On Oct. 1, 2018, Kaki and Elder were fired by DMC and later lost their medical staff privileges. Since 2014, they had been outspoken internally about concerns over quality of care problems at DMC.
In March 2019, Kaki and Elder sued DMC and its parent, Tenet Healthcare Corp. of Dallas, and four executives for retaliation under state and federal false claims acts.
For years, Elder and Kaki were top patient admitters and popular doctors among patients, staff and resident physicians. They had reported multiple problems to top management about dirty medical and surgical instruments, unnecessary procedures on patients performed by other doctors, lack of nursing staff and cutbacks in critical lab and support services.
In a 41-page lawsuit filed in U.S. District Court in Detroit, the two doctors also claimed top DMC and Tenet executives failed to investigate alleged incidents of Medicare and Medicaid fraud.
The U.S. Department of Justice continues to investigate Medicare and Medicaid billing problems, alleged overpayments to on-call cardiologists, poor quality of care, lack of supervision that led to patient deaths and the improper use of employed nurse practitioners, Crain’s has reported.
The investigation by the DOJ was disclosed in February 2018 by Tenet in a federal securities filing. The company has declined interviews on the subject.
Over the past several years, Crain’s has reported continuing problems with surgical instruments at Detroit Receiving Hospital and Harper University Hospital.
The firings, which alleged violation of Tenet’s code of conduct, followed an investigation of the doctors’ interactions with nurses and other doctors by Medicare compliance attorneys with Latham and Watkins LLC, a Los Angeles-based law firm.
“After an extensive review of complaints received from physicians and team members, DMC has asked Dr. Mahir Elder, Dr. Amir Kaki and Dr. Tamam Mohamad to step down due to violations of our standards of conduct,” wrote Steiner, who at the time was CEO of DMC Detroit Receiving, DMC Harper University and DMC Hutzel Women’s hospitals, in an email to 5,000 DMC employees and in a statement to the media.
Elder now practices at Beaumont Health hospitals in Dearborn, Taylor and Royal Oak. He is a two-time Crain’s Health Care Hero and was voted Teacher of the Year by cardiology fellows for 10 consecutive years. He also is a professor of medicine at Wayne State University and Michigan State University.
At DMC, he trained Kaki and dozens of other interventional cardiology fellows for more than a decade and was director of cardiac care, ambulatory services and the endovascular medicine program at DMC Heart Hospital since 2008.
Kaki, who was recruited in 2012 by now-Detroit Mayor Mike Duggan when he was CEO of DMC, is practicing at Ascension Providence Hospital in Southfield and Ascension St. John Hospital in Detroit, where he is director of complex higher-risk indicated patients.
Among other duties at DMC, Kaki was hired in 2014 as director of cardiac catheterization services unit at DMC Heart Hospital, also known as DMC Cardiovascular Center, which is located at DMC Harper-Hutzel Hospital.