Raleigh ENT Doctor Sentenced To 25 Years In Prison For Adulterating Surgical Devices, Defrauding Medicare, Stealing Patient Identities

RALEIGH – Anita Louise Jackson, 62, was sentenced to 300 months in prison for adulterating surgical devices used in more than 1400 nasal surgeries performed on Medicare patients between 2011 and 2018. Jackson was also ordered to serve 3 years of supervised release and ordered to forfeit $4.7 million. In January of this year, Jackson was found guilty by a federal jury on 20 criminal counts, including device adulteration, fraud, conspiracy and identity theft.

“This doctor put profit over patients by reusing single-use surgical devices hundreds of times, even though those devices came into contact with blood and other bodily fluids. In doing so, she risked the contamination of one patient’s sinuses with the bodily fluids of other patients,” said U.S. Attorney Michael Easley. “Medicare auditors also found that Jackson was the top-biller for balloon sinuplasty surgeries in the country, having billed the program over $46 million. When auditors began to audit the defendant’s practice, she and her staff falsified medical records and forged patient signatures in an attempt to justify billing the surgeries.”

Evidence presented at the trial demonstrated that Jackson was an Ear, Nose and Throat doctor who operated Greater Carolina Ear, Nose, and Throat (GCENT), with offices in Raleigh, Lumberton and Rockingham. Jackson, through her employees, marketed balloon sinuplasty, an in-office procedure to treat chronic sinusitis, as a “sinus spa,” and encouraged patients to come to the office for a “free” sinus spa, which was a treatment that they may not have needed. Jackson falsified medical records to justify the billing of balloon sinuplasty surgeries to Medicare auditors.

“This case is a reminder that health care fraud is not a victimless crime. Jackson stole millions of dollars that are essential to the Medicare program and willfully endangered her patients’ health,” said Special Agent in Charge Tamala E. Miles of the U.S. Department of Health and Human Services Office of Inspector General. “Our agency, working with our law enforcement partners, will continue to ensure that those who defraud our federal health care programs and needlessly risk harm to patients are held accountable.”

Between 2011 and the end of 2017, Jackson performed 1555 balloon sinuplasty surgeries on 919 Medicare beneficiary patients, using the Food and Drug Administration (FDA)-approved Entellus XprESS device. However, instead of using the device only once and only on one patient, as required by FDA guidelines, Jackson reused the devices on multiple patients.

Between 2012 and 2017, Jackson obtained, at most, 36 new Entellus devices, despite being, at times, the top-paid Medicare provider of balloon sinuplasty services in the country and providing more than 1500 surgeries. In addition, Jackson failed to inform her patients that they were receiving a procedure with an adulterated device. During the trial, Jackson admitted that she had sufficient money to buy every patient a new device but chose not to do so.

“U.S. consumers rely on FDA oversight to ensure that medical devices are safe and effective. When healthcare providers disregard safety information, including single-use and single-user designations, resulting in the adulteration of medical devices, they put patients’ health at risk,” said Acting Special Agent in Charge Patrick Whelan, FDA Office of Criminal Investigations, Miami Field Office. “We will continue to investigate and bring to justice providers who jeopardize the public health.”

Jackson billed Medicare more than $46 million dollars for the balloon sinuplasty procedures between 2014 and 2018. In that time, she netted more than $4.79 million from Medicare for these surgeries. That amount does not include any sinuplasty surgeries performed on patients with private health care insurance. The jury ordered Jackson to forfeit these profits.

The final judgment on restitution in this case will not be entered until after 90 days. During this time period, patient victims will have an opportunity to present any specific claims of loss to the Court arising from the charges.

The U.S. Attorney’s Office has a pending civil action against Jackson.

Michael Easley, U.S. Attorney for the Eastern District of North Carolina made the announcement Friday after sentencing by United States Judge James C. Dever III.