By Najib Aminy
Cancer accounts for nearly a quarter of the American mortalities each year, as reported by the American Cancer Society. The Stony Brook University Cancer Center is designed to provide the best care and work towards the prevention, diagnosis, treatment and curing of cancer, according to their mission statement. Aspiring to become a National Cancer Institute-designated Comprehensive Cancer Center, Stony Brook University formally hired Dr. Timothy J. Kinsella as the new Director of the Cancer Center on October 8.
Appointed by Dr. Richard N. Fine, Dean of the Stony Brook School of Medicine, Dr. Kinsella will take charge of the two-year-old center, with plans to collaborate with both Cold Spring Harbor Laboratory and Brookhaven National Labs. The Center aims to continue basic cancer research programs, expand therapeutic cancer-related services and provide educational outreach to the community. “Dr. Kinsella is an outstanding physician with considerable administrative experience,” said Dean Fine. “In choosing him to lead our program, we have formulated a vision for development of an National Cancer Institute (NCI)-designated Comprehensive Cancer Center that will serve as a major clinical and research enterprise for Long Island.”
Prior to his hiring at Stony Brook, Dr. Kinsella spent two decades working at the University of Wisconsin from 1987 to 1997. Shortly after, he joined University Hospitals of Case Western in Cleveland from 1997 to 2007. Recently, Dr. Kinsella worked at the NCI, where he was appointed as a member of the Board of Scientific Advisors. Dean Fine’s appointment of Dr. Kinsella is no doubt an effort to make Stony Brook a nationally recognized comprehensive cancer center. However, allegations have surfaced against Dr. Kinsella during his time at both UW and UH, and very recently, the New York Trial Lawyers Association has delved into the process of investigating further information on Dr. Kinsella.
While working at the University of Wisconsin, Dr. Kinsella, who served as deputy director of the Cancer Center before leaving, was investigated by the university after an anonymous complaint was sent to Chancellor David Ward, UW Dean of Medical School Philip Farrell, and hospital billing administrator Dr. Scott Springman. In the letter, dated November 1996, a widower, whose wife was a patient under Kinsella’s care, brought up allegations pertaining to improper medical billing.
According to the anonymous widower, Dr. Kinsella had billed his wife for radiation simulations while Kinsella himself was absent from the actual treatment procedure. The widower discussed his allegation with a neighbor who was an employee at UW. The letter states that the UW employee “has a list of several hundred total patients dating back into the late 1980s,” who had radiation simulation done by Dr. Kinsella on specific dates when there were records confirming that he was out of the state of Wisconsin.
The anonymous letter sparked an investigation by both the Department of Health and Human Services, which regulates Medicare, and the University of Wisconsin itself. Lisa Brunette, a spokeswoman from the University of Wisconsin confirmed that both investigations took place. The DHHS confirmed that no action was taken on Dr. Kinsella after their investigation, since Dr. Kinsella was not excluded from receiving Medicare benefits. On the contrary, the University of Wisconsin probe discovered that Dr. Kinsella received $5,815 from improper medical billings.
The probe looked into a total of 247 medical services while Dr. Kinsella was out of town from 1995 to 1996. Of these 247 services, 66 were found to involve improper documentation, and 19 were discovered for improper billing reported by The Wisconsin State Journal. Dr. Kinsella agreed to pay the $5,815 he received from the improper billings back to the patients as well as $15,000 out of the $22,000 for the cost of the six-month investigation conducted by the University of Wisconsin.
“It was just his idiosyncratic way of summarizing things,” said Michael Weiden of Madison, WI law firm Quarles and Brady, who was Dr. Kinsella’s lawyer at the time. “There is less than meets the eye,” Weiden said to Wisconsin reporters. “Doctors keep personal notes in all sorts of ways—on Post-its, index cards, little notebooks—and the documents in which Kinsella made these notations were not the official hospital medical records.”
A little more than ten years later, Dr. Kinsella confirmed that an investigation had taken place. He said during a phone interview about the probe, “There was an issue of an anonymous complaint of issues with respect to billing that turned out to be false.” According to Dr. Kinsella, the investigation was proven false by a review of the records through the UW hospital. Neither Brunette nor John C. Dowling, a UW attorney could confirm whether or not the allegations in the probe were later proven false.
UW Medical School officials recommended disciplinary action to be filed to Chancellor Ward. He stated in a letter dated May 9, 1997, that there was adequate cause for disciplinary action,” The Capital Times reported. However, no action was filed because Ward recognized Dr. Kinsella’s agreeing to pay for both the improper billings and withdrawing his name from re-appointment as department chair, as both responsible and appropriate. Regarding the probed allegations, Dr. Kinsella said, “Those were investigated. No allegations were found. It was well over a decade ago. That is old news.”
During his time at UW, Dr. Kinsella allegedly left an unfavorable impression on his colleagues. These colleagues would later go to a former UW clinical administrator officer from the Department of Oncology. The former administrative official wished not to reveal their name, as the individual wishes no longer to be involved in any way with Dr. Kinsella. Alleging that Dr. Kinsella was battling with an inferiority complex, the former UW clinical administrator said that Dr. Kinsella “was very combative for other positions with other heads of departments and [had] a way of irritating people.” When Dr. Kinsella made the list of the Top 10 Docs in the Madison Magazine, the surgeon oncologists were livid that his name was included, according to the former clinical administrator.
In addition, many UW employees would approach the former clinical administrator in regards to some of Dr. Kinsella’s behavior. “A lot of people would come to me and complain about Dr. Kinsella,” the former administrator said, adding that it was mostly about his billing procedures and even at times about his sexual promiscuity. The former clinical administrator alleged instances where Dr. Kinsella would excuse himself from meetings and conferences to rendezvous with women.
Though the allegation regarding Dr. Kinsella’s sexual misadventures remains unconfirmed, numerous unnamed doctors were quoted in The Wisconsin State Journal regarding Dr. Kinsella’s medical billing procedures. “It became increasingly nauseating for us to see the Kinsella patients have three or four times the length of the normal procedures,” said one unnamed doctor in the Wisconsin State Journal. The doctor wished to remain anonymous, because Dr. Kinsella could influence the change of the salaries, promotions and tenure of eight doctors and nine medical researchers at the time. “It became unbearable to watch the billing-directed care—it was always directed at maximized billing,” the doctor added. The former UW clinical administrator said, “The number of improper billings done by Kinsella as reported in the articles was under quoted by 10 times the amount.”
Before leaving UW, the majority of the members of the Human Oncology Department voiced their concerns over Dr. Kinsella in a vote of no confidence taken in 1996. The vote of no confidence pertained to Kinsella’s administrative role as Chairman of the Human Oncology Department and unconnected with the investigation taking place by UW. A vote of confidence is procedural and taken annually at UW. According to the Wisconsin State Journal, departmental researchers supported Kinsella, but doctors voted against him due to excessive and aggressive billings, about which one doctor said, “There were some concerns about how he practiced in terms of very aggressive billings.”
Dr. Kinsella responded to the doctor’s critiques, saying in the phone interview, “I think I am recognized nationally and internationally for my clinical expertise in cancer treatments. It stands alone. I’ve published nearly 330 articles and am looked on as an expert in many areas of radiation oncology.”
After withdrawing his name for re-appointment as chairman of UW’s Human Oncology Department, Dr. Kinsella remained at UW teaching, before joining University Hospitals Case Medical Center in 1997 as Chairman of the Department of Radiation Oncology. Over a span of 10 years, Dr. Kinsella and his laboratory team researched biochemical and molecular effects of ionizing radiation and different types of radiosensitizing drugs in human tumor cells, according to Alicia Reale, a UH spokeswoman.
While chairman at UH, Dr. Kinsella specialized in gastrointestinal cancers, lymphoma, melanoma and sarcomas among other cancers. Thus, when cancer survivor Amelia Weber was diagnosed with squamous cell carcinoma of the lip, she turned to Dr. Kinsella for treatment of her cancer in 2006. “My first impression of him was that he was a dirty old man. However, I told myself that I was mistaken in that view, as University Hospitals of Cleveland would never have that kind of person in their employ, nor as the Chairman of the Department of Radiation Oncology,” she said in an email interview. “For those reasons, I granted Dr. Kinsella far too much trust, and became his victim of sexual assault.”
Weber alleges that Dr. Kinsella behaved inappropriately while conducting physical examinations, such as smiling while touching sensitive areas of her body. Additionally, Weber alleges numerous instances where Dr. Kinsella physically touched her in sensitive areas of the body without providing any medical reasoning, all against her will. For example, Weber alleges that Dr. Kinsella asked her to undress. Howeverm when she refused, Kinsella proceeded with the examination. Secondly, Weber alleges that she was billed a total of 35 treatments while she only received 33 and was stunned when she learned about Kinsella’s past at UW. As a result of her experience, Weber filed a complaint to the Ohio State Medical Board (OSMB) through her attorney, Wade Sanders.
In the complaint, there are a number of instances where Weber alleges that Kinsella touched her inappropriately, made lewd comments and called her to solicit for sex. The complaint was sent to the OSMB in March of 2007 and is pending as of October 15, 2008 in an audio recorded confirmation. Furthermore, the Disciplinary Counsel of the Supreme Court of Ohio confirmed that Weber’s complaint was pending on August 25, 2008, after Weber filed a complaint regarding one of Kinsella’s attorneys.
Amy Stone, the Assistant Disciplinary Counsel of the SCO wrote in a letter addressed to Weber, “We typically do not conduct investigations while a grievant and the attorney about whom s/he complained are involved in a pending case or other agency investigation.” Only once Weber’s complaint with the OSMB is processed and concluded would Weber be able to file a complaint to the Disciplinary Counsel, according to Stone. “Once the Board proceedings and any related litigation concluded, presumably with decisions that do not restrict their disclosure to this office, you may re-submit your grievance,” said Stone in the letter.
According to Reale, Dr. Kinsella stepped down from his position as Chairman at UH in October 2007, months after Weber’s complaint was sent. “He stepped down as Chairman at UHCMC to pursue his research in the Department of Radiation Oncology at Case Western Reserve University School of Medicine. He continued to see patients at UHCMC until May 2008,” Reale said in an email.
Reale confirmed that an independent investigation took place at UH after Weber’s complaint was filed to the OSMB. UH concluded that Weber’s allegations were unsubstantiated. In the phone interview, Dr. Kinsella denied having a pending action complaint filed against him through the Ohio State Medical Board as well as having any complaint filed against him through the OSMB at anytime.
Weber’s complaint regarding Dr. Kinsella’s attorney is tied to a possible violation of Health Insurance Portability and Accountability of 1996 (HIPAA). After filing her complaint with the OSMB, Weber looked into the option of filing a civil suit against Dr. Kinsella. Ben Barrett, Weber’s attorney for possible civil action, met with Dr. Kinsella’s attorneys, Melvin Resnick and Jodi Thomaszewski on May 6, 2008, during which Dr. Kinsella’s attorneys said they wanted to “resolve the issue,” according to Weber. In this meeting, according to Barrett’s meeting summary sent to Weber, Dr. Kinsella’s attorneys provided sensitive and confidential information in their defense. According to the meeting summary signed by Barrett, Dr. Kinsella’s attorneys were well aware of Weber’s allegations through the OSMB. In their defense, the attorneys went through 500 medical records to show that the body examinations Dr. Kinsella conducts were consistent.
Dr. Kinsella’s attorney also provided information regarding Weber’s confidential patient satisfaction survey, in which Weber allegedly gave high marks to both Dr. Kinsella and another male doctor while giving negative criticism towards a female nurse. According to the HHS, patient surveys are to be kept confidential.
The HHS also stated that covered entities may disclose protected health information during judicial or administrative proceedings, administrative reviews or licensing and credentialing activities. A covered entity, by definition of HIPAA, is “a health plan, health care clearinghouse, and a health care provider who transmits any health information in electronic form in connection with a transaction covered by this subchapter.” A covered entity may also include a business associate, which is defined as a person who performs activity regulated on behalf of a covered entity. “Business associates exclude a person who is part of the covered entity’s workforce.”
When Barrett met with Dr. Kinsella’s attorneys, there was no judicial case or hearing set. “The confidential patient information that Dr. Kinsella and his attorneys removed from UH and used in a willful and malicious way to harm me, or intimidate me, clearly was not intended to be used with regard to the OH Medical Board investigations rather to a potential civil suit,” said Weber.
As a result, Weber has filed a complaint to the Department of Health and Human Services, Civil Rights Division. According to Kathleen Fimple, a HIPAA team leader in the division of Civil Rights, Weber’s complaint was received and her complaint will be assigned between December and January due to a six-month backlog experienced by the HHS. Penalties for HIPAA violations are fines up to $250,000 and up to 10 years imprisonment if violation was done with intent of personal gain or malicious harm, according to the HHS.
On November 19, the Ohio Association for Justice sent emails to its trial lawyers requesting information about Dr. Kinsella. The email read, “Our friends at the New York State Trial Lawyer’s Association need information ASAP on a doctor who has practiced in Ohio, Dr. Timothy Kinsella. He has been appointed to head of the cancer department in New York.” The email inquired upon lawsuits filed against him in Ohio as well as complaints filed against him through the OSMB. The NYSTLA’s mission is “To promote a safer and healthier society, to assure access to the civil justice system by those who are wrongfully injured and to advance representation of the public by ethical, well-trained lawyers.”
Weber contacted Dean Fine regarding the hiring of Dr. Kinsella and her allegations on October 9. Dean Fine responded to Weber in a letter over a month later, on November 11, the same day that the phone interview with Dr. Kinsella took place. In the letter, Dean Fine wrote, “I received and read your letter dated October 9, 2008. The contents will be reviewed. Thank you for writing to me.” Weber sent a letter to Dr. Stongwater, CEO of the Stony Brook Medical Center, on October 20. Weber received a letter from Strongwater confirming that her letter was received on November 29.
Dean Fine could not be reached for an interview at the time of publication, but in an email responded, “Dr. Kinsella is a nationally known clinician and administrator who was brought on board to help us execute our vision to develop a National Cancer Institute designated Comprehensive Cancer Center that will serve as a major clinical and research enterprise for Long Island. Along with his extensive experience in academic medicine, Dr. Kinsella was recently appointed to the National Cancer Institute’s Board of Scientific Advisors, a highly significant appointment.”