$524,000,000.00
Verdict Against
Health Plan of Nevada
Compensatory Verdict - Click here
Punitive Verdict - Click here
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The Tragedy   The Greed   In Memory Of  
Dr. Cohan warned Health Plan of Nevada in 1997 that Dr. Desai was a dangerous doctor!  To read his courtroom testimony of February 26, 2013 - click here.
CEO of United Health Care, Stephen Hemsley, made a staggering $101.96 million in 2010, the highest amount paid to any CEO in the United States that year.

Stephen Hemsley

The Twelve Commandments of a Safe and Responsible HMO
 (Click here - view PDF file)

 

OPPOSITION TO DEFENDANTS MOTION FOR JUDGMENT AS A MATTER OF LAW
 (Click here - very large PDF file to view - 5MB)

Before Credentialing Committee member Dr. Muthialu testifies on March 18, 2013, Defendant successfully beg the court to prevent Plaintiffs counsel from asking her if she saw Dr. Desai's cobra pit when she went to dinner parties at Dr. Desai's house. Click here to see a cobra pit video.


The Evidence
  The Chief Epidemiologist for the Southern Nevada Health District says that his investigation of the Clinic immediately documented dozens of dangerous procedures by staff. He agrees that Health Plan of Nevada could have easily found the same problems with even a cursory site visit. (Click here to read Labus testimony)   The Chief of Gastroenterology at the largest hospital in Nevada states that he was so concerned that Health Plan of Nevada would re-hire Dr. Desai that he personally drove to their corporate office and told them about 33 cases of billing fraud, 5 cases of medical malpractice and 1 case where Desai altered hospital records to conceal his malpractice. He states that his warnings were ignored and could have prevented the entire hepatitis outbreak. (Click here to read Dr. Cohan testimony)   A former employee at Health Plan of Nevada's surgery center says that Dr. Desai did rushed and shoddy operations there for years before starting his own Clinic. He confirms that the surgery center repeatedly scheduled Dr. Desai to operate on 20 patients in just 3 hours (9 minutes each operation) when all experts agree that colonoscopies should be done in over 30 minutes. He confirms that Health Plan of Nevada management was directly and repeatedly alerted to these serious risks but did nothing. (Click here to read Hawkins testimony)  
             
  A former employee at Health Plan of Nevada's surgery center documents operation where Dr. Desai jerked out the colonoscope so rapidly that feces splattered on the operating room ceiling. The feces is left there for days and causes numerous employees to complain to management that Dr. Desai needs to be terminated. (Click here to read Hawkins testimony)   A former employee at Health Plan of Nevada's surgery center states that Senior Executives refused to allow their family members to be treated by the cheaper doctors that members were forced to use. He documents one case where the Chairman of the Quality Committee demanded that a competant (but more expensive) gastroenterologist be brought in to operate on his wife because she refused to allow the incompetent Dr. Desai to touch her. (Click here to read Hawkins testimony)   The expert hired by the Health Plan of Nevada admits that a reasonable HMO should not hire doctors that will jeopardize the safety of its patients and should not hire a doctor just because he submits the cheapest bid. Health Plan of Nevada contracts with Dr. Desai anyway. (Click here to read Kongsvedt testimony)  

             
  A doctor member of the Committee that approved Dr. Desai as supposedly a “high-quality” doctor admits that he would not vote again for approval if Health Plan of Nevada had revealed that Desai was doing the fastest colonoscopies in the United States (2 to 3 minutes) when the national average is 30 minutes for this screening procedure. He also admits that the hundreds of false billings of 31 minutes for these 2 or 3 minute operations would automatically disqualify the applicant. See Manning February 28, 2013 Testimony.   A nurse member of the Committee that approved Dr. Desai as supposedly a “high-quality” doctor confesses that Dr. Desai should never have been approved given either the investigation by Dr. Charles Cohan or the dozens of prior medical malpractices cases against Desai. She also agrees that the 2 to 3 minute quicky colonoscopies by Desai should have caused in disapproval by itself. See Kinard March 1, 2013 Testimony.   A doctor member of the Committee that approved Dr. Desai as supposedly a “high-quality” doctor admits knowing as early as 2000 that Dr. Desai bragged about doing the fastest colonoscopies in the United States – two years before Health Plan of Nevada contracted with Desai in 2002. He also states that the Committee that approved Desai was not told of the comphrensive investigation by Dr. Cohan of Desai’s misdeeds but should have been. This doctor continues to say that Health Plan of Nevada should have also told the Committee about the 22 medical malpractice cases against Dr. Desai but did not do so. See March 1 2013 Coquit Testimony.  
             
  The competent gastroenterologist that Health Plan of Nevada fired in 1999 to re-hire Dr. Desai confirms that it was generally known in the medical community in the 1990's that Dr. Desai was performing colonoscopies at the amazing speed of 5 minutes or less (“Everybody knew it.”) He also says that the number of these lightning fast colonoscopies in 3 hours (20 operations in one room) or in an entire day (100 operations in two rooms) could not have been correctly done by “Superman” and that, by way of comparison, only 64 colonoscopies each week are done at the entire UCLA medical facility. See March 1, 2013 Fayad Testimony.   Health Plan of Nevada fired Dr. Desai in 1993 because of multiple serious quality of care problems Desai inflicted on their patients at Nevada hospitals. From 1993 to 1999, Dr. Fayad takes over the entire Health Plan of Nevada gastroenterology contract and there are no problems with Fayad’s excellent care of patients. In 1999, the President of Health Plan of Nevada (“Bunker”) calls Fayad and presents him with a take it or leave it offer to either match an extremely low bid from Dr. Desai or lose the entire contract. Dr. Fayad refuses – informing the President that it would be impossible to take care of the patients at this cut rate unless Desai unreasonably cut costs or increased patient volume. Health Plan of Nevada has a stormy Executive Committee meeting where the Medical Quality Director (Dr. Ebbin) insists that Desai be avoided at all costs because of Desai’s horrible care but the President orders that Desai be given the contract to save money. See March 1, 2013 Fayad Testimony.   The former head of contracting confirms that Health Plan of Nevada was very satisfied with the excellent service provided by Dr. Fayad from 1993 to 1999 but decided to send out a request for proposal for the gastroenterology contract to save money. She confirms that an HMO Special Committee including herself, HPN President Bunker, the Doctor Quality Director and another doctor met and that the “prized” contract was taken from Dr. Fayad because he was not the low bidder. She also admits that Dr. Desai’s per colonoscopy rate was so low at $294 per screening colonoscopy that Medicare was paying much more at $459 for the exact same procedure and that a normal HMO rate should have been $588 per procedure. At 10,000 operations a year, this meant that HPN only had to pay Dr. Desai $2.94 Million dollars a year while Medicare would hve paid $4.59 Million dollars a year and a normal HMO rate would have been $5.88 Million dollars a year. She describes the $3 Million a year that Health Plan of Nevada saved through Desai’s bargain basement rate as “a good day for HPN.” See March 4, 2013 Christiansen testimony.  
             
  The premier HMO expert in the United States describes how he has testified before Congress repeatedly, published, lectured, and produced an upcoming CNN documentary on HMOs. He explains that Health Plan of Nevada got five direct financial benefits from the cutrate it negotiated with Dr. Desai for colonoscopies: (1) the HMO reduces is costs by having a low doctor payment rate; (2) the HMO can “buy” new business by offering predatory health insurance rates since it has an extraordinary low cost of business; (3) the new business allows the HMO to increase its market share; (4) having more market share allows the HMO to negotiate discount rates with other doctors and hospitals, further lowering its cost of business; and (5) after it becomes the dominant HMO in the community, the HMO can raise insurance premiums much faster than the national average. The expert observes that Health Plan of Nevada doubled its membership from 199,000 to 400,000 during the 7 years it contracted with Dr. Desai (1999-2007) and states that this is an unprecedented achievement for an HMO. The expert explains how saving $3 Million a year on what it paid Dr. Desai on the extraordinary low colonoscopy payment rate (compared to the much higher hypothetical rate that national models would predict) allowed the HMO to increase its market share to the point of over 80% of the HMO market in Las Vegas. See March 5, 2013 Potter testimony.   Dr.Pierce was a member of the Credentialing Committee.  He said that HPN should have given him the Cohan information and that, if told about the Cohan information, that persons should not have gone to Dr. Deai or ECSN.  See March 18, 2013 Pierce testimony.   Dr. Muthialu testified that she was a member of the Credentialing Committee and that, in a typical year, HPN did on-site inspections of twenty different surgical centers.  But HPN admits that HPN failed to inspect ECSN at any time from 1999 to 2007.  Dr. Muthialu also says that HPN should have given her the Cohan information and that, if told about the Cohan information, neither Dr. Desai or ECSN should have been approved.  See March 18, 2013 Muthialu testimony.  
             
  Dr. Evans is an anethesiologist who was HPN's Chief Medical Director and third highest ranking employee. He admitted personally giving anethesia for hundreds of fast colonoscopies by Dr. Desai and knowing that Dr. Desai did "15 to 20 in an afternoon" and knowing "how long it took him (Dr. Desai) to do operations."  Dr. Evans concedes that ten minutes is the shortest possible time period feasible to do an adequate screening colonoscopy.  When confronted with the fact that the 20 colonoscopies in just 3 hours that Dr. Evans admittedly saw Dr. Desai perform for years averaged out to just nine minutes per colonoscopy. (well under the ten minute shortest possible operation time), Dr. Evans admits that HPN should have been "concerned" about Dr. Desai's overly rapid operations.  See March 19, 2013 Evans testimony.   Dr. Gex as employed as an anethesiologist by HPN and sent to work at ECSN.  He admits giving anethesia for 18 operations in just one day at ECSN and that it was very unusual ("atypical") for a gastroenterologist to do such hasty colonoscopies. See March 20, 2013 Gex testimony.   Dr. Ebbin was the former President of HPN's surgery center and the current Vice President of HPN's Doctor Quality Department.  He admits that he sent his wife to the competent gastroenterologist that HPN terminated in 1999 (Dr. Fayad) for NINE colonoscopies, including mu7ltiple colonoscopies during the EIGHT years that Dr. Desai was HPN's designated gastroenterologist.  See March 20, 2013 Ebbin testimony.  
             
  John Bunker was the President of HPN from 1994 to 2010.  Bunker admits that Defendants withheld $210 Million in budgeted payments to doctors in 2003, 2004 and 2005 and kept the money for itself.  Bunker agrees that HPN could have hired an additional 1,400 doctors with the $210 Million of the doctor budget that HPN instead took for additional executive compensation and shareholder profits and admits that 1,400 more doctors would have dramatically improved medical care for HPN members.  See March 21, 2013 Bunker testimony.          


  Robert Eglet, trial attorney for the plaintiffs, during opening statements in Las Vegas hepatitis C trial for role of Health Plan of Nevada in largest hepatitis C outbreak in U.S. history. Eglet tells jurors he will prove the HMO knew about the practices of the doctors and clinics and did nothing even though they knew it was dangerous for Nevada families.   1