A doctor who trained for two years at the psychiatric unit of a New York hospital said in a lawsuit Monday that poor adolescent patients were routinely provoked into acting out, then restrained and drugged, extending their hospitalization and Medicaid payments.
Dr. Alfred Robenzadeh said that supervisors at Westchester Medical Center in Valhalla retaliated against him when he tried to address what he says was chronic patient abuse that increased the severity of diagnoses, with usual two-week inpatient stays often extended days or weeks. He alleges the practice defrauded Medicaid.
The hospital proposed terminating Robenzadeh's training this year. He said that's subject to arbitration and allegations against him of improper moonlighting and later violating patient privacy in defending against those allegations were trumped up. His complaint named five doctors he says joined in retaliation against him and the hospital's director of labor relations.
The suit was filed under federal and New York whistleblower laws. It seeks damages, including payment for lost employment and business opportunities, and litigation costs. It asks the court to order the hospital to certify his completion of four years of specialty training in psychiatry, saying the defendants have refused to do that.
Westchester Medical Center said the claims against staff are "without merit" and "offensive." Robenzadeh, a psychiatry trainee, raised claims only after being disciplined for certain behavior hospital spokesman Andrew LaGuardia said.
Robenzadeh's suit recounted an instance while on duty, when the nursing staff asked that he order restraints on a disruptive patient, which he declined to do without actually seeing the teen first. He said that he witnessed staff "encroaching on the inpatient's space and using provocative and threatening language and tone," escalating the agitation, and that he instead talked to and calmed the youth, making restraints unnecessary.
"The excessive use of force resulted in extended, unreasonable and unnecessary inpatient treatment days, for which the hospital is reimbursed by Medicaid," the lawsuit said. "Rather than using de-escalation techniques that would not require the administration of chemical or physical restraints, the nursing staff's first and preferred response to the provoked behavior was to seek an order from a physician for the administration of a chemical or physical restraint to sedate the patient."
Robenzadeh said that he proposed studying inpatient metrics to determine why stable patients were having incidents shortly before scheduled discharges and whether it was from policy and practice. Instead, he said, he was "marginalized," stymied in attempts to moonlight as other graduate trainees did, given more hospital patients than they had, and ultimately suspended and terminated from the fellowship program.