State suspends radiologist CEO’s medical license after multiple alleged misreads
The Kentucky Board of Medical Licensure has suspended one radiologist’s license over alleged lapses in clinical judgment.
Commonwealth authorities issued the order of revocation against Anand P. Lalaji, MD, on July 22. Their decision comes after the teleradiologist and CEO of Atlanta-based The Radiology Group allegedly overlooked medical concerns captured in several medical images.
“The board asserts that, based upon a review of his patients’ charts by a board consultant, there were deficiencies in Lalaji’s interpretation of brain studies and additional deficiencies due to Dr. Lalaji’s ‘missed perception’ on several imaging studies,” the order states. “The board asserts that those two types of deficiencies ‘represent a deviation from the standard of care.’”
The Kentucky Board of Medical Licensure previously received a complaint in November alleging that Lalaji violated statutes governing the practice of medicine. Mercy Health Lourdes Hospital in Paducah, Kentucky, suspended his hospital privileges and the organization’s Medical Executive Committee recommended that his credentials be terminated, citing “concerns for patient safety due to poor quality readings of imaging studies.”
Lalaji had received a board subpoena compelling him to attend an administrative hearing in May. The doctor was reportedly informed that failure to attend would result in a default ruling.
Mercy Health Lourdes Hospital detailed eight alleged instances of incorrect or missed readings by Lalaji between June and August 2022. These included a missed brain tumor and perirectal abscess.
“Every radiologist should have grave concerns about this ruling and think twice about practicing in the state of Kentucky,” Lalaji said in a lengthy statement sent to Radiology Business late Monday (and pasted at the bottom of this story).
He noted that the “eight cases” in question were a “combination discrepancy of nomenclature” within the four MRI brain reports and a technical error. The latter sent an old exam to be read instead of the new one for three separate scans. And the missed brain tumor in question occurred due to a “voice recognition ambient background sound, which issued a command to approve a normal template,” an error he contended “can happen to any radiologist in the country.”
“The reason we decided not to pursue the board process is because we felt that we could not obtain a fair and equitable evaluation by the [Kentucky Board of Medical Licensure] of the circumstances of the case,” Lalaji said. “We felt that the KBML let us down. We will be utilizing the court system and litigation to unearth the truth behind the harsh treatment by the hospital and KBML. The people who are appointed to help uphold the protection of the public, unfortunately, sometimes can destroy a good physician's career and reputation. Thankfully, my support system is strong, and we will eventually prevail.”
According to the order, the radiologist met with hospital Chief Clinical Officer Brett Bechtel, MD, to discuss the cases in September 2022. Lalaji said at the time that he could amend his terminology to be more precise in a few of these instances. He also contended that some errors were due to “technical problems” after the hospital had rapidly implemented new teleradiology services. Other medical mistakes were due to “high volumes of reads in a short time frame to meet coverage needs and fill gaps.”
“The licensee stated he felt confident the issues had been resolved,” the order stated.
The Mercy Health Lourdes Hospital Medical Executive Committee reportedly issued a temporary suspension that was lifted after the meeting with the CCO. However, Lalaji was again suspended in November 2022 following another alleged misread.
“The MEC then met and expressed great concern for patient safety,” the order stated. “The MEC addressed poor quality reading in August/September, and at that time, the licensee indicated that issues would be resolved moving forward. Yet, after continuous monitoring, the concerns for patient safety remained.”
A local Fox affiliate first reported news of the revocation on July 26. The outlet noted that Lalaji can apply for reinstatement in two years, if he has paid $7,056 to cover the board’s costs for the case. FOX56 noted that the radiologist’s license is suspended or under review by eight state boards. Lalaji disputed the outlet’s reporting on this issue.
“The comments regarding the other state license suspensions are misleading as they did not find any issues [with me] practicing in those states,” he told Radiology Business. “They are just following the law in those states, since Kentucky issued the revocation, they have rules to ask me to sign a consent order. I remain practicing in nine other states without issue.”
In March, the Department of Justice announced it had reached a $3.1 million settlement with The Radiology Group. The DOJ charged that a United States-based radiologist at the organization spent as few as 30 seconds reviewing reports prepared by overseas readers who were not permitted to practice medicine in the U.S. nor bill government healthcare programs. As part of the settlement, The Radiology Group admitted and accepted responsibilities for the accusations. About 95% of the settlement stems from false claims “due to a faulty guidance from an outsourced billing company,” Lalaji noted. He added that his attorneys are pursuing litigation against the DOJ, citing “inaccuracies” in the agency’s original press announcement.
Statement attributed to Anand P. Lalaji, MD, CEO of The Radiology Group:
“Every radiologist should have grave concerns about this ruling and think twice about practicing in the state of Kentucky.
The ‘eight’ cases were a combination discrepancy of nomenclature within the four MRI brain reports and a technical error, which sent the old exam to be read instead of the new exam for three exams. The ‘missed brain tumor’ occurred due to voice recognition ambient background sound which issued a command to approve a normal template which can happen to any radiologist in the country. However, the error was picked up in one hour and there was no patient issue. These eight cases were interspersed between 3,000 other cases that were interpreted by myself over five months that in some cases were more complex and I was commended for an astute report and helped deliver great care to the patients.
The hospital and board case reviewer, the same person, was especially, uncannily, and shockingly extremely harsh as well as Panel B of the KBML and we do not know why they have been extremely punitive. The hospital as of this day has not scheduled me with a fair hearing from the initial case dating back to August 2022.
I have interpreted over 50,000 cases in the state of Kentucky over the last 14 years and there has not been a single mistake, issue, or claim. Yet the KBML decides to issue an emergency order. There are many examples of physicians that are drug dealers and are abusing drugs or alcohol and have harmed patients have not had their license revoked at the end, yet in this case they considered me a ‘threat’ to the public.
The reason we decided not to pursue the board process is because we felt that we could not obtain a fair and equitable evaluation by the KBML of the circumstances of the case. We felt that the KBML let us down. We will be utilizing the court system and litigation to unearth the truth behind the harsh treatment by the hospital and KBML. The people who are appointed to help uphold the protection of the public, unfortunately, sometimes can destroy a good physician's career and reputation. Thankfully, my support system is strong, and we will eventually prevail.
The comments regarding the other state license suspensions are misleading as they did not find any issues in practicing in those states; they are just following the law in those states since Kentucky issued the revocation, they have rules to ask me to sign a consent order. I remain practicing in nine other states without issue.
I believe you've already stated my comments regarding the FCA settlement; however, I will add that almost 95% of the settlement amount is due to a Medicare billing error secondary to erroneous guidance from an outsourced hired billing company. And that only one radiologist did not follow the compliance guidelines set forth about appropriately reviewing the studies.
Thank you.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.