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www.kcentv.com

Suspended Wortham med spa doctor linked to North Texas medical facility being sued over Arlington mother's death

Recently suspended Frisco doctor, Michael P. Gallagher, was chief anesthesiologist at Integrity Medical Center where Kimberly Ray was treated, per family attorney.
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Both stories are disturbing and sad. Also incredible to know that there are people 'practicing medicine' like that out in the world. Very shady.
What rhizotomy were they performing? Like a dorsal rhizotomy? RFA? I don't even want to know what kind of third world stuff they were doing in this joint Integrity Wellness Center
 
Straight up murder. WTF is up with the Texas Medical Board? THey need to get off their lazy butts and start cleaning up Pain in that state.
 
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lobelsteve said:
Straight up murder. WTF is up with the Texas Medical Board? THey need to get off their lazy butts and start cleaning up Pain in that state.
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Unfortunately TMB has no control over nurses and CRNAs, that’s up to the Texas Nursing Board. And they protect their own, I filed a complaint against an NP for dangerous prescribing practices and after months of investigation they decided she did nothing wrong (she dropped 180 pills of 10 mg diazepam on a benzo-naive chronic pain patient whose MED was over 90).
 
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SMDH. According to article, “Sawicki also said there were no criminal charges brought forth against Houghton, Molina (crnas) and Mandava in Ray's death. He said they all have active medical licenses and continue to practice.”
 
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Interestingly this CRNA works alongside actual pain physicians

txphealthcare.com

Team - Texas Partners Healthcare Group

Dr. Ajay Pathak provides care for the overall medical needs of your family in Little Elm, TX for Texas Partners in Medicine.
txphealthcare.com

Why would they hire him when they’re clearly capable of hiring real physicians
 
I think for our field,
We need oral boards with 30% failure rate and more strenuous requirements.
We need to separate ourselves from fake shaman docs
 
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Love it when CRNAs do rhizotomy. When are we gonna reign this **** in
 
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I found more details on Dallas County Civil Court’s website


The expert witness testimony fills in some of the details


Basically, Houghton is under the supervision of Baber Younas, MD, who is an anesthesiologist who seems to have grandfathered himself into interventional pain without doing a fellowship. This might explain why he hired a CRNA to begin with, he didn’t get formal training himself so he has no respect for the process.

Autopsy showed focal hemorrhage and distension of the dura with CSF, so had she survived Mrs Ray would likely have been paralyzed.

However in a brilliant stroke of incompetence, the CRNA providing anesthesia, Molina, had a documented history of substance problems and impairment at work x2 (known to Texas nursing board). He straight up administered a whopping 200mg of propofol and 100mcg of fentanyl to Mrs Ray for the RFA at the beginning of the procedure. For the non-anesthesiologists, that’s an intubating dose for a big dude. No one breathes through that. (It’s such a mind-boggling dose that I’m wondering if our substance-abusing friend actually gave her less than that and squirreled away the rest for his own fun later? But that probably wouldn’t help his case to say he falsified the records to support his habit).

So poor Mrs. Ray got a one-two punch. The first CRNA suffocates her. The second CRNA spears her spinal cord.

This is actually a good case of greedy doctors supervising unqualified CRNAs to do procedures and make more money.
 
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Agast said:
However in a brilliant stroke of incompetence, the CRNA providing anesthesia, Molina, had a documented history of substance problems and impairment at work x2 (known to Texas nursing board). He straight up administered a whopping 200mg of propofol and 100mcg of fentanyl to Mrs Ray for the RFA at the beginning of the procedure. For the non-anesthesiologists, that’s an intubating dose for a big dude. No one breathes through that. (It’s such a mind-boggling dose that I’m wondering if our substance-abusing friend actually gave her less than that and squirreled away the rest for his own fun later? But that probably wouldn’t help his case to say he falsified the records to support his habit).

So poor Mrs. Ray got a one-two punch. The first CRNA suffocates her. The second CRNA spears her spinal cord.
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Unbelievable. Jail IMO.
 
Agast said:
I found more details on Dallas County Civil Court’s website


The expert witness testimony fills in some of the details


Basically, Houghton is under the supervision of Baber Younas, MD, who is an anesthesiologist who seems to have grandfathered himself into interventional pain without doing a fellowship. This might explain why he hired a CRNA to begin with, he didn’t get formal training himself so he has no respect for the process.

Autopsy showed focal hemorrhage and distension of the dura with CSF, so had she survived Mrs Ray would likely have been paralyzed.

However in a brilliant stroke of incompetence, the CRNA providing anesthesia, Molina, had a documented history of substance problems and impairment at work x2 (known to Texas nursing board). He straight up administered a whopping 200mg of propofol and 100mcg of fentanyl to Mrs Ray for the RFA at the beginning of the procedure. For the non-anesthesiologists, that’s an intubating dose for a big dude. No one breathes through that. (It’s such a mind-boggling dose that I’m wondering if our substance-abusing friend actually gave her less than that and squirreled away the rest for his own fun later? But that probably wouldn’t help his case to say he falsified the records to support his habit).

So poor Mrs. Ray got a one-two punch. The first CRNA suffocates her. The second CRNA spears her spinal cord.

This is actually a good case of greedy doctors supervising unqualified CRNAs to do procedures and make more money.
Click to expand...

its pretty hard to fry the cord with an RF. not sure what to make of that, but it is surprising that there was BOTH the cord damage AND the anoxic injury. regardless, the woman is dead and the care was awful. so much wrong here
 
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SSdoc33 said:
its pretty hard to fry the cord with an RF. not sure what to make of that, but it is surprising that there was BOTH the cord damage AND the anoxic injury. regardless, the woman is dead and the care was awful. so much wrong here
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The scheduled procedure was lumbar rhizotomy…how you end up in the spinal cord is beyond me. Maybe he chases every RFA with a lumbar ESI to make the patient feel better, kind of like the laser spine institute used to do? Or everyone in that facility is on drugs.

CRNAs learn their pain procedures on cadavers, maybe the other guy was trying to help recreate a scenario he’s familiar with
 
apparently there was a physician in the room. What was his role? Was he helping the crna do the procedure?
 
technically, a dorsal rhizotomy would affect the cord and be an intentional procedure. but it should only be done by neurosurgery. and not in an ASC.

while an RFA is a rhizotomy, i usually use the term neurotomy or RFA.
 
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Ducttape said:
technically, a dorsal rhizotomy would affect the cord and be an intentional procedure. but it should only be done by neurosurgery. and not in an ASC.

while an RFA is a rhizotomy, i usually use the term neurotomy or RFA.
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One of my spine surgeon partners always refers pts to me for rhizotomy.
 
Ducttape said:
technically, a dorsal rhizotomy would affect the cord and be an intentional procedure. but it should only be done by neurosurgery. and not in an ASC.

while an RFA is a rhizotomy, i usually use the term neurotomy or RFA.
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You referring to DREZ lesioning?
 
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yes.

but when i read the legal notes, they werent doing drez lesioning - they were doing lumbar RFA.


so the guy's technique was, well, spine tingling...
 
You can't look away

Houghton snatches the KO from Molina
 

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...even more confused now TBH.

Why was there a needle in the canal, and he injected 5cc of local at each level afterwards?

Neurophysiologic testing?

How do you get a cord stick on a lumbar RFA?
 
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The letter itself was confusing, and I don't think it was as strong as it could have been.
 
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I think fluoro was used for the RFA, but maybe the fluoro images during the 5cc of local injected directly into the spine went missing or weren’t saved for obvious reasons…so the expert can’t comment on needle placement
 
MitchLevi said:
...even more confused now TBH.

Why was there a needle in the canal, and he injected 5cc of local at each level afterwards?

Neurophysiologic testing?

How do you get a cord stick on a lumbar RFA?
Click to expand...
I believe the answer to each question can be summed up with “CRNA”
 
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This is absolutely disgusting. How did these people convince themselves that anything they were doing was OK?
 
The CRNA is still practicing. I somehow missed that. He isn't in jail.

The doctor he works with must be pretty good bc he does all types of procedures, even Cool Leaf.

1000018865.jpg
 
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Insurance fraud with them using neuromonitoring for a lumbar RFA as well. Lots of layers to this 💩 sandwich
 
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BobBarker said:
Insurance fraud with them using neuromonitoring for a lumbar RFA as well. Lots of layers to this 💩 sandwich
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Is that insurance fraud? I know of it being done around town. It’s supposed to enhance the safety of RFA although ironically not the case here…
 
I think it is only being done in situations where the physician is invested in the neuromonitoring company.
 
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Agast said:
Interestingly this CRNA works alongside actual pain physicians

txphealthcare.com

Team - Texas Partners Healthcare Group

Dr. Ajay Pathak provides care for the overall medical needs of your family in Little Elm, TX for Texas Partners in Medicine.
txphealthcare.com

Why would they hire him when they’re clearly capable of hiring real physicians
Click to expand...
WtF is going on with that practice and why is this incompetent CRNA still doing pain procedures much less anything medically related still?
 
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thiswonthurtabit said:
This is absolutely disgusting. How did these people convince themselves that anything they were doing was OK?
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Easy: $$$, ignorance and arrogance, but mainly $$$. Once I saw neuromonitoring, 100% confidence everything going on there was for $$$. Why these guys aren't in jail and still practicing is simply amazing.
 
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MitchLevi said:
...even more confused now TBH.

Why was there a needle in the canal, and he injected 5cc of local at each level afterwards?

Neurophysiologic testing?

How do you get a cord stick on a lumbar RFA?
Click to expand...
the needle was in the canal because the "proceduralist" didnt know what he was doing.


weekend course, after all...


could have been up to 15 ml of bupiv/lido as a spinal anesthetic.

then Molina also screwed up - could not intubate.
 
Im guessing the patient was thrashing around in pain when they were emerging from anesthesia and the CRNA was blindly injecting local after the procedure and managed to hit the cord? Crazy
 
So, was the anesthesia administered at the beginning of the case, or in the middle due to "patient discomfort"? BC if she was administered an induction dose while prone without a secure airway, there's still plenty of blame to go on the CRNA providing anesthesia
 
I actually think the anesthetist CRNA has less of a blame now because the patient was breathing through the end of the RFA, but he’s such a f#ck up that he didn’t do any of the documentation that could have saved himself.

I’m surprised they haven’t settled, or maybe the husband is not interested in settling. I hope he sees it through.
 
www.beckersspine.com

Texas pain physicians charged in $12M fraud scheme

Two Texas-based pain physicians have been charged in a $12 million fraud scheme for unlawfully distributing controlled substances and submitting false claims to
www.beckersspine.com www.beckersspine.com

Could they make it more obvious? Billed 80 injections on one patient?
1000004663.png
 
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jeez, dumb people dont really know how dumb they are
 
Desi & Deno

Dumb & Dumber?
 
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"The doctors would place a needle on the patient's body without actually piercing the skin to mimic an injection. If patients actually received any injections they would generally only receive a small amount," according to a statement from the U.S. Attorney's Office of the Northern District of Texas.

In multiple instances, the physicians billed for more than 80 injections to a patient on a single date of service. They also allegedly entered injections that weren't performed into the patients' medical records."

Hahaha. WTF.
 
brothers, it appears.

it can get worse....

in the New Patient Packet that patients are supposed to fill out, there is an Opioid Agreement form and a Controlled Substance form.

i guess you have to sign it before being seen.

and sign the credit card form (as they do not accept insurance).
 
Ducttape said:
brothers, it appears.

it can get worse....

in the New Patient Packet that patients are supposed to fill out, there is an Opioid Agreement form and a Controlled Substance form.

i guess you have to sign it before being seen.

and sign the credit card form (as they do not accept insurance).
Click to expand...
No wonder why we can’t get three Rfa levels anymore
 
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From their website mybodyaches.com

Training is respectable but no mention of a pain fellowship. But claims to do spinal cord stimulation and RFAs? Maybe they’re lucky he didn’t actually attempt a real procedure

IMG_9269.jpeg
IMG_9270.jpeg
IMG_9271.jpeg
 
LMAO at the woman who thought she could get whatever she wanted and have her insurance cover it. The other guy knew what’s up.

IMG_9272.jpeg
 
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Fwiw, if we are talking about rfa, I don’t think I’ve ever done more than two levels (I’m talking the facets being denervated) bilaterally. It’s usually been in lumbar bilateral L3,4,5. Or course would depend on anatomy, prior surgery, etc. Why is everyone so up in arms? It’s also like, in lumbar, I’ve always done bilateral so patients don’t have to come in multiple times. Around me countless docs just do one side at a time (not well by the way) and then when patients see me, they are shocked that I tell them I will do bilateral.

I understand the finances, I’m not dumb, but do people have any scruples anymore? Like how much of a difference is there in money to do unilateral vs bilateral. I’m talking lumbar only at this time
 
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