The New York State Department of Health is examining Bellevue Hospital’s use of unlicensed technicians to assist doctors with weight-loss surgeries.

Bellevue, a large public hospital in Manhattan, performs bariatric surgery on thousands of low-income patients each year, The New York Times reported this month. Doctors are paid in part based on the volume of surgical procedures.

In their quest for speed, bariatric surgeons sometimes asked equipment technicians to scrub and assist in surgeries because they lacked assistants, two Bellevue doctors told the Times. These technicians, who worked for an outside vendor called Surgical Solutions, were not authorized to treat patients.

The national health agency has opened an investigation into the allegations, which could lead to a formal investigation.

“The ministry is studying the issue,” said agency representative Danielle De Souza on Wednesday.

Christopher Miller, a Bellevue spokesman, said the investigation is preliminary and may not result in an ongoing investigation. “We are investigating your allegations and will take appropriate action if the facts warrant,” he added.

Surgical Solutions did not respond to requests for comment.

The use of unlicensed technicians was one of several red flags that Bellevue employees described to the Times about the bariatric program. Two surgeons raced to see how many operations they could perform in a day. And anesthesiologists have reduced doses of painkillers so that patients wake up earlier and operating rooms are emptied more quickly.

Bellevue even recruited patients from New York’s Rikers Island prison complex who had virtually no chance of maintaining the required diet after surgery. Two said they suffered malnutrition because of it.

After the Times article was published, executives at Health and Hospitals Corporation, the New York City agency that oversees Bellevue, emailed employees to tell them that “the article omitted some context important “. They praised the bariatric surgery department for providing “comprehensive care and affordable, high-quality surgical services” to low-income New Yorkers.

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