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Baylor St. Luke’s Medical Center, Baylor College of Medicine and the medical practice group Surgical Associates of Texas P.A. have agreed to pay a record $15 million to resolve allegations they violated Medicare regulations by running multiple “complicated and risky” heart surgeries at the same time, the U.S. Attorney’s Office announced Monday.
The alleged violations involve Dr. Joseph Lamelas and Dr. Joseph S. Coselli, two nationally-renowned heart surgeons and teaching physicians at Baylor St. Luke’s Medical Center. Lamelas, the Chief and Program Director of Cardiothoracic Surgery at the University of Miami, is considered a pioneer of minimally invasive heart surgery; Dr. Joseph S. Coselli is the chief of Baylor’s cardiothoracic surgery division and served as the 96th president of the American Association for Thoracic Surgery.
The investigation into Lamelas, Coselli and a third physician, Dr. David Ott, launched in 2019 following a whistleblower complaint. The whistleblower claimed the three surgeons routinely oversaw two “extremely complicated and risky” heart surgeries in separate operating rooms simultaneously, federal documents show. To complete the concurrent surgeries, the physicians regularly delegated “key aspects” of the procedures to unqualified medical residents, according to the DOJ’s Monday release.
Medicare regulations require teaching physicians to remain in the operating room for certain parts of any surgical procedure. Federal investigators say Lamelas, Coselli and Ott made a practice of violating a number of these regulations – and, in certain cases, attempted to conceal their activities by falsifying medical records with claims they were physically present throughout the operations at issue.
Lamelas and Coselli did not respond to the Landing’s multiple requests for comment.
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“We have proven, using hospital records and operating room timelines, that I was in the operating rooms and did the operations that I claimed and, therefore, have done nothing wrong,” Ott told the Houston Chronicle Monday.
An employee at his Houston practice told the Landing Ott is currently retired from active practice.
Federal investigators said the doctors sidestepped rules when they needed to be present for the life-saving surgeries.
“Patients entrusted these surgeons with their lives – submitting to operations where one missed cut is the difference between life and death,” U.S. Attorney Alamdar S. Hamdani said in a statement. “Allegedly, the patients were unaware their doctor was leaving for another operating room. This settlement reaffirms the importance of Medicare requirements governing surgeon presence and ensuring that no physician – no matter how prominent or successful – can skirt around the rules.”
Baylor College of Medicine defended its operations.
“Baylor College of Medicine did not engage in conduct that violates any applicable federal law or regulation. It is also important to note that no patients were harmed,” college spokespersons said in a statement provided to Houston’s KHOU 11. The settlement agreement acknowledges that Baylor College of Medicine disputed that any federal laws were violated, Baylor spokespersons added in their statement to KHOU 11.
The $15 million settlement is the largest involving simultaneous surgeries to date, according to the U.S. Attorney’s Office.
Lamelas worked at Baylor College of Medicine for two years as associate chief of cardiac surgery after joining the college’s surgery department in 2017. He is professor and chief of cardiac surgery at the University of Miami Health System’s Division of Cardiothoracic Surgery and has trained 800-plus physicians in minimally invasive cardiac surgery techniques over the past 14 years, according to the University of Miami’s Miller School of Medicine website.
Coselli serves as professor and chief of Baylor College of Medicine’s Cardiothoracic Surgery Division and chief of Adult Surgery at the Texas Heart Institute.
Ott has served as the Surgeon-in-Chief at the Texas Heart Institute and is regarded as “one of the world’s most experienced heart surgeons,” with over 20,000 heart and vascular operations to his name, according to the Texas Heart Institute.
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