Chicago's Grant Hospital is to auctioned off after it failed following a Fraud & Abuse scandal at its sister hospital, Edgewater. Edgewater owes millions to the Feds. I feel bad since Grant was not involved per se and I used to be the ED doctor there many years ago. Please see follow-up story in Recent News under Hospitals. Top
The California Court of Appeals ruled that a physician's medical license may be sanctioned and revoked for alcohol abuse unrelated to the practice of medicine. Griffiths, a plastic surgeon in West LA was convicted twice for reckless driving involving alcohol between the years of 1987 and 1992. The MBC placed in on three years probation and ordered treatment and perform community service. He fought it and has now lost. The Court stated that alcohol related crimes show a lack of judgment and may endanger patients. Griffiths is still in practice and has no further problems. The probation and other terms will probably now kick in.
Bonnell v MBC
In a second case decided the same day an appeals court ruled that the Medical Board has 30 days to act on a motion to reconsider its verdict. The physician was charged with gross negligence and this went to an Administrative Law Judge who held for the physician. The Medical Board agreed and dropped the charges. The State Attorney General then asked for a reconsideration and the physician objected due to the time element and sued. the trial court held for the physician but this was overturned by the court of appeal. Top
Lownsbury v Van Buren
The Ohio Supreme Court decided that is is possible for a physician who has contracted to supervise residents and who has never seen a patient to have a duty to that patient. The lower court had stated that absent knowledge of the patient there could be no duty. There were experts that testified both ways and therefore there was a question of fact as to the standard of care and whether or not a duty existed. The case can proceed to trial.
Grey v Tri-City Med. Ctr.
Grey had an appendectomy in 1996 and developed low back pain in August 1998. An x-ray showed a ring shaped foreign body in the right abdomen. X-rays could not accurately tell whether the object was within the colon or within the peritoneum. It was suggested the patient undergo a colonoscopy. He did this 15 months later and it was normal. He then sued for malpractice. There is a one year statute of limitations in California from the time of the incident or the time the incident should have been discovered. The patient voluntarily put off the colonoscopy for 15 months and therefore was outside of the time limits of the statute. He had been put on notice that there may be negligence when the ring was first discovered and should have filed at that time.
In Florida a woman received a $78 million award. She is a 44 year old person who was visiting in Orlando with her husband. One night she had severe abdominal pain and was taken to Sand Lake Hospital. She was seen by a physician assistant who believed she was having either a gall bladder or appendicitis attack. Two hours later she went into cardiac arrest for 13 minutes and was found to have bled internally. The cause was a large liver tumor. Surgery was performed but by that time she was already brain damaged. She currently continues basically in a persistent vegetative state. The award went against the hospital, a physician and the physician assistant. The hospital stated it will appeal and rightly so. The trial lasted seven days and the jury only deliberated four hours to determine guilt and amount.
Chambi v Univ. of Cal.
California has a law Business & Professional Code 801 which states that there can be no settlement by the insurance company without the consent of the sued physician. In this case the sued physician was indemnified by his employer, the University, a self insured entity. The University settled a claim without the agreement of the physician. The physician sued the University and it was ruled that since they are a self-insured government entity, they ae not an insurance company and the indemnity is not insurance. The physician lost. Top
Megrelishvili v Our Lady of Mercy
Where's the deep pockets? The patient sued the physician for malpractice after problems with a breast reduction. During deposition, the plaintiff found that the physician did not have any malpractice insurance and had none for several years. They then sued the hospital for negligent credentialing. The medical staff person was not present during the years in question and suggested that perhaps the hospital vice president and legal counsel might answer the questions. She was subpoenaed and fought the subpoena by filing an affidavit that she had no personal knowledge and no responsibility of the MSO at that time. The Court said to the hospital that they need to produce someone at the deposition with knowledge of the surgeon's appointment and how the hospital reviewed the work of the surgeon and if they inquired about the having of insurance. The hospital is in a hot pot.
Azmut v Shalala
A surgeon agreed to some restrictions on his practice by the medical staff. This led to a report to the NPDB by the hospital. The physician then sued the NPDB to overturn the report. He lost. He was not smart enough to realize that even voluntary reduction of privileges for quality concerns is a reportable offense. The hospital had a duty to make the report. Top
O'Byrne v Santa Monica Med Ctr.
This case decided by an appellate court ruled that medical staff bylaws are not a contract between the hospital and a individual staff member. This went against federal law in the same circuit. The ruling was based on the notion that the state regulations create a preexisting duty on the hospital and medical staff. No contract can enforce a preexisting duty. This ruling would close out any hope of physicians to sue the hospital for damages due to failure of enforcing the bylaws. The physician could still sue for enforcement only. The California Medical Association has asked the state Supreme Court to depublish the ruling. This means that the ruling could only be applicable to that case and could not be used as precedent. Top
Race v Poor Care
Loubeau v U South Florida
A federal court jury, following a 2 1/2 week trail found that the plaintiff was dismissed from the surgical program for poor patient care and not because of race. The University showed multiple instances of mistakes by Loubeau. Loubeau is now in an anesthesia residency in New Jersey. Top
US v Erhart
Erhart, a Brooklyn chiropractor, has pled guilty to 29 counts of insurance fraud netting about $2 million. He recruited people to pose as patients. He is also scheduled for trial on cocaine possession and possession of an unregistered short barrel shotgun.
US v Bowman
A respected North Carolina physician, J. Thomas Bowman was sentenced to 3 months in a half way house and 3 months of house arrest along with a $150,000 fine and resignation of his post as a county board of commissioners. He was selling prescription samples. Top
Kaiser v Cigna, Blue Coss & Shield, Healthlink
The Illinois Medical Society has backed the law suit by Dr. Kaiser, an Alton ENT, against the above PPOs for downcoding and bundling claims. The physician claims this is a breach of contract. The suit against Cigna has been certified as a national class action suit. Top
The American Arbitration Association has decided to not do any more arbitrations between patients and providers. They believe that unless the parties agree to the arbitration at the time of the filing, not at the inception of the contract, they do not want to be a part of it. They consider this to be too important and may need judicial resolution. This means that either the predetermined arbitration in contracts that state the AAA will be the arbitor will be useless. Since they are the largest arbitration group, this will place a burden on the providers to find others that will arbitrate these cases. Top
A California judge has sided with the IPAs to not allow collection of data by the California Department of Managed Care on the financial stability of medical groups. This ruling backed by the CMA does not allow either consumers or physicians to know if an IPA is financially stable. The CMA argued that IPAs are private and that private groups are allowed to keep their proprietary information private. Top
HealthSouth v Health Fitness Corp.
HealthSouth purchased the physical therapy practices and then was surprised to find that at one of the purchased practices the physical therapists had opened in the same building under a different name. HealthSouth didn't like that and sued. HealthSouth lost since they did not put anything in their contract that would forbid the action. Is it any wonder that HealthSouth is not doing well in the stock market with stupidity like that? 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.