Overdiagnosis

Mariah Martinez was 9 years old when she got bad news about her chronic headaches: A doctor said she had epilepsy.

Over the next four years, the suburban Detroit girl took anti-seizure medicine that made her feel sluggish and was occasionally hooked to a machine that recorded her brain waves. She was told to avoid activities that would rouse her heart, making her the target of teasing by other kids at school.

But then a different doctor delivered astonishing news in 2007: Mariah didn't have epilepsy.

"How could that be?" her mother, Laura Abdel-Slater, recalled. "Epilepsy is something that's not curable."

Martinez, now 26, is the first of what could be many former patients to go to trial accusing Dr. Yasser Awaad and his former employer, Oakwood Healthcare, of malpractice and negligence. Jury selection starts Monday.

Awaad ordered tests on hundreds of Detroit-area children and intentionally misread the results, telling them they had epilepsy or some other seizure disorder, say lawyers for Martinez. The diagnoses disrupted their lives, forcing them to take medicines they didn't need and to undergo further tests during repeat visits. 

The lawyers allege that Oakwood was running an "EEG mill," a reference to an electroencephalogram, a test to measure brain activity. The Dearborn medical center was "ecstatic with Dr. Awaad's suspiciously high productivity because all it cared about was making money," they argue in a recent court filing....

Awaad was Oakwood's first pediatric neurologist when he was hired in 1999. Over nearly a decade, his annual salary rose from $185,000 to $300,000. He also qualified for a bonus as high as $220,000 if certain billing targets were met, documents show.

Awaad left Oakwood in 2007 for a job in Saudi Arabia. When his former patients visited new doctors, many diagnoses were reversed. Even other doctors consulted by defense lawyers said he misinterpreted EEG tests.

"If I made a mistake, I came up with a diagnosis to the best of my ability," Awaad told attorney Brian McKeen during a quarrelsome deposition in 2017. "That's a different story than intentionally telling them that you have epilepsy and they don't have epilepsy."

Oakwood merged into Beaumont Health in 2014, years after the first lawsuit was filed.

"While we cannot comment on the specifics of this case because of pending legal proceedings and patient privacy laws, it continues to be our position that patients were treated appropriately," Beaumont spokesman Mark Geary said.

In 2012, Awaad struck a deal with state regulators to settle claims that he unnecessarily gave anti-seizure medications to four children. He paid a $10,000 fine and agreed to have his work reviewed by another doctor for a period of time.

Lawyers representing about 300 former patients lost their bid to make this case a class-action lawsuit, so the first trial will center only on Martinez, who was sent to Awaad in 2003 over her headaches. She was given Lamictal, an anti-seizure medicine, and Awaad performed many follow-up EEGs until another doctor said she didn't have epilepsy.

Martinez's attorneys declined to make her available for an interview before trial. But in a deposition, she recalled being withdrawn as a child and teased by other kids because the epilepsy label limited her physical activities. She said her grades suffered.

"Once I was weaned off medication, my headaches became less frequent, less severe," said Martinez.

Attorneys for Oakwood asked the judge to give the medical center a separate trial, but he declined.

"You can't just look at the malpractice and not consider whether Oakwood should have and could have stopped what was happening," said Wayne County Judge Robert Colombo Jr., who last fall called some evidence "very damning."

https://www.freep.com/story/news/local/michigan/wayne/2019/06/02/oakwood-doctor-trial-misdiagnosing-epilepsy/1320079001/

Courtesy of a colleague