A federal jury in a medical whistle-blower civil trial heard two starkly different versions Thursday of whether Sumter's Tuomey hospital illegally jacked up profits under the False Claims Act.
On the first day in the federal government's case against Tuomey Healthcare System, a U.S. Justice Department lawyer said the jury should award damages against Tuomey for allegedly stifling competition from area doctors and getting illegal, and higher, payments for medical procedures in a near-monopoly market as a result. He did not specify an amount but it could be millions.
"Tuomey hospital was so afraid of the competition it faced for the first time that it was willing to do just about anything to get rid of that competition, including breaking the law," assistant U.S. Attorney Norman Acker told the jury of seven women and five men in opening arguments in a Columbia courtroom.
"What they really wanted to protect was their profits," said Acker, who spoke for an hour.
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Acker warned the jury that Tuomey lawyers will "trash" Sumter surgeon Michael Drakeford, who first brought allegations of hospital misconduct to the government's attention.
"But that is just killing the messenger," Acker said.
Drakeford, in the audience Thursday, is expected to be a star witness.
Opening for Tuomey, Columbia trial lawyer Camden Lewis didn't waste time portraying Tuomey as the victim and attacking Drakeford and "the government" for targeting what he characterized as a struggling little hospital trying to do the best it could.
Asking jurors to reject any award, Lewis said, "They want to come in here and scoop the money up and make Tuomey and the doctors work for free! We're going to ask you to give us the verdict and send the government home."
The trial before Judge Matthew Perry is expected to take up to four weeks.
The case is expected to offer a behind-the-scenes glimpse into the big money world of South Carolina's doctors and hospitals, and how they jockey for payments from patients, the government and insurance companies.
Drakeford brought a lawsuit against Tuomey in 2005, and the federal government formally took over the case in 2008 after investigating Drakeford's claims. Drakeford is considered a whistle-blower since he brought the matter to the government's attention.
The government is allowed to take over an individual's lawsuit under a legal doctrine that allows an individual to initiate a suit against a company that does business with the government.
The case is exceedingly complex. More than 400 legal documents have been filed, and complicated issues involving doctors' pay and federal reimbursements to hospitals and doctors for medical services are involved.
One of the many issues is whether Tuomey hired 19 Sumter area doctors on a part-time basis for its outpatient clinic as a way both to keep a cut of their business and, in the process, control medical costs so the hospital could make more money.
Both Acker and Lewis tried to simplify the numerous intertwined issues of fact and law as the jury, poker-faced, listened.
Acker said Tuomey ignored repeated advice from experts that its outpatient clinic setup ran afoul of government laws.
"They deliberately ignored the warning signs," he said, as step by step, he took the jury through times and dates where Tuomey was warned.
But Lewis - who at times wagged his finger at Acker, calling him "the government" - told the jury Tuomey did eventually get expert opinion that said their operation was legal.
Lewis likened Tuomey to an ordinary citizen doing taxes, saying that a citizen just looks for legal ways to avoid giving the government too much money.
"Nothing wrong with that!" Lewis said.
Lewis also derided Drakeford, saying that far from having pure motives, he was in competition with the hospital. "He wanted to hurt Tuomey," said Lewis, who at times shot Drakeford long, scornful glances. "The other doctors - they wanted to be with Tuomey. Of course, that made Dr. Drakeford mad!"
Acker told the jury one thing would be clear - that Tuomey's motivation was its own financial interests - "not what was in the patients' best medical interests."