FAYETTEVILLE -- A former pathologist charged in the deaths of three patients also committed fraud to hide his alcohol abuse, falsified medical records and gave false statements to investigators, according to a federal indictment.
Dr. Robert Morris Levy, 53, of Fayetteville risked his own life to stay intoxicated on the job at the Veterans Health Care System of the Ozarks, according to the indictment. Levy was paid $225,000 a year plus bonuses to review laboratory test results on tissue samples and make diagnoses based on those findings, according to the indictment.
U.S. Attorney Duane "Dak" Kees and Inspector General Michael Missal of the U.S. Department of Veterans Affairs held a news conference on the case Tuesday and released copies of the indictment at the Washington County sheriff's office. Directors of the Ozark system had no comment Tuesday.
The federal grand jury indicted Levy on 12 counts each of wire fraud and mail fraud, four counts of giving false statements and three counts of involuntary manslaughter. Trial is set for Oct. 7 in federal court in Fayetteville. If convicted on all counts, Levy would face a theoretical maximum of 524 years in prison and fines totaling $7.75 million, Kees said.
"Our veterans go to get help and not be harmed," Kees said of the Ozarks system. "Our thoughts are with the veterans and their families." Missal added later that charges such as manslaughter are "exceedingly rare" in the veterans health care system nationwide, and that observers would have to "go back a number of years" to find any similar case.
Brian Smith of Memphis is an attorney representing several veterans who suffered from missed diagnoses by Levy and their family members or survivors, he said Tuesday. "We are continuing to look at what happened," Smith said. "They are trying to hang all this on Dr. Levy, but we believe people at the medical center and above have responsibility."
"It's been a tough day for the veterans and their families who are involved in this," Smith said.
Levy was being held without bail in the Washington County jail after his arrest late Friday and, as of yet, has no attorney to speak for him, Kees said. Levy pleaded innocent in a federal court appearance Tuesday morning, federal court records show. The investigation into how the situation developed at the Ozarks system isn't over, Kees said.
Pathology errors at the veterans system came to light publicly June 18, 2018, when the Ozarks system and three members of the state's congressional delegation held a news conference at the center in Fayetteville. The other three members of the Arkansas delegation were unable to attend but sent staff members. That news conference announced the beginning of a yearlong review of every case the pathologist had worked on from his hiring in 2005 through 2018. The name of the pathologist wasn't released at the time.
Third District U.S. Rep. Steve Womack, 4th District U.S. Rep. Bruce Westerman and U.S. Sen. John Boozman, all Republicans, attended the 2018 announcement and also issued statements after Tuesday's news conference. All three, along with U.S. Sen. Tom Cotton pledged Tuesday to continue monitoring the situation.
"For the sake of the integrity of the VA medical system and the quality of care of our heroes, we have a duty to ensure that bad actors are held accountable," Womack's statement says. "This situation can never be allowed to happen again."
Patients' families and veteran groups asked at the first news conference and during each of the seven public meetings held after on the progress of the review: Why was the pathologist involved not watched closely after he was reported to be working while impaired in 2016 and allowed to return after passing through a substance-abuse treatment program? Administrators at the Ozarks system said they could not answer those questions because that aspect of the review was a personnel matter.
The indictment released Tuesday says Levy was closely monitored, giving 42 random blood and urine tests after completing the substance-abuse program. He intoxicated himself while evading the tests by using a highly toxic form of alcohol, 2-methyl-2-butanol, according to the indictment. That substance doesn't show up on normal alcohol and drug screening.
"Being a pathologist, he was skilled in toxicology and had the knowledge and the medical equipment to give himself exactly the right amount," Kees said Tuesday about Levy. More than a tiny amount of the substance, carefully measured for the individual taking it, is fatal, Kees said. Kees declined to say how much Levy is believed to have taken in each dose, "but it's a matter of drops."
The 2-methyl-2-butanol compound isn't produced for human consumption, Kees said. According to product listings on a chemical company website, the substance is legal onlyfor research and development.
Levy had to submit blood and urine samples to both the Ozarks system and to the Mississippi State Board of Medical Licensure, which issued his medical license. In all, he submitted his 42 blood or urine samples from Nov. 11, 2016, to July 3, 2018. That averages out to two a month. None tested positive for drugs or alcohol.
Investigators found 12 purchases of "2m-2b" in Levy's financial records, all between June 30, 2017, and June 13, 2018, the indictment shows. Ordering the substance with the intent to defraud the Ozarks system by cheating on the alcohol tests and taking delivery of it resulted in the wire- and mail-fraud charges, according to the indictment.
The indictment says Levy's ruse was discovered by a March 1, 2018, breath analysis. The indictment doesn't say who administered the test or why, but Fayetteville Police Department records show Levy was arrested that day for driving while intoxicated after going to the post office on Dickson Street. In a July 9, 2018, interview, Levy blamed the arrest for his firing the following April and the subsequent review of his work.
Reviewing all of Levy's cases since he started work at the Ozark system in 2005 took more than a year. The review by pathologists from other hospitals found 30 missed diagnoses that posed serious health risks to patients, according to results released May 31 by the health care system. Overall, pathologists found 3,029 errors out of 33,902 cases, but most patients didn't suffer long-term ill effects, according to the review.
The review found an error rate of 8.9% compared with a pathology practice average of 0.7%, according to Ozarks system director Kelvin Parks. That works out to an error rate more than 12 times the average, figures show.
Investigators from the Veterans Affairs Department and the U.S. attorney's office questioned Levy about any substance abuse after March 1, 2018.
Levy testified under oath, the indictment says, that he had no idea what substance had been detected in his March 1, 2018, breath test even though he had ordered 2m-2b before and after investigators first questioned him. Levy denied any knowledge of using any intoxicant after 2016, he told investigators subsequently.
Investigators also found Levy changed the medical records of all three of the patients who died as a result of diagnoses he missed, Kees said. The names of those patients weren't released Tuesday.
Levy caused the death of a patient identified as JRG by entering "an incorrect and misleading diagnosis" on Feb. 4, 2014, in the patient's medical record and falsely putting into the record that a second pathologist verified his results.
Levy then, according to the indictment, entered another equally incorrect diagnosis in the same case by altering the medical record again. The patient was treated for a type of cancer he didn't have and died of small cell carcinoma on July 26, 2014.
Levy made another fatal misdiagnosis on or about Sept. 22, 2014, according to the indictment in the case of a patient identified only as JDQ. According to the indictment, Levy said a second pathologist who reviewed the case concurred in Levy's diagnosis even though "Levy well knew that a second pathologist did not concur." The patient died Sept. 13, 2015.
The third patient died April 28, 2016, after getting a cancer-free diagnosis from Levy in 2009. The tissue samples from that case, of patient identified as DRM, "was obviously cancerous," according to the indictment.
The Veterans Health Care System of the Ozarks serves veterans in 23 counties in Northwest Arkansas, southwest Missouri and eastern Oklahoma.
Metro on 08/21/2019