Texas hospital accused of double-booking operations which saw unqualified medical residents perform heart surgeries to pay $15million to prosecutors

A Texas hospital and a medical practice group have agreed to pay prosecutors $15million after they were accused of double, and sometimes triple, booking heart surgeries - which medical residents were forced to perform instead.

Baylor St. Luke's Medical Center, its associated College of Medicine, and the Surgical Associates of Texas PA jointly agreed to pay the settlement on Monday for the alleged actions between June 2013 and December 2020, the Justice Department announced.

During that time, court documents say Dr. Joseph Coselli, now 71, and Dr. Joseph Lamelas, now 63 would schedule several heart surgeries at once.

They would then allegedly leave one surgery to go perform another, without even informing their patients that they were being operated on by a trainee or a fellow, prosecutors said. 

A third doctor, Dr. David Ott, 77, of Houston, was also named as being a part of the misconduct - but is listed as a cardiothoracic surgeon with the medical practice group Surgical Associates of Texas PA.

The investigation into the alleged actions at Baylor St. Luke's Medical Center - a teaching hospital that employs Baylor College of Medicine physicians and residents - began on August 7, 2019 when an anonymous whistleblower filed a complaint.

The whistleblower alleged the hospital 'engaged in a regular practice of running two operating rooms at once and delegating key aspects of extremely complicated and risky heart surgeries to unqualified medical residents.'

According to federal prosecutors, those surgeries were 'some of the most complicated operation performed at any hospital, including coronary artery bypass grafts, valve repairs and aortic repair procedures.'

'These surgeries typically involve opening a patient's chest and placing the patient on the bypass machine for some portion of time.'

Under Medicare regulations, surgeons who are teaching trainees how to perform these - or any - are only allowed to leave the operating rooms at specific times.

But when the doctors were running two or more operating rooms at once, they would not designate a backup surgeon to take over, prosecutors say.

They also allegedly did not call for a surgical 'timeout' which would allow for the surgeons to pause and discuss key risks to prevent errors.

Instead, federal prosecutors claimed trainees were forced to pick up the slack and perform critical tasks - like making the initial incision, Chron reports. 

The medical staff would then hide from the patients that the surgeon planned to leave the room to perform another operation.

Meanwhile, Lamelas would record that he was present for 'hundreds of simultaneous overlapping surgeries' during his two years at Baylor, court documents obtained by USA Today reveal. He was being paid per procedure. 

The complaint also claimed that Baylor College of Medicine not only knew about these false claims and overlapping surgeries, but actually scheduled the operating rooms for the multiple surgeries, provided resources for the simultaneous procedures and provided residents to perform the surgeries.

In one case, Dr. Coselli allegedly performed an emergency valve and aortic repair on a 46-year-old, who died weeks later.

The victim's daughter, Sarah Coupland, said she remembers the doctor being 'very absent' as her mother, Rebecca Arcangeli, underwent the procedure.

'I feel like he would just come in and say "Someone else will talk to you. I'm the one who did the surgery, but so-and-so will handle it,"' she recounted to ABC 13, noting that she had immediate concerns about the care her mother received.

Just a few weeks later, Coupland said her Arcangeli was rushed back to the hospital and died.

'They told her it was kink in the valve that caused a blockage and she had 100 percent blockage that was caused by the valve replacement that they did.'

Federal prosecutors have also claimed that four patients died under Ott's care without an adequate review of his procedures, and said that the practice of running concurrent surgeries led to longer periods of anesthesia use and excessive internal bleeding, Chron reports.

'Patients entrusted these surgeons with their lives - submitting to operations where one missed cut is the difference between life and death,' US Attorney Alamdar Hamdani said in a statement.

'This settlement reaffirms the importance of Medicare requirements governing surgeon presence and ensuring that no physician - no matter how prominent or successful - can skirt the rules,' he added.

But an attorney for Baylor College of Medicine noted they have not admitted to any wrongdoing.

'Baylor College of Medicine did not engage in conduct that violated any applicable federal law or regulation,' Robert Corrigan Jr. said in a statement to USA Today.

'The settlement acknowledged that BCM disputed that any violations of federal law occurred and that the college being a party to the agreement is not an admission of liability by Baylor.

'The college decided to amicably resolve the dispute prior to a trial on the merits after considering the cost and expenses, including attorneys fees,' he noted.

DailyMail.com has also reached out to Baylor St. Luke's Medical Center and the Surgical Associates of Texas PA for  comment.