CCS Oncology - Imminent closure, bankruptcy, FBI investigation

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Gfunk6

Gfunk6

And to think . . . I hesitated
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Cancer Treatment in Buffalo & Western New York | CCS Oncology
This is a large multi-specialty, multi-site Oncology group located in the metro Buffalo NY area.

This story is blowing up in Buffalo and nationally in Oncology circles. (CCS Oncology - Bing News)

Initially they declared Chapter 11 bankruptcy, then Bank of America started seizing assets due to non-payment of millions of dollars in lines of credit, then FBI raids them, then the State investigates them for non-payment of employees and as the final hurrah they are closing all services effective 4/27/18.

As you can imagine when you have > 1,000 cancer patients on active treatment this will cause many problems, especially for radiation. Fortunately, Roswell Park has stepped up to the plate and has offered to absorb these patients to minimize disruptions in care. Still, there will be insurance problems, logistical problems, etc.
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was it physician-owned? if not, it's not fair to call the entity "Oncology group", IMO
 
Members don't see this ad :)
Googled it and it is indeed Dr. W. Sam Yi. Local RadOnc who was a resident at Rochester.
 
Gfunk6 said:
Cancer Treatment in Buffalo & Western New York | CCS Oncology
This is a large multi-specialty, multi-site Oncology group located in the metro Buffalo NY area.

This story is blowing up in Buffalo and nationally in Oncology circles. (CCS Oncology - Bing News)

Initially they declared Chapter 11 bankruptcy, then Bank of America started seizing assets due to non-payment of millions of dollars in lines of credit, then FBI raids them, then the State investigates them for non-payment of employees and as the final hurrah they are closing all services effective 4/27/18.

As you can imagine when you have > 1,000 cancer patients on active treatment this will cause many problems, especially for radiation. Fortunately, Roswell Park has stepped up to the plate and has offered to absorb these patients to minimize disruptions in care. Still, there will be insurance problems, logistical problems, etc.
Click to expand...
Can someone link to the story itself. Links above are propaganda of the practice.
 
Chartreuse Wombat said:
Can someone link to the story itself. Links above are propaganda of the practice.
Click to expand...

The first link was simply the practice's website. The second link "CCS Oncology - Bing News" will take you to complete web archive of articles by the media.
 
Medscape: Medscape Access

A New York state oncologist has been accused of gross negligence and incompetence allegedly related to the deaths of six patients.

Charges were filed by the New York State Department of Health against radiation oncologist Won Sam Yi, MD, who was the former chief executive officer of the now-defunct private cancer practice CCS Oncology. The charges could result in the loss or suspension of Yi's medical license, and he could face fines and other sanctions.
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In one case, Yi is accused of providing whole-brain radiation therapy to a 43-year-old woman for about 6 weeks in 2012, even though it was "contrary to medical indications" and without taking into account the previous doses of radiation that she had received. The patient died on December 20, 2012.


A second case involved a 72-year-old man who had received radiation therapy in 2009 for prostate cancer that exceeded commonly prescribed doses for his disease and without considering alternative treatments. The patient was also treated with radiotherapy to his right jaw from August to September 2011, "despite lacking clear radiographic evidence that [the patient] was even experiencing metastatic disease at the site." The state points out that this treatment regimen also didn't take into account previous radiation therapy and "thus exceeded appropriate tissue tolerances." This patient died on March 14, 2012.


Seven lawsuits, filed by the patients or families, have been levied against CCS Oncology or its affiliates, but it is unclear as to the amount of overlap, if any, that exists between their lawsuits and state charges.
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Didn't think 6 weeks of WBRT was still a thing... maybe he's a Patchell purist?

Unfortunate for those in Buffalo. Guess Roswell Park can expand pretty easily and create a monopoly of the area there if they are so inclined
 
I was once referred a prostate patient with a nasty jaw lesion for palliative radiotherapy . Fortunately, it occurred to me to consider bisphosphonate-related osteonecrosis, and to hold off RT.
 
seper said:
I was once referred a prostate patient with a nasty jaw lesion for palliative radiotherapy . Fortunately, it occurred to me to consider bisphosphonate-related osteonecrosis, and to hold off RT.
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And if you want to really think outside the box, there's this thing you can send patients for called a "biopsy"
 
medgator said:
And if you want to really think outside the box, there's this thing you can send patients for called a "biopsy"
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To be fair, he didn’t say he didn’t hold off to not biopsy. Could have allowed him time to do so 🙂
 
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Prob would Axumin if I were being really novel.
 
Jaw lesion would depend on the context. If pt were riddled with mets, I would probably not suspect osteoradionecrosis. If solitary lesion, on the other hand, that would be unusual.
 
medgator said:
Updates....

buffalonews.com

Former CCS Oncology chief deemed 'danger' to patients, stripped of state medical license

The state Board for Professional Medical Conduct this month revoked the medical license of Dr. Won Sam Yi following a lengthy review of the care he provided to seven seriously
buffalonews.com buffalonews.com

6 weeks of WBRT in a 43 yo F with previous xrt 😳
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My guess is something like GBM with subsequent gliomatosis-type progression? Said he was trying to "cure" the disease. Would be odd to state that for brain mets. Would still be bizarre treatment, but maybe some precautions were taken. Who knows? I'm guessing it was probably not quite as insane as it seems on it's face. Remember, the initial Patchell regimen was 28 fractions of WBRT which rounds up to 6 weeks.
 
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I’m sure Yi’s life sucks for the most part right now and losing the license is a real gut punch. OTOH based on where I thought this might go way back when and where it is now for Yi, things could have been A LOT worse. When the feds decline to intervene that’s a big win.
 
Take the time to read the full pdf from New York Department of Health; it describes each of the clinical situations in detail; as well as the evaluation by the defendant, his expert witness, and the state board's expert witness. It's .. wow.
 
GI_RadOnc said:
Take the time to read the full pdf from New York Department of Health; it describes each of the clinical situations in detail; as well as the evaluation by the defendant, his expert witness, and the state board's expert witness. It's .. wow.
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Hopefully my therapists aren't about to turn me in for getting 4Ds on livers, pancreases and adrenals.
 
Mandelin Rain said:
My guess is something like GBM with subsequent gliomatosis-type progression? Said he was trying to "cure" the disease. Would be odd to state that for brain mets. Would still be bizarre treatment, but maybe some precautions were taken. Who knows? I'm guessing it was probably not quite as insane as it seems on it's face. Remember, the initial Patchell regimen was 28 fractions of WBRT which rounds up to 6 weeks.
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Even if you did 1.5 Gy fx x 30 = 45 Gy, that is an incredible dose to give after giving radiation, isn't it? Something seems really bad. I didn't read PDF.
 
GI_RadOnc said:
Take the time to read the full pdf from New York Department of Health; it describes each of the clinical situations in detail; as well as the evaluation by the defendant, his expert witness, and the state board's expert witness. It's .. wow.
Click to expand...
link?
 
RealSimulD said:
Even if you did 1.5 Gy fx x 30 = 45 Gy, that is an incredible dose to give after giving radiation, isn't it? Something seems really bad. I didn't read PDF.
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I see your 1.5 Gy fx x 30 = 45 Gy with concurrent use of a heat lamp purchased at Home Depot that is used to bill concurrent hyperthermia. Not relevant in this case, but believe it or not, I've seen it done.
 
Gfunk6 said:
I see your 1.5 Gy fx x 30 = 45 Gy with concurrent use of a heat lamp purchased at Home Depot that is used to bill concurrent hyperthermia. Not relevant in this case, but believe it or not, I've seen it done.
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Marc Pomper has several vans that drive to nursing homes and deliver hdr skin xrt over 8 weeks. He is one of the highest Medicare billers in the USA. A lawsuit had accused him of billing for hyperthermia with heat lamps from Home Depot.
 
GI_RadOnc said:
Take the time to read the full pdf from New York Department of Health; it describes each of the clinical situations in detail; as well as the evaluation by the defendant, his expert witness, and the state board's expert witness. It's .. wow.
Click to expand...
Point taken. I was trying to give benefit of doubt to a fellow physician. Wrong! That **** is bonkers.
 
With the exception of retreating whole brain to 60 Gy after recently getting 50 Gy (and I've seen stuff almost as bad, but I'd still say that wins) I regularly see similar stuff as the other complaints.

Boomers gonna boomer.

Edit: Who was the guy who would regularly prescribe 50 cGy per fraction and drag out treatments for 6 months? I swear that was going on for a long time somewhere.
 
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Moonbeams said:
With the exception of retreating whole brain to 60 Gy after recently getting 50 Gy (and I've seen stuff almost as bad, but I'd still say that wins) I regularly see similar stuff as the other complaints.

Boomers gonna boomer.

Edit: Who was the guy who would regularly prescribe 50 cGy per fraction and drag out treatments for 6 months? I swear that was going on for a long time somewhere.
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Sounds like a Florida thing

Aka the MOS EISLEY of rad onc (hat tip ESE)
 
Moonbeams said:
With the exception of retreating whole brain to 60 Gy after recently getting 50 Gy (and I've seen stuff almost as bad, but I'd still say that wins) I regularly see similar stuff as the other complaints.

Boomers gonna boomer.

Edit: Who was the guy who would regularly prescribe 50 cGy per fraction and drag out treatments for 6 months? I swear that was going on for a long time somewhere.
Click to expand...
Someone in SoCal
 
I heard of someone who has an inhouse PET and owns the machine. They bill globally for this. They get multiple PETs throughout treatment to “guide assessment of response”. Of course many PETs at follow up. This same person treats at 0.5 gy a day treating prostates for months to minimize side effects. Oh and the in house pharmacy brings in lots cheesy dough too.
True story folks!

Personally our field would be better off if FBI would raid all these folks and put them away. Surely they working on it.
 
TheWallnerus said:
Tangentially related... academic satellite located into my town a few years back. Over time have shared some bone met patients w/ them. They appear never to have heard of "8 gray in 1 fraction."
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We hired a therapist on a per diem basis from a local academic satellite (that streams main campus docs. Some big names.) about 3 years ago. She had never once seen a breast hypofractionated before coming to my clinic. Ditto prostate. She was astonished that it's a thing.
 
Palex80 said:
How high can you go with the total dose if you treat prostate with 0.5 Gy per day?
I am asking for a friend. 🤣
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Im sure lord wallrus can write us a thesis on the radbio of treating prostates 0.25-0.5 a day. How would you do it if you were asked lord wallrus?
 
Using an alpha beta of 3, 80 fractions of 0.5 gy a day is an EQD2 of 28. You folks do the math!
 
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