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Surgeon Ousted for Speaking Up; Steward Corruption in Malta? Misleading Clinic Names

— This past week in healthcare investigations

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INVESTIGATIVE ROUNDUP over an image of two people looking at computer screens.

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Surgeon Ousted for Speaking Up

The surgeon brought in to resuscitate a failing Pennsylvania transplant program was ousted soon after he started identifying issues with operations, .

Shortly after being hired in February 2023 as the Milton S. Hershey Medical Center's "director of transplant quality and outcomes," Raymond Lynch, MD, started flagging issues. Patients were missing out on too many donated livers and kidneys, and the medical center was lagging on key metrics, for instance.

But before Lynch was hired, the transplant center was already troubled. Regulators who visited the transplant unit back in 2022 described a "toxic culture of fear and retaliation" where employees were punished for reporting problems.

The program was under "member not in good standing" status by the Organ Procurement and Transplantation Network -- the only hospital in 15 years to receive that severe disciplinary action. Just 9 months after Lynch was hired, it was moved back into good standing. But, as Spotlight PA noted, Lynch still had doubts.

The program still wasn't accepting enough organs and had issues with candidate selection, he noted in an internal memo. Eventually, Lynch brought the concerns to the top brass, and just over a year after his lauded hiring, Lynch was abruptly let go.

Steward Corruption in Malta?

Two Steward Health Care leaders, as well as the former prime minister of Malta, are at the center of a corruption case involving the mishandling of a deal to manage Maltese hospitals, .

Several years ago -- long before Steward declared bankruptcy -- the company got a government contract worth 4 billion Euros to manage and upgrade 3 hospitals in the Mediterranean nation. The partnership was led by Steward CEO Ralph de la Torre, MD; Armin Ernst, MD, who runs Steward's international ventures; and Joseph Muscat, the Maltese prime minister at the time.

A 4-year investigation conducted by a Maltese magistrate recommended that Ernst and de la Torre be charged with money laundering, criminal association, and corruption of public officials -- though they haven't yet been charged.

Muscat told the Globe that the investigation was a "politically motivated witch hunt" and put the blame on Steward for not delivering on promises. Indeed, when Steward took over the contract to manage the hospitals, it missed all of its deadlines to make improvements, a Maltese judge ruled. One of the hospitals is still dilapidated, with "falling debris" signs posted around, according to the Globe.

In related news, Massachusetts is pushing to prevent real estate investment trusts (REITs) from owning hospitals in response to Steward's bankruptcy. Steward had sold hospital properties to REITs, which caused major issues for the hospital system down the line, .

Potentially Misleading Clinic Names

Is an "Urgent Care Emergency Center" an urgent care center or an emergency department? Misleading business names have left patients confused with hefty bills for what they thought was a different service, according to .

Take for instance Tieqiao Zhang, who went to the aforementioned health clinic in Dallas twice for his severe stomach pain, which turned out to be a kidney stone. Zhang thought it was an urgent care clinic since "urgent care" was in the title. But when the bills rolled in, he learned it was actually a "freestanding emergency department" just 40 yards away from the system's main emergency room.

Urgent Care Emergency Center had signage explaining that patients would be charged emergency room fees and potentially facility fees, the hospital's spokesperson said.

Urgent care is significantly cheaper than getting care in an emergency department. For his two visits, Zhang was charged $1,000 in co-pays and his insurance paid thousands more.

Benjamin Ukert, PhD, an assistant professor of health economics and policy at Texas A&M University, told KFF Health News the clinic's name was disingenuous. Zhang thought so, too.

"It's like being tricked," Zhang said.

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    Rachael Robertson is a writer on the ֱ enterprise and investigative team, also covering OB/GYN news. Her print, data, and audio stories have appeared in Everyday Health, Gizmodo, the Bronx Times, and multiple podcasts.