Spine Surgeon Gets Almost 20-Year Prison Sentence for Fraud

January 09, 2017

Aria Sabit, MD, a spinal surgeon who admitted to unnecessary as well as fake operations, was sentenced today to a prison term of 235 months — almost 20 years — in a federal district court in Detroit, Michigan.

Federal prosecutors had sought a long sentence for the 43-year-old surgeon to deter other Detroit-area physicians from committing fraud.

"As this court is well aware, the Eastern District of Michigan has a particular problem with corrupt physicians willing to sell their licenses and judgment in pursuit of personal gain, sometimes at the expense of their patients," prosecutors told US District Judge Paul Borman in a sentencing memorandum in 2015. "In the past six years, more than 60 doctors in this district have been charged with misuse and abuse of their licenses in a variety of healthcare fraud, drug distribution, and/or kickback cases."

There were two chapters in Dr Sabit's criminal career. Practicing at Community Memorial Hospital in Ventura, California, he invested $5000 in a physician-owned distributorship (POD) of screws, plates, rods, and other pieces of spinal instrumentation in 2010 and convinced his hospital to use the gear, prosecutors said. Entitled to "profits" from the POD, called Apex Medical Technologies, Dr Sabit then went on a spree of unnecessary surgeries as well as legitimate ones in which he overloaded patients with hardware. Illegal kickbacks from Apex, which ended in June 2012, came to almost $440,000, according to court records.

Prosecutors described some of the operations as "plain butchery." Nearly 30 of his patients in California — operated on in just an 18-month stretch — later sued him for malpractice. During those 18 months, he accounted for 71% of all patients who were unexpectedly readmitted to Community Memorial Hospital following surgery. Several died from complications, according to whistle-blowing colleagues. The hospital temporarily suspended his privileges in December 2010, explaining that it was necessary to "protect the life or well-being of patients."

In early 2011, his career in California up in flames, Dr Sabit moved to the Detroit area, where the second chapter of fraud unfolded. His use of spinal instrumentation from Apex sharply declined, leading to a break in that relationship, but prosecutors said Dr Sabit hit upon a new scheme. He persuaded patients to undergo spinal fusion surgery with metal instrumentation, but subsequent diagnostic imaging revealed that he never installed the hardware, just bone dowels, and never achieved fusion.

Dr Sabit, a husband and father of three, was arrested on November 24, 2014, and hauled into court unshaven, disheveled, and wearing jeans and a white T-shirt. In May 2015, he pleaded guilty to various counts of fraud, one count of conspiracy to commit fraud leading to serious bodily injury, and one count of illegally distributing a controlled substance. The Department of Justice stated in a news release at the time that Dr Sabit had stolen $11 million from Medicare, Medicaid, and private insurers.

The sentencing was originally scheduled for October 2, 2015, but Judge Borman called it off after throwing out the plea agreement that Dr Sabit's attorneys had worked out with prosecutors, who were seeking a sentence of 9 to 11 years. The surgeon pleaded guilty again, but wrangling over how the court should calculate the sentence consumed more than a year.

All along, Dr Sabit has remained behind bars because the federal district court in Detroit deemed him a flight risk. An Afghanistan refugee who became a US citizen, Dr Sabit had entertained ambitions of going into the oil and mining business in his native country, where he claimed politically powerful relatives.

Detroit Area Is a Hotbed for Criminal Medicine

In court papers filed over the past 16 months, Dr Sabit's attorneys cited a number of reasons why their client should receive a lighter as opposed to a heavier sentence. They produced letters from past patients full of high praise.

"You truly have healing hands," wrote one patient. "I am so grateful. I can't thank you enough. My pain is gone." Another patient wrote to Dr Sabit's hospital in California, "I am now aglow with ecstasy because of his success in dispelling my constant head pain."

As for injured patients, his lawyers said, Dr Sabit has attempted to make restitution. And he was "truly ashamed and remorseful for the conduct which brings him before the court."

Dr Sabit composed his own plea for mercy, and not only for himself, but for his family. In a court filing last November, he described how he survived persecution as a Jew in Afghanistan, sold bubble gum and cigarettes in a refugee camp in Pakistan, went hungry as an immigrant in Virginia, and finally won a college scholarship that led to medical school.

"I came from absolutely nothing to become a neurosurgeon and squandered the opportunity," Dr Sabit said. "I do not deny my guilt."

However, the physician's long memo backtracked on previous admissions of guilt, according to prosecutors. "I did not perform surgery that was unnecessary," he said about his practice in California. "I performed appropriate surgeries incorrectly and developed infections in some." However, he had previously admitted to unnecessary surgeries in his earlier guilty pleas.

Likewise, he originally pleaded that he had fraudulently billed third-party payers for phantom spinal fusions in Michigan even though he never installed the necessary metal screws. However, in his recent memo to the court, Dr Sabit said that he had used bone dowels to "facilitate" fusion, which has "nothing to do with the use of metallic screws." Prosecutors countered that Dr Sabit's assertion was "contrary to accepted medical opinion."

Prosecutors said he warranted a sentence that would make other physicians think twice about following in his footsteps. The Eastern District of Michigan, they noted in 2015, is a hotbed for criminal medicine, with some 300 individuals indicted on Medicare fraud charges there from 2009.

"Physicians are the gatekeepers to Medicare and hold the trust of both their patients, and the program," they said. "Dr Sabit's sentence should reflect the particular need to deter physicians from engaging in healthcare fraud."

Follow Robert Lowes on Twitter @LowesRobert

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