North Carolina Physician Indicted on Reuse of Single Use Surgical Medical Devices

 Sarasota, FL (WorkersCompensation.com) – Anytime a patient has a procedure done, they usually have faith in their provider to use sanitized equipment and supplies to keep them safe. A recent fraud case in North Carolina however, shows that is not always the case.

This week the Department of Justice in the Eastern District of North Carolina handed out indictments against Ear, Nose, and Throat specialist Anita Louise Jackson, MD of Lumberton, North Carolina. Jackson is charged with a host of indictments including Adulteration of Medical Devices, ten counts of Paying Illegal Remunerations, three counts of Making False Statements Relating to Health Care Benefits, two counts of Aggravated Identity Theft, three counts Mail Fraud, and Conspiracy.

Jackson, aged 58, operated Greater Carolina Ear, Nose, and Throat (GCENT), which was outside of any large metropolitan area. However, from 2014 to 2018 Jackson billed more than $46 million to Medicare for around 1,200 “balloon sinuplasty” surgeries. With reimbursement of around $5.4 million, this made Jackson the top ENT provider in the nation.

While Jackson billed out 1,200 sinus surgeries which used a single use balloon device, the records show that she only purchased 30 of the balloon devices. Jackson allegedly reused the balloon devices on multiple patients which had come into contact with bodily fluids such as phlegm, pus, and mucous during surgeries. Additionally, the DOJ asserts in many cases, Jackson would often reuse the devices on the same day on multiple patients but represented them as sterile on the "Pre-Op Instruction for Sinus Spa" forms.

Jackson used and re-used the Entellus XprESS device for the surgeries that she performed. According to manufacturer warnings, re-sterilization can cause compromised device performance and risk improper sterilization and cross contamination. Additionally, warnings state that cleaning with anti-microbial agents has not even been tested with these devices.

Allegedly, Jackson also did not charge patients their true portion for the surgeries that were billed to Medicare. According to the indictment, instead of requiring patients to pay their 20 percent obligation, the practice would charge at most a $50 copay.

Investigators also allege that Jackson failed to maintain medical records in support of medical necessity, as well as operative reports of the surgeries that we done. Additionally, they allege that in attempts to avoid auditing recoups, Jackson fabricated records, as well as backdated and forged signatures.

If convicted, Jackson could face $250,000 in fines, in addition to maximum of 20 years in prison.

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