Four Years in the Life of a Medical Whistleblower

To modern eyes, it seems obvious that a culture in all healthcare organisations that encourages the reporting of concerns would carry with it great benefits. The readiness of staff to draw attention to errors or “near misses” by doctors and nurses, and the facility for them to do so, could have a major impact upon patient safety and upon the quality of care provided.
Dame Janet Smith


Imagine yourself in the position of deciding whether to blow the whistle on perceived corruption. In so doing, you would naturally try to weigh the potential risks against the benefits.

On the one hand, the corruption that you’ve become aware of is pervasive, and there are potentially some players involved with strongly vested interests to protect. On the other hand, the very lives of people may be left at great risk if the corruption is not revealed.

You know that retaliation against whistleblowers is pervasive across all professions.1 Yet, you also know that there are many legal protections promised to whistleblowers.2

You’ve weighed all of the outside factors as carefully as you can. Now, some inestimable factors weigh into the equation. As a medical professional, your patients have entrusted you with their very lives. You see other patients in your facility improperly diagnosed, and, in some cases, left entirely untreated. Your conscience fires up, adding its own weight to the equation.

Four years ago, Dr. Bharanidharan Padmanabhan found himself grappling with precisely these difficult questions. Encouraged by a senior colleague that he admired, he ultimately decided that taking action was the only true course to take.3

Improperly treating patients – and billing the federal government for it – necessarily meant that Medicaid fraud was taking place. Believing that fraud involving medical claims was likely to be taken seriously,4 he reported his concerns to the Medicaid Fraud Unit in the state of Massachusetts, as well as to the Federal Unit in the US Department of Health and Human Services. HHS Inspector General Daniel Levinson became aware of Dr. Padmanabhan’s allegations early on, yet four years later, nothing had happened, notwithstanding a promise made by one of his subordinates in February 2012.5

Dr. Padmanabhan followed his conscience, believing in the rule of the law. He understood full well that the Office of Attorney General was legally obligated to provide him with protection under the Commonwealth’s whistleblower statutes. Instead, the incumbent Attorney General at the time he filed his charges – Martha Coakley – provided him with no protection whatsoever.

His allegations – backed by considerable evidence – included “never events” that may well have cost patients their lives. His allegations included a demonstrated pattern of misdiagnoses, and, in some cases, lack of treatment for patients with readily identifiable medical conditions. All the while, Medicaid was picking up the tab for the treatment – such as it was – for impoverished patients in the “catchment area” served by Whidden Hospital. in Everett, Massachusetts.

“By reporting this egregious malpractice towards this patient I automatically qualified for statutory protection under MGL Chapter 149 Section 187,” Dr. Padmanabhan explains, adding that according to public records requests made of former Commonwealth Attorney Martha Coakley’s Office, her Office had never sought to enforce the whistleblowing protection laws. A letter from the former Attorney General’s Office appears to indicate that throughout the entire period encompassing Coakley’s term in office, not so much as a single record could be produced to demonstrate that an action had been initiated by her office for violations of the whistle-blowing statutes.

Previous Attorney General Coakley had completely ignored Dr. Padmanabhan’s criminal complaints against Julian Harris, the former-director of Massachusetts Medicaid. Two years ago, he’d informed Steven Hoffmann, the Director of the Medicaid Fraud Unit, about the criminal complaint he’d filed against Harris. Four years had gone by without any action being taken. Meanwhile, the well-credentialed physician was out of a job, even though he’d been through his hospital’s hearing process and cleared of the wrongdoing with which he was accused in retaliation for blowing the whistle.

THE PEOPLE’S LAWYER

Just at a time when it seemed impossible to add any more insults to the injuries that he’d already endured, a new Attorney General, Maura Healy, was elected to the office. During her inauguration, she cast her self as “the people’s lawyer.”6

It is relevant to note that among the first major legal actions undertaken by the new Attorney General was to combat an agreement that was brokered by former Attorney General Martha Coakley allowing for the merger of Partners Healthcare Systems, Inc., and South Shore Hospital. Toward the end of changing course and blocking the merger – which was to be overseen by a court-appointed monitor – Healy submitted a three page legal brief to the Superior Court arguing that the merger would be against sound public policy.

The controversial merger was to be allowed to take place after a 5-year-long investigation between Coakley’s Office and the US Justice Department. On January 29, 2015, Superior Court Justice Janet L. Sanders denied the decree that would have allowed the merger of Partners and South Shore Hospital to proceed, writing that,

Significantly, the monitor must rely on Partners for the critical information to make these calculations – so that the fox is literally guarding the proverbial chicken coop. Although payers could blow the whistle on any attempt by Partners to circumvent the price caps as outlined in the Proposed Consent Judgment, they may be reluctant to do so: after the price caps expire, these same payers will be on their own at the bargaining table and need to maintain a strong relationship with Partners going forward.7

One very curious aspect of former Attorney General Coakley’s involvement in the case is described in Justice Sanders’ ruling. The Department of Justice, with whom the Attorney General had coordinated in its investigation, for unexplained reasons “did not join as a signatory on the consent decree or submit a written public comment or court filing regarding the Proposed Consent Judgment.”

Justice Sanders further explained that during two hearings before the Court, “the Attorney General instead read a statement from the DOJ indicating that it supported the consent judgment, but the Attorney General declined to submit the statement itself to the Court, suggesting that federal authorities wish to keep their options open.”

Maura-Healey-investigation-notice

Legal notice served by AG Healy’s office.

What happened next was entirely unforeseen by Dr. Padmanabhan. Imagine his surprise when two investigators from Attorney General Healey’s office arrived at his home to hand deliver a legal notice compelling him to immediately deliver the medical records of 16 of his patients. They certified that providing full and immediate access to the medical records and charts was the minimum level of compliance expected of him as a part of a Medicaid fraud investigation.

What is particularly disturbing about the whole affair is that officials inside of the Attorney General’s office apparently obtained the list of 16 patients from the Massachusetts Prescription Monitoring Database, which collects information on all prescriptions filled within the state. Recognizing the potential for abuse of such a database of personal information, the legislature set in place strict guidelines restricting access.

”This intensely personal information about every single person living in Massachusetts, by law cannot be used to investigate Medicaid fraud,” he explains. The doctor further explains that all of his patients feel that they have been personally violated by Maura Healey’s actions.

“They feel even worse because they know Maura Healey and everyone else within the Government is aware that their doctor has not taken any public money for the past four years, and so there cannot be any genuine investigation into Medicaid fraud.”

WHAT INSPECTOR GENERALS AND OTHER WATCHDOGS SHOULD BE DOING

2014 Inspector General Report

Council of the Inspectors General on Integrity and Efficiency report

In June 2014, the Council of the Inspectors General on Integrity and Efficiency issued a comprehensive report exploring the authorities, responsibilities, and independence of statutory Inspector Generals who were “broadly introduced to the civilian side of the Federal government by the Inspector General Act of 1978.”

The stated purpose of the Act was “to create independent and objective units within each agency whose duty it is to combat waste, fraud, and abuse in the programs and operations of that agency.”

Toward this end, the report explains, “each IG is responsible for conducting audits and investigations relating to the programs and operations of its agency, and providing leadership and coordination and recommending policies for, and to conduct, supervise, or coordinate other activities for the purpose of promoting economy, efficiency, and effectiveness and preventing and detecting fraud and abuse in those programs and operations.”8

The report is intended to serve as something of a guidance document, to assist the Inspector Generals of federal agencies by clarifying their roles and responsibilities. These IGs are specifically entrusted with acting as watchdogs over their agencies, and they are intended to act independently, as the report explains:

The IG Act specifically prohibits agency management officials from supervising the IG. This important organizational independence helps to limit the potential for conflicts of interest that exist when an audit or investigative function is placed under the authority of the official whose particular programs are being scrutinized. This insulates IGs against reprisal and promotes independent and objective reporting.

In addition to the federal agencies that are intended to be kept in check by their respective Inspector Generals, individual States follow this general model in appointing Inspector Generals to oversee state-level agencies.

By way of example, by a unanimous vote of the Illinois General Assembly in June of 1993, the position of Inspector General was created to oversee its department of social services, the legislation rather unambiguously explaining that:

The mandate of the Office of the Inspector General (OIG) is to investigate misconduct, misfeasance, malfeasance, and violations of rules, procedures, or laws by Department of Children and Family Services employees, foster parents, service providers and contractors with the Department.9

Reduced to its essence, an Inspector General – whether on the state or federal level – may fairly be said to play the role of a watchdog overseeing a particular agency or industry.

WHEN WATCHDOGS SLEEP ON THEIR WATCH

By now most people are familiar with the deplorable actions of certain high ranking officials in the U.S. Department of Veterans Affairs. Those whistleblowers who brought the conditions to light payed a high price for their courage.

“Retaliation comes quickly to whistleblowers who expose wrongdoing at the Department of Veterans Affairs,” explains Mark Flatten of the Washington Examiner. In an article published in May 2014, he noted that: “Those who have revealed potentially lethal lapses in health care say they have been ridiculed, transferred, demoted and sometimes fired by agency managers attempting to cover up wrongdoing and silence anyone who dares challenge their dangerous practices.”

Oliver Mitchell, the former Marine who exposed the mass cancellation of medical appointments to hide lengthy backlogs at the veterans’ hospital in Los Angeles, “was stripped of his duties, put on administrative leave and eventually separated from the agency shortly after he reported the purging of medical appointments to the inspector general.” To make matters worse, Mitchell found little help from those who were supposed to be looking out for his interests as a whistleblower. As Examiner writer Flatten explains it:

The IG closed Mitchell’s complaint after VA officials claimed the “mass purge” of appointments was within policy. The U.S. Office of Special Counsel, the agency that is supposed to protect whistleblowers, also dropped his case.

These and other discoveries led to a four-part series published in December of 2014 by the Washington Examiner, reviewing the state of the Inspectors General. The series, “Watchdogs, Lapdogs and Attack Dogs,” found that Interim Inspector Generals have been accused of softening investigative reports under pressure from agency administrators; that whistleblowers routinely say inspectors general failed to investigate their charges of wrongdoing; that retaliation against whistleblowers is a matter of routine; and that high ranking officials went so far as to try to cover up all traces of wrongdoing, which in some cases had continued unchecked for years.

Interim Inspector Generals, according to the report, “are notorious for becoming the toadies of agency management, even though they are supposed to be independent, according to critics in Congress and outside watchdog groups.”

Part three of the series, “Bad things happen to whistleblowers when watchdogs become attack dogs,” explains that a “recent twist is that agencies are now using IGs to retaliate against whistleblowers or silence them by threatening criminal investigations rather than just personnel actions,” citing Tom Devine, legal director for the Government Accountability Project.10

DAVID V GOLIATH

A new study released in the United Kingdom reveals that those in the “helping professions” – particularly in the social work and health care professions – see a very high rate of abuse of their clients, yet they receive precious little support when trying to blow the whistle on wrongdoing.

The study reviewed employment tribunals involving a whistleblowing claim under the Public Interest Disclosure Act between 2011 and 2013.11

The Public Interest Disclosure Act was intended to level the playing field, however chief executive of Public Concern at Work, Cathy James, said it was clear that blowing the whistle remained a “David and Goliath battle,” with workers without legal representation far more likely to lose their cases, according to a write-up by Rachel Schraer on the ComunityCare web site. Schraer continues on to explain:

Those working in the care sector were far more likely than the general population to blow the whistle over concerns for their service users than for themselves, according to the study which reviewed employment tribunals involving a whistleblowing claim under the Public Interest Disclosure Act between 2011 and 2013.

Care professionals most commonly blew the whistle on their employer because of abuse to those in their care and concerns for service user safety, whereas the most common reasons among other groups of workers were discrimination, harassment and workplace safety.12

The advocacy group Public Concern at Work released the study, which is entitled “Is the law protecting whistleblowers? A review of PIDA claims,” as a part of it ongoing research in this area. With regard to access to justice, the study found:

  • Many workers, including GPs, foster carers, non-executive directors, volunteers and healthcare students, were denied protection under the law
  • Only 7% of claimants who brought interim relief claims were successful
  • Fifty-six percent (56%) of claimants do not have legal representation and this group has much poorer success rates compared to those with legal representation
  • There was a 20% drop in the number of whistleblowing claims lodged with the employment tribunal following the introduction of fees
  • Costs of over three quarters of a million pounds were ordered in cases involving a whistleblowing claim
  • A comprehensive review of the operation of the law is made impossible by the absence of an open register of claims.

Sixty-six percent (66%) of claims were lodged by claimants in the private sector; Twenty-one percent (21%) of claims relate to the health and social care sectors; Discrimination/harassment was the most common concern in whistleblowing claims, followed by concerns about work safety and financial malpractice

Ninety-one percent (91%) of whistleblowers first raise their concern internally. In cases where whistleblowers raise their concern more than once, the employer is the final recipient in 81% of cases.13

In a prepared press release accompanying the study, Cathy James, Chief Executive of Public Concern at Work, explains:

Whistleblowers speak up about all kinds of issues that might affect any one of us. From poor care in our hospitals to corruption in our police forces and fraud in our banks. While the law is intended to level the playing field, this report shows the barriers to justice faced by whistleblowers when accessing the courts and demonstrates the David and Goliath battle often faced by whistleblower claimants. Unable to access legal aid and faced with the financial burden of paying for advice, representation and court fees means that many individuals are effectively being priced out of justice.

A previous report issued by the organization found that high numbers of social workers had witnessed abusive (40%), unethical (58%), illegal (24%) or dangerous (65%) practice.14

It is truly a global problem. Columnist Bill Cotterell of the Tallahassee Democrat echoes these concerns, noting that, “On paper, Florida’s whistle-blower law is a veritable rhapsody of employee rights and government responsibility.”

“In practice, not so much.”

Cotterell continues on to explain,

In government, the boss has less to lose than in the private sector. Getting rid of a troublesome employee can probably be done without getting sued, and if the employee wants to fight, stonewalling is always the first defense.

It’s David and Goliath, with the taxpayers paying Goliath’s expenses.15

THE MEDICAL PROFESSION

The “helping professions” of social work and health care appear to put the would-be whistleblower in a particularly precarious position. Following the conviction of Harold Shipman – a General Practitioner who had killed at least 215 of his patients over a period of 24 years – a formal Inquiry was established in the UK. In commenting in the multi-volume report that followed, Dame Janet Smith explained:

To modern eyes, it seems obvious that a culture in all healthcare organisations that encourages the reporting of concerns would carry with it great benefits. The readiness of staff to draw attention to errors or ‘near misses’ by doctors and nurses, and the facility for them to do so, could have a major impact upon patient safety and upon the quality of care provided.16

It must be emphasized that in the majority of cases, those among the medical profession seeking to blow the whistle are motivated by concerns about patients in their facility’s care. The UK Whistleblowing report issued in November 2014 notes a 61% annual increase in whistleblowing cases from the health sector. Within that sector, patient safety concerns have soared by 97% annually.

In February 2015, Sir Robert Francis QC issued a report specifically examining whistleblowing in the medical profession. His report, “Freedom to Speak Up: An independent review into creating an open and honest reporting culture in the NHS,” followed the Mid Staffordshire NHS Foundation Trust Public Inquiry, over which he presided as Chair. Sir Francis explains:

The effect of the experiences has in some cases been truly shocking. We heard all too frequently of jobs being lost, but also of serious psychological damage, even to the extent of suicidal depression. In some, sad, cases, it is clear that the toll of continual battles has been to consume lives and cause dedicated people to behave out of character. Just as patients whose complaints are ignored can become mistrustful of all, even those trying to help them, staff who have been badly treated can become isolated, and disadvantaged in their ability to obtain appropriate alternative employment. In short, lives can be ruined by poor handling of staff who have raised concerns.

Sir Francis further explained, “There is a need for a culture in which concerns raised by staff are taken seriously, investigated and addressed by appropriate corrective measures. Above all, behaviour by anyone which is designed to bully staff into silence, or to subject them to retribution for speaking up must not be tolerated.”17

PUBLIC SUPPORT

There is wide international support for whistleblowing, according to a number of recent studies. “New research by the University of Greenwich shows 4 out of 5 Britons think that people should be supported for revealing serious wrongdoing, even if it means revealing inside information,” explains an article ScienceDaily. The research was funded by the University of Greenwich Business School, and the study employed the firm ComRes, which interviewed 2,000 adults online from October 26 to the 28th of October, 2012.18

In commenting on a joint project between Griffith University and the University of Melbourne, which employed a Newspoll survey of public opinion in Australia, Bernard Keane explains:

The Newspoll survey showed widespread community support for people who reveal wrongdoing. Over half of 1211 respondents thought it was acceptable in Australia to speak up about serious wrongdoing; more than 80% thought people who revealed serious wrongdoing should be supported, and more than 80% said they would feel obliged to report wrongdoing within their organisations if they observed it.18

As for attitudes in the United States, a survey of 1014 self-described “likely voters” conducted between February 14-19, 2007 found overwhelming public support for Congress to “institute a strong whistleblower law to protect government employees from retribution if they report waste or corruption.” The poll found that whistleblower protection was “among the most popular issues for likely voters, with 79% of those surveyed supporting a strong whistleblower protection act, and 41% of those surveyed stating that they would be “much more likely” to support a Congress that enacts such legislation.”20

CONCLUSION

Incredibly, after four years of essentially being ignored by those officials who were entrusted with the task of protecting him, and of investigating his claims, the doctor found himself being accused once again – this time of the very same offenses that he’d reported to begin with!

As his attorney explains in a letter sent to Attorney General Healey’s Office, her client hadn’t taken any public funds – least of all Medicaid – in four years of time, hence the Attorney General lacks jurisdiction to demand Medicaid-related payment information,

Healey’s hand-delivered demands “contains no valid legal basis or authority for the stated demands.”

“Accordingly,” the letter explains, “not only is my client under no obligation to produce any documentsto you, it would be a violation of State and Federal law for my client to do as demanded by the Attorney General’s Office.”

“The first email I wrote to Dr. Glick, who was the chief of neurology, documented patient neglect and official brain scan reports being issued that were 100% wrong. It suggested that the radiologist had not even looked at the scans when he wrote the reports. Dr. Glick called my email a ‘smoking gun’. He approached the leadership of the hospital to improve matters, and within two years we were both gone,” he explains.

He asserts that certain members of the hospital administration were “lying to my face, and it was important to get them to make statements under oath to prove I was fired for being a whistleblower. They held a hearing and overturned my firing, I still do not have my job back and the problems have not been rectified. They are also blocking me from being able to get paid.”

The doctor explains that he filed the suit so that he could be made whole after being wrongfully terminated, and his livelihood being taken from him.

“But I also brought this suit because Cambridge Hospital is a public hospital and the Board of Medicine is a public agency, totally funded by the taxpayers, what they have done and not done should be public, and brought to sunlight.”

He says that he will continue to try and educate the public, such that they may come to pressure government officials to solve the problems at Cambridge Hospital and the Board of Medicine.

“Their first response to my lawsuit was for the opposition to file a motion to impound all the documents, every scrap of paper, and hide it from the taxpayers. I fought that, and happily I won. So all the documents now remain in the public domain. A good chunk of them have been put up on Cambridge fraudcase.com.”

“AG Maura Healey, who has chosen to represent the seven board employees, is now trying to have them all declared judicially immune in federal court,” he explains.

“The story Cambridge Hospital is telling is, that I am a bad physician who is an imminent threat to public safety and does not know how to read brain MRI scans, or diagnose MS, even though I have a PhD in MS and 2 fellowships in MS.

“As it turns out I am one of 50 people on earth with my level of training and expertise in MS. Despite that the Board is trying to throw me out of medicine completely, claiming that my lawsuit is an effort to prevent disciplinary action in order to save the public from me.”

The doctor explains that the Board has dragged his case out “for four long years and never moved against my license. They allowed me to continue to treat the people of Mass but has blocked my ability to get paid. That is what this is all about.”

District Court Judge William Young recently looked at the lawsuit for the first time. “Judge William Young denied my motion as his first decision and act in my lawsuit. The implication is that government bureaucrats are exempt from laws that ordinary taxpayers are required to follow under the threat of legal sanctions. Naturally, I shall fight this to the fullest extent of the law,” he says.

“It is now undeniable that Maura Healey has chosen “Sovereign Immunity” as her main plank in order to actively protect the corrupt within state government whereas Coakley simply did nothing.”21

civil-complaint-cambridge

Civil Complaint against Cambridge, et al.

Dr. Padmanabhan’s journey has included the filing multiple complaints with multiple agencies, both on the State and Federal level. His journey extended to include the filing of a lawsuit with a highly detailed civil complaint in October 2014 against the City of Cambridge, which owns his former place of employment, Cambridge Hospital, as well as against a large list of individuals. It included the filing of a petition before the Supreme Judicial Court of Massachusetts. Now, the prospect of deliberations in a federal court is looming as imminent.22

Such have been the last four years in the life of a physician who would prefer to be putting his talents to use healing the afflicted, rather than fighting an uphill battle against inextricably iintertwined forces intent on cost-containment and federal revenue maximization at all costs.


1. There is a continuous stream of stories in the news media involving claims of retaliation for whistleblowing that is supported by substantial evidence. See for example, Government Accountability Office, “Whistleblower Protection: Sustained Management Attention Needed to Address Long-standing Program Weaknesses,” GAO-10-722, released September 16, 2010 (“We found that OSHA has done little to ensure that investigators have the necessary training and equipment to do their jobs, and that it lacks sufficient internal controls to ensure that the whistleblower program operates as intended”), and Government Accountability Office, “Whistleblower Protection Program: Opportunities Exist for OSHA and DOT to Strengthen Collaborative Mechanisms,” GAO-14-286, released March 19, 2014 (noting that Memorandums of Agreement between the two agencies “do not clearly define agency roles and responsibilities with respect to developing training on whistleblower issues and regional coordination”). This, in turn, generated some level of increased activity on the part of OSHA and the DOT. Some recent press releases from OSHA would include “New York City Transit Authority retaliates against employee for participating in safety inspection and filing complaint, OSHA finds,” March 24, 2015; “Fired for reporting hazards, whistleblower wins $33K settlement,” March 19, 2015 (truck driver fired the morning after filing a complaint OSHA alleging unsafe working conditions); “Culture of retaliation: Union Pacific Railroad disciplines locomotive engineer for reporting workplace injury, owes worker $350K in damages,” March 17, 2015; “OSHA announces final rule on procedures for handling retaliation complaints under Sarbanes-Oxley Act,” March 6, 2015 (announcing establishment of procedures for handling whistleblower retaliation complaints filed by employees who report fraudulent activities and violations of SEC rules that can harm investors in publicly traded companies); “Federal judge orders US Postal Service to pay employee $229K in damages for whistleblower retaliation,” February 26, 2015; “Hanford nuclear facility contractor ordered to pay 2 laid-off workers $186K in wages, damages for retaliation,” December 11, 2014.

2. An informative compendium of “Whistleblower Protections” for various industries may be found at whistleblowerlaws.com.

3. These events were detailed in Rick Thoma, “How One Hospital Lost Two of its Best Neurologists,” Special Report, Lifting the Veil, August 14, 2014.

4. The Department of Health and Human Services Office of Inspector General prominently encourages the reporting of fraud. Some recent press releases from the Office of Inspector General; U.S. Department of Health and Human Services include “Newton Medical Center in Kansas Settles EMTALA Case,” March 17, 2015 (“The OIG alleged that Newton Medical Center failed to provide an adequate medical screening examination for a patient who presented to Newton’s emergency department 38-weeks pregnant and complaining of abdominal and lower back pain”); “Sandoz to Pay $12.64 Million in CMP Settlement with HHS OIG for Misrepresenting Drug Pricing Data to Medicare,” March 16, 2015 (“Sandoz’s misrepresentations undermined the integrity of the Medicare Part B drug pricing system; we will continue to penalize manufacturers that misrepresent or fail to timely file the required information,”); “Denver Skilled Nursing Facility Settles CMP Case,” February 25, 2015; “Alabama Physician and Medical Practice Settles False and Fraudulent Medicare Claims Case,” February 24, 2015; “California Pharmacy Settles False and Fraudulent Medicare Claims Case,” February 24, 2015 (“The agreement with OIG resolves allegations that Hyundai Drugs and its owner Sang Kim submitted claims to Medicare Part D for brand name prescription drugs that it could not have dispensed based on inventory records”).

5. Letter from Jennifer Trussell, Acting Director of the Investigative Branch of the HHS Office of Inspector General, addressed to Dr. Padmanabhan, February 3, 2012.

6. Stephanie Ebbert, “Maura Healey sworn in as attorney general,” Boston Globe, January 29, 2015. Maura Healy was with the Attorney General’s Office under Coakley for seven years, ultimately coming to oversee over half of the office’s 500 employees. She began as Chief of the Civil Rights Division, and went on to direct the Public Protection & Advocacy Bureau and the Business & Labor Bureau. She was also involved in the Non-Profit Organizations/Public Charities division of the Attorney General’s office – the Division being responsible for overseeing over 23,000 public charities in Massachusetts. See National Association of Corporate Directors, New England Chapter. “The Nonprofit Director: Thriving in an Increasingly Complex Regulatory and Governance Landscape,” February 10, 2015 (describing upcoming event at which Maura Healy was scheduled as a speaker). Web downloaded May 22, 2015; Scot Lehigh, “Maura Healey sets sights on AG’s office,” Boston Globe, February 2, 2014; “Maura Healey for attorney general,” Boston Globe, September 01, 2014.

7. In denying the merger, Justice Sanders also noted that: “In fiscal year 2012, the annual revenue of Partners was approximately $9 billion, an increase of approximately twenty percent in the last four years. Its total net assets are more than double the combined assets of the next five largest systems in Massachusetts. It accounts for more than half of the commercial discharges in the state and receives nearly one-third of all commercial payments to acute care hospitals.” Commonwealth vs. Partners Healthcare System, Inc. & Others, Memorandum of Decision and Order on Joint Motion for Entry of Amended Final Judgment by Consent. SUCV2014-02033-BLS2. Superior Court, Suffolk. January 29, 2015. (Internal references omitted).

8. Council of the Inspectors General on Integrity and Efficiency. The Inspectors General. June 11, 2014.

9. Office of the Inspector General, Illinois Department Of Children And Family Services, Report to the Governor and General Assembly, January 2015. This particular agency is seemingly beyond reform and redemption. Even as the agency continues to expand its reach, the number of child fatalities continues to rise. Meanwhile, the agency has a policy of inconsistently “founding” cases in which children had died with co-sleeping suspected as the cause. Grieving parents had their remaining children removed for months at a time while an investigation ensued. This was branded as “ill-advised” by the Inspector General. See Office of the Inspector General, Illinois Department Of Children And Family Services, Investigating and Indicating Parents for Co-Sleeping in the Absence of Drug or Alcohol Use With No Other Evidence of Neglect. January 9, 2014. Part of the continuing chaos as this particular agency may be attributed to the extremely high turnover among its leadership. Rich Miller of Capitol Fax.com ran a brief article on January 7, 2015, aptly entitled “DCFS to get 8th director in three years.”

10. Mark Flatten “Watchdogs, Lapdogs and Attack Dogs,” a four-part series by the Washington Examiner examining the state of the inspectors general. (December 2014). See also Government Accountability Office, “Whistleblower Protection: DOD Needs to Enhance Oversight of Military Whistleblower Reprisal Investigations,” GAO-15-477, released May 7, 2015. Without question, much of the problem is attributable to attorney misconduct. Government Accountability Office, “Professional Misconduct: DOJ Could Strengthen Procedures for Disciplining Its Attorneys,” GAO-15-156, released December 11, 2014. No agency would appear to be resistant to the phenomenon. See Government Accountability Office, “Whistleblower Protection: Additional Actions Needed to Improve DOJ’s Handling of FBI Retaliation Complaints,” GAO-15-343T, released March 4, 2015. For a noteworthy historical perspective, see Fields, William S. “The Enigma Of Bureaucratic Accountability: Monitoring Government-Inspectors General and the Search for Accountability. By Paul C. Light. Washington, DC: The Brookings Institute, 1993. Pp. viii, 274. $31.75.” Book review. Catholic University Law Review. 43 (1994): 505-1247.

11. Public Concern at Work, “Is the law protecting whistleblowers? A review of PIDA claims,” (May 2015). See also for related background Public Concern at Work and the University at Greenwich, “Whistleblowing: the inside story,” (May 2013); The Whistleblowing Commission, “Report on the effectiveness of existing arrangements for workplace whistleblowing in the UK,” (November 2013) (noting that immediate change is needed to ensure whistleblowers are given the confidence to speak out without fear of adverse repercussions).

12. Rachel Schraer, “Whistleblowing care professionals ‘priced out of justice’,” CommunityCare, Sec. Legal Workforce, May 21, 2015.

13. Public Concern at Work, “Is the law protecting whistleblowers? A review of PIDA claims,” (2015).

14. Public Concern at Work, “The UK Whistleblowing Report: 2013,” (October 2014).

15. Bill Cotterell, “In whistle-blower cases, it’s typically David vs. Goliath,” Tallahassee Democrat, July 5, 2014. The David v Goliath analogy is frequently used in connection with the disadvantages faced by whistleblowers. See Kathie Griffiths, “Mother-of-two victorious in ‘David and Goliath’ battle,” Telegraph & Argus, May 31, 2011; Roy Strom, “David v. Goliath: Firms respond to growth in whistle-blower cases,” Chicago Lawyer, October 2012; Jermain Dunnagan & Owens, P.C., “Whistleblower wins Louisiana David vs. Goliath Case, Reports Jermain Dunnagan & Owens, P.C.,” PR Newswire, March 25, 2013; Sarah Buduson, “Real life David and Goliath: How northeast Ohio man helped recover millions of misspent tax dollars,” ABC News 5, Chicago, November 4, 2013; Amy Bingham, “Patient Whistleblower Exposes $150 Million Medicaid Fraud,” ABC News, December 7, 2011 (“In a real-life David versus Goliath story, a 63-year-old wheelchair-bound Medicaid patient took on the multi-billion-dollar healthcare giant Maxim Healthcare. And he won.”); Corporate Crime Reporter, “Iron Mountain and Shred-It Pay $1.1 Million to Resolve False Claims Act Charge,” July 9th, 2013 (similarly describing case as David v Goliath); Duke Helfand, “A mathematical David stuns a healthcare Goliath,” Los Angeles Times, July 15, 2010.

16. Fifth Report of the Shipman Inquiry, “Safeguarding Patients: Lessons from the Past – Proposals for the Future,” December 99, 2004. Page 329. Dame Janet Smith DBE, a High Court judge, was appointed Chairman of The Shipman Inquiry and the work of the independent public inquiry began in February 2001. Harold Fredrick Shipman was convicted January 31, 2000, of the murder of 15 of his patients while he was a General Practitioner. He was also convicted of forging a will. The Shipman Inquiry flowed from those events. The Inquiry’s First Report was published on July 12, 2002, and its Final Report was issued on January 27, 2005.

17. Sir Robert Francis QC, “Freedom to Speak Up: An independent review into creating an open and honest reporting culture in the NHS,” (February 11, 2015). Anyone with an interest in whistleblowing in the specific context of the medical profession would do well to read all 222 pages of Sir Francis’ report. See also the Mid Staffordshire NHS Foundation Trust Public Inquiry, which details long-standing malfeasance and a culture of silence at hospitals that put many patients at tremendous risk, and the Trust went so far as to dismiss the high mortality rate among patients as attributable to data entry errors. For a good overview, see Denis Campbell, “Mid Staffs hospital scandal: the essential guide,” The Guardian, (February 5, 2013).

18. Bernard Keane, “Older Australians, white collars more supportive of whistleblowing,” Crikey, (June 06, 2012).

19. University of Greenwich. “Overwhelming public support for whistleblowers.” ScienceDaily. (November 19, 2012). The complete research report is available as Wim Vandekerckhove, “UK Public Attitudes to Whistleblowing,” University of Greenwich Business School,
November 15, 2012.

20. National Whistleblowers Center, “National Poll Shows Overwhelming Support For New Whistleblower Protections,” (March 1, 2007); Democracy Corps, Frequency Questionnaire, February 14-19, 2007.

21. Information throughout this section is derived from pre-publication review of Valley Patriot article entitled “Maura Healey Accuses Dr. Bharani of Medicaid Fraud,” draft version embargoed for release in May 2015, as well as personal communications.

22. “Former Doctor at Cambridge Hospital Files Suit vs Board of Medicine, Cambridge Hospital,” Valley Patriot (April 30, 2015); Dr. Bharani Padmanabhan, “An Open Letter to Massachusetts Attorney General Martha Coakley,” Valley Patriot (December 13, 2013); Dr. Bharani Padmanabhan, “Physicians Harm Patients to Avoid Being Denounced as Disruptive ~ Medical Corruption,” Valley Patriot (December 2, 2014).