US v Raritan
Perth Amboy, New Jersey, hospital Raritan Bay Medical Center has settled a long running upcoding problem with the feds. The hospital has agreed to pay $7.5 million for its transgressions.
Amerigroup has been found guilty of systematically not taking pregnant women in their program. This is against the FCA since they continued to receive money with the understanding that they were nopt to engage in discrimination. The judge fined Amerigroup $190 million in civil penalties and this was on top of the $144 million the jury awarded the government. The penalty was based on a $10,500 fine for 18,130 false claims. Americgroup states it will appeal.
Court judge in Nevada dismissed the charges of filing false claims against Dr.
Cyril Ovuworie for two dialysis patients. The two patients were unstable
and violent and no dialysis unit would take them. The patients ended up in
the ED of a hospital. Dr. Ovuworie was told by UMC Valley Hospital where
the two patients went to bill for the services as inpatients. The hospital
had an outpatient dialysis unit and actually admitted them for only the 23
hours. The government wanted the physician to bill a different way
necessitating lying on a form. This was intolerable to the judge and he
dismissed the case. Top
US v Raich
Angel Raich has lost again.
She lost her case before the US Supreme Court in 2005 for using medical
marijuana for her brain tumor. The case went back to the 9th who again
ruled against her but left some issues to the trial court. In the meantime
the patient will continue to smoke the weed and the court noted "uncontroverted"
evidence that she needed the drug. She will die continuing to use the
US v Rosenthal
A USDC judge blasted the government for attempting to retry and pile on new charges against Mr. Rosenthal. Mr. Rosenthal was tried several years ago for the Oakland Cannabis Club. He was found guilty but after the guilty verdict came in and before the sentencing phase, the jury wanted to nullify its own findings due to not being told that Mr. Rosenthal was actually an agent of the City of Oakland in passing out medical marijuana. The judge sentenced him to one day in jail and time served. The same judge now forbid the entry of new charges and said even if they won, the sentence could not be overturned since the prosecutors were "vindictive". Top
Green v Catholic Health
Parikh v Family Care
Dr. Parikh signed a contract with the group in 1993 which contained a non compete clause. The practice was owned at that time by Dr. Burns who died ten years later. The corporation was then owned by his widow, a non licensed individual. Dr. Parikh then terminated his services with the corporation and went to work a mile away. The corporation then sued but lost since by operation upon the death of Dr. Burns the corporation went from a professional to a regular corporation which is not licensed. An unlicensed corporation cannot sue a licensed professional. It has no standing. Top
Tran v Mission Hospital
Dr. Tran was an OB at the hospital. He had been at the hospital holding privileges for six years. The hospital medical staff then made a rule that all physicians had to be board certified within five years of coming on the staff. Tran was not board certified. He was terminated from the staff after being denied an extension to become board certified. Tran sued for damages and injunctive relief. The trial court and the court of appeals both found for the hospital on summary judgment. The rule was for all the staff and Dr. Tran did not meet the administrative rule. He therefore was not entitled to a "fair hearing" and could not be reported to the Bank. Top
Wax v Tenet
The plaintiff was injured by a non employee anesthesiologist. The hospital was sued and the court stated that the hospital owed a statutory and contractual duty to provide non-negligent anesthesia. The court stated that there was nothing on the consent form that released the hospital from its duty. This decision cries for reversal.
MacGregor v Rutberg
Dr. MacGregor sued Dr. Rutberg for defamation for testifying for a patient plaintiff in a med mal case against Dr. MacGregor. The court ruled that there was absolute immunity for the testimony. Dr. MacGregor won the underlying med mal case and then sued the plaintiff's expert. Rutberg was expelled from the AANS for his testimony and lack of review of other depositions in this case.
Lobaina v Deckinga
In Petoskey, Michigan, the Lobaina family won a $1.17 million jury verdict against Dr. Bruce Deckinga and a Grayling Mercy Hospital ED physician, Dr. Thomas Wertz, for the death of the patient after he hooked up the esophagus to the intestine instead of the stomach. The surgeon had a small med mal insurance policy and therefore settled just prior to the jury coming back for his policy limits. The jury stated the physician was responsible for 40% of the verdict, the hospital ED physician was responsible for another 40% for separate malpractice in transferring the patient to another hospital. The last 20% was for the patient who was so morbidly obese at the time of his second bypass procedure. Top
Patients v Allina
Patients sued Allina and Fairview hospitals for charging uninsured too much money. Soon after the case was certified as a class action, the hospitals stated that that the settlement was the right thing to do. This didn't happen until the class action. The hospitals will give discounts to those who owe money and those who paid will get vouchers for future treatments.
Planned Parenthood v Union
The Court ruled that there was no discrimination against females for not covering birth control pills in its health plan. The plan also does not cover any male contraception and so is not discriminatory. This overruled the lower court and the 2000 EEOC ruling that under the Pregnancy Discrimination Act employers are required to cover prescription contraception for women if they covered prescription drugs and devices used to prevent other medical conditions. Top
Union American Physicians v
The Oakland based Union of American Physicians and Dentists won a $10.1 million settlement against the county of Los Angeles for their physician members. The suit happened because the county illegally removed the physicians from the benefits after they joined the Union. The stupid physicians then quit the Union to continue to receive their benefits. Now that they have won the settlement, the dumb docs may want to rejoin the Union. ( I have been a member of this Union and think highly of them.) Top
Gonzales v Children Hospital
The mother of a 16 month old child with terminal Leigh's Disease on a respirator and in the hospital for about three months is suing to stop the cessation of life support by the hospital. In Texas, physicians can be the final arbiters as to who lives or dies. If they do not wish to continue the futile treatment, the family has 10 days to find another facility. The mother can find no other institution to take her son but has not asked for any extension of the 10 day time period.
Mueller v Idaho
A federal judge has ruled that the plaintiff has a civil right claim against the state for forcing a spinal tap on a 5 week old to check for meningitis. A social worker, without a court order, gave temporary custody to a police officer to get authorization for the tap which was negative. Did the Ed physician overstate the possibility of meningitis in a child with a fever but no other symptoms. The state wants to settle since to have a precedent would be bad for them and they screwed up big time. Top
March 15, 2007 Recent Legal News
Jordan v Wilkes-Barre Hosp.
Lori Jordan, RN has had an exemplary work record. She was fired from the hospital after reporting a sexual harassment of a fellow employee. Jordan has been promoted at the hospital many times over the 25 years of service and was the clinical director of critical care nursing units. Jordan was 42 at the time of her firing for (according to the hospital) questions relating to her work day as were monitored via parking stamps. Jordan claims that other younger people were not equally monitored. The case was filed in federal court for age discrimination and retaliation.
Goldberg v Rush Univ.
The physician sued for breach of contract for not being allowed an equitable share of ED call and other items she thought she was entitled to. Both court ruled that they will not interfere with a private hospital's internal staffing decisions.
Clayton v Pa. Dept. Pub. Welfare
A Black physician sued after his on call time was cut back, his office and mailbox were moved and he was denied cash and bonus payments. These were over several years. All causes were dismissed either for lack of standing or state immunity. He also failed to establish that race entered into the actions.
Talukdar v VA
Dr. Talukdar was terminated from the VA in 2002 for whistleblowing on the VA for the underpayment for non-citizen physicians. The law is the physicians must be paid the same if a citizen or not. Dr. Talukdar was ordered reinstated to the VA with full back pay. Back pay was also order to those physicians who were underpaid by the VA. This should cost the VA in Fargo North Dakota a pretty penny for four years of a physician's back pay.
Keyes v Murillo
Ashley Keyes is suing Dr. Boris Murillo an his employer, Berkshire Medical Center for breach of privacy. Ms. Keyes' medical record was accessed by the doctor so he could get involved with her. She is accusing the hospital of failure to protect her privacy and the physician for illegally accessing her records. Top
Baker v Akron General
The sons of a woman who died in the hospital have not only sued the hospital but also have requested a change in the cause of death from accidental to homicide. The woman, Victoria Baker, died from a IV dose of potassium phosphate. The med was supposed to go into the feeding tube not the IV line. The med caused a cardiac arrhythmia which caused the death. This will never reach trial. Just get out the checkbook now.
Dinkins v Metropolitan Med
The patient went to the Clinic for an abortion. Post-op she went into a coma and remained so for one month. She is still in the hospital. The Clinic has been closed by New Jersey until it corrects the "immediate and serious" risks. Dinkins had to have an urgent hysterectomy as well as transfusions for her condition.
Thomas v VanTuinen
The patient's heirs sued the physician after she died following being given an anticoagulant. The trial court ruled for summary judgment for the physician since the physician was not the treating physician. The Court of Appeals overruled the trial court and said there are facts that need to decided by a jury such as who signed the order, did the physician approve the use of the drug, or whether a resident was under the control of the physician. Usually the supervising physician is liable for acts of the physicians under his control. The Court also stated that a physician may be liable for a partner if the physician is the president of the group.
Knabb v International Biomedical
The family of Knabb who was a newborn in an incubator in an ambulance being transferred to a hospital was severely injured when the ambulance was hit by a car. The aluminum restraint bar was "faulty". The family received $4.6 million from the company that made the bar and the rest of the $5.3 million from Children's Hospital of Pittsburgh, Guardian Angel Ambulance and the estate of the driver.
Berger v Repro Labs
Two women in New Jersey who wanted to have a child together had the embryos lost by the company. They are suing for $3 million for emotional distress.
Sheikh v Lexington Medical
Dr. Sheikh, a surgeon at the hospital died after a double knee replacement. His heirs sued the hospital, surgeon and anesthesiologist for malpractice in 2002. The jury awarded $30 million to the family. The plaintiff attorney stated at the trail that the doctor was given a lethal dose of pain killers and then lost crucial original records. The hospital countered with the fact that the Doctor had a underlying fatal heart condition. The two attorneys had a secret pact with a high low figure and as part of the pact there would be no vigorous defense of the hospital. The jury took this lack of defense as guilt. The trial attorney now did what in South Carolina is known as the thirteenth juror and nullified the verdict. The case will now be retried.
Hogan v County Villa Health
Hogan sued a nursing home for elder abuse. The daughter had a statutory healthcare power of attorney signed the patient into the home and signed all the papers including one that stated if there was a dispute arbitration would be the method of decision. After the suit was filed the defendant moved for arbitration. The trial court denied the petition since the power of attorney did not allow the daughter to sign away her legal rights. The Court of Appeals overruled the trial court and stated that arbitration was part of healthcare decisions.
Doherty v Aleck
The patient had a history of severe cardiac disease. He visited the defendant podiatrist for a bunion. The podiatrist did multiple procedures on the bunion which eventually caused an amputation of the toe for gangrene. The trial went to the plaintiff for $850,000. The decision was overturned because the expert for the plaintiff did not show causation or state to a medical certainty that the treatment was not needed. The high court overruled stating that the expert did state with enough certainty about the need for the surgery and the causation. The trial verdict was reinstated.
Bailey v US
The family of Iraq veteran Justin Bailey has accused the Los Angeles West Side VA of the death of Justin. Justin checked into the VA for treatment for stress disorder (PTSD). He was given five prescriptions of five meds including Methadone. The next day he was dead in the VA rehab unit. Justin had a habit of drug abuse.
Doe v Kaiser
Kaiser is at it again. This time they killed a seven week old baby with the wrong med dose. Kaiser admitted the fault and blamed human error( not their botched EHR or transplant programs. This one happened again at Kaiser Santa Clara which has made prior errors with three patient deaths in 2004-05. Top
NY v Rashed
Dr. Ahmed Rashed, a resident physician at Maimonides Medical Center in New York, has pled guilty of third degree theft. While a first year medical student he stole a hand from a cadaver and gave it to a stripper friend. He was sentenced to $5000 fine and probation for 15 months, the end of the residency.
US v Surgeons
Three surgeon rented space to HealthSouth and received inflated rental payments for patient referrals. The surgeons Drs. Robert Eberhart, Jonathan Holzaepfel and Thomas King of Portsmouth, New Hampshire paid a total of $275,000 of the total $1 million settlement. The remainder was paid by HealthSouth.
Craker v DEA
In an important ruling a DEA ALJ has recommended that Dr. Lyle Craker, PhD. of the University of Massachusetts be allowed to grow marijuana for research. Dr. Craker was initially denied permission by the DEA. Dr. Craker and the ALJ decided that there is not enough marijuana for legitimate research. The DEA routinely denies requests for political reasons. This ruling may allow others to also grow their own marijuana to do the necessary research on the drug. Top
Ca. Med. Bd. v Roozrokh
The California Medical Board is investigating two physicians from Kaiser. They were both working at the time for the organization that harvests and distributes organs in northern California and not for Kaiser. The claim is that while in the OT awaiting the imminent death of a donor Dr. Roozrokh ordered excessive doses of medication to speed the death process. A new report stated that Dr. Roozrokh ordered 200 mg. of morphine and 80 ml of Ativan. The other physician Dr. Arturo Martinez, the surgical director of the now defunct Kaiser transplant unit, was also in the OR as was the patients primary care physician. The medication did not kill the patient and he was returned to his room where he died the next day. His organs were not harvested. The law states that no transplant person may direct the treatment of a donor due to the potential for conflict of interest. The coroner has ruled the death natural.
Faulkner v North Carolina Med
Dr. Faulkner, a physician from Raleigh, NC, has added his name to a suit against the Medical Board. The plaintiffs allege that the North Carolina Medical Society has too much power over the Medical board. Now the Society, which is not representative of over half of the state's physicians, nominate seven of the 12 board members. Prior legislative changes have not passed. The suit wants the Legislature to do a different selection method that might include the majority of physicians that do not belong to the society.
North Carolina v North Carolina
In an interesting law suit the State is suing its own Medical Board for threatening the licenses of any physician that assists in an execution. The state is attempting to use the argument that the Board can not discipline someone for attending a non medical procedure. This may lead down the slippery slope of since this is not a medical procedure, no physician is necessary which is against a current state court ruling. Top
Hayes v Premier Living
A wrongful death action was filed against the Long Term Facility. The plaintiff requested in discovery the incident reports. The facility refused. The trial and appeals court both stated to hand over the reports since reports that may be considered by a peer review committee are not protected, only those actually considered by the committee or were a part of the committee proceedings or were produced by the committee. These reports were not produced or used by a peer review committee.
Calabrese v St. Mary's Mich.
A physician discharged by the hospital filed an antitrust claim against the hospital. The physician lost, as they almost always do, since the physician failed to plead the relevant geographic market. One needs to prove harm to the market, not just harm to the individual. The court allowed the plaintiff 45 days to amend the complaint.
Vranos v Franklin Med Ctr.
The physician had his privileges summarily suspended after exhibiting "disruptive conduct" at a meeting. As part of his "fair hearing" he was denied access to disputed peer review documents. The lower courts allowed access but the high court said it was not allowed. The disruptive conduct was a "heated discussion by Vranos, the chief of Surgery with the director of surgical services over a policy to restrict surgical availability. This was in a regular scheduled meeting of the surgical support committee. After the meeting the chicken livered director tattled to the president that he had been afraid that he may have been hit. Prior to the argument the president and Vranos had been engaged in conversations to have Vranos leave his group and start a group at the hospital. Vranos decided against that. The day after the discussion the president sent a letter of summary suspension for the argument and a history of disruptive behavior. A peer review committee that included the president met and recommended that Vranos be reinstated with three conditions, an apology to the chicken, resignation as chief of surgery and anger management. The Board approved. Vranos accepted the conditions and then sued for defamation. In discovery, Vranos requested documents prepared for the peer review hearing consisting of incident reports, committee minutes and other statements. There is a rule that allows a physician to obtain the information if there is malice of the hearing, not the initiation of the hearing. Here the court said there was no malice at the hearing. Sounds like the court was misinformed as to the meaning of malice and when it should apply. Vranos should take all business to a competing hospital.
Trover v Kluger
A physician sued a newspaper that printed a story about disciplinary action against the physician by a local hospital. The physician stated that the articles led to his suspension from the hospitals. He stated that the newspaper falsely accused him of grossly negligent conduct. The newspaper said the articles were either true or protected by the First Amendment. The Court stated that all untrue facts came from a failed malpractice case against the physician. The Court did allow a defamation suit to go forward against a physician who published an article about Trover and the newspaper who printed that article. Trover will need to show the newspaper was negligent in checking the truth or falsehood of the allegations in the letter.
Colvin v Grand View Health
The physician was arrested for carrying a concealed weapon into the medical office of a former employer. The office was private but next to the surgical office of the hospital. The hospital decided that this was a violation of the hospital bylaws and the peer review body agreed. He was summarily suspended and reported to the NPDB for "unprofessional Conduct". The physician sued for defamation. The physician argued to no avail that the term "Unprofessional Conduct" was to be reserved for physicians who were practicing at the time. His offense was not while attending to patients. The Court disagreed and said his conduct was unprofessional and that the physician had been told in advance this was the code to be used. The physician did not advance any other code, so lost the argument.
Cretton v Protestant Mem.
A patient's estate sued the hospital after the patient died following a fall in the hospital. Following the fall the nurse did a handwritten note about a meeting with the patient's daughter telling her about the fall. The court ruled that this was not written for peer review but created separately and could be turned over to the plaintiff. The plaintiff won $950,000. Top
Hamrick v Charleston Area Med Ctr.
In the second of two cases against the hospital by Dr. Hamrick, the state high court ruled that the open meeting law applied to non-profit and government hospital Board meetings and the Medical Staff Executive meetings. He had attempted to appear before the Med Exec Committee to explain why he wanted to provide his own med mal insurance. The first case earlier in the week allowed Dr. Hamrick the ability to provide his own med mal insurance. Since he now has that right, he doesn't need to appear and just get his own insurance. Two for Hamrick and none for the hospital.
Drew Univ. v LA
Drew is suing the Los Angeles County for $125 million for breach of contract. The county severed the medical school from the poorly run King Hospital so the hospital could get back on track. The LA Board of Stupes was shocked at the language used by the University against the "betrayal by the county." The County ran the hospital which was awful, not the medical school which had several of its programs decertified by the national organizations.
McKenzie Med Ctr. v PeaceHealth
McKenzie-Williamette Hospital successfully sued the evil PeaceHealth for antitrust last year. The accusation proved in court was that PeaceHealth had used its dominant market place to attempt to get rid of a competitor. The appeal to the 9th Circuit of the $16.2 million verdict is being heard. PeaceHealth used predatory pricing of steep discounts to for Blue Cross in areas where there was no competition in return of exclusivity of the other services. The case was based on a case from the 3rd Circuit. If the 9th doesn't follow then it would go to the Supreme Court for determination.
Patients v BJC HealthCare
Poor or poorer BJC HealthCare in St. Louis. Patients have sued for charging the uninsured more than others for treatment. A judge has granted class action status to those from 1990 to the present. Another problem is the tax exempt status of the non profit hospital. Their expenditure in 2004 for charity care was a measly 0.84%. Still its alot of money in a system that owns 13 hospitals.
Brockovich v Community Med. Ctr.
Erin Brockovich's (yes, that one) suit against the hospital in Fresno, California for billing Medicare for hospital errors. The judge said Ms. Brockovich had no standing in this case or the 48 others she filed. The plaintiff is not a Medicare recipient and had never been treated at the hospital. Top
In re Kayla T v Linda T
The Family court of New York removed a 13 year old female from the custody of her parents due o morbid obesity. The Court had found that all practitioners agreed the obesity was due to lack of exercise and too many calories. The parents had been warned previously. This is the first time it has happened in New York but California, Iowa, New Mexico and Texas have recognized morbid obesity as a actionable cause for removal of custody of a child. Top
Ogle v PacifiCare
Ogle sued for breach of contract and bad faith. The "insurer" moved to compel arbitration. The trial court and the Court of Appeals both said to court. The arbitration notice is invalid by not complying with the statute. The enrollment form contained an arbitration clause printed in bold and above the signature line as required. Then the dumb "insurer" attorneys stated that the form was not a contract and if accepted the "insurer" would send the Ogles a policy with the exact terms and conditions. The booklet was 37 small print pages and only briefly mentioned arbitration without wetting out its parameters.
Kurtek v Capitol Blue Cross
In another correct decision but one that is difficult to swallow the 3rd Circuit stated that the state claims by a women for damages due to a delayed decision by the insurer caused severe injuries to the patient. All that was true but ERISA came in and since the delay was an administrative decision and not a medical one the fed law held. Case dismissed.
Sutter v Oxford Health Plans
An arbitor held that a physician who contended that the plan did not pay claims in a timely manner under New Jersey law was entitled to a class certification. The 3rd Circuit upheld the decision. It held that the arbitration judge did everything appropriately and made the decision based on all known law and facts. Top
Lima-Rivers v UHS of Puerto Rico
In an important case that looks at inpatients and EMTALA, the court ruled that a newborn delivered in a hospital and an inpatient there was not stable for transfer. The case against the hospital was not dismissed. The baby was born by C-section and by the next day had significant GI bleeding. He was transferred to another hospital but arrived in extremis and died soon after. The court stated that EMTALA was not confined to EDs. The court stated that the CMS regulation stating that EMTALA does not apply to inpatients is only a interpretive rule and without the force of law. Top
DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.