HIFU Doc Arrested Again, This Time for Fraud

Nick Mulcahy

March 14, 2018

Urologist Ronald Wheeler, MD, has been arrested for a second time in less than a year in his hometown of Sarasota, Florida, for scheming to defraud a man out of $20,000 to $50,000.

Wheeler, 71, reportedly arranged for the man to be treated for prostate cancer with high-intensity focused ultrasound (HIFU) and collected payment before the procedure, which never took place, according to an online police statement.

Wheeler was arrested last year for practicing medicine without a license.

But this week, Wheeler told Medscape Medical News that he is the victim of "an absolute witch hunt."

Wheeler acknowledges that he received money from the Kansas man and that he never performed any therapeutic procedure. "I owe him the $46,500. I have every intention of paying him back," he said.

There has been a "misunderstanding" but not fraud, said Wheeler.

He also said that inaccurate clinical details from the published police statement are evidence of a "shoddy" investigation.

The story of the fraud, as told by the Sarasota police, is a tale with some unusual twists that spans nearly 2 years.

In May 2016, according to police, a Kansas man contacted Wheeler, who is known to attract patients through Internet promotions. Wheeler allegedly told the man over the phone that he likely had prostate cancer.

Soon after, the man travelled to Sarasota, where Wheeler reportedly performed a physical exam and ultrasound and diagnosed aggressive prostate cancer, according to the police statement.

The diagnosis was made without a tissue biopsy and thus violated the minimal standard of care per the Florida Board of Medicine.

In June 2016, Wheeler sent the man to a physician colleague in Connecticut, who, police said, performed a biopsy, which was negative for cancer. However, Wheeler reportedly told the man that the biopsy had missed the cancer.

In August 2016, Wheeler was back in touch with the man, who wired the urologist $46,500 for a HIFU procedure, at Wheeler's request. After some time in which no procedure occurred, the man requested and received a refund.

Then in November 2016, Wheeler allegedly told the man that his HIFU procedure was "back on schedule." Once again, the man paid $46,500.

However, after this point, the man consulted with his personal physician, who suggested finding another provider. The man asked for his money back. Wheeler agreed, said police, but then "cut off communication" with the victim and kept the money.

Months later, in April 2017, Wheeler's medical license was revoked by the Florida Board of Medicine because of his practice of diagnosing prostate cancer without a biopsy.

The man returned to Sarasota in June 2017 and learned from another Sarasota urologist that Wheeler was no longer licensed. The man also was told by that second doctor "that he had no cancer at all," according to police.

Wheeler's Side of the Story

Wheeler has a different story of events with the Kansas man.

Needle biopsy was not performed as part of the diagnosis of the man's prostate cancer because the patient "wanted nothing to do with a biopsy," Wheeler said. Also, the diagnosis was made with MRI and not ultrasound, as police say in their report, said Wheeler. No one diagnoses prostate cancer with ultrasound, he added. "They are throwing mud at the wall," said Wheeler about the ultrasound claim.

Wheeler acknowledged that he sent the patient to a Connecticut physician to undergo a transurethral incision (TUI) of the bladder neck, which, he said, is standard procedure before HIFU treatment. The tissue removed during the procedure, which is also called a mini-transurethral resection of the prostate (TURP), was negative for prostate cancer, he said.

But that is not a prostate tissue biopsy, as the police claim. "They're muddling all the facts," Wheeler said about the police.

Wheeler said  that "to my knowledge," only one payment — not two payments — came from the man. No initial $46,500 payment was returned. "I never sent it back. That's a lie," he said.

But Wheeler then conceded that his ex-wife, Shelley Cleveland, who was the practice's business manager at the time, could have reimbursed the man after an initial payment, without his knowledge.

Wheeler said that the other Sarasota physician who eventually saw the Kansas man was Steve Scionti, MD, a urologist who is also a HIFU practitioner and Wheeler's local competitor for patients. Scionti performed a 12-core needle biopsy on the man. But Wheeler said Scionti did not communicate the test result precisely and "upset" the patient. Scionti said, "You don't have cancer," according to Wheeler.

"What he should have said was 'The biopsies showed no evidence of cancer.' " This phrasing allows for the possibility that the 12-core biopsy missed the cancer, which is common — "upwards of 50% of the time," he said.

Wheeler believes the current charges against him are not a criminal matter but instead constitute a civil case.

He has not been able to pay back the Kansas man because "when my license was taken away, everything came to a crashing halt."

Wheeler also disputes the validity of his arrest last summer for practicing without a license.

The arrest occurred after an anonymous complaint to the state's Department of Health that Dr Wheeler was still practicing medicine despite the revocation of his license in April 2017.

Local police then went undercover at Dr Wheeler's HIFU Centers of America office in Sarasota. The undercover policemen, who posed as patients with prostate cancer, were told that the office visit cost $3445 and that the recommended HIFU-based treatment plan started at $50,000.

However, in speaking with Medscape Medical News, Wheeler described a July 2017 meeting with one man who was an undercover detective. Wheeler said the man was not charged any money and that no paperwork or exam took place. Wheeler said he spoke to the man as an author and a fellow man concerned about prostate cancer — not as a doctor. "I explicitly said this was not a doctor-patient relationship," he said. 

Wheeler is the author of the 600-page book Men at Risk: The Dirty Little Secret That Prostate Biopsies Really Do Spread Prostate Cancer Cells. In an online promotional video, Dr Wheeler says the book explains that "imaging should precede biopsy, if a biopsy is ever done."

The idea that MRI has a role to play in screening and diagnosing prostate cancer has a growing body of evidence in support of it. But the widely agreed-upon gold standard in diagnosing a cancer is tissue biopsy and subsequent histopathology. However, multiparametric MRI is increasingly used in the diagnostic process.  Nevertheless, MRI is not foolproof and may also miss some cancers.

Follow Medscape senior journalist Nick Mulcahy on Twitter: @MulcahyNick

For more from Medscape Oncology, follow us on Twitter: @MedscapeOnc

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