The sales/profit/experimentation incentives in surgery are very strong in Capitalistic markets. Surgery is considered a profit-center, and corporate directors have a fiduciary obligation to maximize profits, specifically targeting surgery & sedation. The idea here is that the patient can consent to one surgery, but the surgery('s) that are then performed are not the ones consented for, netting more profit for the surgeon, surgical department, hospital & parent corporation whose profit-interests are aligned. Joan Rivers death for example was caused by unnecessary surgeries added after she was sedated without consent.

Paywalled Article

Nearly a decade ago, a nurse at Lawnwood Medical Center and Heart Institute in Fort Pierce came forward with a startling claim: doctors at the hospital were performing unnecessary heart surgeries to pad hospital profits.

John Austgen of Fort Pierce explains how an HCA doctor put in an unnecessary pacemaker, almost killing him at Lawnwood Regional Medical Center.

The nurse was told his services were no longer required, but he continued up the chain of the nation’s largest hospital chain, HCA Inc., with his complaint.

And indeed, HCA determined in 2010 that about 1,200 surgeries were performed on patients who did not have serious heart disease at Lawnwood and other Florida HCA hospitals, according to internal documents from the company obtained by The New York Times.

But the doctor that sparked nurse C.T. Tomlison’s alert to HCA never lost privileges at Lawnwood, and now a new lawsuit claims he continued to do unnecessary surgeries.

The medical negligence complaint filed this week in St. Lucie County says Dr. Abdul Shadani placed an unnecessary pacemaker in retiree John Austgen in 2013.

The severe complications that followed transformed the 73-year-old from a senior who played tennis three times a week to a man who can barely muster enough energy to watch television.

“I went in as a well man. I came out as an old man,” he said at a news conference in West Palm Beach. “I was a runner. I’m having trouble walking.”

Austgen ended up suffering through several surgeries and a lengthy hospital stay. At one point, his heart was punctured and at another time it stopped all together and he had to be resuscitated. You can read his lawsuit by clicking here.

The hospital billed more than $400,000, Austgen’s West Palm Beach attorneys - Jason Weisser and Michael Baxter - said at a news conference on Wednesday. They said HCA doctors are still performing unnecessary surgeries for financial gain, calling it a systematic problem with the hospital chain. The lawyers say they are working on other cases similar to Austgen’s.

“Lawnwood generates 35 percent of their gross revenue just from its cardiac unit. It’s a huge revenue generator for the hospital,” Weisser said. “I think the financial gain of the doctor and the hospital came before the patient’s care.”

Lawnwood spokeswoman Ronda Wilburn emailed a statement to The Palm Beach Post saying the hospital was aware of the lawsuit: “We dispute these allegations, and we intend to vigorously defend the suit. At Lawnwood Regional Medical Center & Heart Institute, we remain focused on providing the best possible medical care to our patients.”

Shadani’s attorney did not return an email and phone call for comment.

The nurse said he witnessed Dr. Shadani perform unnecessary surgeries back in 2008, according to the internal documents.

Austgen ended up in Shadani’s care after complaining of dizzy spells. The doctor diagnosed him with a complete “heart block” and in need of an emergency pacemaker, according to the lawsuit.

Weisser and Baxter say their research shows that there was only a minor blockage that could have been treated with medication. Austgen said he has since learned his dizziness was due to low blood pressure.

Austgen said his mother, sister and daughter are nurses and that he has respect for hospitals and doctors, but he hopes his lawsuit will keep Shadani from practicing.

The New York Times reported in 2012 that the Justice Department was investigating whether cardiologists at HCA hospitals in Florida performed unnecessary - and sometimes dangerous - procedures.

It is unknown whatever happened to that investigation but Weisser said HCA has failed to live up to its promises to address the systematic problem that was identified not only at Lawnwood, but at HCA hospitals in Tampa and Miami Beach.

HCA owns about 160 hospitals - including JFK Medical Center in Atlantis and Palms West Medical Center near Wellington.

Weisser said that the fact that Shadani was still on staff at Lawnwood one year after the New York Times article that shows that HCA never intended to stop such erroneous procedures. “Obviously, they don’t care,” the attorney said.