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Tenet Under Closer Exam

Chae Hyun Moon had his patients' respect, if not love. Now many wonder about him.

November 11, 2002|David Streitfeld | Times Staff Writer

REDDING -- Chae Hyun Moon might have wanted to be a doctor since he was a little boy, but his staunchest supporters agree with his sharpest critics: He missed the class on bedside manners.

"Oh, my Lord, he gives you a heart attack just talking to you," said Lee Cook. The retired computer systems analyst still shudders at the memory of Moon shouting at him not to hang onto the bar of the treadmill during a stress test.

Clifford Baker, a Presbyterian missionary, recalls a 1996 hospital stay when he was experiencing congestive heart failure. "You've got about three months straight downhill," Moon told him. Out in the hallway, Moon advised Baker's wife to make sure the will was in order.

So many patients, so little time for chitchat. In his 23 years as a cardiologist here, Moon has worked on as many as 35,000 people. On some days, he would perform 10 catheterizations, where a thin tube is inserted to open clogged arteries or obtain diagnostic information. Another doctor would consider it a full day's work to do three.

For a long time, Moon had the respect, if not love, of his patients at Redding Medical Center. Twelve days ago, that image abruptly darkened when the FBI filed an affidavit detailing an investigation of Moon and the center's chairman of cardiac surgery, Fidel Realyvasquez. The affidavit outlines a conspiracy to commit health-care fraud by allegedly billing Medicare for unnecessary procedures. Forty agents raided the doctors' offices, carting away boxes of patient records.

No charges have been filed, let alone proved. Yet the claim in the 67-page affidavit that "there is reason to believe that many" Redding Medical patients "have been victims of a scheme" involving "unnecessary invasive coronary procedures" is shaking this city and causing ripples far beyond.

"This is a horror story, at best," said Gary Oxley, a nurse who works with Moon and believes the allegations are untrue.

Moon, who has told colleagues that everything he did was in the best interests of his patients, did not respond to requests for an interview at the hospital, his office or house here. But conversations with colleagues and former and current patients as well as a review of court documents describe an assertive, often arrogant doctor, one who couldn't be bothered with pleasantries, hobbies or critics. For better or worse, his patients have been his life.

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A Slew of Lawsuits

For all the advances in technology, cardiac care can still be as much art as science. Redding Medical was home to the best machines and receptive to the latest ideas. To his admirers, and there are still many here, Moon saw further and knew more. He prevented heart attacks, extending the life and health of many patients.

The affidavit presents a far more chilling scenario, which is that Moon violated the ancient medical oath to "first, do no harm." One case briefly detailed by the FBI: A 59-year-old male received bypass surgery and, four years later, is still too weak to work. A cardiologist who reviewed the man's records for the FBI "found, at most, evidence of a relatively minor problem," the affidavit says.

The investigation, which will take months, is roiling the owner of Redding Medical Center, Santa Barbara-based Tenet Healthcare Corp. Tenet, which owns 113 hospitals around the country, last week revealed a federal audit of its Medicare billing practices. Between the Redding investigation and the audit, Tenet's stock has declined by two-thirds, shaving more than $15 billion off its market capitalization. Analysts have downgraded the stock, saying Tenet's moneymaking ways are threatened.

In this former logging community turned vacation jump-off point, Moon is a more personal matter. The Redding Medical Center draws patients from the entire northern half of the state, and Moon is its star. Everyone, it seems, knows someone who's been a patient or who works for the hospital. It's the most dominant building downtown, except for the jail, and was going to get even bigger. Before the events of the last two weeks, the 238-bed center was to double in size.

In a search for more business, Redding Medical recently mailed out fliers that showed a trim woman with a basketful of healthful groceries.

"After grocery shopping, a few errands and one load of laundry, a 42-year-old woman collapsed of a heart attack," the flier warns. "And you thought heart disease was just a man's problem."

The "lifestyle risk factors" listed are very broad, including "increasing age."

Such an approach can save lives, but it's also ripe for abuse. When does aggressive prevention cross over into unnecessary operations? It's a question many of Moon's former patients are being forced to ask themselves. Some are emerging with their faith intact. Some are uncertain what to think. And some are filing lawsuits.

Lawyers are running ads in the local paper and on television, trolling for victims. One local firm says it will file more than 100 suits all by itself.

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High Self-Esteem

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