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It’s being alleged that beginning in 1999, a few doctors and lawyers in the Las Vegas area decided it would be a great idea to trump up accident related injuries to increase the damages awarded to people injured in automobile accidents or bring false medical malpractice claims against innocent doctors. According to an indictment issued through the FBI and US Attorney Gregory Brower, Dr. Mark Kabins, Noel Gage, Howard Awand, and Dr. John Thalgott, all conspired to falsify medical records, improperly refer an person to a personal injury attorney, and sue an innocent doctor in order to cover up the improper treatment by Drs. Kabins and Thalgott. If this is starting to sound like a John Grisham novel, things are just getting started. But before we get too far into the details of this case, I would like to make it clear that if it’s true the lawyers and doctors involved in this are awful people who have no business practicing law or medicine. The lawyers involved certainly acted unethically and did things I personally would never even think about, but they also do not represent the vast majority of lawyers who represent injured people. Lawyers who act in the manner alleged are not acting ethically. This is not the way most lawyers act; but like every profession a few bad apples can spoil the impression people have of all lawyer – except of course their own. Those attorneys make it easier for people to stereotype attorneys as sleazy so I want to make it clear those attorneys are despicable and unprofessional and I want to do what I can to help keep that stereotype from spreading since it’s false.

An article on CNNMoney sums up how the scheme allegedly worked for the Las Vegas “medical mafia“.

Prosecutors charge that a group of top Las Vegas plaintiffs lawyers and doctors, with the 64-year-old Awand at its center, conspired in an audacious fraud. The participants appeared to act independently but instead colluded. Unwitting accident victims were recruited as plaintiffs and then persuaded to undergo serious, sometimes needless, surgeries. The procedures, in turn, helped inflate the size of personal-injury claims. The result was multimillion-dollar insurance settlements, even for dubious cases, and lucrative fees for the doctors, the lawyers, and, of course, Howard Awand.

The alleged scheme began in 1999 and lasted for at least six years, prosecutors charge. Business and court records and local press reports suggest that the group — which numbered about 30 — colluded in hundreds of suits that yielded hundreds of millions in settlements. According to government evidence, the group coordinated their testimony as expert witnesses, lied under oath, protected one another from malpractice lawsuits — even after the surgeries left a few patients paralyzed — and ate away at the plaintiffs’ settlement money with kickbacks disguised as contingency fees.

The case that finally got them caught involved Cynthia Johnson and her relatively minor auto accident.

Cynthia Johnson, an office manager for a real estate company, was driving to work on Interstate 15 near the Las Vegas strip when a fellow commuter clipped the rear bumper of her Toyota Avalon, propelling it into the truck in front. No one seemed hurt, and the drivers exchanged information.

The accident, on June 12, 2002, might have been forgotten. But Johnson woke up the next day with back pain. She went to her regular doctor but was told that she’d have to pay all her treatment costs upfront, since a car accident could result in lawsuits and her health insurance might not cover her. Worried about the costs, she consulted a physician friend, who pledged to find someone to help her.

No more than 30 minutes later she got a call from a man named Howard Awand, who said he was in the business of handling such cases. Awand (pronounced AY-wand) managed to get her an appointment that night with one of the busiest spine surgeons in the country, Mark Kabins. After examining her, the surgeon referred her to several other doctors and said that Awand had also arranged for her to see one of the town’s most prominent plaintiffs attorneys, Robert Vannah. All for a routine accident on the way to work. Johnson couldn’t believe her luck.

Better still, she didn’t have to pay any money upfront. On her first visit to Vannah’s office, she signed a medical lien. Such agreements mean injured parties pay nothing unless they collect a settlement; if that happens, the person holding the lien (which could be a plaintiffs lawyer, a doctor, or a hospital) is then paid from the settlement. “Over the next six weeks, I had so many doctor’s appointments that I couldn’t keep up,” recalls Johnson, who was grateful for the attention but also confused by a directive from Vannah’s office: Don’t mention Howard Awand’s name to anybody.

Allegedly Awand is the thread that ties all of the players together. He was the one at the center of the alleged conspiracy, getting injured people doctor appointments and an attorney. In the end, the lawyer would pay back the doctors who helped provide falsified medical records or who helped pin the blame on the wrong doctor. This unethical behavior between the doctors and lawyers eventually got so big that the federal government took notice. It’s not hard to believe that would happen when you are talking about hundreds of cases and millions of dollars, with all of the cases working out just right for the plaintiff.

The scheme allegedly began to unravel when Dr. Thalgott decided he wanted out. Melodie Simon, 41, had vertebrae fusion surgery performed by Dr. Thalgott in August 2000, afterwards he went on a preplanned vacation. Ms. Simon developed numbness and tingling related to a blood clot in her spine. Dr. Kabins, the surgeon who was supposed to be covering Dr. Thalgott’s patients while he was on vacation, allegedly ignored the complaints until it was too late, Ms. Simon would be paralyzed from the chest down for the rest of her life.

Ms. Simon hired Noel Gage to represent her, and Mr. Gage then worked with Dr. Thalgott, Mr. Awand, and Dr. Kabins to pin the blame on the anesthesiologist who had drained Ms. Simon’s spine during the surgery. Allegedly as a result of the coordinated effort, Mr. Gage settled the case for 2 million. While that is a huge amount by most standards, had Ms. Simon been able to sue Dr. Thalgott or Dr. Kabins, it may have settled for closer to 10 million. That is a significant difference to someone who is paralyzed for the rest of their life due to a doctor’s medical malpractice.

Allegedly Dr. Thalgott had a change of heart on his unethical practices, he agreed to pay Ms. Simon 1.5 million for the trouble he caused. From what is being reported he is still being investigated by the county and state medical boards for the problems he helped create by falsifying records and providing questionable treatments. Although Dr. Thalgott was provided immunity for his testimony, at this time there has yet to be a conviction against Gage, Awand or Kabins at this time. The legal proceedings continue at this time against all of them, and it’s best to read the litany of articles that exist if you want a more detailed picture of what is exactly may be happening currently.

This is an unfortunate situation that ended up harming the people the lawyers and doctors were supposed to be helping. They all claim innocence on the allegations, but if they are not then the system will likely give them what’s coming to them. It is deplorable for people to prey on the innocent and weak at their most vulnerable, and to so completely and utterly exploit them for sinister motives and financial gain. I have nothing but contempt for professionals who are caught in situations like this one.

One Comment

  1. Gravatar for Joseph Lochert
    Joseph Lochert

    For someone who supposedly is a lawyer, Devon sure does not do much independent thinking.

    First of all, does it say anywhere in the CNN Money article that anyone has been convicted? And when you read the article, can't you tell that most of the information can be sourced to what the prosecutors allege? Are we to assume that prosecutors never lie or do immoral things? (Remember the Duke lacrosse players and how gullible the media was.) When you make the awfully judgmental statement that "the lawyers and doctors involved in this are awful people who have no business practicing law or medicine," based on mere allegations, who's being immoral?

    On its face, the supposed facts on which the government built its case are mighty suspicious. According to the article, you have a prosecutor who gets in an automobile accident, does not like what the plaintiff's lawyer does, and then begins an investigation of the plaintiffs lawyer. She claims that the plaintiff lawyer made a huge problem out of nothing. Should we just accept her side of the story? Doesn't the word "vindictive" come to mind? Shouldn't you at least be skeptical of the prosecutors' motives? (Again, remember the Duke lacrosse players.)

    And what about the role of the insurance companies? The CNN Money article reports that the insurance companies were angry because -- they were getting beat! Yes, they were losing in court! And how much sympathy should that command? The fact that they were losing couldn't be because the plaintiffs lawyers did a better job, could it? Isn't it awfully suspicious that the insurance companies decide to actively support a prosecution of their opponents? (Again, that word "vindictive" comes to mind.) Isn't it possible that the insurance companies were getting beat, not because the lawyers were ginning up false evidence or overdoing the medical procedures, but because they were good? After all, how does anyone recover from the insurance companies without convincing juries that the evidence of negligence causing an injury is strong? Of course, we don't know why the lawyers were successful, but why is it so obvious to Devon that the lawyers and doctors were so evil?

    And the medical lien stuff - why not look into that a little deeper? How does a medical lien arise, after all? It has to be because the patient can't pay. (Certainly paying patients don't generate liens.) So why does the medical service provider sell the lien? Could it be because it wants to get paid and it's skeptical that the patient will ever win the case and collect enough to pay for the medical treatment? Is there really something wrong with that? The article throws it out as if there some sinister plot involved, but the fact is that the writer of the article doesn't have a clue what that's about and is relying on the prosecutors' allegations. Shouldn't Devon at least question that?

    Of course, we don't know what the facts really are. But when you read a magazine article like the one at CNN Money and see that (i) there have been no convictions, (ii) the only case tried was dismissed because the government prevented a favorable witness from testifying, (iii) the prosecutors go after the lawyers after one of their own gets sued, and (iv) the insurance companies try their best to help convict their opponents, you should at least reserve judgment about whether "the lawyers and doctors involved in this are awful people." (Again, remember the Duke lacrosse players.)

    There is enough shoddy reporting of legal matters in the newspapers. As a transactional lawyer in Chicago, I can tell you that the media never accurately reports a legal matter on which I've worked. When it comes to a criminal case, they are hopelessly incompetent. And so, why would Devon, a lawyer, compound the problem by mindlessly gulping up what the media writes?

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