Dr. Anita Louise Jackson, an ENT physician from North Carolina, was found guilty of cheating Medicare out of millions of dollars by reusing single-use surgical instruments on more than 1,400 patients.
The verdict was upheld by a federal appeals court. Jackson’s appeal was denied by the Fourth Circuit Court of Appeals, which maintained her June 2023 sentence of 25 years in prison.
Jackson, 63, was found guilty of several offenses, including identity theft, fraud, conspiracy, and device adulteration.
The court’s ruling highlights the gravity of her offenses, which included misleading Medicare and patients in addition to breaking safety regulations for medical devices.
Dr. Jackson conducted balloon sinuplasty operations, a surgery commonly used to address sinus problems, in her clinics in Rockingham, Lumberton, and Raleigh.
Jackson charged Medicare about $46 million for these operations between 2014 and 2018. Based on the evidence, she performed over 1,500 operations using just 36 FDA-approved Entellus devices.
Jackson broke stringent rules that mandate that each device be thrown away after only one usage by using these single-use devices on several patients.
This procedure was obviously against medical guidelines and put patients at serious risk.
Jackson was charged by prosecutors with selling her operations as a “sinus spa,” urging clients to get treatments they might not have required.
Her practice soon rose to the top of the balloon sinuplasty billing list in the country, which alarmed auditors. Jackson and her employees reacted to these auditors’ investigation of her clinic by fabricating medical records and patient signatures in order to hide their activities.
Jackson tried to claim during the appeals process that the gadgets she used were not legally “held for sale,” which would have rendered some of the rules pertaining to their reuse invalid.
She also asserted that regulations permitting off-label usage of medical gadgets protected her. However, the court dismissed these defenses, concluding that her activities were in violation of federal regulations.
Jackson also attempted to provide proof of her cleaning practices for the repurposed equipment, but the court determined that these practices did not adhere to the necessary medical safety regulations.
Additionally, Jackson cited Centers for Disease Control and Prevention (CDC) papers that recommend the reuse of specific medical equipment under some circumstances.
The court made it clear, nonetheless, that neither Jackson’s cleaning methods nor the particular Entellus devices were covered by these documents because they had not been proven to adhere to the proper requirements.
Jackson’s conviction included a forfeiture order for $4.7 million in earnings she made through deception. She will also be subject to three years of supervised release following her prison term.
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The decision reaffirms the need of upholding moral medical standards and the dire repercussions of misusing patient trust and scamming public programs.
“This doctor put profit over patients by reusing single-use surgical devices hundreds of times, even though those devices came into contact with blood and other bodily fluids,” U.S. Attorney Michael Easley stated after her conviction.
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