January 15, 2016 Recent Legal News




Peer Review and Employment



Hailu v Saint Mary's Regional Medical Center
May Be Filed

A 20 year old female underwent an appendectomy at the hospital for abdominal pain on April 1.  She had brain damage due to low oxygenation and was pronounced dead on May 28.  The father went to court to keep her on life support and the courts agreed, including the state supreme court.  She recently died despite being on life support and now a private autopsy is being performed but being paid for by the hospital.  

Deeds v Virginia

State Senator Creigh Deeds is suing the state for wrongful death of his 24 year old son.  He say the son was denied mental health treatment prior to being fatally shooting himself.  He also stabbed his father multiple times just prior to the self shooting.  The suit claims that by not finding a bed for him and releasing him was below the standard of care.

Duvall v UPMC

Duvall was a double lung transplant patient at the hospital and contracted a mold infection.  He sued stating the hospital could have prevented it.  He was one of four that contracted the infection.  the other three died and he is in the hospital.  He had been placed in a negative pressure room which is not for immunocompromised patients such as Duvall.

Sampson v Ukiah Valley Med Ctr.

The patient was involved in a MVA and sustained major trauma.  The air ambulance could not land and the patient went to the hospital by ground transportation.  The ED physician diagnosed the problem but did not treat the patient and had him transported by ground ambulance to another facility 60 miles away.  He was accompanied by by the air ambulance personnel.  Shortly after leaving the hospital he went south and died.  The family sued all.  The air ambulance folk were denied summary judgment for gross negligence for not intubating nor transfusing him prior to transfer was a sufficient fact to be tried.  The problems with the air transport getting to the accident site was also ripe for trial.  The medical center was also denied summary judgment since the ED physician was employed by a corporation with an exclusive contract to proved services he was an agent of the hospital.  The EMTALA claim also was denied summary judgment since the family had made sufficient allegations regarding the intubation and transfusion may be a violation.         Top


US v Nashville Pharmacy Services

The company agreed to pay up to $7.8 million for billing for prescriptions for people who had already died or did not have prescriptions.  The whistleblower, a former order entry technician, will receive $1.4 million.

US v Terry

Dr. John Terry of Scranton was arraigned for writing false prescriptions for oxycodone.  He wrote for one patient knowing it was to be delivered to another.  He has given up his medical license.

Idaho v Harvel

Norilina Harvel, the former CFO of Bonner General Hospital, is accused of using various schemes to defraud the hospital.  She is to stand trial in the near future.  Interestingly she resigned from the hospital to take a job at a Colorado hospital.

US v Gordinho

Dr. Jose Gordinho of West Virginia has been indicted of distributing controlled substances and now attempting to defraud the feds. 

US v Davida

Dr. Arthur Davida of Bloomingdale, Illinois, was sentenced to two years in prison for approving unnecessary home care treatments for patients who where not actually confined to the home.  He said that if he did not do the certifications he would not get the referrals.  

US v Johnson

Dr. Kenneth Johnson of Ladara Heights, California, was sentenced to 108 months in prison for his part of a $20 million scheme to defraud fed med.  He prescribed expensive meds and allowed the prescriptions to be used to fill fraudulent prescriptions.  

US v Lowe

Kevin Lowe of the Bronx was sentenced to 144 months in prison for illegal distribution of oxy.  He had multiple clinics that charged up to $300 per visit in order to get the phony prescriptions.  

US v Agra

Dr. Lolita Agra is being investigated for illegal prescribing of narcotics.  The investigation started in September after some pharmacies refused to honor her prescriptions and she had hug a sign in her office that "no oxycodone, percocet vicodin will be prescribed".  She was also investigated by the Ohio Medical Board.  To date no charges have been filed.

US v RehabCare

The compnay agreed to pay $125 million for resolve allegations of knowingly having nursing homes submit false billings to the government.  The billed for services not necessary or never delivered.  RehabCare is now part of Kindred.          Top


Patients v Indiana University
To Be Filed

 The University Arnett Hospital lost a flash drive with the information of 29,000 people on it.  The idiot university did not have the drive encrypted and deserves to be fined big time.  

FTC v Henry Schein Practice Solutions

The group agreed to pay a fine of $250,000 for falsely advertising the level of encryption it provided to protect patient data.  This is the first salvo against vendors who claim more than they can deliver.  This is separate from the OCR going after breaches.  The two agencies are cooperating in this.

Walker v Boston Medical Center

A judge has allowed the case to proceed based on the posting of information that was not encrypted on a website.  Damages will be allowed for just the posting of the information.  Good on the judge.        Top

Peer Review and Employment

Willis v UPMC Children's Hospital
3rd Circuit

A NP was terminated and sued for age discrimination.  She met the thresholds for agism but flunked the smell test.  She could not prove that the reasons for her firing were pretexts for agism.

Sara v Saint Joseph Healthcare
Ky Ct App

A nephrologist sued after his application for renewal of staff privileges was denied.  There were allegations of poor records, breaches of standard of conduct and violation of patient care policies.  He had formal peer review procedures and lost.  He sued stating the reporting of the action to the state medical board made the hospital a state agency under Kentucky statutes and the bylaws were a contract that the hospital breached.  The court whipped through these by noting that statute prohibited the hospital being an agency and the bylaws did not constitute a contract and his removal was upheld.

Shore v Children's Mercy Hospital
Mo Ct App

The physician was fired after multiple complaints by nurses and others against him.  He then sued for racial discrimination (he is white).  His supervisor is black but for the first five years was very friendly and they did things socially together.  In view of this he did not get by summary judgment.

Golden v Sound Inpatient Physicians Med Grp.
ED Cal

The physician did hospitalist care prior to the hospital choosing the rival defendant group to do the hospitalist care.  In order to convince the medical staff to use the defendant group they lied in letters to the staff stating the physician did not practice at the hospital any more and they sent a nurse to the physician offices stating the same lie.  She sued for violation of misleading advertising and fraudulent business acts.  The court ruled against the physician on the advertising claim because the group was not engaging in advertising per se.  She won summary judgment on the unlawful business acts.

Carnithan v Community Health Systems
SD Ill

The plaintiff survived summary judgment in his claim of constructive retaliation.  He worked at Heartland Regional as the EMS coordinator and voiced his concern to the CEO regarding the admitting of all Medicare and Medicaid patient regardless so f medical necessity.  He was then moved to a a smaller office he eventually resigned.  He then filed a qui tam suit against the hospital alleging false claims or statements.  The feds intervened and a settlement was reached with the feds and the hospital.  The court tossed all the spurious arguments that Community gave and allowed the case to proceed.        Top


Urbana v Carle Foundation Hospital
Ill Ct App

The court ruled the Illinois law regarding not for profit hospitals was unconstitutional.  The court said that only property used exclusively for charitable purposes were exempt from taxation.  The decision will be appealed to the state supreme court. This is another nail in the coffin of not for profit hospitals in the majority of the country.

Chamorro v Dignity Health
SF Superior Court

A judge rejected the ACLU motion for an emergency order for the Catholic hospital to perform a post partum tubal ligation on the patient following a planned C-Section.  They filed for an injunction.  They lost this too.  The judge ruled that the hospital has religious exemption.

Hospitals v HHS

Fifty five hospitals have sued the feds over their two midnight rule.  They say the HHS violated the Administrative Procedure Act by not providing adequate notice or a meaningful opportunity to comment on the payment reductions.        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.