A Los Angeles surgeon whose recent victory in an employment lawsuit against Cedars-Sinai Medical Center raised questions about the safety of the patients he once saw there was ordered this week to pay a Maryland patient and his wife $800,600 in a malpractice case.
The malpractice occurred after Dr. Hrayr Shahinian left Cedars-Sinai in 2006 and began practicing at Brotman Medical Center in Culver City.
In a scathing ruling this week, Los Angeles County Superior Court Judge J. Stephen Czuleger said Shahinian committed fraud when he performed an inappropriate surgery on the man and then altered a pathology report to cover up his failure to remove a tumor.
The award included $300,000 in punitive damages for "intentional infliction of emotional distress."
Shahinian acknowledged that he missed the tumor but denied that he ever altered a document or tried to conceal the error. He said his lawyers are planning an appeal.
In November, an arbitrator in the Cedars-Sinai case ruled that Shahinian had been improperly stripped of his right to operate there and ordered the hospital to pay him $4.7 million. The arbitrator wrote that for years the hospital had disregarded the safety of Shahinian's patients by ignoring his pleas for backup surgical instruments.
Shahinian, 50, said that he had to postpone or abort dozens of brain operations at Cedars-Sinai because of instrument shortages. Hospital officials said they were responding to his safety concerns when in late 2005 and early 2006 they imposed a series of conditions on him to keep operating -- conditions the arbitrator concluded were unreasonable.
The hospital indicated last month that it plans to appeal the decision.
Shahinian was already at Brotman when George Ralli and his wife traveled from Maryland to see him in 2006. A tiny, non-cancerous tumor behind Ralli's left ear was threatening his hearing. A childhood case of the mumps had already destroyed the hearing in his right ear.
Shahinian "was more interested in marketing than he was in medicine" when he sold the couple on a minimally invasive procedure, the judge said, according to a transcript of the proceedings.
The surgeon removed what he thought was the tumor and reported good results to Ralli and his wife.
But a pathology report showed that the specimen was not the tumor. A version of the report sent to the Rallis had been edited to suggest that the operation had been a success.
"I believe either he or people acting on his behalf whited out a portion of that pathology report," the judge said.
Ralli, now 47, had the tumor removed in Maryland. But he wound up losing his hearing and suffers from chronic headaches, according to court filings.
Shahinian said in an interview that he didn't see any pathology report -- and thus realize his error -- until he was notified by an attorney for the couple two months after the operation.
"It was a very small tumor," he said. "It was in a bony canal. I was fooled by a brown lesion that shouldn't have been there."
A "skull base surgeon" who now operates at Thousand Oaks Surgical Hospital, Shahinian specializes in minimally invasive techniques targeting the base of the brain. He sees patients from across the country.
But he has been controversial from the time Cedars-Sinai recruited him from New York in 1996. Though board-certified in general surgery, he is not trained as a neurosurgeon. Shahinian said his career has been a constant battle against allegations from rivals at Cedars-Sinai and elsewhere that he is unqualified.
At one point, he sued USC Medical School and Dr. Martin Weiss, a neurosurgeon there, for defamation, a case that led to a confidential settlement.
Shahinian said this week's malpractice ruling against him, and several others, were instigated by competing Los Angeles doctors who referred his patients to lawyers.
He has been sued for malpractice about 17 times in his career, including two other cases pending against him, he said.
"A lot of these people were put up to it by my competitors," he said.
He has prevailed in most of the suits. Twice he was investigated by the Medical Board of California, he said, but the cases were dropped. Public records from the medical board show no actions against him.