When his eyesight became clouded by cataracts in 2013, 80-year-old Miguel Diaz of Miami Beach turned for help to the company he has trusted for years to provide his healthcare: Leon Medical Centers, one of South Florida’s most popular Medicare clinics.
The company, with seven clinics in Miami-Dade County staffed by doctors, dentists, optometrists, pharmacists and other providers, quickly set in motion the extensive healthcare machinery that is central to its appeal — dozens of medical services available under one roof.
In short order, Diaz said, Leon Medical Centers scheduled a visit with the ophthalmologist, arranged for cataract surgery and took charge of his post-operative care.
But when the ophthalmologist blinded Diaz in his right eye — as Diaz claimed in a lawsuit filed in Miami-Dade Circuit Court — Leon Medical Centers disavowed the doctor’s work, saying he was an independent contractor and not a staff physician, so they weren’t at fault.
A Miami jury disagreed. On Aug. 31, jurors found that even though Leon Medical Centers had the ophthalmologist, Dr. Jonathan Leon-Rosen, on contract, the company had acted as though he were an employee. The verdict: $13 million for Diaz and his wife, Esther, 70.
Diaz is not the only Leon Medical Centers member suing the clinics for a botched cataract surgery by the same ophthalmologist. Thirteen others also have filed lawsuits in Miami-Dade claiming they lost sight or were blinded by Leon-Rosen.
Leon-Rosen could not be reached for comment. His attorney, John Mauro of Fort Lauderdale, did not respond to messages from the Miami Herald.
Miami-Dade Circuit Judge Peter Lopez has ordered separate trials for each patient’s claim. Diaz’s case was the first, with the next scheduled in November.
Seated in the Coral Gables office of his attorney the day after the verdict, Miguel Diaz was mostly quiet as his wife and their daughter, Maria Febres, explained what happened to him.
“My life has changed a lot,” he said softly. “I have to have my family and friends to help.”
Esther Diaz is blunt.
“They ruined his life,” she said. “He was supposed to see the next day when they removed the bandage. … Now, he can’t walk. He loses his balance. He can’t drive.”
They ruined his life.
Esther Diaz, whose husband was blinded during cataract surgery
After his surgery, Diaz filed a medical malpractice lawsuit against Leon Medical Centers and Leon-Rosen (no relation to the clinics), the ophthalmology practice group, South Florida Eye Associates, and the center where his cataract operation was performed, the Coral Gables Surgery Center.
Diaz settled with Leon-Rosen, the ophthalmology practice and the surgical center in 2015 — but not with Leon Medical Centers, forcing a trial.
The jury found that Leon Medical Centers was not negligent, but that the doctor was an apparent agent of the clinics — making Leon Medical Centers liable for Diaz’s injury.
Jurors assigned Leon Medical Centers 80 percent of the liability with the remaining 20 percent divided equally between the surgery center and the ophthalmology practice.
But unless the judge changes the amount of the jury’s award, Leon Medical Centers is on the hook for the whole $13 million because the court determined that the clinics will not get a reduction for the negligence of the surgical center and the ophthalmology practice.
Leon Medical Centers refused an interview request but said in a written statement that the company will appeal the verdict, and added: “While we are pleased that the jury correctly concluded that there was no negligence on the part of Leon Medical Centers, we are disappointed that the effect of their decision is to hold Leon Medical Centers liable for the actions of an independently contracted ophthalmologist group. Furthermore, Leon medical Centers is committed to facilitating its patients’ access to its independent healthcare specialists and in doing so, it is in no way misleading its patients.”
Attorney Gary Friedman, who represents Diaz and 13 other patients who are suing, said Leon-Rosen no longer works for Leon Medical Centers. The doctor’s license and profile posted online by the Florida Department of Health makes no mention of the patients he allegedly injured.
State insurance filings show that medical malpractice carriers have paid $750,000 on Leon-Rosen’s behalf to settle 19 different claims from patients who had cataract surgery on two dates in 2013: Sept. 3 and Sept. 10.
Miguel Diaz had cataract surgery on Sept. 10 that year. And though he experienced intense pain in his eye after the surgery, Esther Diaz said, he did not realize how badly things had gone until days later when, seated in Leon-Rosen’s waiting room, the couple overheard other patients discussing a “rumor” that the ophthalmologists’ patients were going blind.
When they confronted Leon-Rosen in the examination room, Esther Diaz told the Miami Herald, the doctor told them he had injected an antibiotic called Gentamicin into Miguel Diaz’s right eye. Then he wouldn’t say anything more, she said.
According to the Diazes’ lawsuit, Leon-Rosen typically injected an antibiotic called Gills solution into his patients’ eyes after cataract surgery. But after being told that he could no longer use the medication, the lawsuit said, Leon-Rosen switched to Gentamicin, which was supposed to be applied topically on the surface of the eye.
Instead, the lawsuit said, Leon-Rosen used the wrong type of Gentamicin and injected the antibiotic into his patients’ eyes — contrary to the prescribed topical use.
Diaz’s daughter, Maria Febres, said Leon Medical Centers should have known that Leon-Rosen was hurting patients before he operated on her father.
He performed cataract surgery on 16 Leon Medical Centers members on Sept. 3, 2013, injuring at least nine of them, according to the lawsuit. A week later, on Sept. 10, Leon-Rosen performed cataract surgery on another 22 members, injuring at least five including Miguel Diaz, the lawsuit said.
Though the lawsuit alleged that Leon-Rosen caused his patients’ injuries, Friedman said Leon Medical Centers’ liability in the Diaz case hinged on a broader question common to all the claims: Was the doctor operating as an “apparent agent” of the clinics?
“People were blinded, and Leon [medical centers] says ‘But we have a contract stating that he’s an independent contractor,’” he said. “Florida law says that if you, as a principal, by your words or conduct allow people to think that the person doing the service actually works for the principal, we’re going to hold you responsible.”
Friedman said Leon Medical Centers employs some doctors on staff but pays others, mostly specialists, through what he called “a secret contract” that was never disclosed to the Diazes or any of the other members prior to their eye injuries.
“Leon [medical centers] doesn’t tell anybody that,” he said.
When the Diazes met their ophthalmologist, Esther Diaz said, the doctor wore a white lab coat embroidered with the Leon Medical Centers logo and an ID badge with the same insignia. The clinics also advertised that they employed a network of specialists, Friedman said.
1.8 Million Floridians enrolled in a Medicare Advantage plan
The Diazes, Cuban immigrants who moved to South Florida in 1973, always used the Leon Medical Centers clinic in Little Havana.
Like most of the estimated 38,000 members enrolled in Leon Medical Centers Health Plans — a privately managed Medicare insurer owned by Cigna Corp. — the Diazes received most of their care exclusively at one of the seven centers in Miami-Dade, which are owned by the Leon family of Miami.
The plan and clinics have a reputation for pampering members with complimentary bus rides to the medical centers, where they are greeted by white-gloved doormen and treated to culturally attuned amenities, such as Cuban coffee and guava pastries in an elegantly appointed lobby.
Those services help set Leon Medical Centers apart in the highly-lucrative and super-competitive world of South Florida’s privately managed Medicare plans, or Medicare Advantage. Of the estimated 4.1 million Floridians eligible for Medicare in August, nearly half or more than 1.8 million were enrolled in a Medicare Advantage plan, according to federal enrollment data.
For the Diazes, the benefits of Medicare Advantage are precisely what Leon Medical Centers had advertised: access to doctors and specialists, all under one roof, with the benefit of a culturally sensitive environment.
That’s why they’re still enrolled in the insurance program.
“I thought of changing,” Esther Diaz said, “but it’s very difficult. He gets very perturbed, depressed when he changes. He needs routine.”
Besides, she added, Miguel Diaz still trusts his doctors.