Ulrich v San Francisco
Ulrich, a physician at Laguna Honda Hospital, came under investigation of his professional abilities. He was asked to meet with the Medical Executive Committee as was allowed in the bylaws. The meeting was postponed by request of Ulrich. During the postponement, Ulrich sent a letter of resignation. The Hospital had a rule that all letters of resignation may not be rescinded. Ulrich then found out that if one resigns while under investigation a report is made to the Medical Board of California and the NPDB and attempted to rescind his resignation. This request was denied and the required reports submitted. He then got an attorney and sued the City (owner of Laguna Honda) for breach of contract and a violation of his civil rights. He never got to trial court as summary judgment for the hospital won out. Ulrich appealed and again lost badly. This case shows what happens when you either do things without an attorney or with ineffective legal advice. Top
The Feds have collected over $780 million from health care professionals and others in the six months between October, 2001 and March, 2002. They have also had 250 criminal convictions in the same time period along with 1300 individuals and companies dropped from the federal programs and four hospitals paying a total of $100,000 for EMTALA violations. The march continues!
US v Mannion, MD
Dr. Rodney Mannion, a 71 year old urologist from northwest Indiana, was guilty of false billing of Lupron. He was sentenced to three years probation and a $2000 fine. The prosecutors recommended against prison due to the assistance Dr. Mannion gave them in the investigation of TAP Pharmaceuticals.
US v Garabet, MD
Dr. Antoine Garabet of Glendora, California was convicted last year of fraud for lying to patients. He told patients they had glaucoma or other retinal diseases and then pretended to operate on them with a laser. He was sentenced recently to 21 months in prison along with $264,653 in restitution and a fine of $200,000. His license is currently under attack as well.
US v CHW
Catholic Healthcare West settled with the government for $8.5 million for keeping two sets of books and fraudulently increasing the cost reports for greater Medicare reimbursement. This was done at 13 of their 42 hospitals. The whistleblower will get $1.9 million plus $577,000 in legal costs.
US v UPMC
UPMC in Pennsylvania settled with the Feds for $1.5 million for doing and billing for using non FDA approved devices. The whistleblower was a medical device salesman who will get 20% of this settlement. This is the 24th hospital that has paid up due to the whistleblower.
US v. Scripps Health
The same facts as above got Scripps Health in hot water. They have to pay $6.3 million for the use of the non-FDA heart devices in their 7 hospitals. The government is targeting about 100 more hospitals. The same medical device whistleblower gets his money here as well.
US v St. Vincent's
St. Vincent's Medical Center in Staten Island, St. Frances in Poughkeepsie and Sisters of Charity in Buffalo, New York paid to settle problems with Medicaid. They overcharged for psychiatric visits and had terrible documentation. St. Vincent's must pay $2 million and provide $1 million in free care over the next five years. St. Frances must pay $ 1 million and give $500,000 in free care. Sisters must pay $300,000. Top
Missouri v Williams, RN
Williams has been accused of murdering 10 patients in the Truman VA Hospital ten years ago. The authorities have found that at least 10 of the 33 deaths at the hospital had traces of succinylcholine. The police are also looking into deaths at a nursing home in the state where Williams worked.
Ohio v DiCello, MD
A pain management physician, Michael DiCello Jr., has been accused of writing false prescriptions. In this ongoing investigation, Dr. DiCello was charge with four counts of illegal processing of drug documents and release on bail after pleading not guilty. This was a sting by Euclid, Ohio police and the Ohio Board of Pharmacy. Over a period of years there had been a number of complaints by pharmacists, some of which had refused to fill his prescriptions. Top
Blazo v McLaren Med Ctr.
When does a duty exist between a patient and a physician is at the heart of this case. The trial court stated there was no duty and this court overruled the trial court. The patient is a minor who sued a obstetrician for malpractice. The pregnant patient's mother was at the hospital for an unrelated surgery for carpal tunnel when she began having contractions. The nurse called the patient's OB who was not available. She talked to another OB in the same office who gave the nurse three choices. The case does not detail what choice was chosen nor what the injury was. The court decided that there was a duty to the patient by the telephone call and the physician's making a medical decision by giving three choices.
Montavalo v Arnold, MD
This interesting case determines the rights of the parents to refuse resuscitation for their newborn. The mother was 23 3/7 weeks pregnant with a baby of 679 grams. There was a questionable informed consent in place for a C-section. The mother went into premature labor and required an emergency section. Another physician (dropped) did the section assisted by Arnold. The baby was immediately handed off to another physician who performed emergency resuscitation on the newborn. The issue is can a suit for lack of informed consent for the C-section and the resuscitation ensue. The answer was no. The surgeon doing the C-Section was dropped from the case. That surgeon is the only one who has the duty to get informed consent. The assistant surgeon and the hospital have no duty to obtain consent and therefore are dropped. Since there was an emergency with the child there were two factors at play. The first is the emergency itself which overrides the ability to stop the resuscitation until consent is obtained. The second is the United States Child Abuse Protection and Treatment Act (CAPTA). This Act states that for states to obtain federal funding for prevention of child abuse there must be a policy in place for responding to child neglect, including the withholding of medical treatment from a disabled infant with a life-threatening condition. Here there was no disability but only the possibility of one in the future due to the early delivery and low birth weight. That was enough for the court to go to the Federal law. Since the law and the emergency both required resuscitation, there were no choices for the parents and therefore no consent was needed.
v Cleveland Clinic
A jury awarded Zimmerman $7.5 million for injuries following surgery for obsessive compulsive disorder. The neurosurgeon had only done the procedure once. The patient claimed there was no informed consent to burn small parts of her brain. She believed she was undergoing a routine procedure with a 70% chance of cure. She came out with severe disabilities. The clinic stated that this was not negligence but a complication leading to a bad result. Top
The US District Judge that heard the preliminary injunction to force the closure of three northern California medical marijuana distribution centers has now made the temporary injunction permanent. The three centers are the Oakland, Marin and Ukiah clubs. This will allow the appeal to the more liberal 9th Circuit. It is interesting that the California Supreme Court is also now hearing a medical marijuana case and seems to be leaning toward non state prosecution of people with medical necessity defenses. Top
As reported the Health Plan of the Redwoods is the second HMO in the country to file for bankruptcy under Chapter 11. Now 16 physicians have filed with the bankruptcy court to be released from their contracts with the bankrupt organization. The doctors are being paid fee for service and the HMO has been ordered to have their hospitals and physicians slow their requests for payment. These doctors are already owed hundreds of thousands of dollars and are not willing to go further in the hole. The capitated physicians are continuing to receive their monthly payments. Top
Park Pharm. v S. D.
The Court of Appeals ruled that physicians may sell pharmaceuticals for profit to their Worker Compensation patients. The patients of the Orthopedic group tells each Worker Comp patient that they may receive a prescription. The prescription may be filled at the physician's office or any pharmacy. Each of the physicians purchase and stock their own drugs separately from the remainder of the group. Park Pharmacy runs a shop in the same medical building as Orthopedics and didn't like the arrangement. The Orthopedic group won in summary judgment in trial court since the California Business and Professional Code Section 4170 specifically allows them to dispense drugs for profit to their own patients as long as they follow all the rules specified. 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.