TOLEDO, Ohio — A class-action lawsuit in the Lucas County Court of Common Pleas alleges a pattern of over-billing by the Toledo Clinic.

The claim, which was reviewed by WTOL, said the clinic billed patients for full doses of Botox, while they actually received far less.

The 20-page filing said two doctors, who treated patients with Botox for migraines, didn't use the recommended amount and then charged for more than that amount.

"The patients, including Ms. Schramm, were billed for the full amount of a vial of Botox, but they didn't actually receive the full amount they were billed for," said Carasusana Wall, a partner at Zoll & Kranz, the law firm that filed the suit. "In fact, they didn't receive the amount that was recommended for the treatment of their migraines."

The FDA recommends 155 units of Botox per migraine treatment. 200 units come in one vial.

"Our investigation reveals that they were receiving less than the 155 units, even," Wall said.

Carasusana Wall

The suit also claimed the remaining Botox in each used vial was occasionally reused on someone else.

The Toledo Clinic declined WTOL's request for an on-camera interview, but released the following statement:

"A class action lawsuit has been filed against the Toledo Clinic regarding the administration of Botox by two neurologists no longer associated with the Toledo Clinic. 

"Toledo Clinic compliance officers directed an audit of the Botox administered by all Toledo Clinic-employed providers. In that audit, the Toledo Clinic discovered irregularities with the Botox billing practices of Dr. Mamon Maiteh and Dr. James Auberle and determined that it was possible that some number of their patients had received less than the manufacturer recommended dosage of that medication.

"As a result of its investigation and audit, the Toledo Clinic terminated the employment of Dr. Maiteh and Dr. Auberle, made a full disclosure to the federal government, and began the process of returning the applicable payments to third-party payors and patients. The Toledo Clinic also sent a letter advising patients of the potential dosage issue, apologizing for the need to raise the concern with them, and offering a free evaluation of their clinical status relating to the Botox in an effort to coordinate their on-going care. All of these independent actions were taken by the Toledo Clinic because it was the right thing to do and without any prior knowledge of the now pending lawsuit. The Toledo Clinic did not knowingly participate in any wrongful conduct by Dr. Maiteh or Dr. Auberle.

"As a result of the filing of the lawsuit, the Toledo Clinic will not be in the position to comment further on these important matters."

But Wall said it goes much deeper than reimbursements.

"There's honesty that's required and you can't tell someone that you are using or charging them for something, and then actually doing something else with it," she said.

The class-action lawsuit could take quite some time to wind its way through the courts. It will take at least several months but quite possibly several years.

DOCUMENT | Complaint filed