COLUMBIA, MO. – The University of Missouri settled a $ 16.2 million collection of personal injury and false advertising claims about knee surgery. This seems like one of the biggest public payouts in years.
The 22 plaintiffs, a handful of whom were minors, filed lawsuits from 2018 to 2020 over “BioJoint” operations carried out by two university employees, orthopedic surgeon Dr. James Stannard and the veterinarian Dr. James Cook. The procedure involves a complex operation called “biological joint restoration” on the Mizzou BioJoint Center website, which replaces parts of the knee with cadaver bones or cartilage to treat arthritis or joint damage. Some plaintiffs alleged in court documents that the procedure was sold to them in order to avoid traditional knee replacement.
Plaintiffs alleged in court documents that Stannard failed to advise plaintiffs that “the operation he proposed has a failure rate of up to 86%”. Court documents argued the surgeries were “experimental” and “unproven”, sometimes leaving patients in need of follow-up surgeries and even knee replacements, including young patients.
The defendants denied these allegations in the court records, and the university closed the cases with no acknowledgment of liability or negligence after claims against Cook, Stannard and another employee were dismissed. The Mizzou BioJoint website states that the program does not have 10-year efficacy data because the operations “are based on improvements to traditional techniques”. Unlike prescription drugs or medical devices, surgical interventions are not directly regulated by federal or state authorities.
On Thursday, KHN received the settlement agreements signed in February upon request from public records.
Michelle Mello, a professor of law and medicine at Stanford University, said the settlement amounts often reflect the value of public relations to defendants, as well as the value of what plaintiffs could have gotten in court.
“On a per capita basis that seems like a lot of damage, so there’s something going on that isn’t great for the university,” Mello said.
“We are excited to resolve this dispute,” said Jonathan Curtright, CEO of University of Missouri Health Care, in a statement. “Ensuring safe, high quality care is always a top priority, and we continue to be committed to excellence in restoring joint health and function to eligible patients. We are confident in the expertise and commitment of our people, as well as the innovative, science-based services of the Missouri Orthopedic Institute and the Mizzou BioJoint program. “
Stannard and Cook didn’t return requests for comment on the cases on Thursday. Todd Hendrickson, an attorney for the plaintiffs, said the settlement agreements prohibited the attorneys and plaintiffs from speaking on the matter.
At the heart of the dispute in the consolidated litigation is Cook’s portrayal as veterinarians and veterinarians are generally not allowed to administer drugs to humans. Trials alleged that Stannard negligently allowed Cook to perform portions of Mizzou BioJoint operations on plaintiffs “without proper medical instruction and supervision”.
Some patients claim in court documents they did not know when they underwent the procedure, that Cook was not a “doctor or licensed medical practitioner.” In at least five plaintiffs’ cases, court documents state that Cook was sometimes listed in medical records as “surgeon – other”.
And documents in one case said he was listed as a “surgeon”. Defendants deny Cook was listed as a surgeon in response to this case, but said he was listed as part of the surgical team. An additional filing by defendants stated that Cook was “Orthopedic Technologist – Surgery Certified” and that he joined the surgical team for the “majority of the operations performed by Dr. Stannard.”
In one file, defending attorneys said Stannard and Cook were under no obligation to tell patients that Cook had never been a doctor or licensed medical practitioner at any time prior to surgery because “the operation usually involves people in the operating suite who are not licensed Doctors are. ”
Many new medical techniques are tested on animals before they reach humans. Hence, veterinarians could be involved in groundbreaking medical research, said Dr. Patrick McCulloch, vice chairman of the Orthopedic Surgery Department of the Houston Methodist.
“It’s not uncommon to have veterinarians as part of your research team, but it would be unusual to have them as part of your clinical patient care team,” he said.
“You must be licensed to operate on a person,” added Jeff Howell, executive vice president of the Missouri State Medical Association.
Cook is known as an expert in surgery on other species. He recently performed two surgeries on a tiger at a Chicago zoo, the second after the more ambitious initial procedure was unsuccessful, the Chicago Tribune reported.
He holds the title of prestigious Chair in Orthopedic Surgery from William & Kathryn Allen in the University of Missouri Medical School, Director of the School’s Orthopedic Research Department, and Director of Operations and Research at the Mizzou BioJoint Center. The state paid Cook $ 301,892.04 in 2020.
Stannard, one of the University of Missouri’s highest paid employees other than top athletic coaches, received a state salary of $ 981,977.52 for 2020. His titles include chief medical officer for procedural services, medical director of the Missouri Orthopedic Institute, and chairman of the school’s medical department for orthopedic surgery. He is also a team doctor for Mizzou athletes.
Stannard’s salary is almost twice that of Mun Y. Choi, president of the University of Missouri system. Missouri Governor Mike Parson earned $ 133,820.88 in 2020.
A university spokesman told the St. Louis Post-Dispatch in August that Stannard had increased the Missouri Orthopedic Institute from two surgeons to 30 and that only 2% of his salary came from tuition fees.
Part of the claims of the lawsuits depend on the university’s promotion of the novel proceedings, which aired during a Super Bowl on location in Missouri and which appeared at O’Hare International Airport in Chicago. Some of the plaintiffs said the extensive advertising led them to contact the Mizzou BioJoint Center for knee pain relief.
According to McCulloch, direct marketing of medical devices and surgical procedures has increased in recent years after drug advertisements were successful.
Still, Mello said, it is relatively uncommon for a university to advertise the availability of these techniques or products. She said the advertising claims likely enabled the plaintiffs’ legal team to negotiate a higher settlement amount as false advertising allegations were made in addition to the medical misconduct claims.
LaurenW@kff.org, @LaurenWeberHP
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