Spinal Fusion Too Frequent in FL?

Oct 28, 2013

A Washington Post analysis of 125,000 records of Florida patients who underwent spinal fusion found that about half had diagnoses that experts and professional societies say should not be treated that way.

The Post conducted the analysis as part of its detailed reporting on a case study from Halifax Hospital, which is being sued by a whistleblower and the Justice Department on accusations of failing to curb unnecessary spine surgeries after being warned about it. Neurosurgeons at the Daytona Beach hospital were financially rewarded for performing an above-normal rate of the profitable procedure, according to records unearthed in the case.

It’s not just a financial concern for taxpayers and insurance customers. Spinal fusions carry risks; a number of patients who underwent the surgery at the hospital say they became  permanently disabled, the Washington Post reports.

An auditing team of board-certified neurosurgeons who studied 10 cases by Dr. Federico C. Vinas on behalf of the hospital in 2010 concluded that nine of the spinal fusions were inappropriate, the Post says. But the hospital says a follow-up study found no problems, and Vinas’ attorney says his client never operated inappropriately.

The Post says the Halifax case serves as a case study on the many financial incentives that come into play when a surgeon is deciding whether to operate. Almost all of them push in the direction of operating, even when more conservative treatment is now deemed to be in the patient’s best interest. Attempts by insurers and Medicare to curb excessive surgeries have been squelched by negative publicity and heavy lobbying by the American Medical Association and the medical-device industry, the Post reports.

In other news on the same case, the Orlando Sentinel reports that the attorneys for the whistleblower have filed a motion asking a judge to rule that Halifax Hospital was wrong to destroy records pertinent to the lawsuit.