A New York state oncologist has been accused of gross negligence and incompetence allegedly related to the deaths of six patients.
Charges were filed by the New York State Department of Health against radiation oncologist Won Sam Yi, MD, who was the former chief executive officer of the now-defunct private cancer practice CCS Oncology. The charges could result in the loss or suspension of Yi's medical license, and he could face fines and other sanctions.
Yi will now have to appear before the state medical board's Office of Professional Medical Conduct and answer to administrative charges of gross negligence, gross incompetence, negligence on more than one occasion, incompetence on more than one occasion, and failure to maintain treatment records in connection with seven patients, six of whom have died.
According to the charges filed by the state, on several occasions, Yi failed to "account for prior doses of radiotherapy" as well as exceeding "appropriate tissue tolerances" during the treatment.
He has also been accused of failing to consider alternative treatment strategies and not maintaining records that accurately "[reflect] the evaluation and treatment of the patient."
CCS Oncology's Troubled History
Located in western New York state, CCS Oncology was once one of the largest private cancer practices in Erie and Niagara counties. Yi purchased CCS Oncology 10 years ago and was its sole shareholder, and in 2012 he also acquired CCS Medical, according to a report in the Buffalo News.
As of 2016, the practices provided care to about 30% of cancer patients in the region, and in addition, CCS also began acquiring other practices as it expanded into noncancer specialties, including primary care.
Yi typically agreed to pay "good will" and a set salary to the growing number of physicians who came on board at CCS.
However, CCS began to struggle financially in late 2016, when health insurance provider Independent Health announced it was removing CCS Oncology from its network, according to the Buffalo News. Several vendors and lenders subsequently sued CCS and Yi for nonpayment.
The announcement from Independent Health was reported to be "financially devastating to CCS," and also was "the direct cause" of the practice defaulting on its Bank of America loan and of the practice's inability to pay not only its vendors but state and federal tax agencies.
CCS ultimately owed millions of dollars to its vendors and in unpaid taxes. Earlier this year, a federal district court judge allowed Bank of America to seize the practice's assets, as CCS owed more than $16 million in debt to the bank, according to news reports.
The situation continued to deteriorate when the Federal Bureau of Investigation (FBI) raided CCS a week later, last March, following a three-year investigation by the government into possible billing fraud at the practice, the Buffalo News reported.
Robert Trusiak, the attorney for CCS and a former assistant U.S. attorney who prosecuted fraud cases, said that the FBI investigation did not involve quality of care. "It doesn't concern anything concerning medically unnecessary, invasive treatment. It's a billing dispute," he was quoted as saying in the Buffalo News.
The 3-year FBI investigation reportedly focussed on allegations that CCS Oncology may have defrauded taxpayers out of millions of dollars. The practice denied wrongdoing in news reports, and no charges have been filed against CCS or its executives, including Yi.
In 2016, a whistleblower filed a related civil lawsuit, alleging that physicians and other staffers had engaged in widespread fraud and other misconduct, including billing for more expensive procedures than were actually performed, billing for procedures that never were performed, and performing medically unnecessary procedures on patients. The whistleblower lawsuit remains under seal.
Shortly after the FBI raid, CCS filed for Chapter 11 bankruptcy, and a few weeks later closed the practice. The company continues to go through the bankruptcy process.
Gross Negligence and Incompetence
In addition to the financial woes and allegations of fraud, Yi now faces a new barrage of accusations, including gross negligence and incompetence.
The Department of Health’s claim is closely aligned with lawsuits that were filed by former patients or their estates, which allege that Yi and CCS Oncology provided inadequate treatment.
The state of New York is now accusing Yi of misconduct in the treatment of seven patients ranging in age from 27 to 72 years who were cared for at CCS between 2009 and 2013.
In one case, Yi is accused of providing whole-brain radiation therapy to a 43-year-old woman for about 6 weeks in 2012, even though it was "contrary to medical indications" and without taking into account the previous doses of radiation that she had received. The patient died on December 20, 2012.
A second case involved a 72-year-old man who had received radiation therapy in 2009 for prostate cancer that exceeded commonly prescribed doses for his disease and without considering alternative treatments. The patient was also treated with radiotherapy to his right jaw from August to September 2011, "despite lacking clear radiographic evidence that [the patient] was even experiencing metastatic disease at the site." The state points out that this treatment regimen also didn't take into account previous radiation therapy and "thus exceeded appropriate tissue tolerances." This patient died on March 14, 2012.
Seven lawsuits, filed by the patients or families, have been levied against CCS Oncology or its affiliates, but it is unclear as to the amount of overlap, if any, that exists between their lawsuits and state charges.
A hearing was scheduled before a committee on professional misconduct in September, but it has not been made public if Yi faces any punishment. The New York Department of Health declined to comment on anything that is beyond what is included in the public documents.
Efforts to reach Yi or a representative for comment were unsuccessful.
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Cite this: Radiation Oncologist Charged with Gross Negligence, Incompetence - Medscape - Dec 07, 2018.
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