by Tim Farley.
DOCUMENTS REVEAL PATTERN OF ABUSE BY STATE MEDICAL BOARD
OKLAHOMA CITY – A group of competing doctors, medical malpractice attorneys and the Oklahoma Board of Medical Licensure conspired to ruin a Tulsa spinal surgeon’s practice and reputation, according to a recently filed lawsuit and documents obtained byRed Dirt Report.
Dr. Steven Anagnost, of Tulsa, had made a remarkable name for himself as a top-notch spinal surgeon using a procedure known as Minimally Invasive Surgery (MIS). His patients were enjoying the results and were healing faster with less hospital time. But his Tulsa competitors, who were using more traditional surgical techniques, were feeling the pinch as more and more patients began going to Anagnost to correct their health problems.
That’s when a group of surgeons, organized under the umbrella of Oklahoma Spine and Brain Institute (OSBI), approached Anagnost about investing in their privately-owned Tulsa Spine & Specialty Hospital. He politely declined the 2005 offer, which for him, was the beginning of a long, tragic ordeal that would ultimately ruin him financially and professionally.
“Shortly after, a jihad started to get rid of me,” said Anagnost, considered one of the top three spinal surgeons in a city of about 44. “It’s the oldest reason in the book – greed. I was doing a better job, my practice was thriving and I was charging less. I didn’t trust these guys to go into business with them.”
Every time Anagnost operated on patient, it cut into the profits of the surgeons at OSBI, where a traditional spine surgery might cost as much as $50,000, the doctor said.
It wasn’t long before a plethora of lawsuits were filed against Anagnost, including some from medical malpractice attorney Gary Brooks, who had a clear conflict of interest since he served as a member of the medical licensure board. He was appointed to that position in 2003 by former Gov. Brad Henry.
“I didn’t have any lawsuits against me until then,” Anagnost said. “I had never been in court and I had been practicing in Tulsa since 1999,” he said. “And, lo and behold, the experts in those cases were from OSBI.”
Brooks’ appointment to the medical board was criticized by then-Oklahoma Senator Scott Pruitt, who now serves as the state’s attorney general, and then-Lt. Gov. Mary Fallin.
“The appointment of Gary Brooks or, for that matter, any trial lawyer who makes his living suing doctors, to the medical licensure board creates an outrageous, unacceptable conflict of interest,” Pruitt said in 2003.
Fallin compared the appointment to “a fox guarding the henhouse.”
In 2009, the number of lawsuits filed against Anagnost started to increase.
“At this point, I’m becoming more concerned,” Anagnost said.
In October 2009, surgeons from OSBI began making unsubstantiated verbal and written complaints against Anagnost to the Oklahoma Medical Licensure Board, according to a lawsuit filed in Oklahoma County by Anagnost against several defendants, including some of his former competitors.
The complaints, brought by competing surgeons, centered on allegations of fraudulent billing and not performing the surgeries Anagnost had promised his patients. In January 2010, the medical board held a secret meeting at the Southern Hills Marriott in Tulsa to interview competing spine surgeons about patients who had previously been under Anagnost’s care, documents show.
The clandestine attacks, secret emails and the alleged cover-up in the Anagnost case were far from over.
“Every person, from the plaintiffs’ attorneys and the competing doctors, were making money at my expense,” Anagnost said. “There were complaints coming from the medical malpractice attorneys with and without patient knowledge.”
An emergency hearing in the case against Anagnost was held June 18, 2010, but was dismissed the same day because of the volumes of evidence he presented to the medical board. That decision by Assistant Attorney General and medical board legal counsel Libby Scott left the complaining doctors, particularly those at OSBI, irate and outraged.
“I embarrassed them and humiliated them,” Anagnost said. “They had egg on their face.”
Still, Anagnost’s case remained open and on the board’s monthly docket, allowing public speculation that the doctor’s practice remained under scrutiny.
“Basically, what they said is your license is fine but we’re not sure if we’ll keep the investigation open. It went on for months and months which turned into years,” he said. “In the meantime, more lawsuits are coming in.”
A June 20, 2010 memo obtained by Red Dirt Report shows the board’s medical advisor, Dr. Eric Frische, tried to explain to board members why the state dismissed the complaint against Anagnost.
“I think we felt that we wanted to catch him off guard but clearly he wasn’t,” Frische wrote. “In future cases like this one, we might consider an interview with multiple interviewers and do so on the record and probably in our Board office where we can record the interview. That should be adequate to catch doctors off guard.”
Frische also wrote in the memo that he and other board members were “surprised that our experts’ testimony didn’t hold up once Dr. Anagnost presented his defense. The flaw with our experts was that they didn’t appear to have expertise with the minimally invasive spine surgery.”
The experts were identified as Dr. Frank Tomacek and Dr. David Fell, who both were at that time major investors in Tulsa Spine & Specialty Hospital. Neither Tomacek nor Fell had ever performed minimally invasive spine surgery.
Back to court
More than 25 lawsuits were filed against Anagnost by Brooks, Randy Sullivan and the Sneed Lang law firm in Tulsa. In each case, the attorneys had conflicts of interest based on their connections to the medical board, which is appointed by the governor. Sullivan, a private medical malpractice attorney, also served as a prosecutor for the board. The Sneed Lang firm, according to Anagnost, had received much of their information for lawsuits from the medical board. That, Anagnost said, is a clear violation of the board’s policies.
“The board has an obligation as a state agency to give me due process and they didn’t, which is a clear violation of their policy, the state Constitution and the U.S. Constitution,” the doctor said.
Brooks and Sullivan filed their lawsuits against Anagnost from 2008 to 2010, a time period when Brooks was still serving as a board member and Sullivan was working for the board. Neither attorney could be reached for comment.
On Oct. 28, 2011, medical board investigator Gayla Janke wrote an email to Tomacek urging him to round up as many cases as possible against Anagnost.
“It is important to Dr. Anagnost’s case that all 25 of the patients whose case is with the Sneed Lang Firm (and any other patient you know of that has been injured) fill out the attached Complaint Form, and send it back to the Medical Board. The more Complaints we have the better,” she wrote.
About 18 months after the emergency hearing, it became clear that the medical board was still pursuing a case against Anagnost. An internal email obtained by Red Dirt Report shows Janke corresponded with medical board Executive Director Lyle Kelsey, Scott and Frische detailing a telephone call she had with Tulsa medical malpractice attorney Jennifer DeAngelis.
“She (DeAngelis) blasted me hard about the Board’s lack of action against Dr. Anagnost. She said things like ‘The doctors that are helping us and helping you are ready to do anything we need to do to help the Board with this case. We will get the patients to talk to you,’” Janke wrote.
About an hour later on Dec. 8, 2011, Kelsey wrote in an email to Scott, “Why don’t the doctors get the hospital(s) to do something against his privileges if they are so aghast.”
In a separate email to Scott on the same day, Kelsey wrote, “She (DeAngelis) needs to be castigated for trying to second guess our process and work on getting him (Anagnost) kicked off the Tulsa hospital staffs.”
Kelsey did not return phone calls for comment in connection with this story.
During that same 18-month period, Anagnost was not allowed a hearing to defend his practice and reputation despite the board’s repeated publication of alleged wrongdoing by the doctor on its website.
“One can only conclude that this delay was because there was no credible evidence against him to support the board’s case,” according to lawsuit filed by Anagnost against the medical board members, Kelsey, competing doctors and three medical malpractice attorneys.
The medical board was scheduled to hear the case on July 22, 2010, but that was hearing was improperly continued, the lawsuit alleges. Seven additional continuances were granted, all without a written motion requesting the continuances and without any involvement of the board members.
“These procedures violated legal requirements designed to protect physicians in Dr. Anagnost’s position,” the lawsuit states.
After years of fighting what Anagnost describes as the “unholy Trinity,” – competing doctors, plaintiffs’ attorneys and the medical board – the doctor filed a lawsuit against the board in July 2013. Within two weeks, the attorney general’s office called Anagnost’s attorney, Barry Smith, and offered a settlement.
As a result, Anagnost paid a $100,000 fine and agreed to return to the University of Louisville Medical Center where he performed his fellowship in spinal surgery years earlier. During his brief stay at Louisville, Anagnost was recertified in spinal surgery. As part of the settlement, he also agreed to take a course in medical recordkeeping and medical billing.
It wasn’t long after the settlement was finalized that Anagnost and his legal team discovered the medical board and its executive director had lied on several occasions about sharing information with medical malpractice lawyers. That revelation sparked Anagnost’s most current lawsuit.
The lawsuit, which was amended to add more defendants on Dec. 12, states Anagnost and his attorneys were shown documents in April 2014 revealing the “board’s investigation and prosecution was not fair and impartial and the settlement was procured by fraud, misrepresentation and coercion.” Had Dr. Anagnost known the information about the Board’s investigation and prosecution he would not have signed the settlement agreement dated Sept. 12, 2013, the lawsuit states.
“The information currently known that was unknown to Dr. Anagnost at the time he signed the release reveals the Board did not conduct (in appearance or in fact) a fair and impartial investigation, conspired with his competitors to manufacture claims against him, did not have credible evidence to supports its claims against him, did not preclude or protect him from obvious conflicts of interest of its Board members or specially retained prosecutors and biased its Board Members with improper disclosure of staff and investigatory communications,” the lawsuit states.
According to the lawsuit, the medical board assured Anagnost that medical malpractice attorney Brooks had no involvement or influence in the investigation and prosecution against him. But in April of this year, Anagnost learned the medical board had lied to him.
“Soon after Dr. Anagnost prevailed at the Emergency Hearing, Defendant Brooks began coordinating and working with Defendant Janke on the review of patient files and other information gathered as part of the investigation against Dr. Anagnost,” the lawsuit states.
Three months before the emergency hearing, Brooks was working jointly with Janke to prepare the case against Anagnost. A March 18, 2010 email from Janke states, “Mr. Brooks has met with investigator and received and provided medical records, deposition, transcripts, radiology films and other evidence belonging to the patient.”
Additional documents show Janke was in contact with Brooks on more than eight occasions following the emergency hearing with all of their discussions centered on the Anagnost investigation.
Barry Smith, an attorney with the McAfee & Taft law firm which represented Anagnost in his original lawsuit against the medical board, said he had not witnessed this level of persecution in 30 years of practicing law.
“What happened to Dr. Anagnost could happen to anyone whose reputation depends on a license,” he said. “It’s incredibly frightening that a state agency has that kind of power.”
Long lasting impact
During a five-hour interview with Red Dirt Report, Anagnost talked about the effects the investigation and continued persecution has had on him personally and his family.
“It was absolute war with no rules. They even brought my kids into this by spying on them at school. It was horrible for my wife and kids. I had to miss birthdays and holidays because of this,” he said. “And yes, I’m ruined financially. I’ve spent millions on legal fees and settlements.”
The ordeal has left the physician frustrated and mad that a state agency has been so vindictive toward him with no valid reason or cause.
“I have a (medical) license that I fought and fought for, but it’s not worth the paper it’s written on,” he said. “There is right and there’s wrong and this has been wrong since the beginning.”
Once an active triathlete and surfer, Anagnost rarely, if ever, enjoys the outdoors anymore.
“I hardly get to exercise,” he said. “I sit at the computer and look at all these facts so I can make my case.”
In the meantime, his patients and those he could have helped continue to suffer, Anagnost said.
“Patients are not getting quality, inexpensive care like they used to. My success speaks for itself, but it was my success that made the target so big on my back. This is about racketeering, corruption, economic terrorism and violating the public trust on the part of the board, the plaintiffs’ attorneys and my competing surgeons.”
Right now, Anagnost said he couldn’t move to another state to jump start his medical career because the medical board has shared its investigation and prosecution with other states.
“It’s not until I clear my name can I leave Oklahoma if that’s what I choose to do,” he said. “I need a piece of paper from the governor, the legislature, from somebody, that says this doctor has been mistreated by the State of Oklahoma.”