Who Will Foot Bill in Podiatrist’s Fraud Trial? : Law: After months of testimony, jury will decide fate of doctor accused of billing insurer $28,000 for a bunion treatment.

The case of the $28,000 bunion is finally drawing to a close.

A weary-looking Los Angeles Superior Court panel listened Friday to final arguments in the insurance fraud trial of podiatrist Brian Douglas Carey, the former owner of an Inglewood clinic accused of performing unnecessary work, or billing for services that patients never received.

Testimony about corns, in-grown toenails and bunions has taken almost 100 days spread over seven months of trial time. Transcript volumes sit in piles on the bench, nearly dwarfing Judge William R. Pounders. Boxes of exhibits and charts of bones, veins and feet are spread out in front of the attorneys.

One reason the trial took so long was that more than 100 witnesses were called.

Deputy Dist. Atty. Albert H. MacKenzie accused Carey of “running a cattle call to try to make a lot of money.”

One woman came in complaining about a bunion, and her insurance company got a claim for more than $28,000, the prosecutors said, while another man’s insurer ended up with a $16,244 bill after he sought help for itchy heels.

“He’s not on trial for the amount of his fees,” said Robert K. Crawford, one of Carey’s two attorneys. “The work was done. It was the intent of physicians at the clinic, especially Dr. Carey, to benefit the patients.”

Carey was enjoined from practicing in 1985, when the fraud case was first filed by the Los Angeles County district attorney.

The charges involve 40 counts of insurance fraud, grand theft and forgery pertaining to 26 patients treated at the clinic. The prosecution stemmed from a state investigation launched at the request of the podiatric board after complaints had been lodged about Carey’s billing, said Jim Rathlesberger, the board’s executive officer.

According to the board’s chief consultant, a bunion operation would normally cost $3,000 or less.

Carey was placed under court order not to practice until charges were resolved, but a judge revoked the order last year because of the long delay in prosecution, Rathlesberger said. But Carey has not renewed his license, he added. MacKenzie had no comment on the delay.

Carey said his life has been destroyed by the case. “I’m indigent,” he said outside of court, explaining that he is living in a house provided by a relative. “I have one suit.” Attorneys’ fees are being paid by the county, co-counsel William K. Ringgold said.

Carey spent more than a month on the stand during the trial, and in his closing argument, Ringgold asked the jury not to hold the physician’s testy personality against him. “You may not like him,” the lawyer said. “You may think he’s a windbag, that he’s arrogant. . . . That’s not a reason to find somebody guilty of a fraud.”

The podiatrist’s conviction for Medicare fraud 22 years ago should also not be held against him, his attorneys said, and in fact was a signal Carey was unlikely to try to defraud the insurance companies. MacKenzie charged that Carey would perform a procedure and then use a higher-paying billing code number on his claims. “He spiked his bills,” MacKenzie said.

But Ringgold said, “The problem with that theory is Dr. Carey was under medical review all the time” because of the prior conviction.

Carey said he only got $1,100 for the work done on the woman complaining about her bunion, that resulted in his $28,000 claim. “I did five operative procedures,” he said. “They’re lumping everything into one fee to make me look bad.”

The jury, which is expected to begin deliberations early next week, will have to decide whether Carey performed the X-rays, blood tests and surgeries claimed. If convicted on all counts, Carey could face 10 years in prison.