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Lincare is a huge respiratory system supplier with a long history of complaints about fraud settlements and miserable service, facing the latest legal challenges.
The case is scheduled to go to trial in a state court in St. Louis on March 17th, centering on the death of Lequon Marquis Burner, who suffered severe obstructive sleep apnea in 2020 and relied on the Bypup machine provided by Linkale to help him breathe while sleeping. The lawsuit filed by her mother accused Linkale of negligence after it took the company seven days to report that the device stopped working.
With annual revenue of $2.4 billion, Lincare, the largest oxygen parts supplier in the United States, has long faced an array of legal issues, but its services and equipment have been brought to court. The lawsuit over what happened to Burner provides an extraordinary window into the company’s interaction with vulnerable patients. The account is based on extensive court filings such as medical records, deposit excerpts and LINCARE’s internal “Customer Account Notes.”
Verner lived with his 64-year-old mother, who was disabled, in a tidy, public housing apartment in Madison, Illinois, across the Mississippi River from St. Louis. He suffered from obstructive sleep apnea. This is a common problem among adults with Down syndrome, which is often exacerbated by obesity. Beneath five feet tall, the Verner weighed 280 pounds.
Since 2015, Verner has relied on a BIPAP (or twin positive airway pressure) machine that supplies pressurized air to the mask. The device was prescribed after the Washington University Sleep Medicine Center in St. Louis. “His airways are very crowded,” his doctor wrote in a medical note at the time. Burner, who used Medicare, said he regularly used the device for 10 to 12 hours while he was asleep, according to his mother.
He spent his days at New Chutonesives, a local nonprofit organization that provides educational opportunities for people with developmental disabilities. “He was a happy young man,” said Kim Fears, executive director of the program.
On September 11, 2020, Burner’s Vipap suddenly began making “a loud, lively voice or humming sound.” She called the local Linkare office to report the issue and told a customer service representative that the breathing machine was not working and that it was “what it needed” and “I couldn’t go without it.”
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A representative of Lincare told her that his machine is over 5 years old and that his son is eligible for replacement BIPAP under Medicare rules, but Lincare must first get a new order from a doctor. This was necessary for LINCARE to collect rental payments for new devices. The representative said he called the unresponsive doctorate that day and then faxed the request to the office. (Lincaré said he could not find a copy of the fax in the vast records related to Lequon Burner.)
In the meantime, the representatives proposed to pull out the malfunctioning BIPAP for 30 minutes. It didn’t solve the problem. The representative later promised to have a corporate respiratory therapist contact Sharon Vernor about the issue “until we get a new machine” according to the account’s memo.
But it never happened. Testimony in the case showed no one in the Linkale who had an office about 20 minutes away came out to repair a broken machine or assess the condition of the Lequon burner. (LINCARE has not done any BIPAP home visits or maintenance since 2015.) As the company admits, Lincare has never offered to offer Verner a “lender” BIPAP to use while waiting for a new device to arrive. Industry veterans say other companies generally offer temporary replacements, and patients with malfunctioning devices will wait for repairs or new permanent devices to arrive.
Without his vipap, Burner struggled to fall asleep (and breathe), snoring loudly all night. The Verners did not get any more words from the company until seven days later on Friday, September 18th.
Late that morning, Linkare nurse Anne Marie Evare called Berner’s mother and explained that she would arrive later that day with his new Vipap. The doctor’s order has finally arrived. Sharon Burner prepared a breakfast of sausages and biscuits for his son, who hadn’t been awake yet. She was surprised when he hadn’t shown up yet. The smell of food usually evoked him. Around 2pm she went upstairs to wake him up.
She opened the door and found her son in the bed without moving. A bloody liquid and foam came out of my mouth and nose. His body was cold. The broken vipup was sitting in a nearby dresser. Desperately, she called 911. “I think my son is dead! Lord, God, no!” she cried. “Hurry!”
When Evare from Rinkale stood up to deliver the new Vipap machine, an ambulance and police vehicle were still parked in front of Verners’ apartment. “When you saw it, it only gave you a sinking sensation,” Evare later testified. Sharon Berner shed tears and saw her at the door. Evare’s note states that “we sat with our mother until the family arrived.” Police are still in attendance until the coroner arrives when I leave. ”
A autopsy completed two days later for the Madison County Coroner’s lungs discovered that Lequon Verner’s lungs were “maroon” coloured, extremely “crowded edema” and filled with fluids that made it difficult to breathe. The report attributes Burner’s death to “complications of obstructive sleep apnea.”
In 2022, Sharon Burner filed an illegal death lawsuit against Lincaré and the University of Washington, and is currently on trial next week. Her lawsuit accuss Lincare of making more profits than patient care by confirming that her son has quickly got a replacement BIPAP and refuses to provide “lending equipment” in the meantime.
“In short, when Lincare was faced with information that Lequon’s BIPAP wasn’t working properly,” he submitted in December 2024. “Linkale knew this was a life-or-death situation for his client Lequon,” but he did nothing for the week. “It was a avoidable and terrifying tragedy,” said Johnny Simon, St. Louis attorney for the Verners. (Sharon Vernor refused to request an interview.)
The lawsuit also accuses the University of Washington’s medical program of failing to respond to requests for new BIPAP orders “in a timely manner.” The prescription for Lequon Vernor’s new BIPAP clinic was signed on September 15th, but was not sent back to Linkale for another two days. The University of Washington School of Medicine declined to comment through a spokesman, citing the lawsuit. In a legal filing, the university denied the lawsuit’s motion.
Propublica reports extensively on Lincare, which has a decades-long history of Medicare-related misconduct, including multiple settlements on claims fraud claims. And the fraud continued, whether the company had entered into a government “trial” agreement or demanded that it provide enhanced compliance oversight. The Better Business Bureau website gives the company an average rating of 1.28 out of 5 with 939 customer reviews, and file complaints about dirty broken equipment, delayed delivery, nightmare customer service, inappropriate billing, sales and collection calls harassment.
In an emailed response to a question from Propublica, Lincare provided “sympathy” to the Burner family, but claimed that “the allegations against Lincaré are false.” The company said it is legally prohibited from even offering lender Bypup until it receives a new prescription, suggesting there is no reason to believe Lequon Vernor has faced a life-threatening situation, as “BIPAP is not a life-saving device.” The company added: Our response to this case was consistent with legal requirements and our policy. ”
Linkare’s lawyers went a step further in a court filing in February, condemning the rapid provision of a new order no matter what happens on the alleged failure by Berner’s doctor. “Linkare did the job,” the company insisted. “At the moment Lincare knew that the deceased needed a new machine, Lincare reached out to the deceased’s healthcare provider. However, Lincare did not receive the updated prescription until a week later,” the company added, “at the mercy of the deceased’s healthcare provider in order to provide the updated prescription.”
Sharon Burner’s lawyers challenge Linkare’s claim that he was banned from offering loan bypups without obtaining a new prescription. (A spokesman for the Centers for Medicare and Medicaid Services refused to address the issue, citing the “large communication and public appearance suspension” imposed by the new Trump administration.) Lequon Vernor’s 2015 prescription is filled with Lincare.
How Lincare became a multi-billion dollar scofflaw of Medicare
The two former Lincare managers told Propublica they had blocked the temporary replacement equipment from being dispatched. At least one manager instructed staff to misrepresent clients that “all lenders are out.” Acting on orders from the supervisor, she said the local office had dumped CPAP and BIPAP devices marked as lenders. The respiratory companies they later worked for said that both regularly provided loan equipment to patients who relied on breathing devices while waiting for repairs or doctor’s orders needed to replace it. As one of them said, “We make sure that patients are caring for us at the moment.” (“Lincare’s policy is to provide our patients with lending equipment according to our patient care standards and regulatory requirements,” the company responded.
In deposition, Dr. Gabriella de Bruin, a neurologist at the University of Washington who evaluated Burner’s sleep study in 2015, said that given the severity of his illness, he allowed him to pose a serious health risk without a functioning BIPAP. She noted that Verner has “severe sleep apnea,” saying, “every time we prescribe treatment for obstructive sleep apnea, our recommendation is that patients should use it every night and should avoid it without a device whenever possible.” When asked if Linkale should understand that Verner’s apnea created a risk of death, she said, “it’s very difficult to say there is such a risk that he could die.” She added, “But certainly I’m very worried.”
The judge in the suit settled with Linkale on March 5th and found that the evidence presented by Sharon Berner’s attorney met the state’s legal standards for punitive damages. It would allow the “trier of facts” to reasonably conclude that “Lincaré acted with intentional and prominent neglect, ignoring the safety of others.”
Amidst the suspicion of deposition, Pamela Calvin, manager of the Linkale Outlet, who processed the equipment for the Lequon Burner, testified that “we should have referred Mama if he was so serious, to take him to the nearest emergency room.” Asked if the company was negligent in not providing lending equipment to lenders, she said, “Yes, we failed to provide it.” Lincare then filed an affidavit signed by Karban, saying it did not understand the legal meaning of the term “negligence.”
Doris Burke contributed to his research.
