Subsys Doc Gets 5 Years; Docs Take Billions From Device Makers; Child Abuse Law

MEDPAGE TODAY - JUNE 23, 2021 - Kristina Fiore -

Doc Gets 5 Years for Taking Insys 'Bribes'


A Manhattan physician has been sentenced to almost 5 years in prison for taking kickbacks for prescribing the fentanyl spray Subsys, the U.S. Department of Justice announced.


Jeffrey Goldstein, DO, 51, was sentenced to 57 months in prison for his role in a "speakers bureau" scheme that brought him nearly $200,000 from drugmaker Insys Therapeutics.


Insys launched its "speakers bureau" program in August 2012, using it as a means to induce doctors to prescribe large volumes of its key drug, the DOJ charged. Doctors received fees for supposedly providing educational sessions to other doctors, but these events often turned out to be "social affairs" without any education taking place, DOJ said.


DOJ also said Insys took Goldstein and others to a Manhattan strip club, where it spent over $4,000 on a private room, alcohol, and lap dances. The drug company also paid for the annual holiday party at Goldstein's private medical office, according to DOJ.


"Goldstein put his own patients at risk in order to satisfy his own greed, and will now spend time in federal prison for recklessly prescribing this highly addictive and powerful opioid," said Audrey Strauss, the U.S. Attorney for the Southern District of New York, in a statement. "This sentence sends a loud and clear signal to the medical community that if you take bribes in return for prescribing, you will be prosecuted to the full extent of the law and risk significant prison time."


Four other Manhattan doctors have been caught up in the scheme. Todd Schlifstein, DO, was sentenced to 2 years in prison; Alexandru Burducea, DO, got 57 months; and Dialecti Voudouris, MD, was sentenced to time served. Gordon Freedman, MD, awaits sentencing this summer.


In January 2020, Insys founder John Kapoor was sentenced to 66 months in prison for his role in paying doctors to frequently prescribe the company's addictive opioid.


Docs Get Billions From Device Makers


Device makers have given billions of dollars to the orthopedic surgeons and neurosurgeons who use their products, and those relationships are coming under legal scrutiny, Kaiser Health News reported.


From August 2013 through the end of 2019, these specialists raked in $3.1 billion from manufacturers, KHN found. They make up a quarter of U.S. physicians who received at least $100,000 or more from drug and device makers last year -- even though they represent only 5% of those who have taken industry money.


They also make up two-thirds of physicians who took in at least $1 million last year, KHN found.


While the vast majority (81%) of orthopedic and neurosurgeons received less than $5,000 from industry, questions have been raised about whether payments corrupt medical judgment and nudge surgeons into performing unnecessary procedures.


Indeed, there have been more than 100 lawsuits over the last decade that have accused these surgeons of taking illegal compensation from manufacturers. That includes a suit from the Department of Justice against South Florida surgeon Kingsley Chin, MD, and his company, SpineFrontier. Chin and his company are accused of paying more than $8 million in consulting fees to three dozen surgeons who did little or no work.


A former business associate of Chin's alleged in a whistleblower complaint that the company's management thought that paying doctors was "the only reliable way to steadily increase its market share and stave off competition."


In addition, patients have been bringing lawsuits for the harm done to them related to these devices -- including one against Randy Davis, MD, of the University of Maryland, who is being sued by 14 patients who charge that he implanted devices that weren't FDA approved while getting paid hundreds of thousands of dollars by that manufacturer.


Law Targets False Child Abuse Accusations


A new law in Texas will require courts to hear additional medical opinions before allowing kids to be taken from their parents by the state's Child Protective Services (CPS) agency, NBC News and the Houston Chronicle reported.


Gov. Greg Abbott (R) signed the law last week, and it goes into effect on September 1. The law's origin is tied to a 2019 investigation by the two news outlets of cases where parents were wrongly accused of child abuse by physicians.


Those physicians were child abuse pediatricians, a subspecialty that often works closely with child welfare agencies. The subspecialty has come under fire several times in the decade that it has existed.


The new law states that parents accused of abuse based on a medical report will be allowed to request that CPS gets another opinion from a different doctor. Judges are required to consider that evidence before issuing orders that children be taken away.


It also calls for a commission to study the work of state-funded doctors who diagnose child abuse.


The legislation passed with broad bipartisan support in both chambers of the Texas legislature, according to the news outlets.


"Like all things that CPS does, there is a delicate balance," said state Rep. Gene Wu (D), who is also a lawyer who handles CPS cases. "If you tip it too far on one side, then you will have kids who are returning to families that are abusing them, and if you tip it too far the other way, then you have families that are having their kids stripped away because of a medical mistake. And this is an attempt at trying to figure out ways that we can make the process a little more fair."


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