CHARLOTTE, N.C. — A federal appeals court has upheld the conviction of a North Carolina ear, nose and throat doctor who reused single-use surgical devices on over 1,400 Medicare patients and defrauded the program of millions.

The Fourth Circuit Court of Appeals rejected arguments from Dr. Anita Louise Jackson, 63, who was sentenced to 25 years in prison in June 2023 after being found guilty of device adulteration, fraud, conspiracy and identity theft.

Jackson, who operated clinics in Rockingham, Lumberton and Raleigh, billed Medicare more than $46 million for balloon sinuplasty procedures between 2014 and 2018. Evidence showed she used only 36 FDA-approved Entellus devices for over 1,500 surgeries, reusing them on multiple patients despite rules requiring single use.

Prosecutors said Jackson marketed the procedures as a “sinus spa” and encouraged patients to receive treatments they may not have needed. When auditors investigated her practice as the nation’s top biller for the procedure, she and her staff falsified medical records and forged patient signatures.

The court dismissed Jackson’s arguments that the devices weren’t technically “held for sale” and that she was protected under laws allowing off-label use of medical devices. The court also rejected her attempts to introduce evidence about her cleaning methods.

Jackson also argued that there are CDC documents that allow the re-use of single-use devices, but the court said that this did not apply to the Entellus devices or Jackson’s cleaning methods.

The court heard Jackson’s arguments in November 2024. The ruling was filed on Tuesday, Jan. 21.

Jackson was ordered to forfeit $4.7 million in profits and serve three years of supervised release after her prison term.

“This doctor put profit over patients by reusing single-use surgical devices hundreds of times, even though those devices came into contact with blood and other bodily fluids,” U.S. Attorney Michael Easley said after her conviction.

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