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Home/Legal & Regulatory and Reimbursement/NY Ortho Surgeon Found Guilty in $31M Trip-and-Fall Scheme
Legal & Regulatory and Reimbursement

NY Ortho Surgeon Found Guilty in $31M Trip-and-Fall Scheme

February 9, 2023 2 min read Premium comments

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NY Ortho Surgeon Found Guilty in $31M Trip-and-Fall Scheme
Source: Pixabay and stevepb
#andrewdowd#georgeconstantine#tripandfallscheme

Andrew Dowd, M.D., a New York-based orthopedic surgeon, and George Constantine, a New York-based lawyer, have been found guilty for their roles in a $31 million trip-and-fall scheme.

The three-week long jury trial took place in Manhattan federal court before U.S. District Judge Sidney Stein. According to the U.S. Department of Justice, Dr. Dowd and Constantine “were found guilty of conspiracy to commit mail and wire fraud, mail fraud, and wire fraud, each of which carries a maximum term of 20 years in prison.” Dr. Dowd was found guilty of additional counts of “conspiracy to commit mail and wire fraud, mail fraud, and wire fraud.” Sentencing for Dr. Dowd and Constantine is scheduled for March 21, 2023.

U.S. Attorney Damian Williams said, “Today’s unanimous jury verdict holds George Constantine, a lawyer, and Andrew Dowd, a doctor, accountable for their participation in a widespread fraud scheme that preyed upon poor, vulnerable, and at-times homeless individuals.”

Williams continued, “These individuals were recruited to stage trip-and-fall accidents and undergo medically unnecessary surgeries performed by Dowd that were designed to increase the value of fraudulent personal injury lawsuits filed by Constantine. Constantine and Dowd abused their professional licenses, degrees, and titles to line their own pockets with millions of dollars, and they now face the prospect of lengthy prison sentences for their crimes.”

The fraud scheme involved staged trip-and-fall accidents and fraudulent lawsuits related to the staged trip-and-fall accidents. The scheme ran from 2013 to 2018. The “injured” individuals were individuals who were recruited to “stage or falsely claim to have suffered trip-and-fall accidents at particular locations throughout the New York City area.”

Constantine participated in the scheme as a personal injury lawyer. He would meet with the “injured” individuals and then file the fraudulent lawsuits.

After meeting with Constantine, the “injured” individuals would then go to various medical appointments to justify surgical procedures. The “injured” individuals would then meet with Dr. Dowd.

Again, according to Department of Justice evidence presented at trial, Dr. Dowd “would perform arthroscopic knee and shoulder surgeries on patients (the “injured” individuals) within one to two weeks of first meeting the Patients.” According to allegations and evidence presented at trial, the “injured” individuals were not actually injured and were paid $1,000 per surgery.

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According to the Department of Justice press release and evidence presented during trial, Dr. Dowd performed “nearly 300 medically unnecessary surgeries and earned more than $3.2 million dollars.” For every surgery he performed as part of the scheme, he received $10,000.

A number of other co-conspirators have already pled guilty or been found guilty at trial. For OTW’s ongoing coverage of this matter, see “NY Surgeon Pleads Guilty in Trip-and-Fall Scheme” and “Indictment Charges Ortho and Pain Docs in Trip-and-Fall Scheme.”

React:

Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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