Annals of vascular surgery
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The objective of this review is to provide surgeons basic knowledge regarding the Anti-kickback Statute (AKBS) and safe harbors available for legitimate business activities. The rising costs associated with fraudulent activities have led Congress to demand accountability, fiscal responsibility, and reduction of error rates. To deter and prosecute fraud and abuse, the government currently has available an array of civil and criminal remedies, supported by a number of statutes, investigated by multiple agencies and enforced by the Department of Justice. ⋯ This law makes it a crime to exchange any remuneration for patient referrals. Congress has also issued 23 "safe harbors", which are activities that are protected from prosecution and allow physicians to participate, invest, recruit, joint venture, and refer patients under certain conditions. It is necessary for surgeons to have some knowledge of the AKBS, as well as the various safe harbors provided by the legislature, for lawful business relationships.
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The objective of this study was to review the diagnosis, management, and outcome of the rare iatrogenic arterial injury associated with elective orthopedic joint procedures. A retrospective review was conducted of all patients presenting to the vascular surgery service with arterial injury after elective orthopedic procedures between 1997 and 2002. Clinical records were reviewed for presentation, type of injury, management, and outcome. ⋯ There was one death from septic shock and there were three limb losses (14%). Arterial injury associated with elective orthopedic joint surgery is more common during redoprocedures and in patients with preexisting atherosclerosis. Despite arterial repair/bypass, limb morbidity is common and related to preexisting occlusive disease or extent of arterial thrombosis.