One patient was treated for more than four years as having lymphoma when the patient didn’t have cancer. An 83-year-old was given an antibody drug almost continuously for eight years when the diagnosis of active lymphoma was “a fantasy.” And another patient who had metastatic ovarian cancer was to be treated with her ninth different chemotherapy regimen after eight others had failed. These are just a few of the findings of internal audits and case reviews conducted for the Hutchinson Clinic in 2010 and 2011 over oncologist Mark Fesen’s practice. At one point, the auditor described the doctor’s methods as “Treat, treat and treat some more.” After the audits were completed, the doctor quietly left the clinic he’d been at for nearly 20 years for a new practice in a new city. But a year-long investigation by The Wichita Eagle helped tell patients what they otherwise would have never known about the doctor. This is a story many people didn’t want told. The story involved 12 attorneys, more than 20 sources on the record or background, hundreds of documents, weeks of reporting and more than a year between the first tip and publication. The story began when we got a tip that a cancer physician from a nearby town with a history of inappropriately treating patients had recently moved to Wichita. There were documents — internal audits — to prove it. Two audits, conducted at the request of the Hutchinson Clinic, said 40 percent of oncologist Mark Fesen’s patients had been misdiagnosed or were receiving treatment that was unnecessary, ineffective or harmful. The Eagle obtained several patient case files showing the patients had been made ill by the treatment and some internal memos questioning whether the doctor had committed Medicare fraud. The documents said the doctor: — Did not follow established national cancer-treatment guidelines in about 40 percent of the patient cases reviewed. — Treated some patients with lymphoma and cancers of the blood “unnecessarily” and “often too early, too much and too long.” The auditor suggested that Fesen should either not be allowed to treat those patients or be required to get board certification in that area. — Frequently split doses of chemotherapy and other drugs, without documenting why. — Overprescribed support IV therapies, such as minerals and antibiotics, and gave patients with blood cancer an excess number of bone marrow tests. The auditor questioned whether an external insurance audit would find documentation to justify the treatments. — The clinic worried that some of Fesen’s actions might be “interpretable” as Medicare fraud. Medicare data obtained by The Eagle through the Freedom of Information Act show the doctor’s claims dropped by about one-fourth from 2009 to 2011 to about 68,000 by the time he left the Hutchinson Clinic. The majority of the patients were elderly and from rural areas throughout Kansas. It is unclear whether the clinic told patients about the review or its findings.
