A Connecticut physician practice group that provides professional radiology services alleges that Trinity Health breached a contract, claiming it was hired to do work and found the health system’s radiology department was allegedly significantly mismanaged and that critical equipment “did not exist, was in disrepair,” or was at end of its service life.

Advanced Imaging Specialists, LLC of Danbury, a limited liability company, claims in a lawsuit the breach of contract occurred while it was doing work for Trinity Health facilities, including Saint Francis, Johnson Memorial, and Mount Sinai hospitals, according to the lawsuit.

The suit was filed by the law firm McCarter & English LLP of Hartford, including attorneys Thomas J. Finn, Paula Cruz Cedillo, Snigdha Mamillapalli and Jessica D. Bowman.

When contacted, Finn said, “We have no further comment other than what is set forth in the complaint.”

A Trinity Health spokesperson said, “Trinity Health Of New England denies these allegations and will vigorously defend itself in this lawsuit.”

“We have long provided patients with high-quality, reliable radiology services consistent with a Level 1 Trauma and Stroke Center,” the spokesperson said in an emailed response to a request for comment. “Our commitment to providing excellent patient care is further evidenced by the consistent investments in its infrastructure including, but not limited to, new imaging equipment. We are confident in the quality of all care we provide. While we work through this matter, we are committed to ensuring there is no disruption in patient care and that these services remain available to our community.”

Advanced Imaging Specialists, or AIS, claims that Trinity Health initiated discussions with it to replace its existing radiology and interventional radiology services provider at Saint Francis, Johnson Memorial, and Mount Sinai hospitals and came to agreement, in January and February 2024, for AIS to become exclusive provider of radiology and interventional radiology services at the three hospitals, the suit says. The agreement was for the period from March 2021 to September, 2029, the suit claims.

AIS was to receive support from Trinity Health as exclusive provider of the services at the three hospitals and to have “adequate facilities space, supplies and equipment for AIS to perform the radiology services,” as well as staff to support it, including “an adequate number of nurses, radiology technicians and administrative support staff;” the suit says. AIS also claimed it was assured “Trinity Health had sufficient volume of patient services for physician provider groups to generate sustainable revenue,” among other things.

The suit claims Trinity Health “was paying the fair market value for overnight radiology services, including approximately $200,000 per month to its existing provider.”

Under the terms of the agreement, AIS would be “responsible for maintaining coverage for a sufficient number of providers to perform the radiology services and provide quality patient care 24 hours a day, 365 days a year, at Saint Francis, Johnson Memorial and Mount Sinai,” the suit says.

However, AIS claims, it discovered that Trinity Health’s radiology department was allegedly “significantly mismanaged” and that Trinity Health had made “material misrepresentations to AIS regarding the operation of its facilities,” the suit says.

Among the “material misrepresentations and/or omissions” AIS claims were allegedly made by Trinity Health are:

  • “Critical radiology equipment at Saint Francis was not available for the performance of the radiology services as the equipment did not exist, was in disrepair or was at end of service life. This included magnetic resonance imaging machines, ultrasound machines, interventional radiology equipment, PET scanner and imaging equipment.
  • Mammograms could not be performed or administered at Saint Francis after Trinity Health closed two mammogram/ultrasound procedure rooms for six months due to equipment failures, staffing shortages and lack of  management and/or supervision.
  • Trinity Health underrepresented the number of radiologists required for cancer-detection breast imaging.
  • Trinity Health’s callback rate for cancer detection from screening mammograms was far below the national CMS guidelines.
  • Trinity Health did not ensure adequate staffing of nurses, radiology technicians or administrative support staff to assist with interventional radiology services.
  • The number of fellowship-trained radiologists scheduled to provide services for Saint Francis and Johnson Memorial were significantly underrepresented and inadequate to serve the patient volume with high quality radiology services at a Level 1 trauma and stroke center, 24 hours a day, seven days a week.
  • The AIS interventional radiology providers at Saint Francis were expected to provide call coverage for Saint Mary’s Hospital’s Level 2 trauma center, a Trinity Health Facility not covered by the agreement.
  • Trinity Health’s overnight radiology services generates substantially less than the fair market value for those services, including significantly less than the previously represented $200,000 per month.
  • Trinity Health had a pre-existing exclusive arrangement with its prior radiology provider for all outpatient radiology imaging, which significantly limited AIS’s ability to generate revenue.
  • Trinity Health’s radiology patient volume and relating revenue was not substantial enough to support a radiology practice group.”

However, Trinity Health contends, “Prior to and throughout our relationship with AIS, we have maintained American College of Radiology accreditations for CT, interventional radiology, mammography, MRI, nuclear medicine and PET and ultrasound, which is the quality standard for imaging facilities.”

Trinity notes online that The Comprehensive Women’s Center at Saint Francis Hospital, uses “the latest Hologic’s Genius™ 3D Mammography™ machine which has greater accuracy than 2D mammography for women across a variety of ages and breast densities. 3D mammograms are also the only mammogram FDA approved as superior for women with dense breast tissue.”

Trinity notes online its strong investments in equipment and also reports “Saint Francis Hospital has been awarded a three-year term of accreditation in radiation oncology as the result of a recent review by the American College of Radiology® .”

AIS claims in the suit that when it found the issues in the radiology department at Trinity Health, it sought a solution with the health system that would allow it “continue delivering high quality” radiology services at the three hospitals in the agreement.

AIS said that three amendments were made to the agreement with Trinity, including that it “secured the extension and modification of certain monthly ‘support payments’ from Trinity Health as partial compensation for the ‘shortfall’ arising from AIS’s revenue derived from interventional radiology services and its budgeted expenses.”

The payments meant “Trinity Health recognized that AIS incurred significant losses as a result of Trinity Health’s conduct in connection with the provision of  interventional radiology services under the agreement,” the suit claims.

However, while AIS says it has “repeatedly proposed various solutions to resolve the issues” it claims Trinity “refused to engage in good faith negotiations, including failing to respond to AIS’s inquiries, failing to connect AIS with Trinity Health personnel with decision making authority and failing to cooperate in scheduling and attending negotiation meetings.”

“Despite AIS’s good faith efforts and despite Trinity Health’s continued acceptance of the radiology services rendered by AIS under the agreement, Trinity Health has not addressed any of the issues raised by AIS,” the suit claims.

AIS also clams Trinity’s alleged “material misrepresentations, and its failure to cure the issues with respect to its inadequate facilities, equipment, staffing and mismanagement of  the radiology department,” it continues “to incur losses at a rate of approximately $400,000 per month,” the suit says.

“To date, AIS has outstanding sustained damages greater than $3,200,000 as a result of Trinity Health’s conduct,” the suit claims.

AIS also claims Trinity Health “has accepted, approved of, and benefitted from, the radiology services provided by AIS, which drives Trinity Health’s revenue and furthers its patient care. Trinity Health has failed to reasonably compensate AIS for the radiology services and expenses and costs incurred by AIS in providing the such services, despite due demand therefore,” and that “as a result, Trinity Health has been unjustly enriched.”

Further, the suit claims, “it would be unjust and inequitable to allow Trinity Health to retain the benefit of the radiology services provided by AIS without compensating AIS for the reasonable value of those services.”

The suit seek unspecified damages in an amount to be determined at trial, pre-judgment and post-judgment interest, per terms of the agreement and state law, attorneys’ fees and costs.