Philip Gabriele, MD, a high-profile eye surgeon in Elkhart, Ind., and his wife, the subjects of a 2-year healthcare fraud investigation that ended in a federal indictment, were found dead in his office, on June 15 in an apparent murder-suicide.

The Gabrieles were accused of fraudulently diagnosing cataracts and performing unnecessary surgeries on patients, including children, and then billing Medicare, Medicaid and private payors. Some patients say they were harmed and their vision was damaged as a result of the unneeded surgeries. The indictment also says that Ms. Gabriele changed patient records after the procedures in order to meet medical necessity requirements of payors, according to the Associated Press.

According to the Elkhart County Coroner, Dr. Gabriele shot his wife in the chest more than once and later shot himself in the head, just as police arrived at the Gabriele Eye Institute. Based on evidence at the scene, Ms. Gabriele apparently wanted her husband to kill her. "She was in agreement about her death," said John White, county coroner.

Once the indictment was filed on June 12, the Gabrieles issued a press release saying that Dr. Gabriele would continue to care for the more than 13,000 patients that he treated at three offices in northern Indiana.

The Gabrieles were scheduled to turn themselves over to police the day they died. Susan Manuszak, a close friend of the Gabrieles, said the stress of the investigation and the indictment pushed the couple over the edge. Both had heart conditions. They were "hanging by a thread," Ms. Manuszak told the Goshen News.

Apparently, once they had decided to end their lives, the Gabrieles mailed a package to a South Bend television station with a letter to patients and the community and several documents in their defense against the fraud charges. "It is clear to us that our good works here have come to an end," wrote the couple in the letter. "We are at peace with our decision."

—Kent Steinriede