Could local and federal prosecutors ask clinical laboratories to disclose information on their client physicians’ test-ordering activities when investigating medical errors?

Are physicians facing greater risk of criminal indictments when one of their patients dies, and investigators find that physician impairment or inappropriate medical treatments contributed to the patient’s death? Could clinical laboratories be drawn into federal investigations of their client physicians?

The healthcare industry is responding to often highly-publicized accusations of alleged wrongful care with extensive investigations of the doctors involved. And following suit, local and federal prosecutors increasingly seem willing to bring criminal charges against those physicians.

Thus, it behooves clinical laboratories to be aware of client physicians who may be over-ordering lab tests or regularly ordering inappropriate tests for their patients. At what point might criminal investigators hold medical laboratories accountable for not notifying authorities about lab test utilization patterns by physicians who could be reasonably understood to be putting their patients at risk of harm?

Doctors Charged in Three Cases Involving Deaths of Patients

In two separate reports, Fierce Healthcare covered three pending cases in which doctors are being charged in the deaths of their patients: article one covers a case is in Ohio; and article two covers cases in Arkansas and California. Charges were filed against:

  • William Husel, DO, an Ohio critical care specialist who was indicted for 25 counts of murder for allegedly intentionally ordering fatal drug overdoses, according to a statement by the Franklin County Prosecuting Attorney. He pleaded not guilty, the Associated Press reported.
  • Robert Levy, MD, an Arkansas pathologist who was indicted by a federal grand jury on “three counts of involuntary manslaughter” in the deaths of three patients, according to a statement by the US Attorney’s Office for the Western District of Arkansas. Levy pleaded not guilty at an arraignment in August, the Washington Post reported.  
  • Thomas Keller, MD, a California neurosurgeon who was indicted in the deaths of five patients, which allegedly resulted from his overprescribing opioids and narcotics, according to a statement from the State of California Department of Justice. Keller pleaded not guilty to second-degree murder charges in Sonoma County Court, according to the Press Democrat.
US Representative Bruce Westerman, R-Ark. (above) told the Washington Post, “Of all the medical professionals, the person you really don’t want messing up is a pathologist. If you have cancer, you want to know about it. If you don’t have it, you don’t want to be treated for it.” (Photo copyright: United States Congress.)

Dark Daily’s sister publication The Dark Report (TDR) covered the year-long investigation of Arkansas Pathologist Robert Levy, MD, by the US Attorney’s Office for the Western District of Arkansas. (See TDR, “Arkansas Pathologist Faces Three Manslaughter Charges,” September 30, 2019.)

Levy served as the Chief of Pathology and Laboratory Medical Services for the Veterans Health Care System of the Ozarks in Fayetteville, Ark., from 2005 through 2018.

In a statement, the US Attorney’s Office Western District of Arkansas said, “A federal grand jury … indicted Levy on twelve counts of wire fraud, twelve counts of mail fraud, four counts of making false statements in certain matters, and three counts of involuntary manslaughter.”  

A fact-finding panel interviewed Levy in 2015 after reports that he was under the influence of alcohol while on duty, stated the US Attorney Arkansas, adding that Levy denied the allegations.

In addition to other charges, the US Attorney Arkansas statement said, “The indictment charges Levy with three counts of involuntary manslaughter for causing the death of three patients through entering incorrect and misleading diagnoses and, on two occasions, by falsifying entries in the patients’ medical records to state that a second pathologist concurred with the diagnosis Levy had made. The indictment alleges that the incorrect and misleading diagnoses rendered by Levy caused the deaths of three veterans.”

In a news conference covered by the Washington Post, Duane Kees, US Attorney for the Western District of Arkansas, Department of Justice (DOJ), said, “I don’t think anyone would ever have imagined that a pathologist would use his knowledge and expertise to do something like this.”

Clinical laboratory leaders know how important it is to have quality processes to prevent misdiagnosis, mistakes, and inappropriate test utilization. Now, lab leaders may want to be aware of the activities of their client physicians as well.

During investigations involving harm to patients allegedly at the hands of healthcare providers, information kept by medical laboratories about the lab test ordering practices of their client physicians may become an important resource to officials conducting inquiries.

—Donna Marie Pocius

Related Information:

In California and Arkansas, Two Doctors Charged in Patient Deaths Over Opioid Prescriptions, Misdiagnosis

Ohio Doctor Charged with Murder in Deaths of 25 Hospitalized Patients

Attorney General Becerra Announces Arrest and Charges Against Santa Rosa Doctor

Santa Rosa Doctor Pleads Not Guilty to Murder Charges Connected to Four Patient Deaths

Dr. William S. Husel Indicted for 25 Counts of Murder in Mount Carmel Hospital Patient Deaths

Doctor Accused of Murder in 25 Patient Overdose Deaths

Fayetteville Doctor Arrested on Charges of Wire Fraud, Mail Fraud, Making False Statements, and Involuntary Manslaughter

Former VA Physician Charged with the Deaths of Three Veterans

Pathologist’s Errors Associated with Deaths at Arkansas VA

Pathologists Faces Three Manslaughter Charges