COVER STORY
Do these doctors give medicine a black eye?

With billions of dollars at stake in the fen-phen case, a judge raises questions about legal and medical ethics.

By Berkeley Rice
Senior Editor

In the giant class action "fen-phen" case, with billions of dollars in settlement funds at stake, a federal judge has questioned the conduct of two plaintiffs' law firms and two medical experts, and civil suits have been filed against those experts for intentional fraud. Among the revelations that have emerged:

A Kansas City cardiologist earned more than $3 million from plaintiffs' firms in less than a year by supervising and interpreting more than 10,000 echocardiograms. "Her practice resembled a mass production operation that would have been the envy of Henry Ford," commented the judge.

When questioned about 750 echos she did for two law firms, the cardiologist acknowledged that she spent only a few minutes reviewing each one. She found evidence of "moderate to severe" mitral regurgitation in 60 to 70 percent of the cases she examined for those two firms—far higher than the 5 percent rate that she and other independent reviewers had found in an earlier study of fen-phen patients.

A New York cardiologist who conducted hundreds of echocardiograms for plaintiffs' firms received an extra $1,500 for those in which he found evidence of sufficient damage to qualify for benefits. The judge called this apparent contingency arrangement "highly questionable," and said it "adversely affected" the doctor's credibility.

In late 2002, worried that many fen-phen claims had "no reasonable medical basis," the judge ordered a suspension of payments on all pending claims submitted by the two plaintiffs' firms or certified by their two medical experts until they are audited.

This September, lawyers for the settlement trust filed a civil suit against the Kansas City cardiologist, charging that she had "engaged in a pattern of racketeering activity and intentionally defrauded" the trust by "submitting misleading and false medical evidence to support illegitimate claims" for which the trust has paid many millions of dollars. Her lawyer denies those charges.

In November, trust lawyers also filed suit against the New York cardiologist, alleging that he had certified that "certain claimants had serious valvular heart disease when he either knew that they did not or knew he had no reasonable basis for certifying that they did." His lawyer had no comment.