Dr. Pat ratted him out because he blamed Lombardo for the death of his two brothers. I'm telling you, Lombardo couldn't save them. Auippa/Cerone/Accardo made the final call. There was nothing Lombardo could do about it.

Another example of the weakness of the modern Outfit. Dr. Pat would have disappeared years ago. He ratted out Lombardo based upon his false belief, and nobody fucking cares. Dr. Pat goes to work every day untouched.