MD Accused of Unneeded Eye Surgeries : Medicine: State and federal investigators say the La Jolla millionaire may have bilked Medicare of millions of dollars.

A La Jolla doctor is under federal and state investigation for performing allegedly unnecessary eye surgery on mostly elderly patients and, in the process, bilking Medicare of millions of dollars, officials said Monday.

Dr. Jeffrey Rutgard allegedly performed operations, including cataract and eye tuck surgeries, on elderly patients who didn’t need them, according to sources familiar with the investigation.

Some of Rutgard’s patients who underwent the operations were legally blind; others had correctable vision, sources said. But most were wooed and won over by the 41-year-old doctor’s charm and bedside manner, according to sources and a former patient.

In an effort to lure business, sources alleged, Rutgard dispatched employees to conduct eye tests at nursing homes and senior centers, where the participants were often told to make an appointment to see Rutgard.

Federal search warrants were served Monday at Rutgard’s La Jolla home and his La Jolla and Hillcrest offices, said George Hardy, chief of the U.S. attorney’s special prosecution section in San Diego.

State Deputy Atty. Gen. Sandy Feldman declined to comment on the allegations. But he added that his office is seeking an interim suspension order preventing Rutgard from practicing medicine. Rutgard is the principal doctor for the Southern California Institute of Eye Surgery.

Rutgard did not return phone calls to his offices, which were closed Monday because computers had broken down, said office workers who declined to give their names. Rutgard, a University of Illinois medical school graduate, was issued his license Dec. 12, 1978, to practice medicine in California.

His attorney, Charles Goldberg, said Rutgard is cooperating fully with the investigation.

“We believe these charges are baseless and totally without merit,” Goldberg said in a statement. “The institute is confident that, when all records are examined, it will become clear that these false allegations, which are administrative in nature and are not related in any way to quality of care, are the result of a matter involving a past employee. We are confident that the investigation will demonstrate that no wrongdoing occurred.”

Rutgard, a former clinical professor at UC San Diego’s School of Medicine, had a soothing, reassuring air, particularly to those patients, such as the elderly, who otherwise felt neglected, sources said. In fact, Rutgard has developed a loyal following among his nursing home clientele, who sometimes had little understanding of the procedures they underwent, the sources said.

By all accounts, Rutgard was a financially successful doctor. He owns about $6 million worth of property in San Diego and La Jolla, including several houses, condominiums and offices, according to property records.

His practice was carefully maintained. Rutgard used to run newspaper ads showing a picture of himself and smiling models that read, “We finally see eye to eye in the morning.”

Since 1988, however, the Medical Board of California has received 14 complaints against Rutgard, ranging from excessive prescribing to unnecessary tests and unwarranted surgeries.

“He really deserves to get hung,” said Antonietta D’Anna, a former patient who said she first saw Rutgard when she was 27. He performed cataract surgery on her--though doctors before and after the procedure, which cost $6,000, said it was unnecessary, she said.

“I truly believed in him. He said, ‘Trust me, as if I were your own father.’ I believed in him. I was so excited. . . . But, when they took the bandages off; I knew there was no difference at all,” said D’Anna, now 30, who unsuccessfully sued Rutgard for malpractice.

In a significant development Monday, Rutgard’s former office administrator admitted in a sworn affidavit that D’Anna’s medical records had been altered to support Rutgard’s version of her medical history.

Rutgard ordered the alteration after learning that D’Anna was suing him, according to the affidavit by George Butera, who worked for Rutgard for three years beginning in 1988.

“Ihave personal knowledge that the personal records of Antonietta D’Anna were totally and completely altered or perhaps replaced by others and were not the original,” Butera’s statement says.

He also said he was told by two other office employees that they had been ordered by Rutgard to change D’Anna’s files.

Because the jury ruled in Rutgard’s favor in February, giving consideration to the medical files stating that D’Anna’s eye surgery was necessary, Butera’s admission is a significant one. D’Anna’s attorney, Jim Jarboe, said he has filed a motion for a new trial.

According to Butera’s statement, Rutgard apparently wanted his attorney to settle the case out of court.

“At some time before Antonietta D’Anna’s case came to trial, Jeffrey Rutgard called me in and indicated he was frustrated that she did not settle for $29,999 that had been offered,” Butera said in his statement. “He asked me to contact his insurance company attorney . . . and to direct (him) to offer (Jarboe, D’Anna’s attorney) a cruise or some other incentive to accept the settlement amount.”

Today, D’Anna, a bank clerk, said she suffers constant headaches and perception difficulties so serious that she sometimes falls down stairs. She has also undergone five laser surgery treatments in hopes of correcting her visual difficulties.

“He said I would see 10 times better, and I don’t see any results,” D’Anna said. “I was born with terrible eyes, and when someone makes a promise like that, you’re really, really let down.”

After failing her eye test for her driver’s license, D’Anna first visited Rutgard in November, 1989, at the recommendation of friends.

She found his promise of better vision so enticing that she disregarded the advice of her own eye doctor, Norman Rozansky, to avoid surgery. In court proceedings, Rozansky, a former partner of Rutgard, testified that D’Anna did not have cataracts and did not need the surgery, according to Jarboe.

Rozansky examined D’Anna after she had seen Rutgard and before she underwent the surgery, said D’Anna, who acknowledges that she should have listened to her doctor. But the promise of having better vision was more than she could resist, she said. Rozansky declined to comment Monday, on the advice of his attorney.

Today, according to D’Anna’s attorney, Rutgard’s surgery has placed D’Anna at increased risk for developing a detached retina, glaucoma and degeneration of the nerves in the eye.

“It’s a tragedy--it’s greed. The man is extremely wealthy and he’s gotten it by abusing his medical license,” Jarboe said. “This whole case was based on whether or not D’Anna had cataracts. He said she did. But anybody who goes to his office is going to be told they have cataracts. . . . He’s a very good salesman.”