FARGO — A nearly two-year-old state case alleging Sanford fired a surgical oncologist in retaliation after she raised patient safety concerns has been moved to federal court.

Dr. Sabha Ganai first filed the suit in Cass County in July 2024, claiming her former employer had violated the state’s whistleblower statute. In a statement provided to The Forum, Sanford said it does not comment on ongoing legal matters.

“Sanford Health does not comment on active or pending litigation. Sanford Health is consistently recognized as a top organization to work in health care, demonstrating a strong commitment to workplace culture, leadership development and providing resources that support a work-life balance,” the statement read.

Hired as a surgical oncologist by Sanford in 2020, Ganai and her team “routinely handled highly complex cases … from other departments and … facilities that were unable to properly handle them and often with patients who were dying,” according to court documents.

In August 2023, Ganai’s division came under fire from Sanford administrators for “significantly worse outcomes” based on data from a Vizient report, which allegedly showed Ganai and her division colleagues had “a higher than desired observed to expected ratio for mortality,” court documents said.

Vizient, according to the complaint, is a health care performance improvement company that provides patient outcome data “derived from administrative billing (coding) without clinical verification.”

“Vizient was designed for benchmarking hospital quality, not surgeon quality,” the complaint read, adding that leading surgeons had advised against using Vizient’s data to benchmark surgical performance.

Despite a 2020 review led by Ganai showing that Vizient data had “poor intrinsic validity” and that it only reported 30% of the cases accurately, Sanford continued to use the data, hoping to improve its place in Vizient’s hospital ranking system, the complaint claimed.

The claim said Ganai was asked to meet with Sanford Fargo’s chief medical officer, head of surgery and director of surgical services in August 2023, when she was presented with a performance improvement plan based in part on the Vizient data as well as a peer review. At that meeting, Ganai said she explained that Vizient generates and compares rates for general surgeons, and unlike the rest of general surgery, the surgical oncology division’s practice “includes highly complex cases not solely comprised of general surgery.”

Ganai agreed to the performance improvement plan contingent on receiving the Vizient report data, court documents said. She also requested a peer review meeting and was told one would be scheduled, but no such meeting ever took place, according to the complaint.

After she received the Vizient data, Ganai provided Sanford with a “comprehensive analysis” in response. Again, she explained “that Vizient’s data reliability was limited in providing accurate benchmark performance and that such data is not controlled for coding error complexity, among other things.” She also presented data that showed, for specific case type, she and the division “had excellent outcomes compared to national data.”

The suit claimed that while the Vizient report failed to track patient outcomes appropriately, it also showed that Ganai’s expected ratio for mortality rates “did not significantly differ” from the expected ratio based on the cases she managed, and that one colleague had higher ratios and mortality rates, while another had higher readmission and reoperation rates.

Then, in December 2023, Ganai responded to an anonymous employee survey question saying she was “ashamed” of Sanford’s administration.

“The administration is toxic and does not care about patients or physician well-being,” Ganai said in the response.

Court documents said Ganai’s concerns “stemmed from Sanford’s improper reliance on Vizient Report that did not properly or accurately account for patient outcomes and Sanford’s refusal to provide peer review avenues to address patient safety and comply with the Health Care Quality Improvement Act.”

Later that month, Ganai acknowledged to the vice president of Sanford’s Fargo Region Clinic that the comment was hers, explaining she’d written it out of concern for the treatment surgical oncologists had been subjected to and their perceived lack of support. She also said she had not received a response to her analysis responding to the performance improvement plan and related Vizient report.

A month later, Sanford sent Ganai a letter notifying her that her employment had been terminated.

Ganai’s case was moved to U.S. District Court on March 6. Sanford requested the move because Ganai’s complaint made federal claims, specifically alleging job discrimination and interference under the Family and Medical Leave Act, according to court documents. It had been scheduled for an October trial in Cass County.

Ganai is represented by the Prinz Law Firm in Chicago and locally by Fargo attorney Leo Wilking.