Readers may recall Australian fake practitioner instances, such as Raffaele Di Paolo, Sharobeem and Acharya (discussed in a recent Health Law Bulletin article by myself and Dr Wendy Bonython).
The US litigants claim that Igberase conducted unplanned emergency caesarean section surgeries that were “not medically necessary”, invaded their privacy and that given patients did not know his real identity they were incapable of providing authorisation or consent for medical procedures. The pleading in Russell et al. v. Dimensions Health Corp. (case number 8:17-cv-03106, in the U.S. District Court of Maryland) centres on the claim that over four years Igberase saw at least 1,000 patients and performed at least 500 caesareans. The plaintiffs allegedly suffered physical pain, emotional anguish, fear, anxiety, embarrassment, other emotional injures, intentional infliction of emotional distress, battery and negligent entrustment, and as a result of Dimension's alleged violations of the standards of care. That is reflected in reference to negligent and grossly negligent hiring, retention, supervision, selection, qualification and credentialing.
The plaintiffs argue that Dimensions as the entity responsible for patient safety should have been able to identify and quickly address any misconduct among its doctors, being negligent in vettingIgberase and letting him practice.
Dimensions breached its common law duties and the applicable standards of medical practice on an ongoing basis by negligently failing to investigate, credential, qualify, select, monitor and supervise its medical personnel and to discover, stop and report Oluwafemi Charles Igberase, ...
On information and belief, Oluwafemi Charles Igberase recommended and performed a statistically significant number of unplanned emergency cesarean section surgeries. Many of the unplanned emergency cesarean sections were not medically necessary.The plaintiffs also argue that in March 2012 the federal government denied Igberase's application to enroll in Medicare reimbursement after determining he did o't provide an accurate Social Security number. Dimensions should have terminated Igberase before that time, rather than shortly after the commencement of criminal proceedings: "In 2012, Dimensions knew or should have known that the Social Security number provided to Dimensions by Igberase belonged to another person".
US court documents reportedly list 11 pseudonyms used by Igberase, who appears to have been born in Nigeria and entered the US in 1991 on a nonimmigrant visa. It is unclear whether he actually attended and graduated from a medical school before entry to the US. During the following six years, he apparently fraudulently gained at least four Social Security numbers using different names and different permanent addresses, using those fraudulent identities in seeking certifications from the US Educational Commission for Foreign Medical Graduates, which licenses overseas medical school graduates before they can pursue graduate medical education in the United States. (Certification includes examinations; applicants are not allowed to take the exams multiple times.)
Igberase failed the exams on several occasions but in 1993 and 1994 gained certification under different names. Two certifications were revoked after authorities noticed he had used different names and dates in his applications. However in 1998 he gained a separate certification, which he used for a hospital residency program in New Jersey. Officials subsequently suspended him after realising he had used a false Social Security number and birth date.
Using fake ID he then gained a residency in gynaecology and obstetrics at Howard University in Washington, completing his residency at Prince George’s Hospital Center and gaining a medical license from the Maryland Board of Physicians in September 2011.
In practice over several years - relying on a medical license not in his legal name - Igberase performed physical examinations, made formal diagnoses, read sonograms, made birth plans and performed caesareans. The hospital appears to have responded by stating that Igberase's conduct failed to meet its expectations regarding "sound moral character" but that his credentials and experience appeared valid, with "Several highly reliable agencies [having] validated his credentials including the states in which he held medical licenses". The hospital is "exploring many aspects of this case, researching records, and evaluating processes and procedures upon which we rely to validate information".
The court in the 2016 federal fraud trial found that Igberase had forged or altered his medical diploma, medical transcripts and letters of recommendation in addition to use of a fake passport, visa, birth certificate and immigration documents. The Justice Department's November 2016 media release thus states
A search warrant executed at Igberase’s residence recovered a false social security card in the Akoda name, a false Nigerian passport for Akoda, a false U.S. visa in the Akoda name, and fraudulent or altered documents related to immigration, medical diplomas, medical transcripts, letters of recommendation and birth certificates.In its 2017 motion to dismiss the class action Dimensions argued the hospital owed the plaintiffs no legal duty to ensure Igberase was not using an assumed name or fake Social Security number. Moreover, the plaintiffs had failed to show that a reasonable vetting would have provide the basis for rejecting his employment application. Any emotional harm allegedly experienced by the plaintiffs were not caused by learning Igberase had used a fake name. His actions did not put patient safety at risk.
Whether Dr. Akoda practiced under his 'real' name of Igberase or whether he used a Social Security number that did or did not belong to him has nothing at all to do with patient safety ... [Use of false identifiers does not] transform routine prenatal, labor and delivery care into an invasion of the patient's privacy.
As Shakespeare wrote over 400 years ago, 'What's in a name? That which we call a rose by any other word would smell as sweet.' Whether the patients knew him as 'Akoda' or 'Igberase,' both names denote the exact same person, and that person was a licensed physician, who was experienced and competent in the practice of obstetrics and gynecology.The privacy claim states that Igberase
iintruded upon the solitude, seclusion or private affairs and concerns of named plaintiffs and class members by viewing private areas of each patient's body performing medical procedures on each patient, inserting his extremities inside each patient, performing surgical procedures on patients and other boundary violations all without authorization or consent.
