Thursday, June 28, 2012

NJ Spine: The Hotbed of Misconduct

Since the inaugural launch of The SpineBlogger in February of 2009, occasionally we receive e-mails from unnamed sources looking to either promote a business, a practice or even look for medical advice. As has been our policy from Day 1, we have attempted to keep our blog unadultered or free from commercial interests.  Interestingly over time we had been inundated with e-mails promoting the humanitarian efforts of one Dr. Richard Kaul of the NJ Spine and Rehab Center located in Pompton Lakes, New Jersey.  Kaul's publicist would send us e-mails promoting the good doctor's involvement with something known as The Spine Africa Project. 

Well if its publicity that he wants, it is publicity that he shall get.  On June 14th, 2012 the New Jersey State Board of Medical Examiners voted 11-1 (TSB wants to know the name of the "1") to temporarily suspend the license of Dr. Kaul, an ANESTHESIOLOGIST, for performing spinal surgeries without proper training stating that his actions, "put the public at risk."  The irony of the State's decision is that this is not the first time Dr. Kaul has faced disciplinary actions.  In 2003, the Board had prevented Dr. Kaul from practicing for six months for failing to disclose that a London, England jury had convicted him of negligent manslaughter in 2001.

The question must be asked of our readers, "what is an anesthesiologist doing performing cervical and lumbar fusions?" Where is the oversight that is supposed to be provided by the NJ Medical Society? Something is fundamentally wrong  when multiple patients accuse a physician of gross negligence, incompetence and malpractice.  Who would go to a one room surgical practice to have spine surgery?  Dr. Kaul has been lauded as a pioneer in MIS, supposedly performing over 500 procedures including many that no other physician has yet to attempt as quoted in his press release in the Common Good.  Have we lowered our standards, considering that a surgeon performing spine surgery must have an accepted standard of surgical training, experience, and education?  Based on Dr. Kaul's experience, a new precedent is being set whereby all one has to do is attend a hands-on cadaver training on MIS and become a member of the Spine Arthroplasty Society and you can anoint oneself a spine surgeon.

Don't believe TSB, read the complaint. What are we evolving into as a profession? Hucksters, Conmen? Impersonators? Not only have we become a shameless society, we rationalize that if we make money off of whatever it is that we do, it must be okay. Every individual has a right to a fair trial, yet after reading the allegations, there are no excuses for this type of behavior. TSB wants to know what our readers think?  How many of these types of deals do you see in your local areas?  The truth is that the medical community does a very poor job of policing its own living by the Omertà, that cultural code of silence, a non-cooperation with authorities and non-interference of illegal actions of others in the profession.

59 comments:

  1. http://www.nj.com/news/index.ssf/2012/05/nj_spinal_surgeon_previously_c.html

    Judging by the good doctor's comments on the link above its only a matter of time before Dr. Kaul personally defends each and every attack on this forum. LOL

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  2. I would love to know whose implants he was using. I wouldn't put myself in that type of situation no matter how many procedures this guy was doing. I feel bad for his patients!

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    Replies
    1. He was doing outpatient interbody spine fusions using off label products. Example of his use for implants often included over the years, Spineology OptiMesh for a percutaneous interbody implant, which is not approved and has been denied by the FDA for intra and interbody application after 7+ years of data submission.

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    2. Spineology was selling to this doctor knowing he was not a spine surgeon?

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    3. Spineology has a history of promoting,training, selling and recruiting non spine surgeons...Interventional Radiologists. They sponsor and work with IRs to speak at meeting like ASSR (radiology spine meeting) on outpatient spine fusion opportunities.

      They have dozens of non spine surgeons (typically Interventional radiologist) doing these procedures on a routine basis around the country.

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    4. And Spineology was paying him to train other non spine surgeons (IRs with no spine fellow training, etc...) nationally on how to do the procedure, set up the ASC accordingly and get coding approved with the insurance companies....

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    5. How has Spineology gotten away with this? As a spine rep I would refuse to sell to this guy and wouldn't be caught dead covering his cases. I wonder if Spineology is getting investigated for their involvement?

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    6. Any spine company that has a "per cutaneous" approach is marketing to IRs. If you go to the big IR meetings you will see all the facet fusion (bone dowel or screws), small percutaneous IBF companies (even spine wave) and others marketing to IRs. Its quite sad bit reality in many markets unknown to many.

      Ironically this guy, Dr Kaul was using Zimmer screws at one point so this is MUCH larger than small companies, everyone is a whore when sales are there and they can legitimize it by turning a blind eye.

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    7. Medtronic was happy to supply his implants. Medtronic likes the rules in New Jersey.

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    8. Will be interesting to see how these companies who provided the implants will respond to this. How do you know spineology was paying him?

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    9. Spineology was flying other IRs and non spine surgeons into his outpatient facilities to "learn" from him and paying him to do so...he was advocating some to partner up with retired general ortho surgeons for billing purposes. Spineology was paying him for these session, providing material to assist and flying the potential clients in and paying them for their time.

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    10. Why can't Optimesh get FDA approval?

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    11. The long story or short story. They actually have an approval after their "intrabody approval was rescinded" to main the relative position of a bone graft that does not impact the stability of the spine...or something close to that.
      1-they messed up on all their studies and data. That's what happens when a small company half asses an IDE...
      2- Dr K (creator and former CEO) was arrogantly confident with his knowledge of spine after the BAK and spine tech. Let's just say he rattled a few cages in the FDA before passing.....

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    12. OptiMesh has no predicate device to compare to. Despite being innovative and at times beneficial when used correctly, it offers a unique problem to the FDA.

      the "product" has no structural support. The company has a joint IP on the delivery system with the bone grafting material provided by MTF. In theory it is to provide the structural component. The bone graft is essentially a modified DBX crunch with cortical component which is already 510k cleared WITHOUT structural support. Its an endless game, as the company, Spineology, continually submits data showing equivalency to standard IBF products that provide structural support and the FDA denies as they have no product approved for structural support.

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    13. FDA issued a warning letter about the IDE study.

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  3. TSB can rejoice! The affordable care act and individual mandate ruled constitutional. Today: fixing healthcare by mandating that people buy buy insurance. Tomorrow: fixing homelessness by mandating that people buy a house.

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    Replies
    1. 8:09 - excellent analogy!

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  4. You can thank fraudulent banisters for homelessness and both parties for endorsing a chicken in every pot and a mortgage to tie you down, it's the American Dream

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  5. You can retire in Thailand for a fraction of what you would need here. Ahhhh, I can see myself now...laying under a cabana on Patong Beach in Phuket. Sipping a drink and eating some fruit while a beautiful Thai lady gives me a massage for a few Baht. No worries, no worries.... Oh wait, I've got to get back to the OR for a single-level ACDF. The wife took the kids shopping today and I gotta keep the grind going to support the bills. Plus, I really want that new beamer. Oh well, there's always that sweet dullness I'll feel tonight (like every night) after my first two vodka drinks.

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    Replies
    1. Does the massage come with a happy ending?

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  6. Was he doing Kyphoplasty, Dorsal Column Stimulators, Injections? I have heard of many Anesthesiologist doing these types of "Spine" procedures.

    @8:51 I am not sure about Thailand, but I weigh heavily on trading it all in for a hut in the keys!

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  7. Im in the NJ market...this guy is just skimming the surface with the unscrupulous dark side behavior that is Spine surgery in NJ. Dig deeper and find out how many Anesthesiologists are bringing in Spine surgeons to their own surgery centers, and then billing as first assist or co-surgeon. These pain guys are a joke doing these MILD procedures, assisting on ACDFS and MIS Tlifs. I'm hoping the rest is blown up and cleaned up for good

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    Replies
    1. Wow. Crazy! Is this happening in other parts of the country? dirty Jersey crooks

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    2. Organized Crime runs rampant in NJ especially in Surgi Centers

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    3. You are so so write .

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  8. My crystal ball says one thing xspineless is falling apart! Dan THE BROWN NOSED MAN and James I am a big talker are not the people to run a subway franchise let alone a spine company. Rumor is sales are decreasing faster than the number of Obama supporters. Kissing buttocks will only get you so far in life! Dr K…evorkian You messed up……

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    Replies
    1. How can that be? With the honorable Chris Girsch to help. Wait, two negative don't equal a positive?

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  9. Looks like a creepy bald fuck to me. his patients should be lining up to also sue the vendors that supplied this wacker with implants.

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    Replies
    1. you mean Medtronic. the NJ Medtronic reps liked him alot

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    2. The spineology reps liked him too.

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    3. NJ Medtronic reps will now have to find new business to replace the sales lost. What spine surgeons are willing to cover Kauls numbers?

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    4. You are spot on .This creep is a sociopath .Criminal .Commits Countless Insurance fraud .Heartless ,remorseless
      ,Its always someone else who's at fault ,never kaul .That's why England kicked his ass out .We should do the same ,start a petition to deport this quack .This is Ted Bundy that got his Medical License .

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  10. The creeper has no insurance to cover malpractice for spine surgery.

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    Replies
    1. Think about it for a moment and ask yourself "WHY"?

      If an insurance company won't write you a policy it's likely because you're UNQUALIFIED as in a quack.

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  11. Reading up on Kaul and his antics in anesthesia, spine, charities, real estate and marriage, one can only conclude he is one of the classic charlatans who seem naturally attracted to spine surgery.....

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  12. Maybe the "PR" guy was just doing his job. Very few people knew his qualifications until the news hit the press. Kaul got a substantial amount of press prior to headlines in May / June. Whoever did his PR did a solid job painting a positive picture of him.

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    Replies
    1. Funny....all of these "anonymous" posts. Probably all the same disgruntled patient who got him in trouble to begin with.

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    2. I was a patient of dr Kaul and when I was under his pain mng. Care I lost my ins. Coverage and he continued treating me free of charge for four and a half years he is not in it just for the money. Thank you ,chris

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  13. Wonderful blog & good post.Its really helpful for me, awaiting for more new post. Keep Blogging!













    Special Needs Care in New Jersey NJ

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  14. All anyone, who has a knowledge of the legal system ,needs to do is obtain any of many of KK (Killer Kauls) depositions .Kaul was doing Pain Management with out the proper training ,knowledge or education .And falsely Misrepresented his credentials .All while on Suspension / Probation .The few Depositions I read of KK,anyone could see (Not only Medical Professionals)that he had no knowledge of even a advanced degree of Anesthesiology .He is a sociopath with a medical license .let him keep practicing on the ill informed African's .Maybe that's why the NJMB did'nt take his license sooner .The Butcher of Pomton Lakes .

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  17. Dr. Kaul, although I don't now if I can still call him Dr. As the state of NJ went to court in may o gt his medical license taken away for good. It was supposed o take a short time, but Kauls attorneys were quitting on him one after the other out of fear they were no going to be paid. I know this as fact. Supposedly the trial may have just finally ended at the end of June or the. Start of July. Kaul has got a lot to answer fr,especially to people like me wgho he debilitated by giving me a real bad disease in my spine called rsd or crps. To this who don't know what that is go o the website www.rsdhope.org ,there yo will learn about this devestat ing disease, how it is almost twice as painful as cancer but will not kill you,just make you suffer as if you were just st onfr with the sensation o knives stabbing you at the same time, while it eats away at your joints and has eaten my shuler joints down o my knee. Again the entire thoracic region is in distress with the "fire" sensation accmand with too many other devastating effects. Again,how do I know this? I was a patient of Dr.kauls. Luckily for e at least, is he had insurance to cover the medical malpractice. Although no amount of money can ever give me my life back,and the suffering I will endure until the day I die. I am young,in my 30s ,and have a wife and 9 yr old son,that needs his daddy to teach him life, to love him, to try and hold him close. I cannot even be slightly touched n my back due to this crps, I has put a huge strain on us financially, as I only get disability, its also put a huge strain on my marriage, as we cannot even attempt to be intimate. I ambulate when I can with a walker, at my age,its motifying, b.umt I can hardly walk , I am pretty much bedbound, which is horrible, as I miss so many life events. I am a prisoner in pain in my own mind and body for 2yrsnow. Although as I said this will go on until the day I die, and being in my late 30s that's a lot of time to suffer 24 hours a day 7 a week. I get rushed to the hospital at least twice a month with such bad breakthrough pain, this when the pain cannot be under any control, even by my pain pump I had implanted. I hopevDr.Kaul gets what he deserves, as I, like a few others have NO QUALITY OF LIFE. I am just existing. I am far from depressed, I am MRE the type of person that keeps fighting. May God bless you all,and may you go forth and tell the story of what Dr. Kaul did to me.

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  18. Dr Robert Heary is the doctor in NJ who started the action against Dr Richard Kaul by apparently advising a patient to sue Dr Kaul. Despite being called as a witness, Dr Heary has failed to attend any court hearings and has even had a bench warrant issued for his arrest so that he will give testimony. Where is he? Why is he not prepared to back up his opinions in a public court? The following report could explain his reluctance.

    http://www.romingerlegal.com/new_jersey/supreme/a-100-00.opn.html

    The Court addresses the possible causes of action available to an injured party who claims that a physician misrepresented his credentials and experience at the time he obtained the claimant's consent to surgery.

    Joseph Howard came under the care of Dr. Robert Heary in February 1997 for neck pain and related claims. Howard had a history of cervical spine disease. Following a 1991 car accident, Howard was examined by doctors who determined that he had severe spinal stenosis and recommended that he undergo surgery, which Howard declined to do, even though the condition was worsening progressively.


    In January of 1997, Howard was involved in another car accident causing, among other things, a cervical and low back injuries. Howard sought the care of Dr. Boston Martin, who had treated him after the 1991 accident. Dr. Martin concluded that Howard=s spinal condittion had worsened significantly and recommended that he be seen at the University of Medicine and Dentistry of New Jersey (UMDNJ) by Dr. Heary, a Professor of Neurology and the Director of UMDNJ's Spine Center of New Jersey.


    Dr. Heary had two pre-operative consultations with Howard. In the first consultation, Dr. Heary determined that Mr. Howard needed surgery to correct a cervical myelopathy secondary to cervical stenosis and a significantly large C3-C4 disc herniation. Because of the serious nature of the surgery, Dr. Heary recommended that Mrs. Howard attend a second consultation. What transpired during that meeting is in dispute. Dr. Heary claims that he informed the Howards of the significant risks of the surgery, including paralysis. The Howards deny that they were informed of such risks. In addition, the Howards contend that Dr. Heary told them that he was Board Certified and that he had performed approximately sixty corpectomies each year in the past eleven years. Mrs. Howard claims that she was opposed to the surgery but that she and her husband decided to go through with it based on Dr. Heary=s specific claims of skill and experience. Dr. Heary denies that he represented that he was Board Certified in Neurosurgery and that he claimed to have performed sixty corpectomies per year for eleven years.


    Dr. Heary performed the surgical procedure on March 5, 1997, but it was unsuccessful. The Howards filed a malpractice action alleging that Mr. Howard was rendered a quadriplegic as a result of Dr. Heary's negligence. The Howards moved to amend their complaint to add a count of fraud based on Dr. Heary's alleged misrepresentation of his experience and credentials. The trial court denied the motion, finding that a fraud count would cloud the issues presented.


    The Appellate Division granted leave to appeal and reversed and remanded with the direction to the trial court to allow amendment of the complaint to allege a deceit-based claim. The Appellate Division held that the denial of the motion to amend the complaint violated the interests-of-justice standard. Further, the panel disagreed that the Howards would be required to prove negligent performance of the surgery in order to recover damages under the deceit-based claim. The Appellate Division likened the claim for fraudulent misrepresentation to a claim for battery, when a doctor, other than the one authorized under principles of informed consent, performs the surgery. In such circumstances, proof of negligent performance by the doctor would not be required.


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  19. Read this article which highlights the fact that not even the states main expert witness, DR GREG PRZYBYLSKI, is able to say what credentialling is needed for minimally invasive spine surgery.
    http://ryortho.com/2013/06/spine-on-trial/

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  20. This article gives a very good summary about the core issues surrounding the case against Dr. Richard Kaul. Please read and comment.

    http://www.sasiglobal.org/images/uploads/In_Jersey_No_Credentials_No_Problem.pdf

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  21. Dr Richard Kaul has filed a complaint against the doctors listed below. You can read all about the complaint he has lodged at http://americannewsreport.com/wp-content/uploads/2013/03/Complaint-3_18_13_KAUL.pdf.

    RICHARD A. KAUL, M.D.,
    Plaintiff,
    v.
    ROBERT F. HEARY, M.D., FRANK M.
    MOORE, M.D., PETER W. CARMEL, M.D.,
    GREGORY J. PRZYBYLSKI, M.D.,
    WILLIAM MITCHELL, M.D., JOHN DOES
    1-5, and ABC ASSOCIATIONS 1-5,
    Defendants.
    SUPERIOR COURT OF NEW JERSEY
    LAW DIVISION – BERGEN COUNTY

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  22. If you want to know exactly what has happened to Dr Richard Kaul please read the article in the Blot Magazine.Hopefully this will help explain some of the motives for the action taken against him.
    http://theblot.com/op-ed-dr-richard-kaul-death-doctor-or-medical-hero/

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  23. If you really want to know the truth about the Spine Turf Wars and what is happening to Dr Richard Kaul in New Jersey then read all all about it at http://drrichardkaul.com/releases/
    The information there will explain the actions that have been taken against him.

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  24. Read the complaint against Dr Greg Przybylski
    http://static.squarespace.com/static/51f13ae1e4b08aa4f3665b62/t/52127411e4b06d5f9d344192/1376941073733/08.06.13%20G.P.%20Complete%20Packet.pdf
    Iam writing to file a formal complaint against Gregory Przybylski, MD for grossly unprofessional and unethical conduct in the provision of knowingly false expert testimony in the matter of New Jersey V Richard Kaul, MD. Docket No: BDS 08959· 2012
    Gregory Przybylski, MD was retained by the New Jersey Board of Medical Examiners in September 2011 and rendered an expert report in which he made multiple false allegations about purported deviations from a standard of care that he subsequently admitted on cross examination did not exist The fact that he knew about the lack of any standard ofcare with regards to the education and training required for the performance of minimally invasive spine surgery became clearly evident on his cross examination.
    Gregory Przybylski, MD, as is clear from his attached CV, has for 15 years been actively involved in multiple professional societies and was the president of The North American Spine Society in 2011. There is therefore no question that he knows and understands the ethical and professional responsibilities ofan expert witness which makes his multiple and continued acts of fabricated testimony even more egregious. His grossly misleading statements to the court, regarding the purported deviations from a standard ofcare that he knew did not exist and had it not been for a probing cross-examination would never have been exposed. He had a duty as an expert witness to provide truthful testimony not subject to influence from either the New Jersey Attorney General or his own professional rivalries and as his cross examination clearly demonstrates he was, at the very least, grossly negligent in that duty but more likely willfully dishonest.
    I have attached an article published in Orthopedics This Week in which the senior writer, Walter Eisner, independently observed the cross examination of Dr. Przybylski, during which he admitted the lack of any standard of care with regards to the performance of minimally invasive spine surgery which complete contradicted all of his previous testimony.
    The importance, for many reasons, ofimpartial expert testimony is without question but what makes the conduct of Dr. Przybylski so deserving of further investigation is the fact that he was the 2011 President ofThe North American Spine Society whose guidelines regarding ethical expert testimony demand complete integrity which he obviously did not demonstrate in this matter.
    Dr. Przybylski was named as a defendant in a verified complaint filed 3/22/13 in Bergen County Superior Court, New Jersey, Docket No: BER-L-2256-13, in which he was accused of engaging with 4 other neurosurgeons in anti-trust conduct, collusion and conspiracy in addition to a number of other charges with direct relevance to the central matters in New Jersey V Richard Kaul, MD in which he provided expert testimony. Dr. Przybylski knew or should have known that there was a clear conflict of interest, should have adhered to the ethical guidelines of his professional societies and should have recused himself from the case but he did not, and this is further evidence of his gross deviation from the standard of ethical practice expected from an expert witness, especially one that is the pastpresident of The North American Spine Society.

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    1. Sounds like many of these responses would have been posted by Dr. Kaul.

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  25. http://static.squarespace.com/static/51f13ae1e4b08aa4f3665b62/t/5217a8f8e4b07c5692c24635/1377282296841/TP.pdf

    Read the complaint filed against Dr Petersen in NJ.

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  26. What about the thousands of patients Dr Kaul has treated with excellent outcomes?

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    Replies
    1. Well when the person you care about is on about 100Mg's of Percoset daily and declared totally disabled it's damn hard to focus on those alleged positive outcomes. BTW, has any 3rd party verified those so called positive outcomes?

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  27. Dr Kaul has a webstite that is claiming that Robert Heary MD is the spine blogger, http://drrichardkaul.com/opinion/2013/11/4/who-is-the-spine-blogger

    Knowing what I know about the spine industry when it comes to criminality Kaul is a minor leaguer.

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  29. His name should be Dr. Duck as he is a QUACK and I have the lady friend to prove it. This guy is one arrogant con artist. Gov. Christie and 5 doctors are "Out to get him"? Please, do a search on Narcissistic Personalty Disorder and his picture should be next to the description. Does anyone for a minute think Governor Christie even knows who the quack is? Last time I heard he's dropped out of site and is couch surfing due to his 7 million plus in assets have been seized. He's already demonstrated his ego and incompetence in the UK and now the USA, what's next? Canada for the Trifecta of malpractice?

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