Heart Patient Sues Tenet, Physician

Last June, shortly after his 55th birthday, John Corapi got the bad news from Dr. Chae H. Moon, director of the cardiology department at Tenet Healthcare Corp.’s Redding Medical Center. Corapi had splits in his arteries, according to Moon’s June 11 report. His recommendation: bypass surgery.

Over the next two weeks, Corapi sought second opinions from doctors in Las Vegas, where he had previously lived. Corapi met with five cardiologists, said his lawyer, Dugan Barr, and all of them told Corapi there was no need for bypass surgery.

Barr said Corapi, a Catholic priest, told Redding Medical Center’s chief executive about the discrepancy but was told to stick with Moon’s plan. Then, Barr said, his client contacted the FBI, triggering what has become a major investigation of possible fraud involving Moon and another Redding doctor, Fidel Realyvasquez Jr. Authorities are investigating whether the doctors performed unnecessary heart procedures on hundreds of patients. No charges have been filed against either man.

Federal authorities have not said the hospital or Tenet are targets, although about 40 agents raided the medical center on Wednesday, seizing records and computers. The probe, which was made public Thursday, has created a crisis for Tenet Healthcare.

On Friday, Corapi’s attorney filed a lawsuit in Shasta County Superior Court against Moon, the hospital and Tenet, accusing them of negligence, fraud and deceit. Corapi was traveling and could not be reached.

The Santa Barbara-based hospital company sought in a long conference call to restore confidence among investors and analysts who have hammered the stock amid concerns about Tenet management’s integrity and responsibility for the doctors’ behavior.

Tenet’s chairman and chief executive, Jeffrey C. Barbakow, apologized for waiting a day before disclosing news of the raid, and company officials added more details about the launch of an internal investigation into the practices of Moon and Realyvasquez, who have been practicing in Redding for many years.

Christi R. Sulzbach, Tenet’s executive vice president and general counsel, said that every future medical procedure Moon and Realyvasquez propose to do at the hospital would be reviewed by an independent physician to ensure that it is medically necessary.

The two doctors still have operating privileges at the Redding hospital. Analysts questioned why they were still practicing there, and Tenet said that is up to a committee of doctors at the hospital.

Moon and Realyvasquez, chairman of cardiac surgery at the hospital, could not be reached Friday, but Realyvasquez’s attorney has said that the case is a disagreement among doctors about what constitutes proper medical care.

In an affidavit filed by FBI Agent Michael Skeen, whom Barr said his client had first contacted, the two doctors performed an unusually heavy volume of heart catheterizations and other procedures, including bypass operations. The FBI said that as many as half of the procedures may have been unnecessary, based on opinions of other doctors.

Some analysts said they came away from the 2 1/2-hour conference call feeling better about Tenet. But they remained wary of the company and its stock. The teleconference was held after the close of markets. Tenet’s shares continued their descent Friday, down 8%, or $2.25, to $26.50 on the New York Stock Exchange. Counting Thursday’s $10.22 share-price drop, Tenet’s once highflying stock has fallen by more than one-third in just two trading days.

Among analysts’ concerns is that the FBI has said in the affidavit that some doctors in Redding had raised concerns about Moon and Realyvasquez to top hospital administrators.

Calls to Harold Chilton, the Redding Medical Center’s chief executive, and other hospital administrators were referred to Tenet. In the conference call, Sulzbach said she had not talked to Chilton, but she said that “our best information” was that the CEO had never been approached by doctors with such allegations.

Barr and other lawyers in Redding, who reported receiving dozens of calls Friday from former patients of Moon and Realyvasquez, said they found it hard to believe that Tenet officials missed red flags.

“Other cardiologists in town have complained” about the two doctors, said Robert Simpson, who has been a lawyer in Redding for 22 years. How could Tenet deny knowing of problems “when they have two doctors in Redding, a small regional center, producing more income than doctors in large regional centers?” he asked.

According to the Redding Medical Center’s Web site, the hospital performs about 200 heart catheterizations a month and 700 open-heart surgeries annually. Residents of Redding said the hospital frequently advertises its California Heart Institute as a highly rated center with low morbidity rates.

According to state filings by Tenet, the Redding hospital generated pretax net income of $94 million in the 12 months ended June 30 -- the highest among Tenet’s 40 hospitals in California. Mercy Medical Center, the other hospital in Redding with slightly more beds, reported pretax net income of about $5 million in the same period.