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Cardiologist Daniel West, MD, had practiced at Trinity Health Muskegon Hospital in Muskegon, Michigan, since he finished medical school. His mother worked at that hospital as a lab technician, and West and his brother were born there.\u00a0<\/p>\n
The hospital was his \u201cforever job,\u201d said West, who is 66. He had risen through the ranks to become chief of cardiology and planned to finish his career at the same place he started.\u00a0<\/p>\n
But West\u2019s plans were stymied when he was abruptly fired by Trinity this fall after he reported patient safety concerns about another physician, according to a whistleblower lawsuit filed by West.\u00a0<\/p>\n
West claims Trinity retaliated against him after he shared evidence that another cardiologist was misinterpreting test results and performing unnecessary heart procedures on patients. He was terminated \u201cwithout cause\u201d on October 28, according to a legal complaint issued on November 19 in US District Court for the Western District of Michigan, Southern Division.\u00a0<\/p>\n
\u201cI poured my heart and soul into caring for my patients and supporting my community, my practice, and the hospital for over 35 years,\u201d West told Medscape Medical News<\/em>. \u201cI feel betrayed and humiliated by the very institution for which I dedicated my entire career.\u201d<\/p>\n The case offers lessons for other physicians considering reporting wrongdoing to their employers or government officials, experts say.<\/p>\n Trinity Health Muskegon does not comment on the specifics of active litigation, but the hospital will \u201cvigorously defend ourselves against any allegations which are inaccurate,\u201d a hospital spokesman told Medscape Medical News<\/em>.<\/p>\n \u201cWe remain dedicated in our efforts to uphold high standards and integrity in all aspects of our healing ministry,\u201d the spokesman said in an emailed statement. \u201cWe will continue to ensure that our actions are in the best interest of the patients and community we serve.\u201d<\/p>\n An echocardiography technician first shared his concerns about the other cardiologist with West in 2021, court documents show.\u00a0<\/p>\n The tech raised questions about the physician\u2019s interpretation of echocardiographic studies on patients being considered for implantable cardioverter-defibrillators (ICDs). The cardiologist frequently documented reports of ejection fractions (EFs) of 0.35 or less, when it appeared clear that patients\u2019 hearts were much stronger, the tech told West. Ejection fractions measure the heart\u2019s ability to pump oxygenated blood through the body.<\/p>\n The tech showed an example of the cardiologist\u2019s reading to West, who convened three other cardiologists in the practice to review the results, according to court documents. All three concluded the EF was closer to 0.45.\u00a0<\/p>\n Results of EFs of 0.35 or less indicate that an ICD is appropriate and necessary, according to the complaint, noting that \u201cintentional underestimation of EF leads to unnecessary, expensive, and risky implantation of ICDs in patients who do not require them, with a subsequent need to replace the devices every 8-10 years when the batteries would become depleted.\u201d<\/p>\n When confronted by West, the cardiologist in question allegedly claimed his interpretation was accurate and proceeded with the ICD surgery.\u00a0<\/p>\n West expressed his concerns about the cardiologist to the chief medical office for Trinity Health in Muskegon, who asked West to show proof of his allegations, the lawsuit claims.\u00a0<\/p>\n West and his fellow cardiologists then spent nearly 2 years scrutinizing the cardiologist\u2019s ICD procedures, including requesting data from the medical device provider that supplied ICDs to the Muskegon cardiology practice, according to West\u2019s complaint.\u00a0<\/p>\n In May 2024, West received a list from the medical device provider that detailed devices, including ICDs, supplied to the practice with notation on the implanting cardiologist.\u00a0<\/p>\n West and his colleagues reviewed the data and started a comprehensive review of the cardiologist\u2019s patient files where ICDs were surgically implanted. They believed they had found a troubling pattern suggesting allegedly fraudulent implantation of ICDs on patients whose imaging did not support the procedure. With support from the other physicians, West presented the evidence to Trinity executives.\u00a0<\/p>\n Three weeks later, on June 17, 2024, West claims he was suspended, with administrators giving only \u201ca vague explanation\u201d about some concerns related to his office behavior.<\/p>\n Fearing the evidence would be buried, West and the group of reviewing cardiologists authored a letter to Trinity administrators about their concerns and also reported their findings to the US Attorney\u2019s Office in Grand Rapids, according to court documents.\u00a0<\/p>\n A Trinity administrator later contacted West and the physicians who signed the letter and accused them of violating Health Insurance Portability and Accountability Act (HIPAA) privacy laws by their email transmission of the information. The administrator demanded the physicians destroy their copies of the data.\u00a0<\/p>\n West proceeded to destroy his copies of the information after providing the evidence to the US Attorney\u2019s Office and confirming that Trinity\u2019s counsel had preserved the material. He was allowed to return to work in August 2024, but was subsequently terminated on October 28.\u00a0<\/p>\n Grand Rapids attorney Shoran Reid Williams, who representing West, said Trinity gave no reason for firing West, and that it was clearly in retaliation for reporting the unnecessary surgeries.\u00a0<\/p>\n The other physicians who signed the letter weren\u2019t fired; they continue to work at the hospital. After West was terminated, the hospital offered his position to the other cardiologists in the group, Williams said, but none of the doctors would accept it because they felt what happened to West was wrong.\u00a0<\/p>\n West\u2019s lawsuit accuses Trinity of violating the retaliation provision of the False Claims Act (FCA) and the Michigan Whistleblowers\u2019 Protection Act. Both statutes protect from retaliation employees who report suspected law violations.\u00a0<\/p>\n \u201cIt is incredulous that you would have a group of physicians sign off on a letter to tell the administration, \u2018This doctor is a problem, and here is what the problem is,\u2019 and the response from the hospital is to fire the head of the practice group,\u201d Williams said in an interview with Medscape.<\/em>\u00a0<\/p>\n<\/div>\n Trinity has not yet responded to the complaint. A summons was issued on November 20.\u00a0<\/p>\n A spokeswoman for the US Attorney\u2019s Office for the Western District of Michigan said she could not confirm if there is an investigation involving West\u2019s report. The office does not discuss details or share status updates about investigations, she wrote in an email.<\/p>\n All physicians are protected by the retaliation provision of the False Claims Act. The provision prohibits retaliation against employees who report violations or suspected violations of federal laws. But state protections can vary widely, said Clayton Wire, a Denver-based whistleblower attorney.\u00a0<\/p>\n New Jersey has one of the strongest whistleblower statutes, he said. The state\u2019s Conscientious Employee Protection Act<\/a> bans an employer from taking any retaliatory action against an employee who has reported an employer\u2019s law violation of the law, a rule or regulation issued under the law, or other workplace activities that are potentially harmful to the public and\/or the environment.\u00a0<\/p>\n Other laws, like Colorado\u2019s statute, are less stringent, Wire said.\u00a0<\/p>\n \u201cBut generally speaking, whether it\u2019s through a statutory protection or some sort of common law wrongful discharge type protection, most physicians and medical care providers are going to be able to find some sort of protection under state law,\u201d Wire said in an interview.\u00a0<\/p>\n The National Whistleblower Center<\/a> provides a variety of online educational resources about whistleblowing issues, including information on state rights.\u00a0<\/p>\n In recent years, Wire has seen a rise in whistleblower cases involving allegations of medically unnecessary procedures. This has been an evolving area of law, he said. Some courts have disagreed on whether medical judgement can be the basis of a FCA claim.\u00a0<\/p>\n In Polukoff v St. Mark\u2019s Hospital<\/em>, Gerald Polukoff, MD, filed an FCA action on behalf of the government that alleged another physician had performed thousands of unnecessary heart surgeries and fraudulently billed Medicare for them. Polukoff claimed the physician\u2019s employer was complicit in and profited from the doctor\u2019s fraud. A district court granted the defendant\u2019s motions to dismiss, reasoning that a medical judgment could not be false under the FCA.\u00a0<\/p>\nBusiness Concerns Mount Over a Cardiologist\u2019s Care\u00a0<\/strong><\/h2>\n
Business Retaliation Protections for Physicians Differ\u00a0<\/strong><\/h2>\n
Business Advice For Whistleblower Physicians<\/strong><\/h2>\n