April 1, 2012 Recent Legal News

Peer Review and Employment

Malpractice

Fraud

Healthcare

HIPAA

Peer Review and Employment

Oakes v Boise Heart Physicians
Ohio Supreme Court

The high court ruled that a physician who had successfully sued and won an employment matter against his former employer was entitled to attorney fees and costs.  When Oakes left the employer there was a dispute over the money owed to the physician.  Eventually he sued the employer.  There was a counter claim and the physician was awarded damages far less than he claimed but he defeated the counterclaim.  He therefore won and should have been awarded the fees and costs.  

Nassar v Univ. Texas Southwest
5th Circ

Dr. Nassar was on the faculty of the University and specialized in treating HIV/AIDS.  He left the University after being harassed by a superior for his race.  He attempted to get a position at another hospital which was affiliated with the University and was blocked by Southwest.  Nassar sued and won judgment on racial bias as well as on preventing him getting another position.  The 5th Circuit reversed the bias award but allowed the interfering with employment.  The case was sent back since the award did not differentiae between the two causes. 

Kademian v Marger
Ohio Ct App

 Dr. Kademian was an employee of Dr. Marger in a radiation oncology practice.  Dr. Kademian left the practice and was told he could not practice at the area hospitals due to a covenant not to compete.  He sued and lost in trial court but that was overturned in the court of appeals who stated that hearing the facts as presented by Dr. Kademian was enough to determine there was a true controversy regarding the facts and jury needed to hear the case.        

Crow v Penrose
Colorado Ct. App.

The plaintiff was terminated from a hospital and sued to overturn the decision and for his peer review records.  Since the hospital was private there was no state action and the Administrative Procedure Act did not apply.  Therefore he lost that part of the case.  He won the right to get his peer review records as there is state law that allows it when the physician appeals his termination.  He also won a new hearing after he gets the requested information.   

Kapolovic v Shaw
Ill. App Ct

This story has a moral.  Do not do things without the protection of peer review.  The two physicians worked at the same surgicenter and the anesthesiologist thought the plastic surgeon was attempting to game the system.  He wrote a letter on his own volition to the Board regarding his belief and the plastic surgeon sued the anesthesiologist and the surgicenter vicariously for defamation.  The trial court stated the letter was protected but the court of appeal overturned the ruling stating that the anesthesiologist wrote the letter on his own therefore it is not privileged.  This will cost the surgicenter and the anesthesiologist a lot of money for defense and maybe even for libel.

Pacific Radiation v Queen's Med Ctr
USDC

A federal judge has issued an injunction against the hospital from denying the radiology oncology group from doing procedures at the hospital.  The hospital tried to strong arm the physicians stating they would lose their privileges if they did not become employees of the hospital.  This was a problem for the physicians since Queen's was the only hospital on Oahu that did the procedure.  The court said he could continue to perform the procedure at Queen's.  The judge hinted in his opinion regarding a potential anti trust action against Queen's.   

Russo v NY Presbyterian Hospital & Mark Adams, MD
USDC E NY

Russo sued the hospital and the physician for sexual harassment leading to her termination.  In this motion to remove Adams, Russo won since she showed enough evidence that Adams was a significant contributor to the sexual harassment and to her termination as a perfusionist at the hospital.         Top

Malpractice

Parris v Limes
Ohio Supreme Court

Parris had a prostate biopsy that showed there to be cancer.  After prostatectomy, no cancer was found.  Parris sued for malpractice.  The high court ruled that there was no malpractice and Parris was treated correctly.  However, he was not told post operatively that he did not have cancer so he had post op blood tests.  This was malpractice and the case should go to trial for him having to endure the pain and suffering of a needle stick.

Fernandez v Univ. of Illinois
Settlement

Fernandez under went a robotic splenectomy and he died of post operative complications.  The University settled for $6 million since it was the first one ever done by this surgeon at the Chicago campus and the staff did not find the post operative problem in time to save him.   

Sieman v Huron Medical Center
DC MI

Sieman sued the medical center for med mal and EMTALA violations.  The ED physician sued to intervene since the case involved him in different ways than the hospital.  The court allowed the intervention as it should.  The plaintiff objected but lost.       Top

Fraud

US v Chhibber
Convicted

Dr. Jawinder Rai Chhibber, a Chicago physician, was convicted of health care fraud by a federal jury.  He was accused of submitting bills for unnecessary medical tests and using false diagnosis codes to justify the tests.  He will be sentenced on May 10. 

US v Five Nurses
Arrested

Five nurses in the Philadelphia area were arrested for a healthcare scam involving inappropriate and ineligible patients enrolled in hospice. 

US v Villa
Guilty

Juan Villa of Miami pled guilty of a Detroit scam to defraud Medicare by paying people to get Medicare beneficiaries to come to the clinic in order to obtain the Medicare numbers.  He then used the numbers to bill for medically unnecessary items.  Sentencing of up to ten years is upcoming.

US v Morgantown Healthcare Providers
Settlement

Morgantown Healthcare Providers and Monongalia Health System agreed to pay a fine of $2.5 million for understaffing a long term care facility and thereby giving substandard care.  The care was not OK to bill for therefore illegal.

US v Good Samaritan Hospital
Settlement

The Baltimore hospital agreed to pay the feds $793,548 for illegally giving patients a diagnosis of malnutrition as a secondary diagnosis.  They never documented the disease nor treated for it.  What they did do was coerce the physicians to use the diagnosis so the hospital could get more money.  This is a MedStar hospital.

US v Fadul & Al-Attar
Indicted

Drs. Abdul Fadul and Ali Al-Attar were indicted for income tax evasion for hiding income from their Maryland medical practices.  They will come to trial at a later date.         Top

Healthcare

CMA v Cal. Assn. of Nurse Anesthetists
CA Ct App

The court of appeals stated that nurse anesthetists could give anesthesia without physician supervision.  They would need a physician order to perform the services.  This would help the rural hospitals but it is doubtful that any urban hospital would allow it unless it is strictly for monetary reasons.  

ACLU v Indiana
Indiana Supreme Court

 In a class action suit the Indiana Supremes have ruled that the state may not deny Medicaid, food stamps or welfare to people with better explanations as to why they are not eligible.  The state had just said they were removed without citing specific reasons and would not meet with people on an one on one meeting.     Top

HIPAA

Patients v Georgia Health 
To Be Filed

Yet another hospital employee had a laptop stolen that contained personal health information.  This time the information was medical and not financial and from the Sickle Cell Clinic of Georgia Sciences.  Hospitals should know better than to allow any employee to have any information on any electronic device.  This time over 500 people were affected.        Top

Archive

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.