I must confess that I carry within me a preconceived notion that is not going to erase itself any time soon; the notion is that big business and medicine don’t mix.
I don’t like it when the big pharma sales people show up at my internist’s clinic, I don’t like it when I hear stories of medical device technicians observing – and even participating in surgical procedures, I don’t like it when I have heard stories of non-medical people observing examinations and such.
There is a certain amount of abuse that occurs when barriers are unnecessarily and unethically crossed for it breeds arrogance – and arrogance leads to abuse.
The skins game
No, I am not talking about golf. I am talking about Gary Dudek, a 54-year-old sales rep for a company named Organogenesis.
The company is at the forefront of regenerative medicine; a science that provides physicians with laboratory grown tissues to graft tissues onto patients who suffer from diabetic ulcers. That’s right, hospitals are actually able to buy living skin. It is a science that will gain in importance in the years ahead. It is a beautiful technology with a noble purpose.
Back to Mr. Dudek and his customer, Mercy Philadelphia Hospital. As it turns out, Dudek not only sold the living tissue to the hospital, but he was, according to WCAU TV:
“In charge of managing Mercy’s bio-medical department’s accounts and supplying grafts…”
In fact, the hospital trusted him so completely that he had an open purchase order. It is understandable in one sense; when caring for a large number of diabetic patients requiring skin grafts it is far easier for the orders to be placed on an as needed basis under one purchase order than to create many new orders.
The hospital recently decided to perform a routine, random audit. Much to their surprise, $357,000 worth of skin that had been “ordered” was missing. Not only was it missing, it was never needed. Where was the living tissue? Well, surveillance cameras showed Dudek loading the refrigerated packaging into his car. The skin has still – as yet – been unaccounted for, but we might imagine it was either destroyed or re-sold to another hospital who might have struck a cut-rate bargain.
Too close for comfort
In this day and age when virtually every hospital is running on the narrowest of financial edges, I can well visualize a sales representative for a medical company keeping their own records and in fact, “helping” the purchasing department by keeping records for many of the hospital’s customers.
It is a very gray area and hopefully, ethically, it works out.
Dudek however, saw an unethical opportunity. He had the open purchase order, he had the product and he even kept the records. It was the perfect scam. Between November 2011 and July 2013, he placed orders, he recorded the orders and he kept the product. Undoubtedly, the fake orders were co-mingled with the real.
Perhaps in his mind, Medicare or some insurance company – somewhere, was going to ultimately foot the bill. As the debate over a national health care plan continues to rage, this is one small example of why health care costs continue to spiral out of control. I can’t help but wonder if there are a hundred Dudek’s out there, or perhaps a thousand.
Medical ethics is a broad topic and certainly physicians and nurses and many other hospital workers must adhere to a standard; what about those at the periphery? What about sales representatives who build a long-term rapport with hospital or research facility administration and medical staff? What standards are they held to or is nothing required of them?
I have experienced situations within medical facilities where sales people begin to delude themselves into thinking that they too, are “professional staff.” It is a very dangerous situation.
Would ethical training have prevented this situation? If Organogenesis would have provided on-going training, at the very least, it would have kept them out of the news. They would have done the correct thing.
This story is not quite over, espeically for you and me. It is guaranteed that our insurance rates will rise this year. While I cannot blame Mr. Dudek, I can certainly wonder at the number of characters at the periphery of our healthcare system who have crossed unethical boundaries and made life just a little more difficult for all of us.
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