Dr. Salomon Melgen’s claims that he was an innovative ophthalmologist who would do anything to save his patients’ sight got a boost Monday from a Clearwater retinal specialist.
Contrary to two nationally renown eye doctors — who blasted Melgen’s methods as antiquated, unnecessary and potentially harmful — Dr. Dana Deupree said he uses some of the same tactics as Melgen at his practice on Florida’s west coast.
“It’s an interesting approach,” Deupree said as he examined a chart that showed the Palm Beach County ophthalmologist used low-power lasers to treat an elderly woman who was nearly blind in one eye and was losing her vision in the other. “I’m kind of doing this at this point. I wasn’t a couple of years ago but I am now and some eyes are coming around.”
Deupree is expected to be the last witness to testify for Melgen, who is charged with 76 counts of health care fraud for allegedly bilking Medicare out of as much as $105 million. He is expected to remain on the witness stand for most of this week. Then, after roughly six weeks of testimony, the case is to go to the jury.
Just as the experts called by federal prosecutors did, Deupree is painstakingly going through the charts and eye scans of each of the 30 patients that form the basis for Melgen’s indictment. The 62-year-old wealthy, politically connected doctor, who operated four clinics from Delray to Port St. Lucie, also faces corruption charges in New Jersey along with his powerful friend, U.S. Sen. Robert Menendez, D-N.J.
While experts called by federal prosecutors saw no signs in the scans to confirm Melgen’s diagnoses of wet macular degeneration, Deupree looked at the same images and said the patients suffered from the disease, which slowly robs the elderly of their vision.
Jurors, who have gotten a short-course in the malady, hovered over computer screens as Deupree drew bright green digital lines on the images to explain what he was seeing. That the lines he drew conflicted with ones drawn by prosecution experts isn’t unusual, he said. Retinal specialists often disagree, he testified.
Further, while prosecution experts claimed that few retinal specialists have used lasers to stem the progression of wet macular degeneration since the advent of drugs to treat the disease, Deupree said lasers in low doses can be effective.
Drugs, such as Lucentis, revolutionized the treatment of wet macular degeneration, Deupree said. But, he said, it’s not enough.
“You squirt drugs into the eye and it stabilizes it,” he said. “But it hasn’t gotten to the bottom of what is causing (the ailment),” he said. “Laser does get to the bottom of the problem. It gets to the underlying bleeding.”
He said he began using what is called a micropulse laser several years ago. Less powerful the old-school lasers, it stimulates the eye rather than burning areas that are diseased, he said. The combination of drug and laser treatments — a regime prosecution experts claimed was an unnecessary redundancy that served only to drive up Melgen’s Medicare billings — work, Deupree said.
“I found the combination of treatment works better than either of them did apart,” he said. He dismissed the notion that he shouldn’t embrace the dual therapy until studies prove its efficacy. “If I waited for that study to be conducted I’ll lose the opportunity to help hundreds of patients,” Deupree said.
He also disputed previous testimony that Melgen improperly billed Medicare for eye scans that were unreadable, saying he also bills for bad images. “There’s no guarantee that you’re going to get a perfect study every time,” he told jurors. “If it doesn’t come out as well as you’d like, we’ve still done the work.”
And even sub-par scans can be enhanced, he said. They, along with eye exams, can be used to make a correct diagnoses and plans for treatment. He said even the most damaged eye can be treated — and patients want it.
“I haven’t met anyone yet who is willing to go blind,” he said.