Relationships of doctors and lawyers, and their clients, called into question

Dr. Benjamin Venger was called in to consult on the tragic case of Carlos Pachas, who in 2001 entered a hospital with kidney stones and left permanently disabled.

Venger, a Las Vegas neurosurgeon, thought a lucrative malpractice case might be filed against the doctors and hospital involved.

Venger told medical consultant Howard Awand about the Pachas case. Call it a referral fee or a kickback, but a federal indictment alleges Venger was paid $430,000. (Venger attorney George Kelesis insists that figure is too high.)

As I disclosed Monday, Venger is Physician CC in the federal indictment against Awand and Noel Gage, the personal injury attorney who represented Pachas (Client 1) in medical malpractice cases.

The indictment said Venger "caused Client 1 to be referred to Awand," and Awand referred the case to Gage.

Venger was a tipster for Awand in 2001; today he's a cooperating government witness.

Pachas was a lucrative malpractice case. The settlements are sealed, but they were in the millions. Gage's legal fee was a percent of the settlement, which is routine. The indictment alleges the lawyer and Awand conspired to take even more from the settlement, leaving Pachas with less.

The indictment claims Gage took $1 million from the settlement to pay Awand fees, without disclosing that to Pachas. The attorney also paid the consultant the full amount of two liens Awand had purchased at a discount from a doctor and a hospital. Awand was paid nearly $360,000 for liens he bought for about $135,000. Again, Pachas wasn't told.

"Attorneys have fiduciary and legal duties to provide the clients with honest services that are free from self-dealing, corruption, fraud, deceit and conflicts of interest," the indictment says.

Prosecutors believe there is another way doctors and lawyers duped patients and clients. Melodie Simon, who is Client 2 in the indictment, is supposedly an example of how that worked to the benefit of the doctors and the detriment of the patient.

This wasn't about getting paid for tips. This was about not getting sued.

The indictment claims then-business partners Dr. Mark Kabins and Dr. John Thalgott (Physicians DD and EE) both operated on Simon, a schoolteacher who after elective back surgery in 2000 was left paralyzed.

She hired Noel Gage to represent her.

Thalgott also is now a cooperating government witness represented by Kelesis, who with Venger voluntarily went to federal officials in May 2005 to reveal what had been happening.

However, before that happened, the indictment alleges Awand and Gage met with the two orthopedic surgeons, Thalgott and Kabins, and discussed the possibility of blaming any malpractice on Physician FF, anesthesiologist Dr. Dan Burkhead. The agreement struck was that if they blamed Burkhead, they wouldn't be sued by Gage for medical malpractice themselves. (Kabins denies that through his attorney.)

Simon wasn't told any of this, the indictment says. Nor did Gage tell her she might have a malpractice case against the two surgeons. In their May 2002 depositions in Simon's malpractice lawsuit, both Thalgott and Kabins gave their medical opinions that the anesthesiologist was to blame.

The indictment does not claim Thalgott and Kabins received any money, just the promise they wouldn't be sued for malpractice themselves in the Simon case. "Dr. Thalgott was not the recipient of any payments," Kelesis said.

Attorney David Chesnoff said Kabins had no liability for Simon so there was no need to discuss whether he could be sued. "Dr. Kabins did not perform the original surgery that led to her complaining. He was only involved after she developed the symptoms, and he tried to help her as any doctor is supposed to do."

If the allegations are true, then dirty little secrets about how certain doctors and lawyers are more interested in making money than in the well-being of their patients and legal clients are enough to make you sick.

If it isn't proven true, doctors and lawyers all over town have had their names bandied about and their reputations sullied.

For now, we have doctors turning against doctors and lawyers turning against lawyers, and the truth won't be determined for years.

Jane Ann Morrison's column appears Monday, Thursday and Saturday. E-mail her at Jane@reviewjournal.com or call 383-0275.