New York orthopedists indicted in $31M 'trip-and-fall' scheme that preyed on poor


A group of physicians and lawyers were indicted this week, accused of recruiting a network of people for a slip-and-fall scheme that defrauded New York City businesses and insurance companies of more than $31 million.

The Aug. 25 U.S. Justice Department indictment charges two physicians and two attorneys with conspiracy to commit mail and wire fraud as part of a "scheme to obtain fraudulent insurance reimbursements and other compensation for fraudulent trip-and-fall accidents."

The defendants are:

  • Sady Ribeiro, MD, pain management specialist
  • Andrew Dowd, MD, orthopedic surgeon
  • George Constantine and Marc Elefant, attorneys

From about January 2013 to April 2018, the defendants allegedly coerced people to stage trip-and-fall accidents after which the attorneys would file lawsuits. About 400 fake patients participated in the scheme, which used cellar doors, cracks in concrete sidewalks and apparent potholes to stage accidents, prosecutors said.

Patients were referred to specific attorneys, including Mr. Constantine and Mr. Elefant, who filed fraudulent personal injury lawsuits against businesses and/or insurance companies, according to the Justice Department.

Prosecutors said patients were also instructed to receive chiropractic and medical treatment from certain providers, including Drs. Dowd and Ribeiro. The defendants allegedly told patients that they were required to have surgery if they wished to continue their lawsuits, and patients were typically told to have two surgeries.

As an incentive, patients would receive $1,000 to $1,500 after they had surgery, the Justice Department said. Drs. Dowd and Ribeiro allegedly performed several of these surgeries that were not medically necessary.

Members of the fraud scheme "preyed upon the most vulnerable members of society," according to the Justice Department, recruiting individuals who were extremely poor, many of whom came from homeless shelters in New York City.

The defendants face a maximum sentence of 20 years in prison.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Webinars

Featured Whitepapers