Rheumatologist, former patient testify in healthcare fraud trial

McALLEN — Testimony in the trial for Dr. Jorge Zamora Quezada, the rheumatologist accused of healthcare fraud, resumed Monday with a local rheumatologist taking the witness stand to discuss her practices and experience with one of Zamora Quezada’s former patients.

Angela Christensen, a rheumatologist with Doctors Hospital at Renaissance, said when she first sees a patient, she spends at least 20 minutes taking a patient’s history and then proceeds to administer a physical exam in contrast from previous testimony from a former employee that Zamora Quezada would spend as little as five to ten minutes with patients.

Zamora Quezada, a rheumatologist is currently on trial for allegations that he participated in a scheme to defraud health insurers by misdiagnosing and over-treating patients.

Co-defendants in the case are his wife, Meisy Zamora, and two of their employees, Estella Santos Natera and Felix Ramos. They are accused of also participating in the scheme which allegedly included tampering with medical records and money laundering to conceal the source of the funds they made from the alleged scheme.

When looking for signs of rheumatoid arthritis, Christensen noted that a patient experiences not just pain but also swelling in the joints as well. When asked about methotrexate, the drug that Zamora Quezada’s patients testified he had prescribed them, Christensen said she wouldn’t prescribe it on the first visit without the results of their blood work because the test results can affect the dosage. She also noted the side effects of methotrexate and said it could be harmful to patients who don’t need it.

Christensen said she had seen about 200 of Zamora Quezada’s former patients, including Sylvia Carrillo, who also testified on Monday. Carrillo had previously been diagnosed with Lupus by doctors she had seen in California.

When she saw Zamora Quezada, he diagnosed her with rheumatoid arthritis and fibromyalgia. However, she wanted a second opinion, so she went to see Christensen in March 2018.

During that visit, Carrillo denied experiencing pain in her hands and said at the time she was not experiencing stiffness in the morning.

Carrillo did have a sister who might have had rheumatoid arthritis, Christensen said, but it was not a definitive diagnosis.

Christensen added that during her physical examination of Carrillo, there was no tenderness or swelling and nothing in her physical exam suggested rheumatoid arthritis.

She asked Carrillo to return to do another physical exam, which still showed no swelling or tenderness. Christensen said she concluded a low suspicion of rheumatoid arthritis and recommended that Carrillo stop taking medication she had been prescribed by Zamora Quezada.

The physician testified she is fairly certain Carillo did not have R.A.

When Carrillo testified, she said Zamora Quezada diagnosed her with rheumatoid arthritis, lupus, and fibromyalgia after her first visit to his Edinburg clinic in November 2017. She was prescribed methotrexate which she was administered on a weekly basis but said that after a month of taking it, she began to feel worse.

Approximately around February 2018, she stopped taking the medication because she was going to have surgery to have her gallbladder removed.

The next month, around the time she first went to see Christensen, she returned to Zamora Quezada’s clinics but was seen by another doctor, Dr. Fulgencio Salinas.

During that visit with Salinas, Carrillo testified that Salinas told her she didn’t have Lupus, fibromyalgia, or rheumatoid arthritis and that he said the medication she was taking was preventative.

That was the last time she went to Zamora Quezada’s clinic.

Carrillo said since her last visit with Christensen in April 2018, she hadn’t seen another rheumatologist. She said she is currently not taking any medication for rheumatoid arthritis and hasn’t been experiencing any pain.

Upon cross examination from Zamora Quezada’s defense, Carrillo acknowledged that her medical records from California showed she was experiencing symptoms that were associated with rheumatoid arthritis at the time of those visits, before she ever met with Zamora Quezada.

Those California records also showed that she was administered methotrexate in 2017, also before she saw Zamora Quezada.

The defense also noted that when Carrillo had applied for disability benefits in California, Salinas, the physician from Zamora Quezada’s clinic who Carrillo had said told her she didn’t have rheumatoid arthritis, signed off on the application for disability benefits that stated she did have the disease.

Carrillo, however, noted that was before her final visit with him in March 2018 when he told her she didn’t have the disease.

On re-direct examination by the attorney for the government, they noted that her medical records showed she had no swelling  in her joints before going to Zamora Quezada and she had no swelling after going to Zamora Quezada.

His records were the only ones that indicated she experienced swelling in her joints.

Testimony in the trial is expected to continue Tuesday morning.

bereniceg@themonitor.com