June 1, 2021 Recent Legal News
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Argentina v Seven Physicians
Indicted
Seven health professionals were indicted by Argentina in the death of Diego Maradona, the country's soccor star. They are charged with homicide. The prosecutors hired a medical board to review the actions of the medical team and they found predictably that the team acted in an inappropriate, deficient and reckless manner.
US v Perwaiz
Sentenced
Dr. Javaid Perwaiz, a OB/GYN had been convicted of performing unnecessary surgeries and procedures and 52 counts of fraud. He was sentenced to 59 years in prison and ordered to pay $18.5 million to the insurance companies that covered the procedures. He is 71 years old so will never be out of prison and will not pay the fine.
US v Hameedi
Sentenced
Dr. Asim Hameedi, a cardiologist in Queens, admitted in court to fraud by lying to insurance providers regarding symptoms of patients, backdating procedures. billing falsely and telling other physicians he had done tests which had not been performed. He go 20 months in prison, two years of supervised release, restitution of $550,000 and a $100,000 fine.
US v Dhir and Puri
Settlement
Gunjan Dhir and Gaurav Puri, dentists in Texas, have agreed to pay $3.1 million to settle allegations that they violated the FCA for billing for service never performed. This is a qui tam case started by three ex-employees.
US v Ayala
Guilty
Yudelka Ayala of Jersey City, New Jersey, plead guilty to violating the antikickback law. She worked at a physician's office and developed a special relationship with people working for Prime Aid Pharmacies. The prime employees paid Ayala to get more prescriptions from the physician's office.
US v Medicrea International
Settlement
The French medical devices company agreed to pay $2 million to settle allegations that they paid US physicians at a conference in France and for failing to file those expenses as required by law.
US v Harron
Sentenced
Latisha Harron aka Latisha Holt, was the owner of agape Healthcare Systems in North Carolina, She fraudulantly concealed her prior felony conviction for identity theft when she applied for her license, She was married and lived in Las vegas with another felon and that ws also concealed on her application. They found names of people who had just passed away and billed using their information. She was sentenced to 14 years in prison and ordered to pay $13,400,000 in restitution along with being ordered to forfeith an aircraft, an Aston Martin and other items.
US v Sanford
Sentenced
Dr. Benjamin Sanford of Starkville, Mississippi, was sentenced to three years probation along with forfeiture of $105,000, a fine of $97,000 and restitution of $377,500. His crime was obtaining foreign medications and dispensing and billing for them as if they were the FDA approved drugs.
US v Reddy
Sentenced
Trivikram Reddy, a NP from Waxahachie, Texas, was sentenced to 20 years in prison and ordered to pay $52 million in restitution after pleading guilty to wire fraud. She stole prover numbers of six physicians and falsely used them to bill for treatments never performed. She made multiple fraudulent wire transfers which totaled over $55 million. Good luck on seeing that money.
US v SavaSeniorCare LLC
Settlement
The Georgia company paid $11.2 million to settle allegations that they billed for services that were not reasonable or skilled and that they billed for services that were grossly substandard. It would have been more but this was all they could afford to pay. This is a qui tam.
US v Gyarteng-Dakwa
Settlement
HEAG Pain Management and its owner Dr. Dakwa of Greensboro, Georgia, agreed to pay $500,000 to resolve allegations of billing for unnecessary procedures. They did nerve conduction studies for no apparent reason.
US v Gibbs
Guilty
Drs. Mark Gibbs and Laila Hirjee along with RN Tammie Little were found guilty by a jury of fraud. They worked with Novus Health Services CEO Bradley Harris to defraud fed med by submitting false claims for hospice services, giving kickbacks for referrals destroying documents to conceal fraud and violating HIPAA to recruit beneficiaries. They presigned bland narcotic forms
Yount v J&J
US Supreme Court
The high court refused to hear an appeal from J&J of a jury decision in Pennsylvania that gave the plaintiff $70 million for developing gynecomastia after taking the drug Risperdal. The labeling did not relect the potential for this complication and they failed to warn the providers. Yount developed the enlarged breasts at age five. The company has agreed to pay $2.2 billion to settle other US criminal and civil probes. They are still on the hook for many many many private suits.
Geoffney v Bacerra
9th Circuit
Dr. Willie Geoffney is a surgical oncologist who provided all services to Medicare patients since 1991. In 2005, he continued those services but did not bill Medicare. In 2012 he was informed his Medicare billing privileges had been revoked for not billing for a year. In 2015 he filed a Medicare Application seeking to retain his 1991 billing date so he could bill for past services. That was refused via all appeals including the 9th Circuit. An obvious question is why did he not bill Medicare for all those years and did he bill the patients during that time for more money?
Eli Lilly v US
Filed
Lilly filed a suit to sto the administration from their arbitrary June 1 deadline for pharma to comply with selling to hopital pharmacies drugs under the 340B program or face penalties. They want an injunction until the permanent injunction action is resolved.
US v Zheng
Sentenced
Song Guo Zheng was arrested while trying to flee the country to China after he committed fraud by making false statement as part of an immunology research grant at The Ohio State University. He was sentenced to 37 months in prison and ordered to repay $3.4 million to the NIH and $414,000 to Ohio State. He was planning to give China all his research.
Workers v Methodist Hospital
Filed
The 117 workers feel they are being discriminated against for refusing the hospital mandate to be vaccinated. The basis by the law firm hired is that this violates the Nuremberg Code by making them guinea pigs. Let us hope they lose a lot of money on this suit and they lose the suit big time.
Gorovits v US
DC ED Penn
Dr. Lilia Gorovits sued the HHS to get her billing fed med back after she was convicted of obstruction of justice due to lying when questioned about receiving kickbacks. She said her conviction was not worthy of her ability to bill Medicare patients. The courts disagreed and said her crime was worthy of being unable to bill fed med and she had no property right to continued participation in federal health care programs.
Morgan v Shands Teaching Hospital
11th Circuit
In either terrible lawyering or a bid for a lot of money the plaintiff sued to get his medical records to prove med mal and Shands refusing to give them. The suit for the records was filed in federal court and not the Florida state court for unknown reasons. The problems was the lower court and the 11th both said not in the federal system as their was no federal question raised by the plaintiff.
US v Peachstate Health Management
Settlement
AEON Clinical Laboratories agreed to pay $25,000 to settle allegation that they did a terrible job in complying with the HIPAA Security Rule. They also have to implement a corrective action plan.
Chesapeake Regional Medical Center
v Sentara
Filed
The two main medical systems in an area have been fighting for years but now it is in the courts. Sentara is being accused of secretly poaching cardiologists to get rid of Chesapeake's cardiology program. The "heart" of the matter is the Virginia policy of CON. Chesapeake wants to have a open heart program and Sentara says no.
Siebert v Okun
New Mexico Supreme Court
Siebert sued Okum for med mal and won $2.6 million in total damages. Oku appealed saying the award should be $1,535,000 which included the state cap on med mal non -medical injuries at $600,000. The supreme court said Okum was correct and the cap was legitimate.
Carillo v Alvarez
Ca Ct App
Carillo, a minor, went to Valley Medical Group in 2011 for severe headaches. She had no other findings. She was evaluated by PA Flores and PA student Tobias (no relation) and she was advised to continue Tylenol and return if needed. Several weeks later she had light sensitivity, fever and headaches. She went to Bakersfield ED and as she was being prepped for a lumbar puncture she convulsed and was left permanently quadriplegic. They sued Flores and Valley Medical Group physician Carlos Alverez for negligence for failure to diagnose and treat meningitis. The jury found all parties were not negligent but it did not consider the failure to supervise claim. The appellate court ruled that since Flores was not negligent Alvarez could not be held liable for medical malpractice. They also said there were no ground for negligence based on contract.
Saucedo v El Paso Children's
Hospital
Filed
Ivanna Saucedo was born with hydrocephalus treated with a shunt. At three she became sick with vomiting and the parents took her to the clinic of Cr. Roberto Canales who directed her to the hospital. She was immediately admitted to a floor and no physician saw her for 12 hours until she died. Here's where the complaint gets real interesting. They complaint states that Canales in unqualified, that the hospital said no one can treat his patients except him, that he does not have to go through peer review, that the medical staff would not qualify him for pediatric intensive care work but he hospital gave him privileges anyway. I do not think this will go to trial. BTW she died because her stent was blocked.
Voss v Greenberg
Filed
Voss had IVF by Greenberg and many years later her daughter found out that Greenberg was her biological father. She sued stating he used his own sperm and not that of an anonymous donor from a sperm bank as promised.
Rieder v Segal
Iowa Supreme Court
Reider sued Segal for malpractice and Mercy Medical Center fo negligent credentialing. She suffered complications from the surgical procedure he performed. On the day of her discharge the Iowa Medical Board filed a charge against Segal for incompetence. Segal said he had told Mercy of the pending investigation. At trial the plaintiff expert opined that mercy violated the standard of care by not taking into account not only the Iowa medical Board findings but the prior med mal cases. The court found the opinion inadmissible as prejudicial against Mercy. The appeals court reversed this. The state supreme court agreed with the appellate court but did not take up the matter of whether negligent credentialing claim is legally cognizable in the state.
Smith v Methodist Healthcare of
San antonio
Filed
In an interesting case which has the rare possibility of winning, Dr. J. Marvin Smith, a surgeon for over 40years the hospital accused him of high motility rates. Dr. Smith then proved the figures from the hospital wrong and the hospital changed course to now accuse him of not being competent. The physician had to get a competency test at aplace picked by the hospital and then got his own. To no one's surprise they disagreed. Prior to all that Dr. Smith had sent many letters and communications complaining about the nursing staffing and other issues. Some of the comments in the article are very interesting. The article quotes two physician advocates, one who testifies for the physician in court cases and one who uses non-legal matters to attempt to get the hospital to drop or modify the charges.* Also quoted was a representative for the AHA who said correctly but wrongly that the hospital has nothing to do with the peer review process. He said it is a medical staff issue. True but false. * This is to acknowledge my association with Dr. Richard Wilner of New Orleans who runs the Center for Peer Review Justice.
Brandner v Providence
Alaska Supreme Court
Dr. Michael Bandner, a plastic surgeon, won $1 in damages from Providence after they terminated his hospital privileges. They broke the law in terminating him without a hearing but then gave him a hearing where he was terminated again. This happened after he had emergency open heart surgery and took a leave of absence and he was not allowed to continue to do hand surgery at the hospital. His surgical load at Providence dropped but it increased at the other two hospital at which he held privileges. In 2015 the Alaska Supreme Court rule Providence violated due process and sent the case back to determine damages. After a hearing in which he wanted $230,000 he was awarded $1. The Supremes said there was an adequate basis for the finding that there were no actual damage from the illegal act of the hospital.
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.