February 1, 2005 Recent Legal News




Peer Review

Right to Die


Fraud and Abuse


Daniel v Doctors Lake of Orange Park

Daniel's widow is suing the nursing home where her husband was for Parkinson's.  He suffered a heart attack and the nurses made a clerical error.  He had a DNR order in his chart that was actually for his next door neighbor.  The nurses having seen the DNR and not reading it just put a sheet on him. When the paramedics arrived he was transferred to a hospital where he died.  

Patients v Cardiologists

Seven hundred and forty patients have settled their law suit against four cardiologists at Redding California Hospital for $24 million.  The hospital has previously settled for over $395 million and paid a fine of  $54 million. 

Holt v Alexander
Tenn. Ct. App.

In a case involving informed consent, Holt presented with a kidney stone.  Alexander treated the patient and told the patient that he had spoken to her urologist who agreed to the surgical approach.  In fact, Alexander never spoke to the patient's urologist.  The patient's urologist testified that if he would have been notified, he would have agreed with the plan.  The lower court said this was then okay for informed consent.  the court of appeals did not agree. They stated that Alexander falsely received permission and therefore the case can go to trial.    Top


Cone v Florida Dept. of Health
D. Fla

Cone had his Florida license revoked due to having his California license revoked.  There is a law in Florida to allow this.  The court ruled for the provider stating that there was no showing of how the California revocation impacted the Florida practice.        Top


Patients v Blue Cross of RI

Blue Cross of Rhode Island has agreed to settle a class action suit giving all plaintiffs (policy holders) monies from $95 to $2500.  This is for the use of a silent PPO, where the patients were charged copays based on regular charges but blue Cross got a substantial discount and therefore the co-pay should have been less.  The settlement also prohibits blue Cross from continuing the sneaky practice.  The three law firms that worked on this case for nine years for contingency fees will ask for $5.7 million to be split among them.      Top

Peer Review

El Attar Hollywood Presbyterian
Ca. Superior Ct.

The Court has allowed the suspension of Dr. El Attar from the hospital for quality concerns.  The case is interesting because the action was instituted by the hospital Board when the medical staff wouldn't.  the Board hired outside physicians to check the quality of the work and then suspended the physician who was allowed to remain on staff until his judicial appeal was complete.  The doctor attends to appeal the ruling but will lose. 

Radiation Oncology v Providence Hosp.
Ala. Supreme Ct.

The hospital transferred the hospital based program to an office based one and did not hire any of the same people.  The physicians had a hearing in the hospital per the bylaws and the committee found in favor of the physicians.  The hospital said tough.  The physicians sued for breach of contract under  the bylaws. The lower court ruled for the hospital on summary judgment.  The Supreme Court also ruled for the hospital as they have the right to make the business decisions.  The medical staff bylaws only allow a recommendation but the final decision is the board's.

Feyz v Mercy Hospital
Mich. Ct. App.

Feyz and the hospital had a dispute regarding preprinted orders. The hospital put Feyz on probation.  Feyz sued for a civil right violation.  The trial court ruled for the hospital on summary judgment on the basis that the private hospital could not be sued. The court of appeal stated that civil right violation trumps the theory of judicial non-reviewability.  The court basically threw out any perceived difference between private and public hospitals.

Kibler v Northern Inyo Hospital
Ca Ct. App.

Kibler was suspended due to disruptive conduct against the nurses and personnel of the hospital.  The physician filed suit for tortious interference with business.  The hospital said this was a SLAPP suit (Strategic Lawsuit Against Public Participation). The lower and the court of appeal both stated the physician was in violation of the SLAPP suit law and the physician did not exhaust all administrative remedies as he did not go before the judicial review committee. He also executed a release and so had no possibility of success. 

Braswell v Haywood Med. Ctr.

 Braswell wrote a letter to a physician potentially having him not settle in the hospital's area.  Two years later after an adverse patient event, Braswell was investigated and removed from the staff.  he sued for tortuously interference with business and interference with his civil rights. The hospital wanted summary judgment under HCQIA.  They were denied since if Braswell can show the peer review panel were competitors and biased due to the prior letter, then the peer review was tainted and possibly maliciously done.  This negates the federal law protecting hospitals. HCQIA also specifically does not apply if the physician can show a civil rights violation. 

O'Meara v Palomar-Pomerado 
Ca. Ct. App.

O'Meara was removed from the staff after he continually argued against managed care decisions against his medical judgment.  The hospital argued that the suit was not valid since it was against the SLAPP statute. The court stated that peer review and a private hospital is not a state action so the SLAPP concept does not hold and the case goes back to trial court.       Top

Right to Die

Fla. v Schiavo
US Supreme Ct.

The US Supreme Ct. has refused to consider the Florida Supreme Court ruling that stated that the state had no legal right to interfere with the husband's right to disconnect the feeding tube from Terry.        Top


US v Dameron Hospital

Dameron Hospital in Stockton California, settled with the government for a fine of $75,000 for failure of screening properly of sixteen patients in 2002.  the problem was that the patients were triaged and not screened by a qualified person.

US v Borgess-Lee Hospital

The 15 bed hospital in Dowagiac, Michigan, settled for $5000 for allowing a patient to go to another hospital with chest pains for a routine dialysis appointment. The patient arrived in an unstable condition and died the next day. The fine was so low due to the hospital's documented financial condition.         Top

Fraud and Abuse

US v Baptist-Lutheran of Kansas City

The hospital had an illegal relationship with a physician and settled the allegations by paying a fine of $1.56 million.  The relationship was found by an internal audit by the hospital.

US v North Mississippi Med. Ctr.

The Tupelo hospital paid $675,000 to settle claims by the government of over billing for ER claims.  The actual culprit was EmCare, the same Texas outfit that just was removed from the Minnesota hospital. It was EmCare that upcoded but the hospital submitted the charge. EmCare was not charged since they did not put in any false claim to the government.

US v Alvarado Hospital

In a strange move, Alvarado Hospital in San Diego rested after the government put on its case.  They stated that the Government did not prove its case.  This was after the hospital's associate administrator admitted paying physicians and testified for the government. They are claiming that the government did not prove that any physician was influenced by Alvarado.  I believe the standard is that they attempt and not actually succeed in paying physicians for referrals.        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.