UnitedHealth Unit Accused of Failing to Monitor Doctor

A UnitedHealth Group Inc. unit put money ahead of people by failing to properly monitor a Las Vegas doctor who gave colonoscopy patients hepatitis C by mishandling the anesthetic Propofol, a lawyer told a state court jury.

UnitedHealth’s Health Plan of Nevada subsidiary didn’t provide adequate oversight of Dipak Desai, a gastroenterologist accused of infecting patients with hepatitis C by employing substandard medical practices, because it wanted to hold down costs to boost revenue, Robert Eglet, an attorney for women who contracted the disease, told a Las Vegas jury today.

The insurer’s “primary concern was profit, not safety,” Eglet said in closing arguments at the case filed by two of Desai’s former patients.

The trial is the first against the unit of Minnetonka, Minnesota-based UnitedHealth over the 2007 hepatitis C outbreak linked to Desai’s practices. Patients contend the outbreak was tied to Desai’s reuse of vials of Propofol, an anesthetic used in colonoscopies, and failure to sterilize equipment. Nevada officials were forced to notify 50,000 patients they may have contracted the potentially fatal blood disease from Desai’s actions.

‘Attorney Greed’

Lawyers for Bonnie Brunson and Helen Meyer, the two former patients of Desai suing the insurer for allegedly failing to properly vet the doctor and his practices, said in jury selection that they may ask jurors to award $1 billion in punitive damages over the UnitedHealth unit’s lack of oversight. They are seeking more than $25 million in compensatory damages.

Lee Roberts, a lawyer representing the insurer, told jurors today that Brunson’s and Meyer’s attorneys hadn’t produced any evidence that the company failed to provide proper oversight of Desai.

“The sheer weight of unsupported allegations cannot make up for the lack of evidence and proof,” he said in his closing statement.

The insurer’s officials said on a website created to provide information about the trial that they believed Brunson’s and Meyer’s cases were being “driven only by attorney greed.”

Nevada juries already have handed down multimillion-dollar punitive awards against Teva Pharmaceutical Industries Ltd., which made the Propofol used by Desai. Three juries awarded colonoscopy patients more than $750 million in punitive damages over the drugmaker’s decision to sell the anesthetic in oversized vials that could be reused.

Teva, based in Petach Tikva, Israel, agreed last year to pay $250 million to settle more than 80 lawsuits over Propofol sales.

Murder Charges

Desai, 62, and two nurse anesthetists are facing second-degree murder charges over the death of a colonoscopy patient. The former doctor also faces federal fraud charges.

Meyer and Brunson are suing under a Nevada law that requires HMO officials to file annual reports showing they have reviewed the quality of health services provided to consumers covered by their plans.

Jurors will be asked to decide whether officials of the UnitedHealth unit knew Desai had a reputation for sloppy practice before giving him a contract to handle colonoscopies and then didn’t check the quality of his work. At one point, Desai was a member of Nevada’s Board of Medical Examiners, which oversees the licensing of doctors in the state.

The plaintiffs contend the insurer didn’t properly monitor Desai’s practices and procedures even though they received complaints about his operation.

During the trial, witnesses said Desai adopted a cavalier attitude toward patient safety, speeding through procedures so he could see as many as 20 patients in a three-hour period.

Nine Minutes

Performing colonoscopies every nine minutes left no time to properly sterilize equipment between procedures and didn’t provide proper recovery time for patients, Melvin Hawkins, a former operating-room technician who worked with Desai, told jurors, according to court transcripts.

Eglet said today internal memos from Desai’s practice showed the doctor trained his staff to move patients through quickly. That help boost profits for Desai and the insurer, he added. “Quick patient turnaround was their priority, not patient care,” he added.

The UnitedHealth unit’s executives had an obligation to insure Desai was providing quality care to their members and could have reviewed his operations at any time.

‘Right to Inspect’

“They had the right to inspect at any time they wanted, but they never” visited Desai’s clinic, he added.

Lee countered in his closing argument it wasn’t reasonable to hold Health Plan of Nevada officials liable for Desai’s bad medical practices.

“The question is not what we know now, but what we did back then” in deciding to give Desai the colonoscopy contract in the Las Vegas area, Roberts said. He argued the insurer properly reviewed Desai’s work and credentials at the time it hired him.

The company contends in court papers health insurers shouldn’t be responsible for providing full-time monitoring of physicians hired as part of an HMO network. It noted that Desai had been credentialed at several Nevada hospitals when it hired him.

The case is Meyer v. Health Plan of Nevada Inc., A5837999 (Consolidated), Clark County District Court (Las Vegas).

(Updates with defense argument in sixth paragraph.)
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