photograph.

HYANNIS — A former cardiologist and medical director at Cape Cod Hospital has filed a lawsuit against Cape Cod Healthcare, alleging he was fired after blowing the whistle on the hospital’s allegedly unethical practices that prioritized profit over patients’ care.

Dr. Richard Zelman, 64, is an interventional cardiologist and surgeon who has been affiliated with Cape Cod Hospital since 1990. He was hired full-time in 2006 and became the medical director of the hospital’s Heart and Vascular Institute in 2018.

According to a lawsuit filed in Barnstable Superior Court on Tuesday, Zelman claims his employment was terminated in September after blowing the whistle on the hospital’s allegedly unethical practices.

The lawsuit states that in 2019, the hospital’s CEO Michael Lauf didn’t allow patients with Medicare or Medicaid insurance to use “Sentinel Devices,” instead prioritizing patients whose insurance reimbursed the hospital at higher rates. Sentinel Devices filter out stroke-causing debris during a transcatheter aortic valve replacement, according to the lawsuit.

Although Lauf eventually conceded to Zelman’s concerns, the lawsuit says, Zelman faced retaliation for his actions including an investigation into his performance.

Cape Cod Healthcare denies Zelman's claims

Cape Cod Healthcare officials declined a request for an interview but in a statement to the Times on Thursday, the hospital denied all of Zelman’s claims, especially that they retaliated against him for raising patient safety issues.

“We value and support the many dedicated physicians, nurses and other staff members who care for our cardiology patients every day. This litigation is unfortunate and the allegations are a disservice to the hard work of these professionals,” the statement said.

The hospital also points out that it has won several awards for patient care including the 2021 Patient Safety Excellence Award.

Zelman is now in private practice in Hyannis but still retains privileges at Cape Cod Hospital.

Concerns about other cardiac surgeons at Cape Cod Hospital

In 2021, Zelman reported two cardiac surgeons at the hospital had caused preventable patient deaths, among other negative outcomes. This included three post-operative deaths on low-risk candidates who were supposed to have uncomplicated surgeries, a fourth patient died as a result of their life support tube, which was sutured in place by one of the surgeons, falling out during transport to another facility, according to the lawsuit.

He also accused the two surgeons of leaving the hospital premises when they were expected to be present for scheduled procedures.

Zelman claims in the lawsuit that "Lauf referred to a number of 'botched' procedures by the cardiac surgeons and stated the '15% mortality rate from the cardiac surgeons is unacceptable,' or words to that effect."

"Proficient cardiac surgeons have a 1-2% mortality rate," according to the lawsuit.

Zelman reported his concerns about the cardiac surgeons to Lauf and Chief Medical Officer Dr. William Agel, though they did not take steps to protect patients, according to the lawsuit. The cardiac surgeons worked at Cape Cod Hospital but were employed by Brigham and Women’s Hospital so Lauf deferred to that hospital for oversight of the surgeons, according to the lawsuit,

Zelman's lawsuit claims Lauf did not take action due to "the potential substantial lost revenue."

In February one of the two Brigham and Women's cardiac surgeons working at Cape Cod Hospital was suspended after he brought an unloaded rifle onto the hospital campus in Hyannis. He was later terminated for the automatic rifle incident, according to the lawsuit.

Zelman eventually took his complaints to a representative of the Brigham and Women’s Hospital after he said Lauf and Agel did not respond adequately to his concerns, according to the lawsuit.

After taking his complaints directly to the Boston hospital, Brigham and Women’s self-reported billing irregularities to the Centers for Medicare and Medicaid Services, which included the cardiac surgeons’ failure to properly document their participation in transcatheter aortic valve replacement procedures with Zelman, according to the lawsuit.

This resulted in the Brigham and Women’s Hospital refunding the Centers for Medicare and Medicaid Services for six years' worth of transcatheter aortic valve replacement costs, according to the lawsuit.

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“We have been made aware of Tuesday's court filing and are reviewing its contents," Brigham and Women's Hospital said in a statement to the Times. "As health care providers, patient safety is our first priority and we regularly review our care to ensure it meets the highest quality standards.”

When Brigham and Women's refunded money to the Centers for Medicare and Medicaid Services, it increased the risk of Cape Cod Hospital also having to provide refunds, according to the lawsuit. Cape Cod Hospital’s legal counsel told Zelman that Brigham and Women’s Hospital chose to self-report billing irregularities out of fear of Zelman’s whistleblower activities, according to the lawsuit.

Zelman was informed his employment would be terminated shortly after Cape Cod Hospital found out Brigham and Women’s Hospital would be refunding Centers for Medicare and Medicaid Services, according to the lawsuit. However, Lauf was willing to allow Zelman to continue his employment if Zelman agreed to sign a contract that would force him to be silent on patient safety issues.

Zelman refused.

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“Over the past 25 years, I have been instrumental in bringing advanced cardiac care to Cape Cod. My commitment has always been to deliver the same quality, outcomes and safety as the academic centers in Boston," Zelmen wrote in a statement issued to the Times on Thursday.

"Unfortunately, over the past five years, there has been inadequate oversight by the hospital administration and problems have occurred that in my opinion have led to serious patient consequences. I have voiced concerns over several years and they have been ignored," the statement continued.

"Cape Cod Hospital offered me a million-dollar contract if I agreed to immediately issue a written statement endorsing the quality and safety of the cardiac surgical program that no longer exists. No amount of money was going to buy my silence,” Zelman in the statement.

Cape Cod Healthcare joins Beth Israel Lahey Health

Cape Cod Healthcare owns and operates Cape Cod and Falmouth hospitals, rehabilitation centers, an assisted living facility and outpatient health centers, including six urgent care centers, according to its LinkedIn profile. The company touts itself as the Cape’s leading provider of home care and hospice services and the only local laboratory service, according to the profile.

In January Cape Cod Healthcare officials announced that they have entered into a clinical affiliation with health care giant Beth Israel Lahey Health to expand access to comprehensive care for Cape residents and visitors

Under the agreement, Beth Israel Lahey Health provides cardiac surgeons in place of Brigham and Women’s Hospital in Boston, which has partnered with Cape Cod Hospital’s open-heart program since its inception in 2002.

Contact Asad Jung at ajung@capecodonline.com. Follow him on Twitter: @asadjungcct.

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This article originally appeared on Cape Cod Times: Cape Cod Healthcare accused of 'unethical practices' in doctor lawsuit