TOBIAS WEST SPINE SURGERY SCAM, TOBIAS WEST, TOBIAS WEST SPINAL SOLU
Complaint 337566 Details

Patients Screwed in Spine Surgery ‘Scam’
Tobias West Spinal Solutions is accused of running a multimillion-dollar scam in spinal surgery hardware that could leave thousands in pain if their shoddy materials fail.
With a metallic clatter, evidence of an elaborate scheme to enrich a few landed in the receiving room of Richard Walker’s surgical supply firm in South Africa.
Although the true extent of the caper remains buried in the necks and backs of people scattered around the U.S., it began to unravel that day in 2009.
Ortho Sol makes precision screws for the most delicate of construction projects: spinal fusion. Doctors around the world drive them into the vertebrae of patients with devastating back injuries.
The company had repossessed some of its screws after one U.S. distributor, Tobias West Spinal Solutions LLC, stopped paying its bills. But now, nestled with the returns, the brighter yellow luster of a few screws caught Walker’s eye.
Testing confirmed his fears. Some were not made of his firm’s medical-grade titanium. Their uneven threads showed potential for backing out or breaking, he said. He feared the laser-etched markings intended to make them look authentic could be toxic to patients.
Walker’s conclusion: The Southern California firm was knocking off his products.
Yet it would be two more years before an employee of Tobias West Spinal Solutions alerted the U.S. Food and Drug Administration to the counterfeiting, and even then, the agency didn’t shut down the company.
By the time Tobias West Spinal Solutions went broke in 2013, the company had sold millions of dollars in implants to a nationwide network of surgeons, The Center for Investigative Reporting has found.
Now patients are left with more questions than answers.
“What do they do if they find out there are these bogus parts that can come unscrewed?” said Susan Reynolds, a Riverside County, California, woman whose doctor used Tobias West Spinal Solutions screws on her in 2009, following years of intractable pain. “I’m a walking time bomb.”
The man at the center of the scandal is a company president who indulged in luxury—private planes, strip club spending sprees, courtside seats at L.A. Lakers games—as the company collapsed into debt. Attorneys lined up to serve him with legal documents now say they can’t find him.
The company sold its wares to doctors who received consulting deals from Tobias West Spinal Solutions worth thousands per month, rides on company planes, even bundles of $100 bills, company insiders allege. In turn, the physicians ordered the company’s implants for their surgeries at hospitals in California, Nevada, Texas, Wisconsin and Maryland.
Surgeons insist they never used subpar implants, and CIR has no evidence the doctors were involved in the scheme. But one former company insider says knockoff screws were mixed in with real ones.
An elderly machinist finds himself unexpectedly wrapped up in the scandal. In an interview with CIR, he admitted to making scores of copies of surgical screws for Spinal Solutions. The company bargained him down to $65 a screw—less than half of what they usually cost.
The screws, real or fake, all funneled into what lawsuits claim was a larger scheme to bilk California’s workers’ compensation system, an employer-funded program designed to help those injured on the job. Some hospitals billed insurance carriers as much as $12,500 a screw before a 2012 change in state law shut down the astronomical markups. From that, Tobias West Spinal Solutions stood to reap several thousand dollars from the sale of a single screw.
Patients, though, may end up paying the steepest price.
Patient’s hardware raises questions
Derika Moses hefted a case of 2-liter soda bottles while setting up a grocery store display in 2007. Her back popped, leaving the former softball star frozen in excruciating pain.
Nothing helped. In desperation, Moses opted for spinal fusion surgery.
The procedure offered little relief: Chronic pain and infections plagued her. Five years later, she had most of her spinal hardware removed, convinced that the erector set of metal in her spine was the source of ongoing problems.
She begged hospital staff to let her keep the rods and screws. She hoped to fashion them into a necklace, she said, as a symbol of the pain she had endured.
A nurse slipped them under her pillow.
“Roger told me... ‘These doctors are greedy. They’re so greedy, you can’t believe it. All I do … I take advantage of their greed.’”
Moses, 38, of Riverside, had all but forgotten the bag of hardware until she received a letter from an Oakland, California, law firm in March. It suggested she might be the victim of medical fraud.
“I had to know if I was part of it,” Moses said. “I had to know.”
Attorneys contacted Moses after finding her name among Spinal Solutions’ sales records. The law firm, Knox Ricksen, is working with other firms to file lawsuits—more than 30 and counting—on behalf of Moses and other patients. The lawyers accuse Tobias West Spinal Solutions of selling counterfeit implants and doctors of accepting kickbacks in return for using them.
Spinal screws are not Home Depot fare. The implants must fit together precisely to support a body in motion, said UCLA neurosurgeon Dr. Duncan McBride.
“It’s like building a bridge in the back of someone’s spine. So if you have inferior material, it’s not going to work as well,” he said. “It’s going to be less successful and potentially harmful.”
CIR showed photos of Moses’ hardware to U&I Corp., the South Korean company whose logo was etched on it.
Company engineers noted the finishes and lot numbers on some of Moses’ screws and connectors did not match their product. But the dead giveaway was the logo, they said, which lacks the firm’s signature forward-leaning font.
During an interview at the company’s U.S. office in Orange County, California, General Manager Sung Hwang identified three of Moses’ four screws as fakes.
“This is obviously not what we did,” Hwang said. “I feel sorry because (patients) got the surgery with improper devices, so they might suffer from it.”
Hwang said the company first heard about Spinal Solutions’ counterfeiting from plaintiffs’ attorneys in 2012 and is not happy about the matter.
Moses’ initial reaction on hearing about the apparent scam was fear because a few metal pieces remain in her back. But she says her feelings changed as she learned more from her attorneys about kickbacks that Tobias West Spinal Solutions is accused of paying to doctors.
“It always, always turns to anger,” she said, “every time I sit and think about what they did.”
Moses lost her job, and then her home, as she grappled with pain and illness after her spinal surgery. The flashy businessman who sold her implants, meanwhile, lived a life of luxury.
An executive’s lavish lifestyle
One private plane wasn’t enough for the Tobias West Spinal Solutions founder. Roger Williams had three.
Williams spent 16 years in the orthopedic sales business with his father before he went out on his own. He started Spinal Solutions in 1999 and launched a firm selling knee and hip implants three years later. From nothing, he built an $18 million-a-year business based in Murrieta, California.
By 2008, his planes were shuttling staff and surgical equipment from coast to coast. He also followed the Los Angeles Lakers all over the country.
He ordered his seven-seat jet painted with stripes of Lakers purple and gold, and he and his wife sat courtside among celebrities, according to interviews with former employees. Sometimes he invited a member of the team onboard.
“He lived like the richest guy on earth. Like a movie star or something,” said Andreas Leuthold, a pilot who worked for Williams.
Williams and his wife had a BMW, a Mercedes-Benz, a yacht named “Spare Change” and a 6,300-square-foot Murrieta home, according to court records and interviews.
He withdrew thousands of dollars from Spinal Solutions’ account to patronize strip clubs like the Spearmint Rhino Gentlemen's Club. When creditors later asked why, he said, according to court transcripts, “Because I felt like it.”
But Tobias West Spinal Solutions also racked up big debts with hardware manufacturers and then refused to pay, according to industry executives and lawsuits.
The company increasingly relied on Lenders Funding LLC, a firm that fronted cash at an interest rate of 35 percent. By 2013, the company owed the lender about $35,000 per month—solely in interest payments—and imploded in debt.
It remains unclear when Tobias West Spinal Solutions began to counterfeit surgical implants. And it is nearly impossible to trace each knockoff to each patient or to confirm how many were affected.
In a line of business built on meticulous order, the inner workings of Tobias West Spinal Solutions were a study in disorder.
Take Operations Manager Jeff Fields, whom Williams called “my main guy.” Fields was in charge of the company’s inventory of surgical implants.
A court declaration from Williams’ brother-in-law says that Fields’ work was “sloppy” and that he’d seen him use methamphetamines on the job. Fields did not respond to letters and Facebook messages. When reached by phone, he said, “I’ve got no interest in speaking to anybody,” and hung up.
The brother-in-law, Carl Sisler, was Spinal Solutions’ first employee and knows more about the company than anyone else, Williams said in a court filing. Sisler is described as a “Medical/Surgical instrument technician” in his own court declaration.
But Sisler denied being an instrument technician and told CIR he was in prison for domestic violence for many years of the company’s run. Sisler’s convictions also included making a terrorist threat and indecent exposure, but he was paroled in 2008, according to prison records.
“I was a nobody there,” Sisler insisted in a telephone interview, during which he slurred his words and acknowledged he was drunk. “I was the gofer guy who made $285 a week cleaning toilets.”
Williams, meanwhile, accused his bookkeeper of sabotage and embezzlement in a court declaration and said the books never were made right.
Williams had an especially volatile relationship with his wife, Mary, whom he once described as the company’s chief financial officer. He was convicted of misdemeanor domestic violence in 2013.
The IRS determined the Williamses underpaid their taxes by a combined half a million dollars due to fraud in 2009 and 2010, according to court filings. The couple’s taxable income topped $5 million each year.
Mary Williams filed an appeal to the IRS in tax court last year, blaming her “controlling, abusive” husband for the problem.
She referred CIR to her attorney, who declined to comment.
The company’s records got caught in the crossfire. In a deposition related to creditors, she described getting law enforcement to open the Tobias West Spinal Solutions offices so she could take hard drives.
“Half of the stuff is gone because my wife took it, you know,” Roger Williams said during a bankruptcy-related hearing.