It’s almost unthinkable.

A doctor cutting open patients, fiddling around just enough to make it seem like a surgery is happening, and then sewing them back up without addressing the problem. This isn’t a placebo surgery experiment. This is what attorneys in multiple lawsuits and now the New York Office of Professional Medical Conduct have accused Dr. Spyros Panos of doing.

Malpractice lawsuits against the orthopedic surgeon, which now have been filed by more than 250 plaintiffs, caught the attention of Sarah Bradshaw at the Poughkeepsie Journal. The Journal is a local, Gannett-owned paper, and a lean operation. So lean that Bradshaw doesn’t just do great investigative pieces, she also writes the occasional traffic story.

Often doctors behaving badly can get away with it for a while and then get caught without bringing anyone else down with them. In this instance, we may see more heads roll. Dr. Arthur Caplan talked about the case to Good Morning America, which followed Bradshaw’s stories and reported on Panos being forced to surrender his license last week. Note that GMA called him “Caplin,” and I’ve inserted the correct spelling of his name in the quote below.

Arthur [Caplan], the director of medical ethics at NYU Langone Medical Center and a former non-MD representative with the New York State medical licensing board, said he also found it troubling that others besides Panos aren't under investigation. "You can't perform this many suspect surgeries without the cooperation of many other people," he said.

That’s exactly right. Bradshaw’s reporting points to a list of possible organizations and individuals who, in a perfect world, would be under scrutiny right now.

Mid Hudson Medical Group. Panos was a part of this physicians’ group until July 2011 when he was shoved out. He also had served on the group’s board of directors. The group wouldn’t tell Bradshaw much for a piece she wrote in September 2011.

Mid Hudson Medical Group President Joseph Garvey said Panos was "terminated from our group for not meeting our professional standards.

"We expect all of our physicians to meet the highest standards of integrity," he said. Garvey said the decision to terminate Panos was made by the group's board of directors and was effective in July. He wouldn't say specifically how Panos stopped meeting the groups' standards, but he added, "We became aware of this over the early part of this year."

This could be the case of a doctors’ group doing the right thing, and they could all be heralded as heroes in this affair as the legal cases proceed. But it also could be that members of the group knew a lot more than they are letting on. And earlier. No doubt the legal proceedings will reveal more.

The Hudson Valley Center at Saint Francis LLC. Panos performed some of his surgeries here. And, as a result, plaintiffs sued the center along with Panos. But in May 2013, the center dissolved itself, at least complicating the legal process if not absolving the doctors and the hospital that ran the center. Bradshaw wrote:

It’s unclear how the change in the center’s ownership may impact the pending litigation against the Hudson Valley Center. Court records show the corporation is named as a co-defendant in many of the about 250 lawsuits involving orthopedic surgeon Dr. Spyros Panos, who is accused of malpractice. … One immediate effect on the Panos’ lawsuits was reported to the Journal by a Queens attorney representing dozens of Panos’ former patients. J.T. Wisell said one of his process servers tried to serve the Hudson Valley Center with legal documents Tuesday, but was informed the center was out of business.

I’ll offer more examples of organizations who may be caught in the phantom surgery dragnet in my next post.

Image by Salim Fadhley via Flickr