Posted and filed under Commentary.

“Justice delayed is justice denied” by William Gladstone is a quote that comes to mind when I think about fraudulent providers and Elizabeth Holmes.

I am obsessed with the podcast The Drop Out, featuring the trial of Elizabeth Holmes, and this week’s episode was released within days of the 600 pages of personal text messages that came out describing Elizabeth Holmes planning her lavish Vegas trip (top-shelf restaurants, high-end hotels) at the exact time her company, Theranos, was suffering and giving bad results. It is interesting to me that this period of time was about 6 years ago, but only now is she on trial and she has been living a fun life during this time (we have all seen the pictures of her at Burning Man) and I am sure we have seen her apartment with the hospitality heir. It takes so long to get to the bottom of things this big, and the whole time the person who wronged others continues to live high on the hog. Doctors not going to jail, or at least being unable to continue to practice after something bad comes out about them (like killing people for example), is unacceptable. When a provider is convicted, the license is typically suspended pretty quickly. There is usually not a period of time when they can continue to practice after being convicted criminally of something.

Holmes often delivered the heartfelt story of her uncle who died from a cancer that could have been prevented if he had gotten an early warning sign. Interestingly enough, Theranos was supposed to help with giving early warning signs, but rather while ignoring quality control checks, patients’ tests were coming back incorrectly. Ignoring failures in quality control of real patients’ tests is an egregious crime.

Of course, Holmes living life better than most while awaiting trial irks those who have remained ethical without engaging in financial lying, but as we have previously shared, for us, we care more about the patients and what happens to their care.

Turning back to the point of my post, according to the testimony of this Mount Carmel doctor, Dr. Raymond Kraynak did not update a patient’s file for 10 years and ignored signs the woman was abusing opioids. Also, according to this article, a 35-year-old woman had a prescription written to her by Dr. Kraynak for oxycodone in May 2015, even though her file contained records from other doctors saying she was abusing the medications. She died just days later and, according to testimony from Thomas (Dr. Stephen Thomas, of Pain and Disability Management Consultant PC, of Pittsburgh), records from the state Attorney General’s Office showed her last prescription was filled after she had already died. Other points of interest from this article were:

 “Thomas, who has provided expertise on pain medicine for the U.S. Attorney’s Office, the state Attorney General’s Office, the FBI, the Department of Justice and Medicaid fraud, analyzed 50 files of Kraynak’s patients, focusing on 12 patients who died of overdoses. He reviewed those files over four months in 2017.

Thomas said a doctor should always review their procedures when patients die unexpectedly to determine whether anything medically could have been done or changed. But nothing changed in Kraynak’s office, he said.

He testified that Kraynak had a pattern of inappropriate prescribing practices that were not for legitimate medical purposes. Many of the doctor’s decisions did not make sense or were not documented in the medical record, Thomas said.”

What is the punchline? I know a provider who prescribed hydrocodone to his patients and it was reported to the appropriate law enforcement and related organizations, but nothing has happened. It has been 3 years and we are still waiting. The problem is that he is out there still practicing. If we cannot get this provider to stop practicing while we wait for the investigation, what can you do? I say this about us at Advize because we know who work the investigations, and even then, the queue is long and the process sometimes leads nowhere. It is sad and disappointing.

By Jeanmarie Loria