Surgery Legal Fraud Scam

Men Expose Billion-dollar Back Surgery Scam Involving Doctor Kickbacks And Fake Hardware

Nearly a decade after Bill Reynolds and Mark Sersansie first learned about one of the most outrageous medical frauds in California history, they met with some of the patients who say they are still suffering from the devastating consequences of this scam.

"After surgery, it was nothing but pain-filled days," said patient Derika Moses. "I couldn't sit, I couldn't walk. I couldn't be a parent."

“I didn't want to live anymore,” said patient Gisela Fabila.

"I didn't want to live anymore," said patient Gisela Fabila.

"You didn't want to live anymore?" Alex Ferrer, host of "Whistleblower," asked.

"No. One time, I was planning, 'I'm going to go outside, and I'm going to run' -- said, 'I'm going to kill …'" Fabila recalled in tears.

Ferrer, a police officer-turned-lawyer-turned judge, takes viewers on Sersansie and Reynolds' journey from the hallways of southern California hospitals to the homes of patients who suffered the consequences of this scam in the latest "Whistleblower" episode, "The Billion Dollar Back Surgery Scam: Patients in Pain and Peril," airing Friday, June 21 at 8/7c on CBS.

Together the men would discover an illegal scheme, where middlemen were paid to find patients who had back problems stemming from work-related injuries and doctors were paid kickbacks to perform the spinal surgeries at specific hospitals. 

"One of the physicians … wanted … Super Bowl tickets, airfare and hotel," said Sersansie, who worked in sales for a California medical supply company.

Many patients say the scam left them in unbearable pain from surgeries, some say, they didn't need in the first place.

"This was entirely a medically unnecessary surgery that was performed," said patient Josh Lash.

Ultimately, they would learn that hospitals were not only overbilling for the spinal hardware but, in many instances, dangerous counterfeit hardware was implanted into the backs of innocent people.

"I'm looking at invoices that ranged anywhere from $350,000 to $475,000," said Reynolds, a medical fraud investigator.

Moses has had much of her spinal hardware removed.  "We've had experts come out," she said, "that have identified my screws as being counterfeit screws."

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