Top UPMC surgeon testifies about suboxone use

A secretly recorded conversation between the head of UPMC’s department of cardiothoracic surgery and the doctor treating him with suboxone for a previous problem with prescription narcotics is at the center of a hearing in Allegheny County Common Pleas Court.

Dr. James Luketich, who is the subject of a federal whistleblower complaint, testified on Monday that he suffered a shoulder injury in the 1980s while attending medical school at the University of Pennsylvania and took prescription narcotics. Concerned he was developing dependency, Luketich said he sought and received help. Then, in 2008, he was prescribed suboxone for pain stemming from a slipped disc.

During the injunction hearing, Luketich said he does not know how the recording was made but suspects it could have been a voice-activated recorder taped under a table in the room where the conversation occurred. He believes two previous colleagues recorded him as retaliation for him expressing concerns about them having an improper relationship and accusing them of potential academic misconduct.

Those two colleagues, Dr. Jonathan D’Cunha, who filed the whistleblower complaint against Luketich in federal court in 2019, and Dr. Lara Waleed Schaheen, no longer work for UPMC.

D’Cunha, who left in 2019, now serves as the head of cardiothoracic surgery at the Mayo Clinic in Phoenix. Schaheen works in Phoenix as well.

Judge Philip A. Ignelzi is presiding over the hearing, which is in response to a request for an injunction Luketich filed to stop plaintiffs in a civil lawsuit against him from being able to use the secretly obtained recording made on Feb. 26, 2018, between Luketich and his primary care physician, Dr. David Wilson, in a surgery observation room at UPMC Presbyterian.

The motion alleges the recording violates state wiretap laws that require authorization by the parties when a recording is being made. Luketich did not know of the recording’s existence but later learned that D’Cunha and Schaheen said they received anonymous copies of it, as well as a transcript, in the mail.

Luketich alleges they improperly shared the recording with the plaintiff in the lawsuit. In that malpractice complaint, filed by Paul and Bernadette Fedorka, Luketich was not the treating physician. Instead, he is being sued in his role assigning surgeons to the lung transplant center. The lawsuit, which said the lungs were not a proper match for Bernadette Fedorka, alleges that Luketich did not properly staff the center and that she received a lung that she should not have, resulting in long-term injuries, including end-stage renal failure.

According to court documents, Schaheen turned her copies of the recording and transcript over to federal investigators.

On Monday, the recording was played in court, but only after Ignelzi ordered the courtroom to be closed to the media and members of the public.

D’Cunha denies making the recording and said in one court filing that Luketich’s allegations are lacking in “factual and legal merit” and “frivolous, retaliatory and a direct result” of his reporting Luketich for multiple reasons to various law enforcement and professional agencies.

“Desperate to avoid the consequences of his actions, Luketich has concocted (his claims) in an attempt to ‘kill the messenger’ rather than face the truth,” D’Cunha’s attorney wrote.

On cross examination by attorney Efrem M. Grail, Luketich testified on Monday that after his shoulder injury, he was concerned that he was becoming dependent on the narcotics he had been prescribed and self-reported. He was given a two-year period of probation under the Pennsylvania Board of Medicine, which he completed in 1989. After that, Luketich said he submitted hundreds of urine tests that were clean and went on to mentor other physicians in what was then called the state impaired physicians program.

After developing back pain from an injured disc, Luketich began using suboxone in 2008. He said that while all opioids carry risk with their use, suboxone is the safest because of its chemical composition.

Luketich testified that after he began using suboxone, he was tested for any possible neurocognitive impairment from its effects and had none.

On cross-examination Monday afternoon by attorney Robert M. Barnes, who represents D’Cunha, Luketich said he would not characterize his use as “drug abuse.”

“I reached out for help. I don’t call that abusing. I was on a prescription narcotic,” he said. “I felt I was developing signs of dependency.”

Luketich said he was using the narcotics according to the prescription.

“I never used illegal drugs. I never purchased drugs on the street,” he said. “I thought I needed help. I sought it. I got help.”

During cross-examination between Luketich and Barnes, Luketich called D’Cunha a “better than average surgeon,” but not a “master surgeon.”

Luketich did, however, agree, that the Mayo Clinic, where D’Cunha works now is a “top center.” Luketich recruited D’Cunha to UPMC and attempted to retain him when other hospital systems were trying to court him in 2016, Luketich testified. After several questions on the topic, he finally conceded that D’Cunha is “quite an adequate surgeon” and ranked him in the top 20% of his field.

“It’s your opinion he would throw away his entire career over a five-minute conversation with Dr. Wilson?” Barnes asked.

“I’m pretty certain he’d hoped to never be implicated in the taping of it,” Luketich answered.

D’Cunha, who was hired in 2012 and served as the surgical director of lung transplantation at UPMC, helped lead UPMC’s program out of probationary status with the national United Network for Organ Sharing, Luketich testified.

When asked about the probationary status, Luketich said, “There were some rules that were broken from time to time — in the best interest of the patient, but not the national program.”

Among the concerns, he said, were when donor lungs would be designated for one recipient, but for a variety of reasons — including if that recipient couldn’t receive them because of infection — they would go to someone else.

According to a chart Barnes used as an exhibit, UPMC peaked with 131 lung transplants in 2010. As of May 31, there have been 22 in 2022. There were 48 such surgeries last year.

Luketich said the decline in the number of procedures stems, in part, from other regional lung transplantation programs opening in Cleveland and Philadelphia.

D’Cunha filed his whistleblower complaint against Luketich in 2019 under seal. That was followed by a federal civil complaint against Luketich, UPMC and University of Pittsburgh Physicians filed by the U.S. Attorney’s Office in September 2021. That complaint alleged that Luketich improperly performed as many as three complex surgical procedures at the same time; left patients under anesthesia for extended periods of time unnecessarily causing additional risk; and submitted hundreds of false claims to Medicare.

According to federal prosecutors, Luketich was one of UPMC’s highest-paid employees, receiving more than $2.4 million annually from 2017 to 2019.

UPMC and Luketich deny the claims against them. The federal case is currently stayed after the parties suggested in a joint motion in July that they were attempting to resolve it.

That stay, while the parties “explore amicable resolution,” is set to lift Sept. 30.

Luketich will return to the stand in state court on Tuesday morning.