health care

In Hospital for Routine Biopsy, Bronx Woman Left With Broken Jaw and $14K Medicare Bill

Lorraine Evans, 85, says some of her teeth were knocked out during a biopsy at New York-Presbyterian Hospital.
Lorraine Evans, 85, says some of her teeth were knocked out during a biopsy at New York-Presbyterian Hospital. Photo: Ben Fractenberg/THE CITY

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During the last few months of 2014, Lorraine Evans’ voice began to grow increasingly hoarse.

The Bronx resident, then 80 years old, had no idea what was causing the lingering rasp — she’d never been a smoker and she hadn’t recently been sick.

After weeks of searching for medical help, Evans was referred to a doctor who specializes in voice disorders at New York-Presbyterian Hospital on the Upper East Side. In late 2014, she was told she had a “right vocal fold mass” — a growth on her throat tissue.

The doctor believed the growth needed further analysis, so Evans, who lives in Co-Op City, scheduled a biopsy for Jan. 9, 2015.

She arrived at the hospital at 7:30 a.m. that day, and was anesthetized by 10:30 a.m.

Evans woke up about an hour later, in a hospital hallway — with blood streaming from her mouth, she told THE CITY.

A Shocking Discovery

The biopsy hadn’t happened, doctors told her, because some of her teeth “fell out” and a hospital dentist had to be called in to repair them.

“I was just dumbfounded,” the now 85-year-old said. “When I finally looked into the mirror, my whole top lip was so swollen.”

Four agonizing days passed before the pain drove her into the office of her friend and former employer, Dr. Robert Reiss, a Manhattan dentist.

It was there she discovered that during the procedure, five of her teeth had been “knocked out” and their roots fractured, according to a September 2015 complaint she filed in Bronx Supreme Court.

Upper East Side dentist, Dr. Robert Reiss, on Sept. 26, 2019.
Upper East Side dentist, Dr. Robert Reiss, on Sept. 26, 2019. Photo: Ben Fractenberg/THE CITY

The damaged teeth had been stuck back together with glue and wire by the hospital’s dental surgeon, “in a manner that [Reiss] could only describe as primitive,” the suit reads. It took Reiss two tries, on separate days, to untangle it all, according to Evans.

Reiss referred Evans to Dr. Burton Langer to have her teeth repaired. But an X-ray in Langer’s office revealed another problem, she recalled: “He said to me after they took the X-ray, ‘Don’t you know they broke your jaw?’”

Still, the hospital billed Medicare for a “voice box exam with biopsy,” charging a total of $14,166, according to documents sent to Evans from Medicare — even though the biopsy was aborted.

Medicare paid the hospital $13,693, Evans’ benefits paperwork, shared with THE CITY, showed.

“I couldn’t feel worse, knowing that they did that,” she said of her disappointment at the bill.

Medicare allows for billing even when doctors can’t follow through with procedures, in certain circumstances.

New York-Presbyterian — which successfully argued to get Evans’ suit dismissed over the summer — declined comment, citing patient privacy laws. THE CITY was not immediately able to reach the doctor for comment.

Evans said she’s not ready to give up her fight, and plans to appeal.

“They just probably see that I’m just some woman from The Bronx, and to hell with me,” she said.

Disparities in Treatment

Reiss, who has been a dentist for about six decades, said he’s witnessed a persistent, biased culture in the healthcare industry that can result in poor treatment for black patients.

The concept is well-documented: A 2013 scientific review of research articles on race and surgical outcomes indicated that the “vast majority” of this scholarship showed that “across several types of surgery, blacks also appear to suffer higher rates of in-hospital complications and/or disease recurrence.”

A cast of Lorraine Evans’ mouth made after her biopsy.
A cast of Lorraine Evans’ mouth made after her biopsy. Photo: Ben Fractenberg/THE CITY

And with limited exceptions, the researchers stated, “uninsured and publicly insured patients typically have higher morbidity and mortality than privately insured patients.”

“I’m not going to let this go,” said Reiss, 90, who helped Evans get a lawyer. “This poor woman has been brutalized. And I know that if it weren’t an 80-year-old black lady from The Bronx, this would have been settled out of court a long time ago. But they didn’t know they were dealing with me.”

New York-Presbyterian did offer Evans $10,600 in April 2015 — provided she sign a release waiving certain legal rights. She had just over two weeks to decide, according to a letter from the hospital’s patient services office.

Reiss advised her not to sign.

“She did want to,” he said, “and I told her, ‘You can’t.’”

Almost four years after Evans’ lawsuit was filed, a Bronx Supreme Court judge dismissed the case in late July.

The hospital “submitted undisputed evidence that dental injury is a known complication and risk of a microlaryngoscopy procedure that occurs in approximately 1% of cases,” the decision read, noting that complications that are “unusual in severity” can happen in the absence of malpractice.

“It’s unfortunate,” said Evans’ attorney, Josh Abraham. “Appeals are very expensive.”

Never Saw a Case ‘This Severe’

Both Reiss and Langer — who estimate that the free work they did to help Evans was worth about $50,000 — said they couldn’t understand just how she was injured during the biopsy procedure.

In a sworn account, the doctor who conducted the biopsy described the extent of her injuries as unprecedented in his experience.

“In general terms, dental injury is a known complication of microlaryngoscopy [a voice box examination],” he said in a deposition last June. But, he added, “Something this severe, I’ve never encountered in my career, nor read about.”

Evans’ medical records from New York-Presbyterian that day, court papers and the deposition last year all suggested the injuries were the result of a “sudden shift” in position of an instrument called a laryngoscope.

Evans said she left the hospital that day unaware of the extent of the damage. She said in her lawsuit she was “given instructions to take vitamins and basic pain medication.”

Unable to eat regularly for four or five months, Evans lost 22 pounds, she said. Stress over her appearance, Evans said, kept her from going out or seeing family and friends.

She never got the biopsy done, though the hospital offered to have her see another doctor there, Evans said.

“I never went back, but I can feel there is something there,” she said of her throat. She is still hoarse.

“It made me feel really bad, you know?” Evans said of her experience. “Because I have a decent family. And nobody ever went to jail. We all went to college and we went to school.

“Oh, my goodness,” she added. “They have no respect for whoever you are out here.”

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