Another week of testimony in the ongoing trial for Dr. Jorge Zamora Quezada concluded Friday with more former patients testifying about their experience with him.
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.
Marsha Renee Pittman, from Hondo, testified that she saw Zamora Quezada at his San Antonio clinic in 2014.
She was referred to Zamora by her primary care physician in Hondo.
Her visit with Zamora Quezada, Pittman said, lasted about 15 minutes during which he checked her knees and joints.
Although, Pittman said Zamora Quezada never told her he diagnosed her with rheumatoid arthritis, he prescribed her three medications and told her she needed knee injections of methotrexate on a weekly basis. However, she stopped taking the injections after the fourth time because she didn’t feel they were helping.
She also stopped going to his clinic altogether because she didn’t feel like he was doing anything for her and thought it was a waste time, especially considering the drive from her home in Hondo to San Antonio.
Pittman said she still experiences pain today but that no other physician had diagnosed her with rheumatoid arthritis.
However, on cross examination by the Zamora Quezada’s defense attorney, Trey Martinez, showed Pittman her medical records from her visits to the Medical Clinic of Castroville — from 2017 to 2019 — which reflected that she was diagnosed with rheumatoid arthritis,
Pittman, though, said she was never told that she had rheumatoid arthritis.
“I guess I have rheumatoid arthritis, I don’t know,” she said.
On redirect questioning by the attorney for the U.S. government, Cynthia Villanueva, Pittman said she didn’t know who verified her medical records and reiterated that she didn’t recall ever being told she has rheumatoid arthritis, is not currently being treated for it, and is not taking medication for it.
Another of Zamora Quezada’s former patients, Jamie Parchman, testified that she saw him from 2011 to 2013, prompted by her general practitioner who was concerned she might have psoriatic arthritis.
She said Zamora Quezada diagnosed her with rheumatoid arthritis but no other doctor had ever diagnosed her with it before and said that she has since been told that she didn’t have the disease.
Parchman said Zamora Quezada began treatment right away and she began taking methotrexate injections once a week and would also receive infusion treatments.
She testified that she stopped going to see Zamora Quezada after he brought out X-rays that were labeled as belonging to her but which she knew weren’t hers at all.
She she said that she didn’t get a chance to have X-rays done so she knew the X-rays that he had shown her couldn’t possibly by hers.
“I got terrified,” she said. “I waited until he was done and I walked out.”
She got herself off the medication and never returned.
Parchman later began to see another rheumatologist in Brownsville who told her she didn’t have rheumatoid arthritis.
She has been seeing that rheumatologist for six years and continues to do so for her osteoarthritis and for her psoriasis.
Another doctor, a dermatologist, diagnosed her with psoriatic arthritis for which she started taking methotrexate but then switched to pills.
On cross-examination, the defense showed her medical records of her visits with a doctor she saw before she ever went to see Zamora Quezada which listed her symptoms as pain in her feet, both shoulders, hands, and knees.
However, Parchman said that was incorrect and said she hadn’t reported that with that doctor.
Similar symptoms were shown on records for her visits to Zamora Quezada and her visits with her current rheumatologist. She disputed the accuracy of those records and noted that part of the writing on the records from Zamora Quezada’s office didn’t match her handwriting.
On Friday, the jury also heard from a Brownsville-based rheumatologist, Dr. Muhammad Shamin.
Shamim attended medical school in Pakistan but moved to the U.S. in 1993. He then moved to the Rio Grande Valley in 2004 and currently works at the Brownsville Community Clinic.
Shamim said he sees patients with rheumatoid arthritis almost every day at his clinic and emphasized the importance of physically examining the patient because labs alone are not helpful for a diagnosis.
He testified that it very rarely goes into remission without treatment and said that true joint-space narrowing never goes away.
When it came to a patient he saw in 2015 who had been previously diagnosed by Zamora Quezada with early rheumatoid arthritis, Shamim said his joint examination of her was negative and that her X-rays of her were also negative.
There was no joint space narrowing and no swelling and therefore concluded there was no evidence she had rheumatoid arthritis.
Upon questioning by the defense, Shamim said cases of early rheumatoid arthritis can be difficult because blood tests may only be positive about 50% of the time as opposed to established rheumatoid arthritis which are positive about 80% of the time.
When he tested the patient, he saw nothing, but Shamim acknowledged that with early rheumatoid arthritis there is a chance of chaining the course of the disease by treating it early.
It’s a fine balance between early treatment an over treatment, he said.
The government is expected to call on more witnesses when the trial resumes next next.