Spyros N. Panos, M.D., surrendered his medical license to the New York State Board for Professional Medical Conduct on August 26, 2013. It’s a license he’s held since 1995.
The Poughkeepsie, New York, orthopedic surgeon also faces over 250 lawsuits from former patients who accuse him of performing fake or negligent surgeries.
The Surrender Order No. 13-270 states that Dr. Panos said he applied for permission to surrender his license on the grounds that he cannot “successfully defend against at least one of the acts of misconduct” alleged in the charges against him. Dr. Panos said that receiving permission to surrender his license allows him “to resolve this matter without the various risks and burdens of a hearing on the merits.”
Statement of Charges
In the Statement of Charges, the Factual Allegations assert that during a period of 2007 through 2010, Dr. Panos failed to “render appropriate care; maintain an adequate, complete and accurate medical record and submitted bills for payment for medical services when he was not in fact entitled to such payment.”
The last charge caught the attention of federal accountants at the Department of Justice resulting in Dr. Panos and hospitals where he worked becoming targets of multiple federal criminal subpoenas. Neither Dr. Panos, nor any of the hospitals have been charged with any offense.
In addition to the civil and criminal legal issues facing him, Dr. Panos has endured intense public scrutiny in 19 investigative articles in the Poughkeepsie Journal by investigative reporter Sarah Bradshaw. National exposure came on September 5, 2013 with a story on ABC News headlined “Surgeon Accused of Faking Operations Surrenders Medical License.”
Attorneys representing former patients said that clients with potential cases against Dr. Panos began flooding their offices with calls immediately after Bradshaw wrote about the first few lawsuits in September 2010. Bradshaw said she was tipped off to the litigation from an anonymous source.
Dr. Panos and his attorneys have declined to comment to media.
Dr. Panos worked at the Mid-Hudson Medical Group in Poughkeepsie, New York, as an orthopedic surgeon from 1999 until he was fired in 2011 for not meeting the group’s “professional standards.”
Patient Allegations
Debra Cole, a retired telephone company technician is suing the surgeon for allegedly performing two faked knee surgeries.
JT Wisell and his law partner Nancy McGee, representing 153 plaintiffs, told us on September 6, 2013 that at least one-third of the firm’s cases involve patients who had been told by a second physician, after surgeries by Dr. Panos, that the procedures were actually not performed.
One of their clients, Gary Flynn, according to Dr. Panos’ surgical records, needed an acromioclavicular (AC) joint recession. Instead Dr. Panos allegedly performed a rotator cuff repair. Physicians have the right to practice medicine, but Wisell points out that the two procedures are different body parts.
“Phantom Knee Surgery”
Wisell also told us of a case where Panos claimed to have performed a full hip arthroplasty, when in fact, he had only performed a partial arthroplasty. Another former patient, Constance Nenni, died less than 24-hours after having an alleged “phantom” knee surgery.
The Journal’s Bradshaw reported that Chris Hanson filed a lawsuit against Dr. Panos because he says he never got better after two surgeries. He claims the doctor didn’t actually operate on his knees and made him worse by improperly operating on his big toe.
Hanson gave the Journal a medical invoice showing that the Hudson Valley Center filled a claim with Medicare for $13, 389 for a February 16, 2010, arthroscopic knee surgery.
Personal injury attorney Luis Solimano, said he received “four or five” complaints from Dr. Panos’ former patients. Without identifying a complainant, Solimano reportedly said that one patient went in for a surgery, but when the pain continued and the patient went for a second opinion, the new doctor said the surgery hadn’t been performed.
Michael S. Kelton, a medical malpractice defense director at a large New York law firm with no ties to any plaintiffs in this case, told Bradshaw that he couldn’t recall a malpractice claim against an orthopedic surgeon in which the surgeon said he or she performed surgery and the patient underwent anesthesia, but the surgery wasn’t actually performed.
Brian Brown, Nenni’s attorney, accuses Dr. Panos of using patients like human cash registers, scheduling as many as 22 surgeries a day. The average orthopedic surgeon typically schedules no more than 32 procedures a month, according to American Academy of Orthopaedic Surgeons statistics.
Billing Practices
Arthur Caplin, the director of medical ethics at NYU Langone Medical Center and a former non-M.D. representative with the New York State medical licensing board, said he found it troubling that others besides Dr. Panos aren’t under investigation.
He told Bradshaw, “You can’t perform this many suspect surgeries without the cooperation of many other people.”
This is where the plot thickens. Lawyers for the plaintiffs are also suing Dr. Panos’ former employer, the Mid-Hudson Medical Group, as well as other defendants including Vassar Brothers Medical Center and Saint Francis Hospital and Health Centers in Poughkeepsie, claiming they didn’t supervise Dr. Panos properly and billed payers for the surgeries.
Because of the federal subpoenas issued to Dr. Panos and the medical group, there is a legal stay in place that prevents plaintiffs’ attorneys from taking sworn statements from any employee and former employee of the medical group or any hospital where Dr. Panos practiced, according to Wisell.
The group wanted to put on hold the multiple civil cases filed against the group and Dr. Panos, a former shareholder and board member, until after the federal criminal investigation is complete, according to the motion.
The stay was put in place for Dr. Panos to avoid self-incrimination in the federal cases of fraud and billing irregularities, Wisell told Bradshaw. Mid-Hudson and the various hospitals and surgical centers where Dr. Panos practiced have submitted billing records, surgical records and surgical schedule logs to plaintiffs’ lawyers, but under the stay, are not yet required to directly respond to civil actions, Wisell added.
False Claims
The group’s motion said the criminal investigation appears to focus on alleged fraud, including seeking payments for false representations of procedures.
According to Bradshaw, Panos’ lawyer said Mid-Hudson Medical billed for medical services, not Dr. Panos, and the money went directly to the group.
Plaintiffs argue that the hospitals where Dr. Panos performed their surgeries should have been able to tell from surgical records that he was an outlier in the number of procedures he was performing.
High Volumes
On July 21, 2013, Bradshaw reported that Dr. Panos’ surgical records show he performed half as many operations in one day as the typical orthopedic surgeon averages in one month raising questions about administrative oversight and patient safety.
She reported that Dr. Panos was in nearly back-to-back surgeries over the course of sometimes 12-hour-long surgery days, often with two patients under anesthesia at the same time, according to records kept by the City of Poughkeepsie hospital where he had privileges. In three cases, he was in two surgeries at the same time, according to the records. He frequently performed short operations—one was only seven minutes—according to his surgical schedules at Vassar Brothers Medical Center. The logs are for four days between December 31, 2009, and December 16, 2010.
Plaintiffs’ attorneys allege that Dr. Panos couldn’t have done legitimate surgeries during the times given on the surgical records involving their clients.
The Journal obtained Dr. Panos’ surgical records for December 12, 2009, May 20, 2010, July 29, 2010, and December 16, 2010. Operation times are tracked by the start and end of anesthesia.
According to a Journal analysis, the logs show:
- For those four days, Dr. Panos performed 69 surgeries, or an average of 17 per day.
- In three cases, Dr. Panos was supposedly in surgery with two different patients at the same time: On December 16, 2010, he was supposedly in surgery with one patient from 9:15 a.m. to 10:25 a.m. and with another patient from 9:57 a.m. to 10:27 a.m. On the same day, he supposedly finished a surgery at 2:40 p.m. but had started another surgery at 2:28 p.m. that also ended at 2:40 p.m.
- Dr. Panos’ highest-volume day was 19 surgeries in 10-1/2 hours. His volume of surgeries ranged from 10 in 6-1/2 hours to 20 in 12 hours.
Plaintiffs’ attorney Brown said he has seen a dozen Vassar Brothers surgical logs for days ranging from April 24, 2008, to December 16, 2010, which show the same pattern—Dr. Panos performed between 15 and 22 surgeries each day.
Brian Brown of Manhattan said the surgical logs are “irrefutable evidence” that others knew Dr. Panos was putting people under anesthesia and, in some cases, doing nothing at all, and billing for multiple procedures.
A Safe Exit?
In the midst of the legal proceedings, Mid-Hudson, with about 120 physicians, announced in April that the group was planning to transfer its assets to the Mount Kisco Medical Group, with about 285 physicians.
McGee, the attorney for 153 plaintiffs told Bradshaw she found it “interesting that it’s not a merger, a buyout, that the employees of Mid-Hudson Medical Group will just become employees of Mount Kisco Medical Group. That is very curious to me.”
Brown said Mid-Hudson shareholders are being allowed to “walk away from taking any responsibility for the heinous acts committed against so many of their former patients.”
That asset shift was challenged in court by attorneys for the plaintiffs in the Panos lawsuits.
On June 26, 2013, Bradshaw reported that a judge ruled that the civil cases were not a reason to block any transferring of assets to Mount Kisco.
The strange case of Dr. Panos gets even weirder as the Journal ran further reports documenting that he was doing individual medical evaluations for Fiduciary Insurance Company of America and then was arrested in Maryland for allegedly shoplifting baseball cards from a local Wal-Mart.
There has been no news from the Justice Department and no civil trials have started. Dr. Panos is innocent until proven guilty, but he has already paid the price.
Bradshaw’s investigative reports are available here: Poughkeepsie Journal.
