March 15, 2015 Recent Legal News

Healthcare

Fraud

Peer Review and Employment

HIPAA

Malpractice

Criminal

Healthcare

King v Burwell
US Supreme Court

The circus has started.  Oral arguments brings out the pundits who state how the court will rule and the partisans on both sides.  The truth is nobody knows how the justices will react be it political or legal.  If allowed the government will talk about what will happen if the law subsidy is removed.  The court really should not allow this argument as it has no legal bearing on the case.  They will also attempt to challenge the standing of the plaintiffs when they did not do it in the lower courts.

Notre Dame University v Burwell
US Supreme Court  

The high court has basically killed off the contraception mandate by ending the case back to the 7th Circuit stating they must rule aCalifornia Blue Shield
ccording to the Hobby Lobby decision.  Therefore the University does not have to comply with the contraception mandate.

Oracle v Oregon
Filed

Since Oregon sued Oracle the reverse is also true  They state that the former Governor and others worked to kill the Oregon website.  The fight is due to the failure of the Oregon site to register any

Cascade Medical Center v BofA
Filed

The Hospital in Washington state is suing the Bank of America for not doing its ob in protecting the hospital funds from phishing.  A trojan horse was inserted into the system and a total of about $1 million was illegally removed from the account.  The bank was able to get back about $400,000 but who is responsible for the other $600,000 is up for legal review.  I remember when I had several million stolen from an account by a developer who was supposed to but didn't pay the subs.  We had to sue our bank and eventually received a substantial settlement in mediation.  Banks do not have to protect businesses from theft.

Dubeck v California Blue Shield
Ca Ct App

Blue Shield after two years rescinded the plaintiff's insurance due to what they say is a material breach.  The plaintiff, they say, did not reveal that the day of her application she had a needle aspiration of a breast lump.  The insurer then paid for breast cancer treatment that they state should have been denied as a pre-existing condition.  She is suing for damages since the letter to her stated that the coverage would be prospective and any claims prior to the cancellation would be paid.  The court ruled the insurer by waiting so long waived the right to rescind.        Top

Fraud

US v Baptist Medical Center North Little Rock
Settlement

The clinic agreed to pay $2.7 million to settle allegations that it billed for short stays instead of outpatient stays.  They are also on CIA and annual claims review.

US v Gunter
Sentenced

Shawna Michelle Gunter was a surgical assistant in Maryland where she embezzled funds and was fired.  She then found a pediatrician in Maryland that needed a physician assistant.  She forged all her documents and went to work for the unsuspecting physician.  She was eventually caught and convicted of fraud and aggravated identity theft.  She has been sentenced to three years and to pay restitution of $53,550.  Good luck with that.

US v Purewal
Settlement

Dr. Prabhjit Purewal of Manteca, California, an oncologist agreed to pay the feds $500.000 to settle claims of buying foreign drugs and charging as if they had been purchased in the US.  He has already paid $400,000 prior to this settlement.

US v Johnson
Guilty

Dr. Roman Johnson of Buffalo pled guilty of Medicare fraud and agreed to restitution of $5.4 million.

US v Abide Home Care
Indicted

The feds indicted the owner of the home health facility along with four physicians and nine nurses for health care fraud.  The owners allegedly hired the four physicians as house doctors to sign off on bogus orders for home health.  The agency would locate Medicare beneficiaries, have them meet with a house physician who would order home heath that they would not medically need.  Then the nurses would go to the homes and sign off to falsify the visits.        Top

Peer Review and Employment

Pham v Presbyterian Hospital Texas 
Filed

Nina Pham, the first nurse to catch Ebola, has filed suit against the hospital for poor training and a myriad of poor practices which allowed she and another to catch the virus.  She states the hospital's lack of training and roper equipment and violations of her privacy made her a symbol of corporate neglect.  This will not go to trial and she will receive a large settlement.

Yedidag v Roswell Clinic
New Mexico Supreme Court

The surgeon sued the clinic for terminating him after he participated in a peer review hearing.  The hospital received a report that was unsubstantiated that Dr. Yedidag verbally attacked another physician under peer review.  The jury found for the surgeon and awarded both compensatory and punitive damages.  The hospital appealed and lost in the appellate and supreme courts.  There is a state law that prohibits the hospital from disciplining the surgeon from any action in a peer review hearing.  This was in his contract.  The courts allowed him to bring the private right of action and the court also said that "the acquisition and use of confidential peer review information for purposes of employee discipline is not a statutorily permissible use of peer review information."  This is a rare time when a physician wins against a hospital.

Melez v Kaiser
CD Ca.

Dr. Melez started working for Kaiser in 1991 and ten years later she was asked to sign a Dispute Resolution Procedure form.  He initially refused but was told without it she could not continue working at Kaiser, so she signed it.  Recenty she was terminated and sued for the usual suspects.  Kaiser moved for arbitration under the signed Dispute Resolution form.  The physician said the form was oppressive and should be tossed.  The court did not agree since she was a highly educated person who could get another job.  The court continued to rule against her on the other items as well.  To arbitration.

Dysart v Palms of Pasadena Hosp.
MD Fla

A patient did not want to be treated by a person of dark skin.  Nurse Dysart was prohibited from treating the patient due to the color of her skin.  She sued for discrimination.  In this difficult case of patient rights versus discimination the nurse won partial summary judgment.

Bastidas v Good Samaritan Hospital 
ND Cal

The notice below was published in the April 1, 2014 issue.  Following the next paragraph in quotes is a email I received.

Dr. Bastidas, an oncology surgeon at the hospital did a Whipple procedure on a patient and removed a kidney and injured the Superior Mesentery Artery.  The patient died.  The surgeon had his pancreas surgical privileges pulled and asked for a peer review which he lost.  He sued for racial discrimination but failed to show the hospital was a state actor and failed to show discrimination.  He also sued for lack of due process but lost that as well. 

"I would appreciate if you review and consider some amendment:
1.  I did not perform as Whipple on the patient as you stated.  It is correct that the defendants represented that statement and it was repeated in the judge's decision.  However, a careful review of all the court documents outline that the patient explored with the intent of trying to perform "an extended Whipple"
2.  The court has held that the hospital/administration has demonstrated 'brazen retaliation' behavior and has granted me a court date on that issue for later this year."

DeCambre v Rady Children's Hospital San Diego
Ca Ct App

Dr. Marvalyn DeCambre, a pediatric urologist did not have her contract renewed.  She sued for racial and gender discrimination and alleged the usual suspects as causes of actions.  The hospital moved to strike due to the California Anti SLAPP law.  The trial court agreed and the appeals court reversed the harassment and intentional inflection of emotional distress since they did not arise out of a peer review process.  They then disallowed her discrimination issue since it was based on the opinion that she was "not a team player".  They also reversed the awarded attorney fees.      Top

HIPAA

Patients v Medical College of Wisconsin
To Be Filed

Per usual a laptop was stolen and information on 400 people were compromised.  Again, someone broke into a physician's car.  There are policies against information on computers but of course this physician believed the rule did not apply to him/her.

Patients v St. Mary's Hospital
To Be Filed

St. Mary's Hospital was hacked and the information on 4400 people were compromised. The hospital is giving free credit checks to those hacked.

Patients v Jones
To Be Filed

In an unusual scenario a private physician in San Pablo, California, has sent notices to 350 people that their identity could have been compromised after a theft of a credit card machine and records.  The physician is employed by the Sutter Health Foundation who have had other records stolen in the past.

Patients v Indiana State Medical Assn.
To Be Filed

I have no idea what a medical association is doing with patient IDs but they did and had a server stolen.  They are notifying the 39,000 people affected about the problem.          Top

Malpractice

Perry v Luu
Verdict

The California jury awarded the plaintiff $700,000 in compensatory damages and %5 million in punis for making her have painful sex post sling operation using the Abbrevo sling for incontinence.  J & J is the one paying for the improperly design of the sling and failure to warn.  This is the first case to find fault with the sling.  No money since the case will be appealed.

McMath v UCSF Children's Hospital
Filed

The case like the child will not die.  This is the child who following a tonsillectomy died but the mother would not accept the death so refused to take her off life support.  One year later she is still alive and a vegetable.  They are now suing for medical malpractice for the operation and the post surgical treatment.

Patients v Cedar Sinai
to Be Filed

The second hospital has reported CRE in their duodenal endoscopes.  The hospital has also confirmed several cases of the disease already at the hospital.  There are potentially 67 cases in the wings.        Top

Criminal

Pennsylvania v Windslowe
Guilty

Padge-Victoria Windslowe is a former madam who killed a dancer in 2011 with silicone injected into her buttocks went to her lungs.  Guilty of third degree murder.

California v Babael
Indicted

The owner of a care home and the administrator were charged with elder abuse after they abandoned 14 people in the Castro Valley home.  The patients were left in the care of a cook and a housekeeper.  The owner Herminilda Noeda Manueal and the administrator  Edgar Babael each face 17 years in prison.        Top

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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.