Indiana v Hedrick
Dr. William Hedrick was found guilty by a jury of prescribing pain medicine from his pain clinic and forgery. He was accused of being responsible for the deaths of eight people.
US v Holmes
Elizabeth Holmes and her boy friend and second in command Ramesh Balwani were indicted for wire fraud. She is the infamous founder of Theranos, the company that said they could do multiple blood samples from a very small blood sample. They were called out at first by the WSJ and later by all. They actually did some tests with a routine analyzer and not their own proprietary machine. They duped many supposedly savvy investors out of millions of dollars. She has resigned as CEO of the company.
US v Payne
Dr. David Payne, Jeffery Gross and Lokesh Tantuwaya were all indicted for their roles in a scheme by Pacific Hospital in Long Beach, California, and owned by Michael Drobot. They are alleged to have received payments for referring patients to the hospital which is illegal under federal law.
US v Livingston Regional Hospital
The Tennessee hospital has agreed to pay $744,000 to settle allegations that the submitted false claims for psych patients care that was not necessary. The whistleblower will get $156,000.
Texas v Xerox
The court said that Xerox was the culprit for allowing unqualified people to judge who needed and who did not need orthodontic surgery. The state sued both the providers and the company. Xerox said it was the providers that created false information to get profits.
US v Robinett
Dr. Kelly Robinett of Texas was found guilty oof fraud for signing medical paperwork for home health unneeded. He never saw any patients he certified for the home health because he got paid to "rubber stamp".
NY v Anyanwu-Mueller
Collins Anyanwu-Mueller RN was sentenced to one year in jail. He has repaid New York state $25,000 and has agreed to pay the remaining $367,954 still owed. The private duty nurse presented false claims for nursing that was never provided to severely disabled people.
US v 601 People
The US Justice Department has filed against 601 people for healthcare fraud and opioid crimes. This includes many physicians, nurses and pharmacists.
US v 16
As part of the above sweep in SoCal 16 people were indicted. One of the indicted was an attorney Irena Shut who was accused of paying kickbacks to two podiatrists. She was a marketer for TTY Consulting to get prescriptions to the pharmacies affiliated with TTY. She received about $6,8 million for this work. The podiatrists are Domenic Signorelli and Robert Joseph. in a compounding pharmacy scam six were indicted. They are Thu Van Le, Cau Nguyen, Truong Le, Kevin Le, Nha Le Tuan Truong and Jeffery Lawrence. In another pharmacy scam wher prescriptions were billed for but never dispensed the following were indicted: Irina Sadovsky, Yigal Keren, Mikhail Khanukhov, Shahriar Kalantari, Andrei Sotikov, Nida Rosales and Juan Eniquez of Five Star and Ultimate Pharmacies. Others indicted were pharacist Armen Pogossian, Tamar Tatarian, Rubin Filian, PA, Dr. Stephen Levine, managers of medical clinics Sarkis Manukyan and Eduard Tersipyan and Lucille Lam. As part of the same general sweep the following were indicted for illegal kickbacks at Pacific Hospital in Long Beach Dr. Daniel Capen, Dr. Timothy Hunt, Dr. Tiffany Rogers, Chiropractors Lauren Papa and Brian Carrico, Suits George hammer and William Parker.
US v Caris Healthcare
The hospice chain agreed to pay $8.5 million to settle allegations that they billed Medicare for patients they knew were not eligible for the benefits. The whistleblower nurse will get $1.4 million.
US v Paulus
A jury convicted Dr. Richard Paulus, a cardiologist at King's Daughter Medical Center, of fraud for billing for heart procedures that were not medially necessary. The court then overruled the jury stating the interpretation of angiograms involved subjective opinion. The 6th reversed and reinstated the jury verdict stating that stenosis is a fact capable of proof or disproof. The court said that the jury has the ability to believe one expert or the other.
NY v Corines
Dr. Peter Corines was indicted for stealing money from a 98-year old woman by claiming to be her power of attorney and impersonating her. He has plead not guilty.
California v Superior Court
California has appealed and won a temporary stay from the appellate court on the End of Life Option Act. It was correctly called unconstitutional by the lower court judge not because of the law itself but how the legislature passed it. They used a special session dedicated to healthcare and this was not healthcare. The law opponents have until July 2 to file arguments against the decision.
Dordt College v HHS
Dordt college in Iowa and Cornerstone University in Michigan sued the feds for a permanent injunction to not have to provide medical insurance for abortion which goes against their Christian beliefs. The judge ruled in the colleges favor.
California Dialysis Council v
The SEIU filed a petition for a proposition to be put on the November ballot which would determine how much outpatient kidney dialysis clinics may charge for patient care. The high court said the the item may be placed on the ballot.
Danny P v Catholic Health
The self funded group plan refused to cover room and board coverage for a residential treatment program for mental health issues. The lower court ruled for the plan and the 9th Circ reversed. They say that mental health coverage must be the same as med/surg coverage and to deny residential is improper.
National Institute of Family and
Life Advocates v Becerra
The 9th continues to be overturned. They lost twice on the same day once on immigration and again on this case. The court said that freedom of speech rules and that clinics established to persuade women do continue their pregnancies can not be forced to tell them about the availability of abortion. This over turns a California law that would have forced the speaking of abortions by anti-abortion providers.
Lee-Thomas v LabCorp
The patient was in Providence Hospital in Washington, DC where she received treatment from LabCorp. She claimed the public nature of the intake computer station violated HIPAA. She filed a complaint with the OCR which decided not to pursue the matter so she sued. The court agreed with the OCR. There is no private right to sue under HIPAA. Wonder how happy her attorney is?
French v St. Anthony North Health
Lisa French had back surgery at the Colorado hospital and was insured. She was part of her employer self funded ERISA plan and was told she would have to pay $1336 out of pocket. She paid $1000 immediately. The hospital billed the insurer $303,000 and they paid $74,000. The hospital then sued her for the remainder. They used the chargemaster to determine how much was owed and her attorney argued these were not reasonable charges. The jury came back with a verdict for the hospital in the amount of $766. The hospital will appeal.
Physicians Regional Medical Group
v NCH Healthcare System
The group and the affiliated hospital accuse NCH of stealing physicians. The say the NCH recruited physicians employed by Physicians Regional after resources were spent to develop mature practices. The suit says that NCH referred all recruited physicians to an attorney who said their restrictive covenants were unenforceable. This was part of the recruitment pitch, says the suit. Since 2012 Physicians says it recruited seven physicians who were poached by NCH.
Southeast Anesthesia Consultants v
The court refused to issue an injunction against the hospital for hiring a new anesthesiology group. It did restrict the new group from hiring anyone from the old group until 7/1/19.
Patients v UPMC
The state high court ruled that law suits against the hospital could go forward. The patients sued after they became infected with hepatitis C after the hospital failed to report an employed who stole fentanyl. They should have reported him so he could do no harm at other hospitals but they did not. The suing patients are from hospitals that he worked after leaving UPMC.
Steniford v Southard
The patient sued his internist and a neurologist for not ordering an HIV test on him therefore allowing his HIV to progress to AIDS. The patient won $18.4 million. He was known to by gay and worked as a paramedic around bodily fluids.
Anderson v Khanna
The state high court ruled the patient may sue the physician and his employer Iowa Heart Center for med mal since he did not disclose he had never performed the surgery prior. Post op he was in a coma and needed a second surgery followed by a heart transplant. The court ruled that physicians have an obligation to disclose their professional experience and training if it is material to the decision by a reasonable person. In the 4-3 decision the dissent stated that the surgeon met the standard of care in the surgery so not disclosing is immaterial.
Jackson v Providence St. Vincent
The patient is suing the hospital for not doing an MRI on him because he was too large for the machine. He had back pain and was discharged following the realization of being unable to do an MRI. Six days later he was paraplegic from a thoracic epidural abscess. He is suing for not being transferred to another hospital to prevent the paraplegia.
Three Families v DaVita
Three families sued DaVita in federal court in Denver for wrongful deaths. The patients died after being dialyzed with Granuflo, which can cause toxic pH imbalances and alkalosis. The families got compensatory damages plus $125 million each in punis. DaVita will appeal. The product was never in question and is still in use as it has been for the last quarter century.
Peer Review and Employment
Grabois v Memorial Regional
During a department meeting where he was the chief of OB a nurse complained about another physician shoving a washcloth into the mouth of a screaming patient. He made a comment "Like Fifty Shades of Grey". He was told to either resign or have his credentials changed to six months at a time. The Broward County Medical Association is also backing Grabois for not receiving a fair hearing.
Mayo v Wisconsin
In this horrific case the mother of 4 went to the hospital ED with fever and abdominal pain. She was seen by a physician and a PA and sent home to see her gyne for her fibroids. The next day she became worse and went to a different hospital ED where she was diagnosed as septic. She lost consciousness and eventually lost all four extremities due to Strep A. She sued and won compensatory damages of $8.8 million and $15 million in non-economic damages. The trial court knocked that down to the state law of $750,000 and Mayo appealed. The appellate court upheld the original jury decision stating the cap on non-economic damages was unconstitutional. The Supreme Court over rode that and reinstated the original $750,000 stating the cap is rational.
Mitchell v Shikora
The lower court ruled that physicians may be liable if the patient suffers a known complication of the correctly performed procedure. In the underlying case the patient sued the Ob/Gyne for med mal for negligent in surgery. She did not claim the the physician did not get informed consent. However, at trial Dr. Shikora said the complication is a usual one that is performed even if the procedure is performed correctly. The plaintiff's attorney objected and the judge overruled the objection. The jury found for the physician. the appellate court said the known risks were not to be presented in a new trial. The Supreme Court will now make the ultimate decision.
Employees v Cerner
Cerner, after stonewalling for years, has agreed to pay an undisclosed sum to settle accusations that they illegally exempted delivery consultants and system analysts fro overtime pay. The suit alleges these were actually entry level positions.
Davis-Boutte v Georgia
Dr. Wendell Davis-Boutte, the dancing dermatologist who lost her license after videos of her appeared on line dancing during surgery and having multitudes of med mal suits against her is suing for an injunction to the emergency license suspension.
Perry-Bottinger v John Doe
Dr. Lynne Perry-Bottinger, a New Rochelle cardiologist, has filed suit against John Doe who posted a bad review of her on HealthGrades. She believes it is posted by a competitor physician. She claims the bad revue has caused appointments to be cancelled and stopped seeing her. HealthGrades will not release the name of the poster without a subpoena. She wants $1 million. So do all of us.
Yarus v Walgreen Co
In what seems poor lawyering an orthopod sud Walgreens for defamation. They wrongly refused his prescriptions and told the patients that he was under investigation by the DEA, not true. This was due to an internal computer malfunction. The physician's attorney contacted Walgreens and was told the comments in the system were removed. The comments to patients continued and he sued. The court rightly threw out the case as it was against the statute of limitations. When the attorney first contacted Walgreens that is the date he actually knew about the problem and the attorney nor the physician ever checked to make sure the comments were removed from the computer system.
Beharie v Citrus Valley Health Partners
Dr. Carlos Beharie, OB/Gyn, is suing for killing his practice. He started Citrus OB and eventually got it to a total of five physicians and the practice was delivering 80-100 patients a month. The West Covina Partners wanted to buy the practice but the two sides could not reach an agreement. Soon three of the physicians were working for Citrus Valley Health Partners. Dr. Beharie saw the handwriting on the wall and closed the practice. They offered $1million for the practice but got it gratis.
Wiorek v Children's Hospital of Wisconsin
Apparently Dr. Lori Wiorek during a staff seminar said to a black person "do you want to get lynched". It was in the context of her not agreeing to something that all needed to soon enough. She is no longer employed at the hospital. The local Black Panthers got involved and they named the physician.
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.