Category Archives: dishonest people

Patient Safety’s First Scandal: The Sad Case of Chuck Denham, CareFusion, and the NQF

In retrospect – always in retrospect – it should have been obvious that, when it came to Dr. Charles Denham, something was not quite right.

In a remarkable number of cases of medical errors, it’s clear – again, in retrospect – that there were signs that something was amiss, but they were ignored. The reasons are manifold: I was just too busy, things are always glitchy around here, I didn’t want to be branded a troublemaker by speaking up…. Part of the work of patient safety has been to alert us to this risk, to get us to trust our internal “spidey-sense.” When something seems wrong, we tell front-line clinicians, speak up!

It’s fitting, then, that the first major scandal in the world of patient safety has a similar subtext. The scandal, which broke two weeks ago, involves a $40 million fine levied by the Department of Justice against a company called CareFusion. The company allegedly paid Denham more than $11 million in an effort to influence the deliberations of a “safe practices” committee of the National Quality Forum co-chaired by Denham. While I was shocked to hear this news, in retrospect there were so many unusual things about the career of Chuck Denham that alarm bells could have, okay, should have, gone off – for many people who knew him, including me. But they didn’t.

Let me say at the outset that while some people feel strongly that leaders in safety and quality should have absolutely no ties with industry, I am not one of them. I serve on a corporate board (of IPC, the largest hospitalist staffing company in the US) and advise several companies working on various safety fixes, mostly technologies. I find this work interesting, enlightening, and fulfilling, and I am compensated for my time and expertise. I report all of these activities to my University and other organizations, and recuse myself from any decision that might possibly relate to one of these companies or their products, or potentially be perceived that way (a fuller description and a list of the companies is here).
Returning to the CareFusion/Denham affair, I first met Chuck Denham about 10 years ago, when he asked me to participate in a session that he was organizing for the National Patient Safety Foundation’s annual conference. The NPSF runs on a shoestring, yet I recall this session as being lavishly staged, our speeches accompanied by a video with Hollywood-like “production values.” I remember asking myself: Where did this person come from? And, more pointedly, where did his resources come from? I looked him up and learned that he ran an organization, called theTexas Medical Institute of Technology. I found precious little information about the Austin-based institute’s structure, staff, or history on the web, and Denham himself was based in Southern California. It all seemed a bit unusual, but not enough so to set off any alarms.

Over the next several years, I ran into Chuck at half a dozen safety meetings. I always found him enthusiastic, cordial, and highly (perhaps too highly?) complimentary of my work. He asked me to do a few things, including speaking in a couple of webinars staged by TMIT. These were quality events, well produced, and they gave me no reason to question his effectiveness or his motives.

Yet over the years, I found myself scratching my head about him on several occasions. A colleague visited him at his home in Laguna Niguel, an affluent beachfront LA suburb, and reported that it was palatial – not something commonly acquired on the salary of a former radiation oncologist. About five years ago, trying not to be too obvious, I asked Chuck where his money came from. He mentioned something about his wife’s family, and that he had decided to leave clinical practice to commit his life to patient safety. On several occasions, he talked about his “research test bed,” saying, “We’re in more than half the hospitals in America.” It wasn’t entirely clear what this meant; having visited many hospitals over the years, I never heard of one that was using the services of TMIT, the way you hear about hospitals that work with Premier or the Advisory Board or the Governance Institute. Very little of this added up, yet still there was no smoking gun.

Over the past few years, I received at least five different calls from colleagues who had been approached by Chuck to work on one project or another – a video to improve radiology safety, an effort to reduce central line infections, and several others I can’t recall. In each case, the question posed by my colleagues was a version of, “Is this guy for real?” In each case I said the same thing: Yes, both he and the situation seem odd, and no, I don’t know where he gets his money. Yet he appeared to be a nice guy, good to his word, and he produced results. I told them that – despite my head scratching – I couldn’t think of a sound reason not to work with him. When I mentioned this yesterday to Peter Pronovost, the Johns Hopkins intensivist who is the world’s leading safety researcher, he told me, “It’s not that five people didn’t understand Chuck… I don’t know anyone whodid understand.”

Things got odder still. Zelig-like, Chuck kept popping up in extraordinary places. After Dennis Quaid’s twin newborns nearly died of a heparin overdose at Cedars-Sinai Medical Center, I wondered whether Quaid would become a spokesperson for patient safety. The next thing I know, Quaid is holding a news conference, and standing beside him is Chuck Denham. And soon, a very slick video, Chasing Zero, was released and distributed gratis to hospitals everywhere. The producer: Chuck Denham.

And there’s more. The Journal of Patient Safety launched early in the safety field, co-sponsored by the National Patient Safety Foundation. To me, JPS has never been very good or particularly influential, and by all accounts it struggled to make ends meet. Then in 2011, I learned that it hadnamed a new editor. You guessed it: Denham. The change had been made so precipitously that the NPSF, a founding sponsor, claimed it had been blindsided and removed its sponsorship in protest. I looked back to see whether Denham’s pedigree could justify his being named the editor of an academic journal. A PubMed search revealed that, before 2009, he had not had a single first-author publication in a 20-year career. Since then he has had 12, 11 of them in JPS.

Which brings us to the National Quality Forum. The NQF was founded in 1999 to vet and endorse quality measures. After the safety field launched, NQF added several safety-related products, most famously an NQF-endorsed list of “safe practices” and another of “serious reportable events,” the latter more commonly known as the “never events” list. Two individuals shared the job of chairing the NQF Safe Practices committee. One, Gregg Meyer, is a respected academician and safety leader, whose career has included stints at AHRQ, Mass General, and now Dartmouth. The other: Chuck Denham.

All of this is preamble to the announcement earlier this month that the U.S. Department of Justice had fined CareFusion, a manufacturer of safety-related products (market cap: $8.5 billion), $40 million for having given Chuck Denham’s company $11.6 million to try to influence the NQF’s endorsement of safety practices. It should be noted that, although Denham is specifically named in the Justice Department documents, no formal charges have been filed against him and both he and his attorney have denied that the payments were kickbacks designed to manipulate the NQF process. Denham’s statement, in which he calls the allegations “blatantly false,” is here.

The picture has become clearer with reports from several NQF insiders that Denham lobbied the Safe Practices committee to insert a new recommendation to “use chlorhexidine gluconate 2% and isopropyl alcohol solution as skin antiseptic preparation…” (Safe Practice 22). Though committee members did not realize it at the time, such specificity would have been a home run for CareFusion, since its product ChloraPrep was the only one on the market containing that formulation. In addition, Denham changed a previous general recommendation to use chlorhexidine to prevent central line-associated blood stream infections (CLABSI, Safe Practice 21) into one that specified the ChloraPrep formulation. Several committee members, including Pronovost and Patrick Romano of UC Davis, have described being completely unaware of Denham’s CareFusion relationship. In the case of Safe Practice 22, the NQF meeting transcript, posted by ProPublica, shows Denham twice referencing a still-unpublished New England Journal of Medicine article that touted the effectiveness of the 2% formulation.

This is troubling on several levels. First, questions have been raised about potential conflicts in theNEJM article, since all of the study’s investigators received funding from Cardinal Health, CareFusion’s parent company. Second, there was no evidence, then and now, that the 2% formulation works any better than other chlorhexidine formulations. Finally, how did Denham, who was not an author, gain access to the NEJM findings prior to the paper’s publication?

Equally concerning, the NQF has also acknowledged that much of the staff work for the Safe Practices committee was supplied, gratis, by Denham’s company, Health Care Concepts. Denham was removed from his NQF position after concerns were raised by both staff and committee members, and a competitor, 3M Health Care, objected to the specific recommendation of the CareFusion product in the draft of Safe Practice 22. An ad hoc committee quickly convened by NQF reviewed the 2% recommendation and voted to replace it with a more generic one, which is what appeared in the final report. On the other hand, according to Romano, the 2% recommendation for CLABSI was not discussed in committee meetings, yet it did appear in the final report for Safe Practice 21. Moreover, Denham hosted webinars, under the NQF banner, that cited the CareFusion product as the one endorsed by NQF.

Several recent articles (in Modern Healthcare, WBUR’s CommonHealth blog, and ProPublica) have described the relationships between Denham’s companies and NQF in more detail; the chronology is well summarized by Roy Poses on his Health Care Renewal blog. Despite Denham’s protestation, I can’t come up with any other interpretation than that he was being paid by at least one company (CareFusion) to infiltrate at least one (NQF) and potentially other patient safety organizations (he also chaired an influential committee of the Leapfrog Group – he resigned from it earlier today – and has collaborated with the World Health Organization) and influence their work on behalf of corporate sponsors, while withholding information about these corporate links.

And CareFusion was far from TMIT’s only corporate partner. Here’s another, from TMIT’s website: “The documentary Surfing the Healthcare Tsunami: Bring Your Best Board was partially funded by General Electric Corporation and the Denham Family Fund with some in-kind support by HCC Corporation, an affiliate of TMIT that is a contractor to General Electric.” Interesting.

The NQF, whose CEO is now Dr. Chris Cassel, who was CEO at ABIM when I was board chair last year, has approached this scandal as a mortal threat, which of course it is. Cassel is relatively new to the NQF (Denham was long gone by the time she assumed her role) and she and her senior staff are in crisis mode, pledging to review all of the Safe Practices and to markedly strengthen their conflict-of-interest policies. Cassel is not mincing words when she describes Denham: “He clearly lied,” she told Marshall Allen of ProPublica. “He just didn’t say anything about any of his business relationships.” According to the NQF, Denham was asked on several occasions about potential conflicts and never mentioned the multi-million dollar CareFusion contract.

It’s hard to protect our institutions completely against a lie. But in retrospect, all sorts of alarm bells should have gone off when it came to Chuck Denham. Who was this person, who seemingly came out of nowhere to a position atop the patient safety universe? Where did his resources come from? Why was he lobbying NQF for a particular product? Why was his company willing to donate what must have been hundreds of thousands of dollars of in-kind services to NQF? (According to ProPublica and confirmed by NQF, TMIT staffers conducted NQF evidence reviews and produced multimedia presentations on the Safe Practices.) “It was all a bit of a mystery to us that Chuck Denham was so generous with his time and his staff time to support this process,” Patrick Romano told ProPublica.

And I can’t help but wonder: What was the process by which the Journal of Patient Safety became yet another Denham franchise. To its credit, the journal has reportedly released Denham and installed the highly respected David Bates of Harvard as interim editor (he was associate editor). But the journal needs to go further, describing any financial relationship that might have existed between it and Denham or his companies.

What are the lessons from this sorry affair? For me, a personal one is to trust my spidey-sense: when something seems odd, nearly inexplicable, perhaps things really are not right. In Denham’s case, there’s a related lesson, reminiscent of a saying one frequently hears in Silicon Valley: if a product is being given to you for free, then there’s a good chance that you are the product.

Organizations like the NQF must have potent conflict-of-interest policies and enforce them strenuously. Though others may disagree, I don’t believe that individuals participating in such organizations need have absolutely no corporate ties – we’ll lose too many good people, and academic-industry partnerships can be good for patient safety. But these relationships have to be transparent and well structured. This means that the disclosure process must be rigorous and strictly enforced. Conflicts should be presented at the start of every committee meeting, and the culture has to be one in which individuals with even close call relationships err on the side of recusal, and colleagues feel comfortable “speaking up” when they’re concerned about potential conflicts. Would this have caught the Denham issue earlier? I’m not sure. But we must try.

As care standards increasingly drive payment and public reporting policies, and as electronic health records allow us to “hard wire” certain practice standards and monitor them in real time, the stakes will grow ever larger. Brian Johnson, publisher of, told WBUR’s CommonHealth blog, “Large legal settlements involving kickback payments to doctors happen quite frequently. The Justice Department is very aggressive in prosecuting companies for kickbacks, off-label promotions, these types of alleged wrongdoings. This case is unique because in essence, it appears to be an attempt to influence an entire health care system by paying a key member of a very influential patient safety organization.” Such influence was never possible before. It is now.

This means that the fields of patient safety and quality are no longer sleepy mom-and-pop affairs fueled by the passion of a handful of true believers. There is now big money involved. “It’s an enormous business,” Pronovost told ProPublica’s Allen. “Hundreds of millions or billions of dollars are at stake, but our transparency procedures haven’t matured.” It is up to the field’s leaders to ensure that decisions are based on evidence, that our processes and structures are fair and transparent, and that individuals and organizations that violate the trust of our patients and clinicians are dealt with swiftly and sternly.

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Dishonest Company from Colombia


September 15, 2015 06:19

If you receive an inquiry from a company Teknopolis in Bogota Colombia beware because it is a scam. They inquire about 3M Littman Stethoscopes and ask to pay with credit cards and ship next day. The person who will contact you is Wiston Tobon. Below find the info:

carrera 30 # 19 – 38 local 155
tel 57301 5394674
whatsapp 57300 2923659
Bogota Colombia

Beware of these scammers!

Frank Bleischmidt

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The following post was discovered on as an advisory regarding some alleged dirty dealing regarding an PET/CT sale/purchase.   The original poster is iodentifieds at the end of this blog, if you wish further details.  Pat


August 01, 2015 12:44

John Gebhardt signed a contract and agreed to sell us a PET/CT for $335,000.

We sent him a $51,367 deposit in January of this year and he disappeared refusing to answer emails or return phone calls.

Not only has he not returned our deposit but he was trying to sell the same unit to other dealers.

Be careful of him and John, if you see this, please return our deposit.

Nationwide Imaging Services Inc

Robert Manetta, Manager
DOTmed user since November 2012

2301 Atlantic Avenue
Manasquan, NJ 08736 USA
Phone: +1 (732) 262-3115

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Dishonest Company – Industry Alert – SPT Medical Equipment

from ICE (

 We wish to inform all of our colleagues in the medical imaging equipment industry of scammers that we recently encountered, who are specifically targeting buyers of medical equipment. The company is called SPT Medical Equipment from Helsinki, Finland, and the contact we communicated with went under the name Henri Kapanen. This company is skilled at looking legit. They were able to provide us photos of the equipment (in this case, a Siemens Emotion CT scanner) that matched the description, and they gave full specifications as would be expected from someone selling an actual system. Be aware, however, that this company will steal your deposit and suddenly become impossible to contact. The equipment never shows up.
  • We have since learned that these people may operate under different names and websites, appearing to be from different countries. These include,,,, and possibly others. Notice the similarity between these websites, the images, and the content. Some of our information suggests that the individuals responsible may actually be from Russia.

    How do you avoid scammers like this? Always know who you’re dealing with. Ask for and check for reputable industry references. Whenever possible, physically inspect the equipment, and look for any signs that the vendor may be trying to avoid allowing an inspection. (In our case, they told us the equipment was already crated and in a facility where inspection was not possible. This is a major red flag.) Always get good pictures and details, and check that the pictures are consistent. (We have seen other brokers actually send marketing or promotional pictures for equipment, claiming them to be the actual equipment being sold. Some people send images they found on the internet.) Verify that the vendor is a member in good standing of well-known industry communities that check member credentials, such as DOTMed or IAMERS. If they are not, contact these organizations and ask if they are aware of any reasons to be concerned.

    Those of us well grounded in this industry hold it very dear, and it is our responsibility to uphold integrity and to keep dishonest people like this from conducting their immoral form of “business.” Thanks for your attention, and please spread the word!

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BEWARE of the Laser Outlet, Mr. Sam Lehrer

reposted from DotMed forums . . .

BEWARE of the Laser Outlet, Mr. Sam Lehrer

November 02, 2011 05:40

by Thomas Karrs

Pre-owned Laser buyers Beware of the Laser Outlet.

Mr. Sam Lehrer is not to be trusted. Our sales agreement, dated 15 Dec 2009, has yet to be completed. Our office was in the market for a Palomar laser system, but we felt a new system was more than we could afford. After speaking with Mr. Lehrer, he persuaded me that his business could provide a laser system, with a variety of hand pieces and equipment maintenance for a very good price. The purchase order was completed and we mailed the check to his office. Mr. Lehrer insisted that we mail the check before he shipped the Palomar system. We requested delivery before the end of the calendar year, and he assured us that would not be a problem. Mr. Lehrer spoke about the delivery with my office manager. The 300 Palomar base system was delivered 6 weeks late, without our hand pieces. The hand pieces that accompanied our shipment were for another office in Texas. We received the LuxRS two months late and the LuxG was delivered four months late. The LuxG was nonfunctional in a few weeks. We returned the hand piece several times for Mr. Lehrer’s office to fix, it never happened. In fact, Sam was so unethical; he offered to resell the broken hand piece to another buyer and afterward we declined, he proposed to sell us another LuxG hand piece for an additional fee! We are over two years removed from the dated purchase order and no sign of the third hand piece. The 1540 has yet to show up at our doorstep. There was yet another laughable attempt to re-sell us a 1540 at a “very fair price!” Fair? Fair would be for this company to provide us with the products and services we agreed to purchase! We feel that we have been more than patient with Mr. Lehrer’s office. Mr. Lehrer’s office has not made a single attempt to contact us in any regard about our purchase order. We have contacted the Better Business Bureau, Florida Attorney General’s Office and Florida Commerce Department. Now Mr. Lehrer has the audacity to inform everyone that we owe him $600.
As a member of the AAD, I feel that it is my responsibility to inform and warn all my colleagues that Mr. Lehrer is an unscrupulous businessman who gives all used medical equipment businesses a bad name. He is a skilled sales man and will promise you the moon, but beware, his guarantee are meaningless and in my opinion his company is nothing less than a scam.

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