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Tag: 2016 News

Nose Cells Used in Knee Cartilage Transplant

In a small trial of 10 patients with damaged knee joints, doctors harvested cells from their noses to engineer new cartilage tissue and transplant it into their damaged knees. In a paper published in The Lancet, the Swiss team describes how 2 years after transplant, most of the patients had developed new tissue similar to normal cartilage and reported improvements in knee function, pain, and quality of life.

However, the authors point out that while the results of their phase I study are promising and show the approach is feasible and safe, there is still a long way to go before such a procedure can be approved for routine use with patients. There now needs to be randomized trials – with longer follow-up – that compare the promising treatment with conventional alternatives.

About 2 million people in Europe and the United States are diagnosed with damage to knee joint cartilage every year, caused by injury or accident. Joint or articular cartilage is the layer of smooth tissue at the ends of bones that eases movement, and protects and cushions the surfaces of the joint where the bones meet.

As this tissue has no blood supply, if it gets damaged it cannot regenerate. Eventually, as the cartilage wears away, the bones become exposed and inflamed from rubbing against each other, leading to painful joint conditions like osteoarthritis.

There are medical techniques – such as microfracture surgery – that can prevent or delay the onset of cartilage degeneration following injury or accident, but they do not regenerate healthy cartilage to protect the joints.

There have also been attempts to use cartilage cells or chondrocytes from the patients’ own joints to make new cartilage in the joint, but these have not been very successful at creating the right structure and function of the cushioning tissue.

One of the unique features of the new study is that Prof. Martin and colleagues used chondrocytes harvested from a site far away from the damaged joint – from the patients’ nasal septum. These cells have a unique ability to grow new cartilage tissue.

For the study, the team enrolled 10 patients (age 18-55) with full-thickness cartilage damage to the knee and took a biopsy from their nasal septum under local anesthetic. They grew chondrocytes harvested from the biopsy tissue by stimulating them with growth factor for 2 weeks.

The team then took the cultured new cells and seeded them onto “scaffolding” made of collagen and grew them for another 2 weeks. The result was a 2-millimeter thick graft of new cartilage measuring about 30-40 millimeters.

Each patient then underwent surgery where the damaged knee cartilage was removed and replaced with their own cultured graft cut into the appropriate shape. After 2 years, scans showed new tissue of similar composition to cartilage had grown at the affected sites.

Nine of the 10 patients – one was excluded because of sports injuries not related to the trial – also reported significant improvements in the use and function of their knee and reduction in pain, compared with pre-surgery.

The authors note there were no reports of adverse reactions to the surgery, although there were two reports of injuries not related to the procedure. Patient age does not appear to affect success They also mention the promising result that patient age does not appear to affect the success of the procedure.

Blood Test Detects Early State Osteoarthritis

There is currently no blood test for early-stage osteoarthritis, a degenerative joint disease where the cartilage that eases and cushions movement breaks down, causing pain, swelling, and problems moving the joint.

Now, researchers at Warwick University in the United Kingdom have developed a blood test that can provide an early diagnosis of osteoarthritis and distinguish it from rheumatoid arthritis and other inflammatory joint diseases.

The researchers, led by Dr. Naila Rabbani of Warwick Medical School, report how they developed the new blood test in the journal Arthritis Research & Therapy.

The test could be available within 2 years, say the researchers. The earlier that arthritis is diagnosed – before physical and irreversible symptoms set in – the better the chances that treatment can focus on how to prevent the problem, for instance with lifestyle changes.

The new blood test looks for chemical signatures in fragments of joint proteins (amino acids) that have been damaged, as Dr. Rabbani explains: “The combination of changes in oxidized, nitrated and sugar-modified amino acids in blood enabled early stage detection and classification of arthritis – osteoarthritis, rheumatoid arthritis or other self-resolving inflammatory joint disease.”

Dr. Rabbani notes that scientists have known for a while that proteins in the arthritic joint get damaged, but this is the first time they have looked at them from the point of view of early disease diagnosis. “For the first time we measured small fragments from damaged proteins that leak from the joint into blood,” she adds.

For the study, the team recruited 225 participants. These included patients with knee joint early-stage and advanced osteoarthritis and rheumatoid arthritis or other inflammatory joint disease, and healthy volunteers with no joint problems.

Using mass spectrometry, the researchers analyzed samples of blood and synovial fluid (from the affected knee joints) for oxidized, nitrated, and sugar-modified proteins and amino acids.

They found some patterns of damaged amino acids in samples from patients with early and advanced osteoarthritis and rheumatoid arthritis that were markedly lower in samples from the healthy volunteers.

Using sophisticated bioinformatic computer methods, they developed algorithms – based on 10 damaged amino acids – that can diagnose early-stage osteoarthritis, rheumatoid arthritis, and non-rheumatoid arthritis. The researchers note the new blood test has a “relatively high sensitivity and specificity for early-stage diagnosis and typing of arthritic disease.” Sensitivity is the extent to which a negative result is able to rule the disease out, and specificity is the extent to which a positive result can rule the disease in. In the case of early-stage osteoarthritis, the study found the blood test had a sensitivity of 92 percent and a specificity of 90 percent.

These compare favorably with current techniques. For instance, in their background information, the researchers note that current magnetic resonance imaging techniques for evaluating cartilage damage in early-stage osteoarthritis have sensitivities around 70 percent and specificities around 90 percent.

Risk Manager Goes to Prison for Work Comp Embezzlement

The Santa Barbara Independent reports that Freddy Pachon, a former vice president of risk management for Select Staffing, was sentenced Monday to eight years and eight months in prison for embezzling more than $700,000 from the Santa Barbara-based temp agency.

Between January 2008 and December 2012, Pachon funneled money from reimbursement checks related to workers’ compensation claims into a personal account he created under the fictitious business entity “Select Consulting Services.” At a previous court hearing, it was revealed that Pachon had placed his sister-in-law, Paula Orozco, in a job at AG Employment Services, the company contracted by Select Staffing to handle medical claims. Orozco testified she altered the checks then mailed them to an address provided by Pachon, on some occasions even hand-delivering them to him in the Select Staffing parking lot or at his house. Orozco was later fired from her job but avoided criminal charges.

According to prosecutors, Pachon spent the stolen funds on a lavish home and backyard renovations. At the time of his arrest, he was earning approximately $250,000 a year from Select Staffing, where he’d been working since 2001.

At the Monday hearing, Pachon’s attorney Steven Andrade admitted his client “made a horrible exercise in judgment” but deserved leniency and probation, not the 20-year prison sentence prosecutor Brian Cota had asked the judge to impose. Andrade said as soon as Select Staffing discovered Pachon’s theft, he immediately sold his home and transferred the funds to the company. He had hoped to make full restitution and not involve law enforcement, Andrade said. “Mr. Pachon was like the most cooperative suspect in the world,” he stated. Since his arrest, Pachon has been volunteering and cleaning offices part-time, and still works in risk management. “He’s really fighting for his family,” Andrade said of Pachon’s wife and young children.

Pachon’s wife, Julia Orozco, also pleaded with Judge Michael Carrozzo to show her husband compassion. “I know he did something wrong,” she said, “but he’s not a bad guy. He’s a good father.” Attorney and real estate broker John J. Thyne III, who helped Pachon sell his home, said he found him honest and well-meaning.

In arguing for a lengthy prison term, Cota stressed the depth and repetition of Pachon’s deception. “And using a family member is way beyond a typical embezzlement case,” he said. Cota said Pachon meticulously planned his scheme and deserved no credit for selling his home, as it was going to be foreclosed upon anyway. “He was just trying to save his own skin,” Cota said, noting that since his arrest Pachon has still not paid Select Staffing any of the the $250,000 or so he still owes. Instead, that money has been used to pay four different private attorneys. In addition, Cota went on, all the embezzled funds previously went toward “vanity projects” so Pachon, who has multiple ex-wives and as many as 10 children, would “look like the big guy in the office.” None of it went to his family.

More than a dozen of Pachon’s family members were present in the courtroom Monday. During a short break in the proceedings, a woman who identified herself as one of Pachon’s cousins offered to pay Independent staff photographer Paul Wellman to not publish photographs of Pachon. Wellman declined. The cousin persisted, offering to double his hourly rate and insisting he could take the money without the Independent finding out. Wellman again declined.

In handing down his sentence, Judge Carrozzo said while Pachon’s case certainly didn’t warrant probation, he also didn’t deserve 20 years behind bars. “I think the defendant is a good person who made a mistake,” Carrozzo said. He noted multiple letters of support from friends and family influenced his decision. He said he hoped Pachon, from Colombia on a work visa, would get his life back on track after prison. “I hope Mr. Pachon is still able to become an American success story,” he said.

Though Pachon was technically sentenced to eight years and eight months in prison, the credit he receives for good behavior – along with new incarceration rules guided by current and pending legislation aimed at reducing prison overcrowding – may make him eligible for parole in as little as eight months.

Court Affirms $180K Administrative Penalty for Uninsured Employer

The Department of Industrial Relations, Division of Labor Standards Enforcement (DLSE) imposed a $179,329.60 penalty, pursuant to Labor Code section 3722, subdivision (b) against Aron’s Automotive for failure to maintain workers’ compensation insurance as required by section 3700. The employer unsuccessfully pursued an administrative appeal and later court appeals of this penalty.

Aaron’s Automotive has been in operation since 2007. On January 22, 2015, DLSE inspected and discovered the business had employees but had never acquired workers’ compensation insurance coverage. On February 9, 2015, Taylor obtained coverage through the State Compensation Insurance Fund, which was effective as of January 29, 2015.

At the administrative hearing, Taylor argued: (1) the term calendar year, as used in section 3722(b), means January 1 to December 31; (2) section 3722(b) violates the equal protection clause of the Fourteenth Amendment; (3) the penalty violates substantive due process; and (4) the penalty is an excessive fine imposed in violation of the Eighth Amendment.

On April 8, 2015, the hearing officer issued written findings and affirmed the penalty assessment. The hearing officer found: “[Taylor] did not have workers’ compensation insurance for the period of February 27, 2012 through January 29, 2015 and had 11 employees during that time period.” The hearing officer concluded Taylor’s constitutional arguments provided no basis for defense in an administrative hearing and also determined the term calendar year, as used in section 3722(b), means “one year back from the date that the director determines an employer has been uninsured on the date the citation is issued.”

Taylor filed a petition for writ of administrative mandamus. A demurrer to the petition was granted without leave to amend. The Court of Appeal affirmed the dismissal in the partially published case of Aaron Taylor v Department of Industrial Relations.

The parties frame this case as primarily a dispute regarding the meaning of “calendar year” in section 3722(b).

It is undisputed that the date of “the determination” is the date the penalty assessment citation issued – in this case, February 27, 2015. Taylor maintains the term calendar year necessarily means January 1, 2014, through December 31, 2014, and that “this is the required statutory interpretation of this term no matter how absurd the result of that interpretation . . . .”

DLSE, on the other hand, insists calendar year means “the one-year period immediately before the date that the director determines that an employer is uninsured” – or, in this case, February 27, 2014, to February 27, 2015. DLSE analogize section 3722(b) to “a one year statute of limitations on issuing a citation.” (See Code. Civ. Proc., §340, subds. (a), (b).) In other words, section 3722(b) allows a citation to be issued “if the DLSE determines that an employer was uninsured [in excess of one week] during the past year, whether or not the employer subsequently obtains insurance.”

The interpretation of section 3722(b) is a question of first impression. The Court of Appeal concluded that “calendar year”, as used in section 3722(b), means the 12-month period immediately preceding the determination. In this case, a triggering event of uninsurance did occur between February 27, 2014, and February 27, 2015. Therefore, this construction of the statute does not in any way invalidate the penalty imposed.

LA Occupational Therapist Guilty in $2.6 Million Fraud Case

A licensed occupational therapist pleaded guilty in Los Angeles for his role in a $2.6 million Medicare fraud scheme that involved billing for occupational therapy services that were not provided.

Keith Canlapan, 38, of West Covina, California, pleaded guilty to one count of conspiracy to commit health care fraud before U.S. District Judge George H. Wu of the Central District of California.

Sentencing is scheduled for Feb. 16, 2017, before Judge Wu.

As part of his guilty plea, Canlapan admitted that he was a licensed occupational therapist employed with JH Physical Therapy, an occupational therapy clinic located in Walnut, California. Canlapan further admitted that through JH Physical Therapy, he billed Medicare for occupational therapy services when no such services were provided to the Medicare beneficiaries. Instead, the Medicare beneficiaries received massage and acupuncture services, which are not reimbursable under Medicare rules, he admitted. In fact, on dates that Canlapan purportedly provided occupational services to Medicare beneficiaries at JH Physical Therapy, Canlapan was admittedly not present at JH Physical and instead was either out of the country or at his other places of employment on some of those dates.

Between approximately October 2009 and approximately December 2012, Canlapan, through JH Physical Therapy, billed Medicare $2,669,618 in false and fraudulent claims, of which Medicare paid $1,860,786, he admitted.

Canlapan was charged in an indictment returned on June 16, 2016, along with co-defendants Simon Hong, 54, and Grace Hong, 50, husband and wife, both of Brea, California. Simon Hong is the owner and Grace Hong is the co-operator of JH Physical Therapy, and they are charged with one count of conspiracy to commit health care fraud and three counts of health care fraud. Both are pending trial, which is scheduled for Jan. 17, 2017. An indictment is merely an allegation and all defendants are presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.

Co-conspirator Roderick Belmonte Concepcion, a licensed occupational therapist, was also previously indicted in a separate related case and pleaded guilty in April 2016. His sentencing is scheduled for Jan. 23, 2017.

The case was investigated by the Los Angeles Region of HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California. The case is being prosecuted by Trial Attorney Blanca Quintero of the Fraud Section.

Skilled Nursing Company Pays Back $145 Million in False Claims

Life Care Centers of America Inc. and its owner, Forrest L. Preston, have agreed to pay $145 million to resolve a lawsuit alleging that Life Care violated the False Claims Act by knowingly causing skilled nursing facilities (SNFs) to submit false claims to Medicare and TRICARE for rehabilitation therapy services that were not reasonable, necessary or skilled;

Life Care, based in Cleveland, Tennessee, owns and operates more than 220 skilled nursing facilities across the country including ten in California. The California facilities include Bel Tooren Villa Convalescent Hospital in Bellflower, Life Care Center of Escondido, La Habra Convalescent Hospital, Lake Forest Nursing Center, Life Care Center of Menifee, Mirada Hills Rehabilitation and Convalescent Hospital, North Walk Villa Convalescent Hospital in Norwalk, Orangegrove Rehabilitation Hospital, Rimrock Villa Convalescent Hospital in Barstow, and Life Care Center of Vista.

“This resolution is the largest settlement with a skilled nursing facility chain in the department’s history,” said Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department’s Civil Division. “It is critically important that we protect the integrity of government health care programs by ensuring that services are provided based on clinical rather than financial considerations.”

This settlement resolves allegations that between Jan. 1, 2006 and Feb. 28, 2013, Life Care submitted false claims for rehabilitation therapy by engaging in a systematic effort to increase its Medicare and TRICARE billings. Medicare reimburses skilled nursing facilities at a daily rate that reflects the skilled therapy and nursing needs of their qualifying patients. The greater the skilled therapy and nursing needs of the patient, the higher the level of Medicare reimbursement. The highest level of Medicare reimbursement for skilled nursing facilities is for “Ultra High” patients who require a minimum of 720 minutes of skilled therapy from two therapy disciplines (e.g., physical, occupational, speech), one of which has to be provided five days a week.

The United States alleged in its complaint that Life Care instituted corporate-wide policies and practices designed to place as many beneficiaries in the Ultra High reimbursement level irrespective of the clinical needs of the patients, resulting in the provision of unreasonable and unnecessary therapy to many beneficiaries. Life Care also sought to keep patients longer than was necessary in order to continue billing for rehabilitation therapy, even after the treating therapists felt that therapy should be discontinued. Life Care carefully tracked the minutes of therapy provided to each patient and number of days in therapy to ensure that as many patients as possible were at the highest level of reimbursement for the longest possible period. The settlement also resolves allegations brought in a separate lawsuit by the United States that Forrest L. Preston, as the sole shareholder of Life Care, was unjustly enriched by Life Care’s fraudulent scheme.

As part of this settlement, Life Care has also entered into a five-year chain-wide Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General (HHS-OIG) that requires an independent review organization to annually assess the medical necessity and appropriateness of therapy services billed to Medicare.

The settlement, which was based on the company’s ability to pay, resolves allegations originally brought in lawsuits filed under the qui tam, or whistleblower, provisions of the False Claims Act by Tammie Taylor and Glenda Martin, former Life Care employees. The act permits private parties to sue on behalf of the government for false claims for government funds and to receive a share of any recovery. The government may intervene and file its own complaint in such a lawsuit, as it has done in this case. The whistleblower reward in this case will be $29 million.

This matter was handled by the Civil Division’s Commercial Litigation Branch, the U.S. Attorneys’ Offices for the Eastern District of Tennessee and the Southern District of Florida, and the HHS-OIG, with assistance from the U.S. Attorneys’ Offices for the District of Colorado, the Middle District of Florida, the Northern District of Georgia, the District of Massachusetts and the District of South Carolina and NCI/AdvanceMed, a Medicare Zone Program Integrity Contractor.

Going and Coming Rule is More Restrictive in Tort Cases

Helmerich & Payne International Drilling operates oil drilling rigs located in south Kern County on an Occidental Petroleum leasehold.

One of the drilling rigs operated by H&P was called Oil Rig 261. The night shift crew for Oil Rig 261 included defendant Luis Mooney, a floorhand, and Mark Stewart, a motorman. Ruben Ibarra was the crew’s driller and, therefore, the supervisor of Mooney, Stewart and other members of the crew. Ibarra and Stewart did not live in the area and stayed at the Best Western Hotel.

Mooney lived in Bakersfield and provided Ibarra and Stewart with rides to and from the drill site in his personal vehicle, a Ford F250 pickup. Mooney testified that he had given Ibarra a ride at least 50 times. Ibarra testified that he believed he had ridden with Mooney a few dozen times before the accident. Mooney’s route from his home to the jobsite took him by the hotel. As pointed out by plaintiff, Mooney’s route changed when he gave rides because he would have to turn off of Stockdale Highway and into the parking lot of the hotel to pick up or drop off his passengers. This slight change in route is not relevant in this case. Mooney would have traveled by the accident site on his way to and from work regardless of whether he was providing crew members with a ride to or from the hotel.

On December 12, 2011, after the end of their shift, Mooney was returning home and giving Ibarra and Stewart a ride to the hotel. Mooney also had driven Ibarra and Stewart to work the previous afternoon. At approximately 6:30 a.m., about 13 miles from Oil Rig 261, Mooney’s pickup collided with a Chevrolet 2500 pickup driven by plaintiff Brent Pierson. Mooney crossed the double yellow line and into the lane of oncoming traffic.

Pierson and his wife filed a personal injury action against Mooney, and later added H&P as a defendant. Travelers Property Casualty Company of America, the worker’s compensation insurer for Pierson’s employer, intervened in this lawsuit.

H&P filed a motion for summary judgment against Pierson and Travelers. The motion asserted that the incident occurred when Mooney was driving home from work and did not occur while he was in the course or scope of his employment with H&P. Pierson opposed this motion and filed his own motion for summary adjudication on the scope of employment issue. The trial court granted summary judgment for H&P, concluding as a matter of law that the going and coming rule applied and, therefore, Mooney’s operation of his vehicle at the time of the accident was not within the scope of his employment. Subsequently, a judgment was entered and Pierson filed an appeal. The Court of Appeal affirmed the dismissal of H&P in the published case of Pierson v Helmerich & Payne International Drilling.

The doctrine of respondeat superior holds an employer liable for torts of its employees committed within the scope of their employment. Thus, a plaintiff suing an employer under the doctrine must prove that the tort was committed within the scope of employment.

A corollary of the doctrine of respondeat superior is the “going and coming rule,” which states that employees do not act within the scope of employment while going to or coming from the workplace. The rationale for the rule is that the employment relationship is suspended from the time the employee leaves work until he or she returns because an employee ordinarily renders no service to the employer while traveling.

The going and coming rule is used in tort law to determine the scope of employment for purposes of respondeat superior liability and also is used in workers’ compensation law to determine whether an employee injured while traveling to or from work sustained an injury arising out of and in the course of the employment for purposes of Labor Code section 3600.

However the Court of Appeal noted that the coming and going rule applied in tort law to determine the scope of employment is not identical to the rule applied in workers’ compensation law to determine the course of employment. The differences exist because the policy considerations underlying each field of law are different. This view of the going and coming rule is nothing new and has been confirmed by most recent published decisions addressing the going and coming rule.

Secondly, the workers’ compensation cases awarding coverage under an exception to the going and coming rule cannot be categorically excluded as having persuasive force in tort cases involving the same exception and similar facts. The two versions of the rule and its exception are closely related and, as a result of this overlap, courts often cite tort and workers’ compensation cases interchangeably.

Third, workers’ compensation cases awarding coverage do not necessarily provide reliable precedent for tort cases because the version of the rule applied in tort cases is more restrictive.

LA is Most Costly Region in the Most Costly State

The WCIRB expands its research on regional differences in California workers’ compensation claim costs and frequency with the release of its second report, the 2016 Study of Geographic Differences in California Workers’ Compensation Claim Costs. The Study, which controls for wage level differences and industrial mix, includes nine new maps illustrating regional differences.

Earlier this month the Oregon Department of Consumer and Business Services (DCBS) announced the results of its bi-annual nationwide study of the costs of workers’ compensation programs for 2016. According to that study, California once again is the worst state in the union in terms of costs. It ranks at 176% of the study median. It is a good distance away from the second highest state, New Jersey, which ranks 158% of the study median. Rounding off the worst five, third worst is New York at 154%, Connecticut is the fourth worst at at 149%, and fifth is Alaska also at 149%.

To sum it up, California ranks as the most costly workers’ compensation program in the nation, and Los Angeles is the most costly region in the most costly state. You might call that ground zero.

Key findings of the new WCIRB Regional Study include:

1) The Los Angeles/Long Beach area continues to show higher indemnity claim frequencies than the rest of California, while the Silicon Valley region continues to show lower indemnity claim frequencies.
2) The median permanent disability rating is higher in northern regions of California than in the central and southern regions.
3) The Los Angeles/Long Beach Area is the most litigious region in California. Medical legal costs are over 2.8% of total incurred costs on indemnity claims in the Los Angeles/Long Beach area compared with 2.0% statewide.
Pharmaceutical spending as a percentage of total medical costs also varies by region.

The complete Study and a mapping of nine-digit zip codes to the regions included in the Study are available on the WCIRB website in the Research and Analysis section.

Former Senator Calderon Gets 42 Months in Prison

Former California State Senator Ronald S. Calderon was sentenced to 3½ years in federal prison after pleading guilty to a federal corruption charge and admitting that he accepted tens of thousands of dollars in bribes in exchange for performing official acts as a legislator.

Ron Calderon pleaded guilty in June to one count of mail fraud through the deprivation of honest services. In a plea agreement filed in this case, Ron Calderon admitted accepting bribe payments from the owner of a Long Beach hospital who wanted a law to remain in effect so he could continue to reap tens of millions of dollars in illicit profits from a health care fraud scheme. Ron Calderon also admitted taking bribes from undercover FBI agents who were posing as independent filmmakers who wanted changes to California’s Film Tax Credit program.

Ron Calderon’s brother, Thomas M. Calderon, 62, also of Montebello, a former member of the California State Assembly who became a political consultant, was sentenced last month to 10 months in custody for his conviction on a money laundering charge for allowing bribe money earmarked for his brother to be funneled through his company.

The Calderon family was a political dynasty for decades in California. A third brother, former Assemblyman Charles Calderon, was not implicated in the corruption scandal. Ronald Calderon’s nephew Ian Calderon is a state assemblyman and the last family member in state elected office. He was not alleged to have any part in the scheme.

Ron Calderon admitted participating in a bribery scheme involving two areas of legislation and the hiring of a staffer who was also an undercover FBI agent.

In the first part of the bribery scheme, Ron Calderon took bribes from Michael Drobot, the former owner of Pacific Hospital in Long Beach, which was a major provider of spinal surgeries that were often paid by workers’ compensation programs. The spinal surgeries are at the center of a massive healthcare fraud scheme that Drobot orchestrated and to which he previously pleaded guilty. Ron Calderon was not charged in the healthcare fraud scheme that led to well over $500 million in fraudulent billings. Drobot, who was described in court papers filed by prosecutors as “a greedy fraudster robbing taxpayer-funded federal programs,” was a client of Tom Calderon’s political consulting firm.

California law known as the “spinal pass-through” legislation allowed a hospital to pass on to insurance companies the full cost it had paid for medical hardware it used during spinal surgeries. As Drobot admitted in court, his hospital exploited this law, typically by using hardware that had been purchased at highly-inflated prices from companies that Drobot controlled and passing this cost along to insurance providers.

Drobot bribed Ron Calderon so that he would use his public office to preserve this law that helped Drobot maintain a long-running and lucrative healthcare fraud scheme, which included Ron Calderon asking a fellow senator to introduce legislation favorable to Drobot and attempting to recruit other senators to support Drobot. The payments from Drobot came in the form of summer employment for Ron Calderon’s son, who was hired as a summer file clerk at Pacific Hospital and received a total of $30,000 over the course of three years, despite the son doing little actual work at the hospital.

In a sentencing memorandum filed with the court, prosecutors write that Ron Calderon “sold his vote not just to help pay for the expenses of living beyond his means, but for the more banal and predictable aims of corruption – fancy luxuries, fancy parties, and fancy people.”

The memorandum further argues that a significant term of imprisonment was necessary to send a message to other political officials and the electorate because, without such a sentence, “the trust already eroded by individual detections of corrupt politicians will spread like cancer and threaten the fundamentals of a trusted democracy. It is not hyperbole to insist that nothing less is at stake in defendant’s sentencing.”

His attorney Mark Geragos suggested during the court hearing that his client should serve no time in prison. He alleged that the government had entrapped Calderon and raised the former lawmaker’s poor health. The former state senator’s legacy has been ruined by his guilty plea in the case, he added. “This is going to be the opening paragraph of his obituary, unfortunately,” Geragos told Judge Snyder.

When Snyder rebuffed Geragos’ appeal and said Calderon needed to spend some amount of time behind bars, Geragos switched tactics, asking her to consider a two-year sentence.

Striking a defiant tone throughout, Calderon, 59, refused to admit any wrongdoing or to apologize.”My goal was always to do the right thing for California,” he said. “At no point did I intend to break the law.”

Calderon added that he was unemployed and tens of thousands of dollars in debt. He said he was not only banned from running for public office again but had been stripped of his real estate license and had been unable to get a job. His wife, he said, would likely have to declare bankruptcy and sell their house.

Judge Snyder was unmoved. “I did not really hear Sen. Calderon accept responsibility or apologize,” she said. “It was really about himself.”

More on How Hospitals Make You Sick

The U.S. Food and Drug Administration is seeking to improve hospital reporting of injuries and deaths associated with medical devices after inspections at 17 hospitals revealed widespread under-reporting of such events. And of course an injury or death of an injured worker while being treated at a hospital would be a compensable consequence additional injury.

Reuters Health reports that the FDA initiated the inspections following high-profile safety scandals involving power morcellators and contaminated duodenoscopes.

Morcellators are used to remove uterine fibroids but can spread unsuspected cancerous tissue beyond the uterus. Duodenoscopes are threaded through the mouth and throat to treat problems in the pancreas and bile ducts. Contaminated scopes can carry infections from one patient to another.

In a blog posted on the FDA’s website, Dr. Jeffrey Shuren, head of the agency’s device division, said many events uncovered at the 17 hospitals should have been reported and were not, in violation of the agency’s reporting requirements. The FDA believes such under-reporting is a nationwide problem.

“We believe that these hospitals are not unique in that there is limited to no reporting to FDA or to the manufacturers,” he said.

In some cases, hospital staff were neither aware of, nor trained to comply with, the agency’s medical device reporting requirements.

Shuren said the agency wanted to “work with all hospitals to address these issues.”

On Dec. 5, the FDA will hold a public workshop seeking input on improving hospital surveillance systems and how hospitals can better evaluate how well devices work in the clinical setting.

Last year, the FDA sent warning letters to manufacturers of duodenoscopes, saying they skirted a host of testing, manufacturing and reporting requirements. The biggest makers of the products are Olympus Corp, Pentax Medical and Fujifilm Holdings Corp.

The FDA first warned of their potential to transmit antibiotic-resistant germs in 2009. Since then they have been implicated in superbug outbreaks at multiple U.S. hospitals.

In 2014, the FDA warned that morcellators could inadvertently spread uterine cancer. It recommended that the use of these instruments be restricted and that the label includes a boxed warning, the most severe possible.

Morcellators are used to slice fibroid and uterine tissue into small pieces inside the body, allowing it to be removed through a small opening.

The FDA estimates that 1 in 350 women who have fibroid surgery have an unsuspected uterine cancer.