Surgeon got career break, but more allegations surface

North Vista Hospital might have exposed itself to potential federal penalties by allowing Dr. Mark Kabins to assist in operating on patients covered by federal programs, according to prosecutors.

After his felony conviction, the Las Vegas surgeon was excluded for five years from getting any payments for patients covered by any federal programs, including Medicare, Medicaid and the military.

But prosecutors said they have information that “on more than one occasion, Kabins has been present in the operating room for patients who were beneficiaries of federal health programs, assisting others with surgeries.”

Kabins has also required federal health care patients to sign documents acknowledging he is barred from being paid by any federal programs and requiring patients to agree to pay him by other means, the prosecutors contended. The patients signing the waivers might be elderly and vulnerable and might not understand what they are signing, prosecutors wrote.

North Vista officials were not prepared to comment Friday afternoon. The North Las Vegas hospital is the only local facility where Kabins still has privileges. He can practice there because the Nevada Board of Medical Examiners did not take away his medical license after his 2010 conviction.

The allegations about the hospital and Kabins were included in the government’s objections to terminating Kabins’ probation after 18 months of a five-year probation.

Senior U.S. District Judge Justin Quackenbush of Spokane, Wash., actually terminated Kabins’ probation July 22, without waiting for the government’s response, much as I predicted he would. The judge wrote that Kabins’ role was “minimal and certainly did not involve in any manner or degree a lack of professional competence or negligence.” Three days later, he stayed the order after federal prosecutors Dan Schiess and Steve Myhre objected to the termination granted without giving them a chance to oppose it.

In 2010, Kabins pleaded guilty to misprision of felony, seeing a crime and not reporting it. The plea bargain he signed indicated a more active role. He admitted he feared that patient Melodie Simon would sue him for medical malpractice after she was paralyzed following surgery first by his partner and then by Kabins.

He asked a medical consultant to persuade her attorney not to sue him. And he admitted he created a false record covering up his role and shifting blame to an anesthesiologist and he admitted lying in a deposition.

The prosecutors objected to Quackenbush’s analysis that there was no negligence by Kabins, citing three experts who said Kabins’ treatment of Simon fell below the standard of care.

Kabins had experts who said his care did not fall below the standard of care, which is one of the reasons a plea bargain was reached.

The prosecutors also noted that Kabins’ attorney, David Chesnoff, had not informed the judge that he was barred from participating in all federal health care programs. The motion for termination and the letters of support — including several from North Vista Hospital officials — argued that if probation were lifted, he could help more patients, including veterans and service members.

Because Kabins’ crime was a felony related to federal health care services, Chesnoff would have to persuade federal officials to lift its ban. The ban extends to Kabins either directly or indirectly providing services “even when the federal payment itself is made to another doctor who is not excluded.”

In other words, if another surgeon were performing surgery and splitting fees with Kabins, that’s a violation.

If it’s proven that North Vista Hospital officials permitted Kabins to violate the federal ban, it’s a sign of three things.

One, that Kabins doesn’t think the rules apply to him. Second, that hospital officials were so happy to have someone bringing in customers and making money for them that they looked the other way. Third, everyone thought they’d never get caught thumbing their noses at federal bans.

Jane Ann Morrison’s column appears Monday, Thursday and Saturday. Email her at Jane@reviewjournal.com or call 702-383-0275. She also blogs at lvrj.com/blogs/morrison.