Department of Health and Human Services - Office of Inspector General
July 2014 Letter

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James R. Caputo, M.D.                                                                               Jamesville, New York 13078

 

 

July 14, 2014

 

 

Boo Kim

Investigations Analyst

Department of Health and Human Services

Office of Inspector General

NY Regional Office

26 Federal Plaza, 13-124

New York, NY 10278

 

Dear Investigations Analyst Kim,

 

I am responding to a letter from Peter Clark, dated June 9th, 2014.  I called your office on July 11, 2014 to let you know that I had been away from home for the majority of June and that this letter would be forthcoming.  I again called today and spoke to an April who kindly facilitated my being able to email this letter to you.  I was initially surprised to get Mr. Clark’s letter but given the nature of what I have already experienced, it stands to reason that such an inquiry would be necessary.

 

It is my utmost desire to maintain my current good standing with Medicare, Medicaid and all Federal health care programs.  For the entirety of my career, I have always been compliant with each of these programs and have never had a single event where my participation was suspect in any manner.  It is true that I surrendered my medical license to the State of New York in June.  The circumstances leading up to this decision are somewhat complex and unfortunately not based upon a form of jurisprudence that would be considered legitimate in any American courtroom.  I do not wish to inundate you with too much reading but in the interest of sustaining my Federal stature, I believe it is necessary to apprise you somewhat of the events leading up to this license surrender.  I will, therefore, attach a limited number of the many exhibits I have on this matter as an essential element of substantiating pertinent points to be made below.

 

This letter is one of more than a hundred incarnations of some form of explanation of this now almost thirteen year matter.  With each writing, I have struggled to know just how much to disclose in order for the truth to be understood without overwhelming the reader.  The depth of information is extensive but I will try earnestly to be succinct with what I believe illustrates the point of this all.  I’m only going to take one particular aspect of the events that led up to this license situation and therefore why I believe I should be allowed to maintain my Federal status.  It is totally understandable that as you read, various thoughts and deductions will naturally be made that this whole thing just can’t be true given how outrageous the ensuing facts are.  Let me assure you that despite whatever official document(s) exists from the NYS DOH, or whatever (expected) opposition to these facts are offered by those who are responsible – despite any degree of scrutiny or ad hominem attack, everything single thing I write on this experience is completely supported by substantial material evidence.  I trust that your experience in government bureaucracy has informed you that not all “official” actions are necessarily valid though we all would like to believe so.  Please keep this in mind as you read.

 

In 2001, after an unfortunate medical outcome in one of my Obstetrical cases resulting in a stillbirth that was forensically proven to be due to a rare biological phenomenon and not anything of negligence, I was targeted by a small group of members in my hospital department at Crouse Hospital in Syracuse, NY who used an institutional process, (little known to me at the time), called medical peer review to purposefully and methodically over the course of several years destroy my career, practice, marriage, family and name and in the process wreaking unspeakable financial losses on me and my five children.  The motivation for why such a thing would be done involves a great deal of foundation, the length of which would needlessly strain the purpose of this letter.  Let me just say this, the majority of the leadership in question within this department has been there for more than forty years.  During this tenure, (to name but a few), the training program has been on probation more than once, the majority of residents graduate marginally trained and ill equipped, the educational standards have for years been described by medical students as the worst in their scholastic experience and most importantly, the observable quality of care for women and unborn babies has, in too many cases, been shockingly substandard.  I have case examples that defy anything previously thought possible in regards to negligent care involving these parties to prove these of many points as to why there was motive by these men strictly on these clinical grounds alone.  Motive because as a relatively new member to the community, I foolishly dared to stand up in a department meeting in 1999, (not knowing who I was dealing with), and asked to openly discuss this highly perceivable problem of quality that was now having an impact on the care of my own patients.  My inquiry brought immediate disfavor from this entrenched department leadership.  Yet, as bad as the care truly (still) is and has been for decades, such a motivation on their part to cover over it tragically takes a back seat to even more reprehensible actions by these men that will be elaborated on below.  Please understand that certain forces from within this Crouse Hospital Ob/Gyn department (led primarily by two men with direct, personal connections to the NYS DOH) had reason to conceal these and other improper activities that they were engaging in.  They used their status and connections to Albany to implement this dubiously corrupted form of peer review on my life as someone who they apparently saw as a threat.  The industry term “sham peer review” would then become well known to me as the moniker this unseemly practice has been given nationwide.  Exhibit A is comprised of a few short articles characterizing this very entity and experience of sham peer review that has consumed the past thirteen years of mine and my family’s life.  Grasping this one facet (that of sham peer review) of this account is crucial to the understanding of everything that would follow for the next several years.  I appreciate you reviewing this first Exhibit.

 

Again, while having a sham peer review cost me my license might seem a sensational claim, I assure you that not only are these activities sadly becoming almost epidemic in our country, but in my case, I have accumulated a large amount of material evidence to demonstrate every component of what was done.  Here I am crying foul and saying emphatically that the State executed a malicious prosecution upon my license and that none of the clinical cases ever warranted any sort of investigation and in fact, all were well within the acceptable standards of care.  Yet, the cases were unique enough for easy manipulation and only found their way to the DOH by someone secretly sending them, and not that of any patient.  So, if they were all properly managed, then how could the State of New York see fit to prosecute me regardless of how they learned of them?  This is a very good and logical question.  Here is the key to it all and the one aspect of this ordeal I wish to impart to you as part of defending my Federal status.  What made their (those within the hospital) plan capable of being executed to its final end was the fact that they had direct help from an ally within the State’s Department of Health who wields enough power to not only rig the entire matter for the past thirteen years, (this is indeed true), but left a trail of evidence to prove it.  I have chosen that one element of this ordeal as most pertinent in trying to impart the truth of this experience in order to prevent HHS from canceling my participation.  This insider help by no means represents the only counterfeit element of this mess but in fact is one of several used in order for those responsible to unjustly prevail.  As part of this unseemly journey, Constitutional rights were wholesale denied; ill-defined rules were repeatedly violated; exculpatory evidence was blatantly ignored; and official guidelines for rendering a determination were completely disregarded as just a small number of the tactics I was continuously subjected to.  Yet, despite these other schemes, it should seem pretty obvious to anyone, (that’s if it’s true, of course) that without this one component of having whoever it is on the inside, this whole thing would never have happened at all.  So well understood is the abuse in general by the DOH’s Office of Professional Conduct (OPMC) that in the early 2000’s, Reform legislation was unsuccessfully introduced by two State Senators to address such abuses.  Exhibit B illustrates this Reform Bill.  Virtually every abuse cited on this Bill information sheet was experienced by me.  So, the basis for this proposed legislative effort was undeniably valid.

 

There are so many details to this entire New York State Department of Health ordeal that speak volumes to how utterly dishonest it was while never truly being about the medical care itself.  This last statement might seem hard to believe when one reads what the State has posted on their website about the specific cases and the care provided as part of my “conviction”.  It would seem so to me as well.  What any reader doesn’t realize is that virtually none of the facts stated in that Determination were accurate and true to both the actual medical records and that of legitimate Obstetrical medicine.  My expert, who himself has worked for the DOH in the past, was equally dismayed with what he saw being done.  It was shocking to say the least to see how material facts and medical science could be purposely manipulated, altered and distorted in order to produce the appearance of wrongdoing.  The agenda was quite obvious to anyone consciously observing any of it.  This is why the entire thing had to be carried out in restricted, closed-door sessions.  For example, the investigative process at the DOH that determines whether even to prosecute is homologous to a grand jury in an ordinary legal proceeding.  Yet, with the DOH, there is no openly available record of any decisions made, material evidence considered or basis for pursuing prosecution.  Despite cooperating and providing scores of exculpatory evidence and statements during the numerous interviews I complied with, I still somehow ended up at a hearing (or trial).  Therefore, essentially anything goes.  As a measure of defending my capacity as a physician as it both applies to this DOH account as well as consideration by HHS as far as my future participation goes with the various Federal health care programs, the following few, yet verifiable, facts are offered. 

 

  • For the entire ten years I was on staff at the incident hospital (Crouse Hospital – Syracuse, NY), I consistently ranked at the top of the Department in every single quality assurance statistic kept.  I have been repeatedly denied access to these formal reports within the hospital but do have one from 2005, specific to the Gynecology portion of the specialty.  See Exhibit C for this.  During that year, you can observe that (especially for high volume providers) I was at the top of the department on this report.  Physician #1595.  This was the case for every year I was there for both Gynecology and Obstetrics.
  • There have only been a total of three (3) complications throughout my entire career in more than 2,300 surgical cases and more than 1,300 deliveries.  This is an overall complication rate of 0.08% when the national average is upwards of 3-4%.  This more than thirty fold difference is a profoundly objective illustration of the excellence delivered through my practice of medicine.  Not ever was I any sort of threat to the public that needed disciplinary measures, which is the mission of OPMC.  They knew this.
  • Not one case that was used by the New York State Department of Health was derived from a patient complaint while the patients themselves (including the one who lost her baby) stood up and testified on my behalf at the State hearing, angry that their cases were being used against their doctor.  When has this ever happened at the DOH as part of a prosecution?  Incidentally, I delivered the next two children of the dear woman just mentioned because of her knowledge of the truth. 
  • I have always maintained a willingness to transparently go through each and every single medical case used by the DOH and their OPMC in an open and honest forum before any number of peers with the medical records and the industry standards of care on the table to show just how dastardly this entire thing was, even to the extent of them fabricating scores of charges that were never rooted in reality but just a manipulation of the facts to give the appearance of misconduct.    

    The DOH knows every one of those statistics and claims and a great deal more about how proficient I was in the practice of medicine.  These truths did not matter nor was anything defensively offered going to change the agenda.  The effort by those involved to ultimately prevail at the State level took thirteen years with a trail of material evidence that tells a very clear story.  There are so many more specifics that could be provided to redundantly illustrate the manner by which my due process rights were both denied and how inconceivably corrupt this experience truly was.  Three legal/procedural precedents were set as part of this experience that stand as lasting testimonies of their ruse.  Below are some of the primary facts that unmistakably establish that there was illicit help from inside of the Department of Health and why based on these facts alone, (in addition to all else), my entire prosecution and loss of my medical license should be seen as a terrible miscarriage of justice.  Please read each one carefully
  • In 2002, after being victimized within the hospital by the four members who initially banded together to carry out their sham with National Practitioner Data Bank ramifications, I wrote an extensive complaint to the DOH citing widespread abuses by these men and conduct unbecoming any physician, not to mention those holding offices of regional leadership in Ob/Gyn medicine.  I received a response from the DOH with a case number assigned to my complaint.  The significant fact is this.  The DOH is obligated (with emphasis) to investigate every single complaint they receive until a final conclusion is reached.  There are no exceptions to this hard and fast rule.  Yet, despite it having now been almost twelve years since levying this complaint and receiving their letter, there has not been one answer or action from them since.  This is despite my attorney also writing them two years later seeking any sort of response.  Nothing was ever received.  Exhibit D consists of a couple of documents.  The first is a September 2010 letter from the Office of Health Systems Management after having written the then Governor Paterson about these matters.  I recently came across this document where another State agency is clearly establishing the mission of the DOH as carrying out a thorough investigation of all complaints.  The second is the response from the DOH after having received my grievance – note the case number indicating an official logging of the complaint.  The third part of the Exhibit is the unanswered letter sent from my attorney.  The fact that the complaint I wrote and sent involved the very individuals who were responsible for my travails and that it has effectively been quashed for nearly twelve years is most certainly illustrative of someone on the inside having the power and authority to do so.  You might not readily see this yet, but as you read the other accounts, it will be clear and convincing that someone is not only helping these men but is also protection them as well.  I would gladly furnish you with the filed complaint itself as it is quite detailed and spells out everything that was illegitimately done – contemporaneous with the time mind you.  It is a bit long (twelve pages) so I will reserve that upon request.  These are not the only times that this unanswered complaint has been ignored by the DOH.  In numerous communications, including formal letters to investigative counsel, it has been brought up only to fall on deaf ears. 
  • In 2005, the first of two OPMC hearings was held for the initial set of cases used against me.  Despite extensive and compelling evidence and testimony by the defense, as expected, there was an adverse Determination made after this initial hearing.  However, with numerous grounds cited, the conviction was thrown out on appeal because the main juror, otherwise known as hearing panel member (and the only Ob/Gyn physician) was cited as having pre-knowledge, pre-judgment and that bias pervaded the entire proceeding.  After seeing this man step way out of bounds during the proceeding, including a personal discussion with the State’s expert witness after one of the hearing sessions, my attorney and I demanded to know more about him.   It turns out that this juror just so happened to be good friends with the primary of the two men in my department who were anonymously engineering this entire matter at the State level through their inside connection.  In other words, the one main physician from within my department who was deviantly using the anonymity protection of the law to write fraudulently disparaging letters about me to the DOH was able to get his buddy seated on my jury.  Not only are there (unconstitutionally) no rules whatsoever that guide the selection of panel members for these legal State proceedings, being able to situate someone like that on my jury (panel) is clear evidence of having inside assistance.  And significantly so.  Remember that this is now three years after the DOH received and cataloged my complaint about these very men who they were now aiding, abetting and protecting.  This tainted panel member’s behavior was so outrageous that on one particular day, the ALJ had to call an emergency executive session to reprimand this man for stepping way outside of his limits as he tried to coach the State’s expert’s testimony while she was still on the stand.  The ARB’s determination to throw out my entire hearing with a remand to an entirely new set of participants is the first of three precedents set as part of this malicious prosecution.  Such a thing had never before occurred in the DOH.  This is very telling as to the utter lack of veracity of this entire matter.  While I don’t have immediately available a copy of the ARB’s ruling of bias having pervaded the entire proceeding, Exhibit E is a letter written on my behalf by my attorney citing this fact as well as other motions by my defense that should have ended this matter on this date, especially the component involving the State’s attorney who was also complicit with the very “bias” cited by the ARB in their decision.  Yet, he was allowed to continue on in direct violation of the overturn order.  This motion in Exhibit E was also ignored.  As one can readily see, the inside agenda was not going to be stopped.
  • In the Spring of 2006, after the ARB remanded the original hearing to be redone but with all new people, at that point, the DOH had sixty days to commence the next hearing.  In keeping with all sorts of repeated time constraint rules violations, OPMC did not begin the next hearing for over a year.  During this time, the one and only Ob/Gyn jury member that they were able to find just so happened to be connected to a somewhat adversarial and main competitor practice in my community who not only had their own interest in seeing my practice diminished but also had long term ties to the two men in my department orchestrating this entire thing.  Again, this speaks clearly to there being help within the DOH for this man to be seated – marking for a second consecutive time a calculated juror being situated to have great influence over this formal State hearing.  My attorney raised an objection on the first day of the hearing, a document of which I have in a storage box somewhere and can certainly be found if necessary, but our concerns were denied when seeking a replacement of this panel member.
  • In December of 2007, after going through the second hearing on the same cases because of the previous bias ruling, the Determination was once again unfavorable – over and against every possible material piece of evidence and in contravention to the State’s very own rules on how a Determination is to be carried out by the panel members.  The following fact is critical to understand.  Up to this point in time, all of these proceedings had remained confidential (by law) from public knowledge.  It was to remain that way until all appeal rights had been exhausted.  By now, those who were driving this mess from within my department were growing impatient as it was almost six years since their clandestine efforts had commenced.  My practice was growing extensively, my position in the community through hard and quality work had elevated as a premier provider, and the egregious deeds of those interested in seeing me gone were slowly becoming more aware to others.  So, when I technically “lost” the second round, my attorney immediately filed appeal papers since it was clear from what transpired at the hearing itself that our foundations for this second appeal were going to be even stronger than the first.  By filing these papers, it was supposed to keep the entire thing confidential.  Yet, even though the DOH and all the preset policies within it are inherently programmed and structured so that these matters do remain confidential, someone with a great deal of influence and power at the DOH authorized the Determination and Order, (that was actively under appeal mind you), to be posted on the State’s website whereafter the local newspaper guy just so happened to get a call informing him of this privileged information resulting in a large article being written about the conviction.  I was in my office at the end of the day on December 12, 2007 when I got a surprise call from the newspaper.  I was apprised of the article and was given one hour to write a rebuttal.  I pointed out to this reporter that the fact that he even knew of this information was a violation of the law.  It mattered not to him.  The next day a horribly inaccurate and disparaging article hit the paper and literally destroyed my practice overnight.  An immediate motion was filed with the State Supreme Court where a Temporary Restraining Order (TRO) had to be put in place ordering the State to take down the report, which they did.  It was too late, the damage was already done.  The DOH then had the gall to challenge the TRO and took the matter up with the Supreme Court.  Through excellent work by my attorney, Judge Joseph Teresi would ultimately affirm the violation of the law by the DOH with the second precedent needing to be set as part of my ordeal with OPMC.  Such a violation of a standing DOH policy and said department’s need to formally challenge the interpretation of this plain-as-day law before the State Supreme Court had never before occurred.  They knowingly violated that statute and after deciding to challenge it in the high court, justly lost because of how blatant a violation it truly was.  Interestingly, as a result of the State Supreme Court confirming OPMC’s inability to publicly shame a physician before his day in court is complete, the DOH shortly thereafter enacted a new policy that now states that whenever any physician is so much as served charges concerning alleged misconduct, before anything is adjudicated, he is now subject to public disclosure.  The third precedent.  They got around the law by unilaterally changing their own policy.  Exhibit F includes the initial article that hit the paper, (there was a follow up one as well), and the TRO from Judge Teresi and the State Supreme Court Ruling from Judge Teresi concerning the State’s knowingly and willful violation of the law in order to specifically inflict harm upon my career before it was lawfully allowed.  There is no way possible something like this could happen unless there was someone very influential on the inside capable of overriding foundational rules and procedures of a State level agency.
  • After being out of work and (literally) homeless for more than two years after this thing ended my marriage, I was able to reopen my practice in 2012 after a lengthy struggle to get on a local hospital staff.  Within three months, I was once again victimized by members of this new set of administrators, this time at St. Joseph’s Hospital, whose executive members rub elbows with those at Crouse Hospital.  Again, out of respect for the incredulity that these statements should arouse, for any doubts as to any of these assertions, I remain completely transparent with all medical records and corroborating documents available in support.  After I was wrongfully ousted from this hospital in a manner just as dubious to that at Crouse, it inspired me to write a detailed account/story of all that has been experienced in this medical community and titled it The Truth Test.  I posted it online in March of 2013.  In this document, I shared certain revelations concerning the local Ob/Gyn leadership and moreover, the care for women and unborn babies in this community.  Aside from the demonstrably negligent and superficial care that permeates the department at Crouse and its resident physician training program, the story also pointed out that the Regional Perinatal Center (where the two men mainly responsible for the underhanded activity/partnership with the DOH are in charge and wield tremendous power) has for years been using their influence over nearly every single other patient and Obstetrician (for that matter) across a huge region of NY to purposefully and repeatedly streamline premature babies into Crouse Hospital’s Neonatal Intensive Care Unit (NICU), making it the number one profit producing department in the institution.  In other words, because these two men had self-established the power and authority to control nearly all cases of potential premature delivery in this massive region, they used it to purposefully “undertreat” such cases in order to fill the NICU with big time profit producing cases – at the expense of the babies themselves, their families and moreover, the insurance companies funding this scam.  The cursory care provided to these women before wrongfully allowing their babies to just prematurely deliver is unconscionable, professional medical misconduct and one would dare say, illegal – particularly along the lines of insurance fraud.  Being one of the only Obstetricians in the region who did NOT turn his patients over to these bandits, it not only garnered animosity towards me but also a will in them to use their influence in a nefarious manner.  Incidentally, because premature delivery was a personal research interest of mine, I developed a protocol that effectively eliminated all such occurrences (premature delivery) from my practice for six consecutive years before I was forcibly shut down by the State.  I collaborated with an MD PhD on the data analysis with highly significant results.  This elimination of premature delivery was very clinically substantial.  The protocol was a noticeably radical departure from what had been “taught” by these so-called experts to the unsuspecting residents and nursing staff for years in this community.  The net result was all the more motive for what they would ultimately do, especially when there are dollars involved.  As if gross incompetence with repeated bad outcomes and premature babies for profit were not egregious enough, add to this disclosure the fact that I became aware of and possess the material evidence (both mother and baby charts) for a case where Crouse Hospital intentionally caused the death of a five day old newborn that was damaged as a result of some of the worst negligent care imaginable rendered to his mother upon her arrival to the hospital.  What had to amount to an executive decision at the highest level was made in order to mitigate their financial liability in the matter.  I possess the records that clearly indicate this insane reality that the parents are still not completely aware of, even though they would eventually sue and get very little for their loss.  The hospital would eventually find out that I knew of what they did which then added to the already full-force agenda to bring my career to a destructive halt.  Here is where these points get interesting.  In March of 2013 as part of The TruthTest, I posted, online, the account of how this baby was unmistakably murdered along with other extensive disclosures as to my experience within the whole realm of sham peer review at both the hospital and State levels.  You can say that I was not holding back anymore.  These postings integrated extensive exculpatory material evidence into the information as well, including a line by line rebuttal/repudiation of the State’s official conviction document that they have maintained online.  After making this damnable information public, the NYS DOH was then recorded as having visited my website and having loaded all pages associated with The TruthTest more than 600 times, downloading all of the documents offered as part of both my defense of what happened to me as well as my revelation about the ethical bankruptcy within this Ob/Gyn community.  Also contained well within The TruthTest was a highly detailed description of how Crouse Hospital carried out the active euthanasia of this five day old baby mentioned above.  The DOH read it and is well aware of it.  The TruthTest also implicated, once again, the very same members of my department responsible for all of this that were cited in my 2002 complaint to OPMC, but without specifically naming names.  The point is that the DOH is well aware of the unethical goings on in this community within two separate hospitals, including but not limited to repeated negligent care for women, premature babies for profit, a murdered five day old baby to avoid a large lawsuit payout (I learned that dead babies are worth very little in a lawsuit compared to long-term injured ones) on top of active participation in sham peer review.  They (the DOH) have done nothing while the very individuals responsible for my circumstance remain immunized from any accountability and perhaps the worst purveyors of suspect care around.  Again, it takes a substantial inside influence to overlook such travesties that continue to place this community at risk.  Exhibit G contains a card received back in 2008 from a physician in a local community where they are required to practice under the auspices of these two men and their inept Perinatal Center.  As you can see from the card, it was no secret to those in his region that they were under a heavy and dark influence by these men.  Along with this one Exhibit document is a letter from Crouse Hospital’s attorney responding to various frank disclosures within The TruthTest concerning his hospital, including the fact that they committed murder of a five day old newborn to avoid paying millions in damages.  Note how he alludes to my writings but there is no denial whatsoever of the hefty claim.  The hospital’s only response was to place me under some sort of security lock-down should I ever step foot in the institution – which I have no reason to.  His lack of any refutation of my claims is because what they did is true.  Were the planned murder of this baby not the case, this attorney’s letter would have been an admonition of my disclosure coupled with a threat of litigation.  Of course it did not because he could not.  The last component of this Exhibit is the shorter of two IP address printouts of visits to my website showing that OPMC not only knew of The TruthTest and the incriminating information contained therein, but that they also downloaded various documents as well.  The printout for the other IP address is quite long (>25 pages) containing over 450 page loads and illustrates substantially more of the same including many other downloads of exculpatory and evidentiary documents.  Though not included in this Exhibit, this lengthy visit history printout is readily available at any request.
  • The last of several more examples I could cite for the illegitimacy of the my entire prosecution is this.  After being back in practice for just over a year, I (like essentially all physicians punished by OPMC) was struggling mightily to sustain my practice because of the probationary stipulations that had been placed on me back in 2008 but hadn’t run their course because of being out of work for so much of that time BECAUSE of these very same stipulations not capable of being met.  I was desperate for relief and in July of 2013, wrote the Director of the Board of Professional Medical Conduct, Keith Servis, an appeal/modification letter.  This letter was the second one I have written since 2008.  The first was denied since I was told that it did not establish a sufficient enough basis for reconsideration.  Therefore, with the previous denial letter in hand, I wrote a point by point appeal addressing each and every component necessary in order to obtain some sort of relief.  In the letter, there was an earnest urgency expressed given the fact that to this very day, I have not been able to earn a legitimate paycheck since March of 2008.  Needless to say, financially, everything is a disaster.  Despite this modification letter containing everything necessary as imparted to me by the director in his previous letter, it has now been over a year since it was sent and not one response has been received.  The Board of Professional Medical Conduct is obligated to respond and have chosen to simply ignore it.  Yet, almost immediately after I sent this letter, three bogus cases [that were sent to the DOH anonymously back in 2008, again by that one primary member of my department orchestrating this thing for years as part of (indeed) another sham peer review that was levied against me out of retaliation for revealing, at that time, what they had already done for the preceding six years], were now being aggressively pursued by the DOH.  Five year old cases where full cooperation and extensive clinical details were provided were mysteriously now substrate for a new laundry list of charges.  The facts were wholly defensible with these cases merely there for show with what their main objective was for this latest round.  This time around, they were seeking a level of punishment that was not only incredibly excessive but also in contradiction to previous DOH precedents having been set on similar and substantially more problematical issues than I would ever be charged with.  During my time out of work, while still possessing an active medical license, I called in a small number of harmless prescriptions for family and friends who were in need and asked that I help them.  After obtaining the necessary information concerning their complaint/need, these prescriptions were for things like antibiotics, birth control pills and topical creams.  Nothing immoral, nothing suspicious.  In fact, all doctors and providers I have ever encountered perform such a courtesy now and then which is completely legal.  Yet, by doing so in my case, I technically (truly unknowingly and unwillingly) violated my probation order which implied that I had to have two stipulations in place in order to even call a prescription in.  Again, outside of these stipulations imposed as part of the previous hearing, this was not wrong for me or anyone to do.  The writing of the prescriptions was an honest and highly limited oversight where many other physicians previous to me have been equally cited as having violated their probations for the same reasons as well and in some cases, far beyond this.  For one such case, a physician blatantly violated not just this one component to the practice of medicine but his whole Order and reopened his entire practice for months in gross violation of it until his actions were discovered by OPMC.  His degree of violation was eons worse than the few prescriptions that I wrote.  His penalty – he was given a short (six month) extension on his probation as his only punishment.  In my case, the State was threatening felony counts, fraud, huge monetary penalties, possible jail time, etc.  The medical cases were nothing more than an additional front to pursue the one set of charges that I had no real defense for.  For this reason, along with simply being tired of fighting what I know I cannot win, I decided to surrender my license pleading no contest.  This entire section again illustrates the incomprehensible bias contained within the ranks of the DOH as the inside influence has been able to manipulate.  When asked of the latest DOH prosecutor as to how it was that (medically) he felt he had a case concerning what ultimately turned out to be charges for only two patients, his response was “just following my marching orders from the higher ups.”  Who are these higher ups?  Exhibit H includes a section of the Public Health Law that establishes my right to seek a modification of my Order.  Also is the actual modification appeal letter written along with the proposed agreement mentioned in the letter.  For there to have been no response whatsoever from this agency after that letter was sent to them, followed by an intense ramping up of yet another dishonestly based prosecution can only support further the fact that whoever is working on the inside has indirectly showed himself once again.

 

I have provided merely a snap shot of all there is to this thirteen year saga for my life, family, children and career.  There is a great deal more material evidence that supports all of the sham peer reviews that were directed towards me, including the most recent at St. Joseph’s Hospital.  I hope that this information is sufficient to the Department of HHS to avoid losing my status with the various government programs.  Forgive me for the relative extensiveness of it as well.  I hope the facts were able to be followed.  With the writing of this letter, the time has also arrived to formally log a complaint with New York State’s Office of Inspector General.  A mirror of this letter will be sent to them coupled with a great deal more detail concerning the specific individuals involved, the case of the murdered baby, additional cases of horrific care as well as the current state of the training program, all of which continue to place this community at real and legitimate risk.  With the protection of the public as their stated mission, OPMC has directed their attention at the wrong party.  If only my complaint had been seriously handled by the DOH back in 2002, I know of multiple babies that would likely be alive today.  There have been too many families aggrieved by the elements that sadly continue to rule the practice of Ob/Gyn in this community.  This is just my closing commentary.

 

The time taken to read and consider this appeal is greatly appreciated.    Please do not hesitate to request more information regarding these facts in order to rest comfortably with your agency as part of rendering a decision.  I am presently trying to raise enough money to disseminate license applications to other states.  As I undertake this new direction, it is my belief and petition once again that my status with HHS and the various Federal health care programs remain intact.  Thank you very much.

 

 

Sincerely,

im3

James R. Caputo, M.D.

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