Doctor Loses License Over Elderly Care : Medicine: A state board takes the action after the Van Nuys physician is accused of false billing, negligence and incompetence.

A Van Nuys doctor has had his medical license revoked for endangering the health of elderly nursing home patients by thrusting an instrument down their throats without warning or medication.

State investigators said Keith A. Lasko also gave unnecessary medical exams to patients, including a blind woman who was charged for an eye exam and another woman who underwent $1,862 worth of tests after complaining of a bad cold.

The Medical Board of California revoked Lasko’s license Jan. 22 when he did not contest board charges of false billing, negligence and incompetence and state investigators could not locate him. The board made documents related to the action public last week.

Lasko’s last known office address was on Van Nuys Boulevard, and a telephone there has been disconnected.

Investigators said Lasko was grossly negligent in not telling a dozen elderly patients--most with severe physical or mental disabilities--before sticking an endoscope into their throats or noses to raise their heart rates so he could test for pulmonary stress. An endoscope is a lighted probe used to examine internal organs.

Deputy State Atty. Gen. Nancy Ann Stoner, who filed charges against Lasko on behalf of the medical board, said pulmonary testing is normally done on a treadmill. But she said many of Lasko’s patients were bedridden and could not get up.

“So his idea was just to cause body stress by jamming something down their throat or nose,” she said, adding that Lasko did not medicate patients to suppress gag reactions.

“Some of these people were very disoriented or almost comatose. To suddenly insert something could cause them . . . to gag or have another reaction that would be dangerous to a person in that medical condition,” Stoner said.

She said no patient died or required medical treatment as a result of Lasko’s exams, but that “increasing the heart rate in some of these people is dangerous by itself.”

Investigators said Lasko billed the federal Medicare program and a private insurance firm for exams that were not done, were not necessary or were more extensive than the procedure he actually performed.

In 1988, Lasko billed an 88-year-old woman for an “extended ophthalmoscopy”--a detailed inner-eye exam--even though she is blind, medical officials said.

Lasko asked the woman, who also suffers from brain damage, a few simple questions and later billed her for a “cerebral functioning assessment” and “cognitive testing,” Stoner said. None of the procedures was medically necessary, she said.

Lasko billed Medicare for $1,862 after he was visited at his office by a woman who complained of a bad cold, officials said. The woman was given eight different tests on her heart and eyes--none of them necessary, they said.

Stoner said Lasko gained access to three Los Angeles area nursing homes by offering on-site medical exams for patients who were bedridden, Stoner said.

“The facilities were not in cahoots with him at all,” she said. “They were taken by surprise. They thought he was providing them a service.”

The case was referred to the medical board by auditors for Medicare and a private insurer that discovered a pattern of excessive and unnecessary bills from Lasko, Stoner said.

“A lot of the bills would go unscrutinized by the patient or the facility,” Stoner said. “Unfortunately, it is an easy scam to pull off.”