As a Houston, Texas medical malpractice lawyer, I have had a lot of cases involving end-of-life and hospice care. While for most patients and families, this type of care is compassionate, helpful, and appreciated. In other instances, healthcare providers suggest hospice care for selfish reasons.
Frisco, Texas hospice debacle
In May 2018, a hospice executive in Frisco, Texas admitted to her role in overdosing patients to “hasten their deaths.” According to court documents, an operations director for Novus Health Services, Inc. and Optim Health Services, Inc., pled guilty to federal health-care fraud charges and is expected to testify against 15 other people involved in the alleged conspiracy.
Reading the court documents is a chilling experience. The Novus Health Services operations director described herself as the “go-between” between an accountant and five doctors who are also charged in the alleged conspiracy.
The accountant had no medical training, yet, according to the operations director, decided which medications the hospice patients should receive. In a “Factual Resume” filed with the court, she said that, “These directions included [the accountant’s] instructing nurses to intentionally over medicate beneficiaries with medications such as hydromorphone and morphine with the intent to hasten their deaths.”
The operations director further admitted to falsifying paperwork to admit patients into hospice who were not even eligible for hospice services and to falsifying do not resuscitate orders (DNR) for patients. She also admitted to accepting patients into hospice care without a face-to-face physician visit. The apparent purpose of the alleged scheme was to generate more and more profit.
According to an FBI search warrant, the accountant sent a text message to a nurse, “You need to make this patient go by-bye.”
What you can do
Based on my experience, I believe that conversations about continued health care, end of life, and hospice care should be handled over time, rather than in a rush.
I think that patients should react with suspicion when doctors, nurses, or hospital administrators try to push and advocate for a hasty and immediate decision. If you hear healthcare providers urging that “they wouldn’t want to live like this” or making similar statements, perk up and think twice.
I have seen cases, for instance, where I believe that healthcare providers were aware that they committed medical malpractice that severely injured a patient and then immediately advocated for the family’s consent to allow the patient to die. I am thinking about one case, in particular, where this happened to a 16-year-old girl. I helped them arrange transfer of their daughter to another facility and she survived and lived for several more years with her family.
While the Frisco case clearly involves allegations of criminal intent to profit from a conspiracy to harm patients, I believe that in many instances financial considerations trump patient safety and some hospitals.
I have seen countless instances where hospitals and physicians said that continued care was necessary, up until a day or two before the Medicare or health insurance benefits were about to run out.
In many other cases, I believe that shrewd hospital administrators and risk managers wanted to avoid liability for costly future medical care caused by their own medical malpractice by hastening the death of a patient. Current Texas law actually creates a financial incentive for this type of behavior.
Let’s say that a hospital was negligent and caused injuries to a patient that would require $2 million in future medical care. If the patient survived the hospitalization, the hospital would potentially be on the hook, at trial, for that full amount. On the other hand, if the patient died, the hospital’s liability would likely be limited to the non-economic damages cap of $250,000.
For reasons like this, I think it is important for patients and family members to think about whether they are getting good advice when it comes to end-of-life or hospice care recommendations. In some situations, it may be appropriate to request a second opinion from a trusted physician.
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Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. A member of the board of directors of the Houston Bar Association, he was honored, in 2017, by H Texas as one of Houston’s top lawyers. In May 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.
