Has Your ENT Really Helped You—or Scammed You?
Balloon sinuplasty is promoted as a quick, low-risk fix for sinus problems. But behind its growing popularity lies a disturbing trend: some ENT (ear, nose, and throat) doctors are exploiting this procedure for profit—putting patient safety and trust at risk.
At Kitchel Law, our Washington, D.C., medical malpractice lawyers serve clients in Arlington, Alexandria, Fairfax, and Washington, D.C.—and we care deeply about helping those who may have been taken advantage of by medical professionals. If you’ve undergone a balloon sinuplasty and something didn’t feel right, you’re not alone—and you may have legal options.
This guide outlines key red flags to watch for, including insights from recent federal prosecutions, and what you can do if you suspect your ENT acted unethically or fraudulently.
What Is Balloon Sinuplasty?
Balloon sinuplasty (also called “balloon dilation”) is a medical procedure used to treat chronic sinusitis, a condition where the sinus passages become inflamed and blocked.
The process involves inserting a tiny balloon into the entrance of a sinus cavity and inflating it to widen the opening so mucus can drain. It’s minimally invasive and typically performed in-office. When medically necessary and properly performed, balloon sinuplasty can be a helpful treatment.
But its high insurance reimbursement rate and in-office convenience have made it vulnerable to overuse, misuse, and outright fraud.
A Growing Problem: Balloon Sinuplasty Fraud
In recent years, federal agencies have investigated and prosecuted multiple ENTs for misconduct involving balloon sinuplasty. A striking example is the United States v. Anita Louise Jackson case. Dr. Jackson, an ENT in North Carolina, was convicted in 2023 of reusing single-use devices, performing unnecessary procedures, and fraudulently billing Medicare—costing taxpayers over $47 million.
Key findings included:
- Balloon sinuplasties performed during a patient’s very first visit, without proper diagnosis
- Recruiting patients at churches and retail stores with misleading promises of free procedures
- CT scans performed before any doctor evaluation
- Reuse of “single-use only” devices, exposing patients to infection risks
- False claims to Medicare and manipulation of billing codes
Though that case occurred in North Carolina, similar patterns are emerging nationwide—and Virginia and D.C. residents should be alert.
Red Flags That May Indicate You Were Scammed
Here are key warning signs that your ENT may have acted inappropriately, negligently, or fraudulently:
1. You Had a CT Scan Before Seeing the Doctor
If you were sent for a CT scan before a physician ever evaluated you, that’s a red flag. Proper medical care starts with a clinical examination—imaging should follow only when indicated. In fraudulent schemes, mobile CT scanners are used to fast-track patients into procedures with minimal oversight.
2. You Were Offered Balloon Sinuplasty on the First Visit
Balloon sinuplasty should never be the first step. A responsible ENT explores non-surgical treatments first—such as medications, allergy management, or other diagnostics. If your ENT offered the procedure immediately, especially without discussing alternatives, it’s worth questioning.
3. You Were Told the Procedure Was “Just a Rinse” or “Sinus Spa”
ENTs have marketed balloon sinuplasty using phrases like “sinus rinse” or “spa treatment.” This minimizes the fact that it’s still a surgical procedure. If you weren’t fully informed of risks, benefits, and alternatives, you may not have given informed consent.
4. You Weren’t Told About the Device Used—or It Was Reused
Ask yourself: Were you told what device was used? Balloon dilation tools are FDA-labeled as single-use. In Dr. Jackson’s case, she sterilized and reused them up to 30 times—exposing patients to serious risks. If you don’t have documentation, or the practice was vague about device use, that’s a serious concern.
5. The Practice Promised “Free” Procedures or Waived Co-Pays
Fraudulent ENTs often attract Medicare patients with promises of “no cost to you” procedures. In some cases, they waived co-pays, a potential violation of federal anti-kickback laws. Be cautious of any ENT who downplays the financial aspects of your care.
6. You Weren’t Given Time to Ask Questions
If you were rushed through paperwork, told to “just sign” something, or weren’t encouraged to ask questions about the procedure—your rights may have been violated.
7. You Experienced No Benefit—Or Your Symptoms Worsened
While no medical procedure is guaranteed to work, balloon sinuplasty should not be performed on patients who don’t meet clinical criteria. If you experienced no relief or your condition worsened, the procedure may have been unnecessary or improperly performed.
What Should You Do if You Suspect Fraud?
You are not powerless. Here are steps you can take:
- Request your medical records, including:
- CT scan reports
- Operative notes
- Manufacturer details of the balloon device used
- Billing records (CPT codes, insurance submissions)
- Ask your ENT for an explanation. A legitimate provider should have no issue answering detailed questions.
- Document everything: Take notes about your appointments, consent forms, conversations, and outcomes.
- Contact a personal injury attorney. At Kitchel Law, we will listen with compassion, review your records, and help you determine whether your ENT acted negligently or fraudulently.
You may have a claim for:
- Medical negligence
- Fraud or misrepresentation
- Unnecessary or unauthorized procedures
- Injuries caused by reused devices
Why Trust Kitchel Law?
At Kitchel Law, we bring Experience, Expertise, Authoritativeness, and Trustworthiness to every case:
- Experience: We’ve represented clients throughout Northern Virginia and D.C. in complex personal injury and medical negligence matters.
- Expertise: We understand how balloon sinuplasty works—and how bad actors exploit it.
- Authoritativeness: We stay on top of federal cases, insurance fraud alerts, and medical regulations.
- Trustworthiness: We’re a small, dedicated firm that treats every client like a human being—not a case number.
We offer free consultations, and if we take your case, you don’t pay unless we win.
FAQs
1. Is Balloon Sinuplasty Ever Legitimate?
Yes. When used correctly for patients with chronic sinusitis who haven’t responded to medication, it’s a valid procedure. Problems arise when it’s overused or improperly billed.
2. What’s the Statute of Limitations for These Claims?
In Virginia, most personal injury or fraud claims must be brought within two years of the incident. In D.C., it’s three years. However, the clock may extend if fraud concealed the harm—ask us to review your case.
3. Can I Sue Even if I Wasn’t Physically Injured?
Potentially, yes. Having surgery you don’t need in and of itself constitutes a physical injury, even if you don’t feel long-term impacts. If you were misled into a procedure you didn’t need, or if you were exposed to infection risk due to device reuse, you may still have a claim.
4. What if I Can’t Find All My Records?
We can help you request them. Under law, you’re entitled to a copy of your own medical records.
5. Is Kitchel Law Taking New Clients for This Issue?
Yes. We’re currently reviewing potential balloon sinuplasty cases across Virginia and D.C.
Conclusion
Medical fraud is a betrayal. If you trusted your ENT and later discovered signs of rushed care, misinformation, or reused equipment, you deserve answers—and accountability.
At Kitchel Law, we don’t just fight for compensation. We fight for clarity, dignity, and justice.
Call to Action
If you believe your ENT may have scammed you with an unnecessary or unsafe balloon sinuplasty, don’t wait. Call Kitchel Law today for a free consultation. We’ll review your records, explain your rights, and help you take the next step. Serving Arlington, Alexandria, Fairfax, and Washington, D.C.
