February 15, 2007 Recent Legal News







Peer Review



Dennis-Johnson v Kaiser
Ca. Ct. App.

In an interesting case, Kaiser Permanente did a double whammy on Dr. Johnson.  They took away her privileges and terminated her from Permanente Medical Group.  She requested a hearing but due to delays by her attorney and by the attorneys for Permanente getting an impartial hearing officer, the time accorded in the bylaws ran out.  She then sued to get her hearing on her privileges and she should be reinstated in Permanente.  The Court stated that she should get the reinstatement since she already had her privileges revoked and could not be a danger to anyone while the hearing took place on her privileges and termination of employment.  Permanente will probably have to pay her for the back pay since 2002 and going forward.  

Kumar v United Health Hospital
ND Pa.

Dr. Kumar, a resident physician, made sexual advances toward an employee of the hospital and was dismissed.  He sued for discrimination but was rebuffed since he could not overcome the hearing and the admission that he lied about the incident.  

Mehta v Cedars Med. Ctr.

Dr. Mehta was the chief of the hospital's cath lab since 1995.  While at a meeting in 2002 he talked with a HCA executive, HCA owned Cedar, and was told about a concern over too many cardiac procedures being done at the hospital.  Dr. Mehta investigated and reported to the CEO of the hospital.  The CEO warned him that his job may be in jeopardy due to these investigations. Dr. Mehta later was told that some stents sent to the hospital had ended up in South America.  He reported that to the CEO as well.  Dr. Mehta was then terminated from his $6000 per month job.  Dr. Mehta was then investigated by the FBI for unnecessary procedures and was found no longer to be a target of any investigation.  The CEO filed a report to the State Board as well but that was also dismissed.  there has been no medical disciplinary action against the physician but the hospital terminate his privileges in 2004.  The hospital then sued the physician for not paying Cedar's bill for Cedar's beeper.  This was also dismissed.  This is good case for those who believe there are no sham peer reviews.   

Agarwal v Promed IPA
9th Circ.

Cardiologist Chandrahas Agarwal had his contract with the IPA non-renewed due to the perception by the IPA that he ordered too many tests.  The contract was an evergreen yearly contract.  After the first renewal of the contract the IPA filed for Chapter 11  bankruptcy.  After the filing the IPA routinely stopped authorizing his requests for tests but allowed them on appeal.  The bankruptcy court and the district court ruled for the IPA.  The 9th Circuit also agreed but allowed the state court claims to proceed.  This was the wrongful termination and the unfair competition claims.  The IPA is in trouble.

Carter v Muenster Hospital
Texas App. Ct.

 Drs. Carter and Davidson-Cox were employed by the District hospital.  They both complained about a physician who they believed was causing patient neglect and billing falsely.  They were then notified that they were the subject of an disruptive physician investigation.  They both left.  Carter stated she was constructively discharged and Cox stated she was terminated.  They both sued for retaliatory discharge.  The hospital also sent demand letters for the return of money the hospital had advanced.  The District also filed a counterclaim against the physicians stating they had resigned and therefore the hospital was due the funds.  By counter suing the hospital lost its immunity for suit under Texas law.  The Court went on to limit the damages that the two physicians could receive to the amount the hospital was asking to be returned.  This is only for the retaliatory discharge claim and did not include any money won by the physicians on the breach of contract claim. Who says sham peer review doesn't exist?

Haas v Wyoming Valley Health

 Dr. Haas, an orthopedic surgeon, had a mental health disorder which was treated.  The hospital reinstated the surgeon but imposed a six month condition that he must be monitored in surgery.  He sued for lack of reasonable accommodation.  It is the opinion of this person that the hospital is on good solid footing here.

Nurses v Allina Health
       Ca Dist Ct.

Seven nurses and other female workers have sued Dr. Donald Blowers and the Allina Woodlake Clinic for sexual harassment.  The women state the physician had groped, made lewd comments and assault for more than ten years.  They also accuse Allina of doing nothing to stop the behavior and retaliating against the complainants.   Top


N. Dakota v Hsu
North Dakota Supreme Ct.

The Supreme Court of this state overturned the lower court who reinstated Hsu after the Medical Board revoked his license instead of a lesser punishment.  The Supreme Court stated that deference must be paid to the Board over the facts. An administrative law judge had ruled for the physician as did the trial court.       Top


Farishta v Tenet
Texas Ct. App.

The hospital did not require the physicians who were independent contractors to do testing on mothers to be.  This the Court said was below the standard of care and the hospital could be sued by the parents of the child who had the disease that was not screened for. 

Davis v Humphrey Health Center

Davis visited the Center owned by Los Angeles four times in 2004 for headaches and blurred vision.  He was diagnosed as sinusitis.  A year later he saw an ophthalmologist who ordered a CT scan.  The scan showed a brain tumor and Davis is now legally blind.  The county settled for $1.8 million.   

Schlock v USC

LA County also settled this case for $1.5 million.  The patient was injured on a construction site and an x-ray showed air and bone fragments around a major artery.  No vascular studies were done.  He then had a stroke with major brain damage. 

O'Sullivan v Kinch
Rhode Island Superior Ct.

  In an outrageous award the family of the plaintiff was awarded $21.5 million from an ED physician for negligent care.  Most of this was damages for non-economic injury.  This will be appealed and settled. 

LA v Hollywood Presbyterian Med. Ctr.
To Be Filed

In an egregious breech of ethics a paraplegic patient from the hospital was dumped on skid row without any wheelchair or walker.  He also had a colostomy bag that was loose.  This hospital has been accused in the past of illegal patient dumping.  This time charges may be filed.  The patient was re-hospitalized at a county hospital.   The investigation into the incident has now has shown the above act was the second attempt by the hospital to get rid of the patient.  The first was caught on video.  

Salvatore v Winthrop Univ.
NY App. Ct.

The patient went to the ED after an auto accident.  As part of the treatment a physician used a catheter which broke and part lodged in the patient's brain.  The lower court ruled for the plaintiff against the physician without a trial.  The higher court reversed and stated the expert's opinions were too conclusionary and that a trial was necessary.  The court did not overturn the vicarious liability of the hospital stating whenever a patient comes to an ED of a hospital and not a particular physician the hospital is potentially vicariously liable.

Laredo Med. Grp. v Jaimes
Texas App. Ct.

The patient sued a physician and his medical group for malpractice.  The problem was the physician had left the group prior to the incident.  Apparently there was a miscommunication between the group and the court where the court believed the group would be liable for what ever damages.  The higher court said this was a mutual mistake and stated al damages were to the individual physician only.        

Garcia v Kent
Ca. App. Ct.

The patient tried to sue an administrative agency that supplied a physician for malpractice.  They stated that the agency should be liable for their employee.  They also thought the other non-treating physician with their names on the door of the agency should be liable.  None of that nonsense worked.  The agency had nothing to do with the independent contractor physician nor did the non-treating physicians.  The agency was not a healthcare provider so owed no duty to the patient. 

Alcorn v US

Gavin Alcorn was born at the Jacksonville Naval Hospital after being transferred from Italy due to the high risk birth of twins.  The one twin was born with cerebral palsy and blindness.  Doctors at a non-military hospital said the cause was lack of oxygen during the birth.  The suit is for $150 million.  This suit will never see the light of day and will be quietly settled.       Top


Flushing and Jamaica Hospitals v UnitedHealth

The two hospitals have filed a RICO claim against the insurer for actual and at least $50 million in punitive damages for lying to patients.  they allege the insurer told their patients that the two hospital were not in their system when indeed they were.  

US v Sotto

Diana Sotto, the president of a medical billing company, and five others were convicted of fraud for billing for expensive medications for patients that were never given.  Ms. Sotto got 10 years and one month in prison.  The others were not sentenced as yet.

US v Torres

Dr. Julian Torres was indicted for fraud along with two co-conspirators.  They are accused of submitting claims for medically unnecessary durable medical equipment.   

Connecticut v Moffat

Dr. Mitchell Moffat and a patient were charged with illegally prescribing and obtaining controlled drugs.  The physician was charged with 1136 counts and the patient in 1106 counts.

US v Graf

A bogus medical insurance agent and his accomplices have been convicted and the agent was sentenced to 25 years plus restitution of $20.5 million.  They took premiums and never purchased the insurance.  All cash an the homes have been seized and will not add up to enough to repay all the debt.

Louisiana Supreme Court

The state high court overruled itself when it previously ruled the $500,000 cap on non-economic damages was unconstitutional.  The case now goes back to the Court of Appeals to discuss the separation of powers, due process and the prohibition of separate laws.  This will come back to the high court for final resolution at a later time.


Louisiana v Pou

Dr. Pou and two nurses were indicted by a DA without proof of murder.  The deaths happened during Hurricane Katrina when the physician and nurses stayed to care for patients. The case has now taken another turn against the prosecutor since the coroner will not label the deaths as homicide.      

US v Sabir

A judge has ruled that Dr. Rafiq Abdus Sabir can be prosecuted for pledging to treat al-Queda members.  This constitutes material support to terrorists under federal law.  The prosecution is not for providing medical care or being a physician as expert advice or assistance to the enemy. 

Italy v Riccio

Dr. Riccio, an anesthesiologist, turned off the respirator of a man with terminal muscular dystrophy who requested the act.  He was accused of murder but the medical panel cleared him of any wrongdoing.  A court had previously denied the patient's request for removal of the ventilator.  

US v Tate

Dr. Tate, the radiologist who claimed he worked 20 hours a day for King/ Drew was convicted of tax evasion and ordered to pay back taxes of $35,138 and a $10,000 fine.  He apparently was paid over one million dollars for the one month stint at the hospital.  Criminal charges were never filed for the claim of the hours worked.       Top


Bagent v Blessing Care
Illinois Supreme Ct.

The Illinois Supreme Court ruled that a hospital employee who blabbed confidential patient information to the plaintiff's sister while in a bar could not be acting under her scope of employment and therefore the hospital could not be vicariously liable.  

Planned Parenthood v Indiana
Ind. Ct. App.

 The Court has reached the logical conclusions that when physicians and patients discuss contraception and other treatments of reproductive health, these conversations are private.  The State had attempted to obtain records of low income girls who sought medical services.  

Patients v John Hopkins
To Be Filed

 Approximately 135,000 records of workers and patients of the institution were told that their personal information had been lost for the past seven weeks.  The non-medical information was on back-up tapes which may have been accidentally incinerated.  The University recommended that the people put a fraud alert on their credit agencies but were not willing to pay for it. 

Veterans v VA
To Be Filed

Yet another breach of privacy by the model health organization, VA.  After their screw-up last year put millions at risk, they have lost another portable hard drive is missing.  They at least will offer free credit monitoring services as opposed to the idiots at John Hopkins who are inviting suits.       

Patients v St. Mary's
To Be Filed

Another Maryland hospital has admitted losing the names and social security numbers of 130,000 people dating back to 1989.

Peer Review

Reed v Franklin
WD La.

The physician was summarily suspended without a hearing and sued.  The Court stated that a post-suspension hearing was not a problem if patient safety was an issue.  The court also stated that non compliance with the bylaws is not important in the due process analysis.  Another in a long string of physician losses in this arena.

Crawford v Duggan
WD Pa.

The physician's suit against a hospital for retaliation after a complaint regarding understaffing of the ICU and a report to the NPDB was dismissed by the court.  The physician was non-compliant and did not help his own counsel.  He caused a two year delay in the proceedings and the sanction was dismissal of the case.  

Jenkins v Methodist Hosp of Dallas
5th Circ

The physician was dismissed from the hospital and sued for discrimination.  The court ruled that the hospital's rationale for the suspension, creating a hostile work environment, was non-discriminatory.        Top


Physicians v Blues

The Excellus BlueCross BlueShield agreed to pay the physicians of Rochester Community IPA $29 million for their cheating them on their fees.  Neither side admitted wrongdoing but one doesn't pay this much unless they are wrong.  The money will be divvied up between the 2600 physicians of the group.  These same physicians also beat the same insurer in 2001 and 2003 for the same thing.  They won $4 million and $19 million respectively.  The spin doctor for the insurer stated that the settlement shows their willingness to partner with physicians.  Nonsense, they just got their hand caught in the cookie jar again. 

Calif. Assn. Realtors v Blue Shield

 The Association has filed suit against the insurer for canceling its contract and dropping coverage for about 8000 individuals.  Blue Shield stated that there was a contract provision that if the Association did not have 79% of its members covered under the group plan, the plan could be dropped.  The Association states that it had over the required 79% in the plan.  They state that they were at 99%. If that is true then blue Shield may expect a fine for every person that is non covered plus terrible publicity.            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.