Rothman Institute is ending its Eagles partnership as the official team doctors because of malpractice risk

Rothman Orthopaedic Institute ended its decades-long run as official team physicians for the Philadelphia Eagles this month, citing the risk being found liable again in another large medical malpractice verdict like the $43.5 million award last year to Christopher Maragos.

The former Eagles special teams captain alleged that medical negligence by a surgeon in Pittsburgh and Rothman — which was found liable for $14.3 million of the award — forced Maragos’ early retirement after the knee injury during the 2017 season. No Rothman physician was sued individually.

“That can never happen again,” Rothman’s president Alexander Vaccaro said in an interview Friday, describing the large verdict against Rothman, which describes itself as one of the nation’s largest private orthopedic groups.

Rothman’s decision to end its team physicians’ contract with the Eagles comes as Philadelphia is seeing both an increase in large jury awards and a surge in malpractice cases filed in the city, where juries are considered favorable to plaintiffs. A new rule allows cases to be filed in Philadelphia, rather than in the county where the incident occurred, if the defendant has a business presence in the city.

The Philadelphia Eagles had no comment on the end of the team’s formal relationship with Rothman.

Rothman’s contract with the Eagles ended June 6, but Eagles players will not go without health care. The team’s chief medical officer, Arsh S. Dhanota, is a Penn Medicine physician.

Rothman has appealed the Maragos award, which increased to $15.8 million when damages were added because Rothman did not pay promptly, Vaccaro said, adding that the total could rise to as much as $18 million including interest, if Rothman loses its appeal.

Rothman, as a company, separate from its individual physicians, has insurance that covers just $1 million in malpractice cases. “No Rothman doctor has been sued, so all the partners in this practice have to take money out of their pocket” to cover the bulk of the award, Vaccaro said.

Rothman already experienced financial consequences from the Maragos case. A Philadelphia Court of Common Pleas judge allowed garnishments of Rothman accounts at two banks and two major insurers, effectively freezing the practice’s assets.

“That caused a potential significant business disruption,” Vaccaro said.

Rothman reached a deal in April to deposit $8 million into a new account and to deposit $1 million a month into the account until it reaches the $15.8 million judgment amount.

Rothman talked with health systems, including Penn, Jefferson Health, and Capital Health, about forming a partnership for the Eagles team physician contract after the Maragos verdict. No one wanted to do it, Vaccaro said.

During contract renewal talks with the Eagles, Rothman sought liability protection from the team. “They were not willing to provide that protection. They felt that was our responsibility,” Rothman CEO Ed Tufaro said.

“I don’t blame them,” said Vaccaro, who has been an Eagles team doctor since 2004.

One path for Rothman may have been to increase its insurance coverage to include multiple layers of coverage, like health systems have.

But it already spends more than $100,000 per year for every physician in the Philadelphia area, Rothman officials said. The cost is higher in New York and slightly less in Florida, where Rothman is the official orthopedic group for the Orlando Magic through its hospital partner Advent Health, Tufaro said.

“We can hardly afford the coverage we have now. We talked about, shall we spend more money? We voted not to get more coverage,” Vaccaro said. “If we increase our costs, we won’t be able to provide care for the average person in the city.”

Rothman doctors used to be team physicians for the Philadelphia Flyers and the Philadelphia 76ers. Both of those teams now have deals with Penn for medical care and for marketing.

Rothman physicians remain in that role of team physicians with the Philadelphia Phillies.

Bob Boland, a professor of sports law at Seton Hall Law School in Newark, N.J., predicted that large verdicts like the one Maragos won will have a chilling effect on private physician groups working as team physicians and getting the marketing and advertising benefits through related contracts.

“There will be others wanting to step into that void,” Boland said. Verdicts like that have “the potential to move the service upward to larger health-care entities, who are very active in this space.”