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Texas Man Sues Doctor for Negligence, Fraudulent Billing

A Houston doctor's negligent treatment and fraudulent billing scheme left one of his patients with a permanently damaged right hand and wrist, according to a Texas state court lawsuit.

According to the complaint, filed in the Harris County District Court, Luis Hinojosa received unlawful medical treatments under the direction of Dr. Ihsan Shanti, owner of two Houston medical businesses, Shanti Pain & Wellness Clinic and Texas Surgicom LLC.

Shanti fraudulently billed Hinojosa's workers' compensation insurer, Texas Mutual Insurance Co., for $68,000 in treatments that were performed by unlicensed personnel, had no therapeutic value or were never rendered at all, the complaint says.

Hinojosa alleges common-law fraud, medical negligence and violation of the Texas Deceptive Trade Practices Act. The DTPA allows for treble damages.

According to the complaint, Hinojosa went to the Wellness Clinic March 31, 2005, for treatment of an unspecified injury to his right hand and wrist. Over the next year an unlicensed physician, Shanti's brother Bilal, performed his monthly medical treatments, the suit says.

The treatments allegedly included medically unnecessary neck injections, spine X-rays and treadmill exercises. Hinojosa also was enrolled in a "sham" pain management plan at the clinic that had no therapeutic value, according to the suit.

Hinojosa alleges that his hand condition deteriorated under Ihsan Shanti's negligent medical care. By August 2005 his fingers were bent and he could not open his hand, he says, and three surgeries beginning that December failed to correct the condition, leaving him permanently disabled.

The complaint also accuses Ihsan Shanti of paying kickbacks to Renaissance Hospital as part of the fraudulent billing scheme. The Houston hospital is also named as a defendant in the suit.

Renaissance allegedly allowed Texas Surgicom to rent a surgical suite and submit bills in the hospital's name in exchange for referring Hinojosa there for treatments in violation of Texas law.

The deal with Renaissance aided Shanti in a triple billing fraud that allegedly cost Texas Mutual nearly $20,000 for a $2,000 pain treatment procedure, the suit says.

According to the suit, Hinojosa learned of the medical fraud sometime after Feb. 22, 2006, when he saw a news report saying Bilal Shanti was practicing medicine without a license.

Hinojosa then checked his Texas Mutual benefits forms and discovered the allegedly fraudulent billing.

He seeks unspecified damages for physical disability and mental pain and anguish in addition to $204,000 in trebled damages under the DTPA.

To comment, ask questions or contribute articles, contact West.Andrews.Editor@Thomson.com.

To comment, ask questions or contribute articles, contact West.Andrews.Editor@Thomson.com.