Feds: Doc made cuts for cash
By KIM JANSSEN Federal Courts Reporter August 31, 2013 2:08AM
Dr. Vittorio Guerriero in 1979.
Updated: October 2, 2013 6:28AM
To those he treated at a dozen Chicago-area hospitals, he’s Dr. “Vic” Guerriero, a third-generation doctor with a reassuring 35 years of experience.
To the feds, he’s “Physician E” — a surgeon they say cut “medically unnecessary” holes in the necks of his patients as part of a ghoulish and sometimes deadly money-making scheme.
It isn’t the first time his ethics and competence have been questioned.
But now Vittorio Guerriero is facing a fight for his reputation, his career and potentially his freedom as one of the key targets of a major federal investigation of an alleged multimillion-dollar Medicare and Medicaid fraud at the now-closed Sacred Heart Hospital on Chicago’s West Side, sources say.
Guerriero, 64, who lives in Lake County near North Chicago, hasn’t been charged with any crime, and he continues to hold a license to practice in Illinois. He denies any wrongdoing and has “always acted to the highest standards of his profession,” according to his attorney, Anthony Onesto.
But sources familiar with the ongoing federal probe told the Sun-Times Guerriero is the doctor the FBI earlier this year alleged in court papers had performed 28 questionable tracheotomies on poor, elderly and mostly black patients at Sacred Heart, five of which resulted in death.
The for-profit hospital’s wealthy owner, Edward Novak, allegedly pushed for such procedures, calling them his “biggest money-maker,” worth up to $160,000 each in government payments whether or not the patient survived.
The mortality rate for those Guerriero operated on was more than three times the state average, the feds say.
According to court records, Guerriero or his insurers have paid a total of more than $1 million to settle four malpractice lawsuits in the past seven years. And he has been stripped of his staff privileges at one Chicago hospital and of his surgical privileges at another, according to court papers.
On one occasion, he allegedly removed a woman’s ovary even though he did not have privileges to perform gynecological surgery and had been ordered not to by his boss.
On another, he was disciplined by the Illinois Department of Financial and Professional Regulation after he was accused of improperly and repeatedly prescribing painkillers to a cocaine addict who later died of an overdose.
To the fury of the addict’s family, Guerriero — who was also formally accused of an inappropriate business relationship with the addict — collected nearly $300,000 and a luxury Mercedes from the addict’s estate after he died, records state.
The scandal at Sacred Heart came to light in April when FBI agents and U.S. Department of Health and Human Services investigators ended a two-year undercover investigation with a raid on the hospital at 3240 W. Franklin.
Four doctors — Venkateswara Kuchipudi, 66; Percy May Jr., 75; Subir Maitra, 74, and Shanin Moshiri, 57 — were charged with a classic kickback scheme. Prosecutors said the doctors received illegal payments orchestrated by Novak and his finance chief, Roy Payawal, in return for phony patient referrals.
Far more serious allegations were spelled out in a search warrant affidavit, which accused Novak of coordinating the tracheotomy scam.
It worked like this, the feds say: First, another doctor, identified as “Physician D,” would give an order to “snow the patient” — deliberately over-medicating until only the whites of the patient’s eyes were visible.
Then, when the drugged patients were too drowsy to breathe unassisted, the feds say, the tracheotomies were ordered.
That’s where Guerriero came in, according to the feds, having the excuse he needed to cut a hole in the patient’s neck and insert a breathing tube.
Though Physician D was not named in court papers, Dr. Venkata Buddharaju’s attorney, Thomas Breen, confirmed that Buddharaju is “D.”
But Breen said the allegations against Buddharaju, who has not been charged, “don’t conform to the medical care or decisions” he made.
U.S. District Judge Amy St. Eve last month gave prosecutors until the end of September to wrap up a grand jury investigation into the original allegations against Novak, Payawal and the four doctors so far charged.
Novak’s attorney, Sergio Acosta, said at a court hearing last week that a conversation secretly recorded by a government informant shows that Novak and Physicians D and E had their patients’ best interests at heart.
Guerriero recently filed a lawsuit accusing Novak of conspiring to let another surgeon, Dr. Merlin Kelsick, steal his cases.
Lawsuits have also been filed against Novak and the hospital by the families of two patients, Katheryn Robinson, 62, and Walter Bruce, 70, who died after receiving tracheotomies at Sacred Heart.
Other Sacred Heart tracheotomy deaths investigators are looking into include those of Tommy Miller, 59, Earl Nattee, 49, and Naaman Durham, 48.
“I think they killed him,” Durham’s daughter, Mayola Nash, told the Chicago Sun-Times earlier this year. “I kept asking the doctors why he was getting all these treatments, but nobody could give me a straight answer,”
An unusually high number of tracheotomies were performed at Sacred Heart, authorities say, and Guerriero performed most of the ones done there since the beginning of 2010, Medicare and Medicaid records show.
Guerriero continued to work there even after a series of malpractice suits and allegations of wrongdoing.
Those include allegations that Guerriero removed a 69-year-old woman’s ovary at Lincoln Park Hospital in 2005 a day after the hospital’s chair of surgery had told him his gynecological surgery privileges were revoked.
Guerriero sued the hospital, alleging he’d been set up by hostile bosses, but a federal judge dismissed the suit.
A year later, in 2006, the doctor agreed to pay $215,000 to the family of Melida Servellon, who died of breast cancer after Guerriero allegedly botched a biopsy at Thorek Hospital. Directed to remove a suspicious area of Servellon’s left breast for testing, Guerriero allegedly took a sample from the wrong place, leading to Servellon being given a false all-clear, according to the family’s lawsuit.
According to court papers, Guerriero lost his surgical privileges at Thorek.
In another case, he agreed last year to pay $60,000 to settle a lawsuit filed by Shirley Pena, a homeless woman who claimed he’d messed up her stomach surgery at Sacred Heart, leaving her with permanent injuries.
He also agreed to pay $650,000 to settle a suit by Leonid Mironiv, a Sacred Heart patient whose left leg was amputated below the knee after Guerriero allegedly mishandled the removal of a vein.
Guerriero’s lawyer, Onesto, noted that none of the settlements included any admission of wrongdoing by Guerriero. “Lawsuits are lawsuits,” he said.
Onesto declined to comment on earlier allegations against Guerriero made in a probate case by the family of Anthony Orlando, a 42-year-old Vernon Hills trucking company owner and patient of Guerriero who died in 2007 of a cocaine overdose.
After his death, Guerriero filed a claim against the estate, saying he was owed $253,000, plus interest, for truck leases.
During a bitter battle over Orlando’s estate, Orlando’s mother Phylis wrote to the judge handling the case, saying Guerriero took advantage of Orlando in business deals while over-prescribing him “too many drugs” for pain.
As a result of the allegations, the Illinois Department of Financial and Professional Regulation accused Guerriero of violating medical ethics by improperly prescribing drugs to someone he knew was abusing cocaine and seeking prescription drugs elsewhere.
The state agency also accused Guerriero of improperly: purchasing trucks from Orlando, then leasing them back to him; sleeping at Orlando’s house; and registering a medical business at Orlando’s home while treating him.
Guerriero denied the allegations but agreed to a deal under which his medical license was placed on probation for two years in return for him signing a document agreeing that “should this matter proceed to a contested hearing, The Illinois Medical Disciplinary Board could find a violation of the Medical Practice Act.”
He ultimately got $287,000 from Orlando’s estate — unpaid debts Orlando owed him for a legitimate “investment” in the trucking business, according to Orlando’s former attorney, James Kogut, who said Orlando met Guerriero when he went to see the doctor for a “medical emergency.”
Kogut pointed to the recent federal indictment of Orlando’s brother, Frank Orlando, in an Outfit-connected extortion scheme, as evidence that the Orlando family’s account isn’t to be believed.
But Orlando’s mother accused her son’s lawyer of actually conspiring with Guerriero.
In her letter to the probate court judge, Phylis Orlando wrote “Jim Kogut is also a liar. He set this all up with Vic” and an accomplice.