October 15, 2010 Recent Legal News




Peer Review




Baptist Health v Murphy
Arkansas Supreme Court

It's hard to believe that it is finally over.  This case has lasted seven years.  Little Rock Cardiology owned 14% of a cardiac hospital in competition with Baptist.  Baptist put in an economic credentialing policy and removed the cardiologists from the staff.  The cardiologists sued for an injunction and won.  The case has been going back and forth in the state and federal courts ever since with the cardiologists still on the staff.  The Supreme Court finally ended the case with a victory for the physicians.  The Court stated that the economic credentialing interfered with the patient physician relationship and referral patterns and could not be enforced.          

Cator v Ashland Hosp.
Kentucky Supreme Court

Dr. Cator, a locum tenens anesthesiologist at the hospital, was accused by the hospital of falsifying her time sheets. She was under contract with a staffing agency at the time.  The hospital refused to pay the agency and the agency sued the hospital.  
That case was settled.  The physician sued the hospital for slander and interference with business. She won in court but the appellate court overturned the verdict due to a qualified immunity of the hospital.  The Supreme Court agreed with the concept of qualified immunity but stated it was a matter for the jury to decide whether or not the hospital abused its privilege.  The case was remanded back for retrial.    

Owhor v Providence Hospital
ED Mich

Owhor, a Nigerian physician assistant, was fired for being asleep on the job.  He sued for equal protection and the court rightly tossed the case.  Anyone found asleep on the job would be fired, therefore no discrimination.     Top


Ruiz v Podolsky 
California Supreme Court

Ruiz sued Dr. Podolsky, an Orthopod for med mal and wrongful death.  Prior to the surgery the patient had signed an arbitration agreement with the physician.  The high court said that a binding arbitration agreement meant that the heirs could not sue and had to arbitrate.  

Rennix v NY

Rennix, a pregnant female, was in a bakery when she developed an asthma attack.  Present in the bakery were two EMTs who were off duty.  They called the dispatcher immediately but did not render aid.  The patient died and the mother is suing the EMT's employer, New York City and one of two EMTs.  The other EMT was shot to death earlier this year.  The suit claims wrongful death.  We will probably never hear of this civil suit again. However, the city is considering criminal charges against the EMT.      Top


US v Allen

The feds indicted five people from Johns Hopkins for identity theft charges.  The Grand Jury stated they stole personal patient identification to open credit at stores.  They face up to 30 years in prison.    

US v Northwest Mobile Servies

The Beaverton, Oregon, organization has agreed to pay the government almost $1 million for using x-ray techs that did not meet government standards. 

US v Kazarian

The Wall street Journal had a story of a nationwide Armenian scam that netted about $35 million in payments not deserved.  This is another example of the government not vetting in advance and then trying to collect money already paid out.  There were $100 million in fraudulent bills submitted to Medicare for services not rendered.  So far ninety three have been arrested including physicians and attorneys.      

US v Nelson
Guilty and Sentenced

Lindsey Nelson, a psychosocial worker in Idaho will spend thirty days in jail for billing Medicare for tickets to a rap concert.  She billed for individual counseling for two boys but really took them to see a rap concert in Spokane. 

US v DeLeon

Veronica DeLeon, a nurse in Weslaco, Texas, pled guilty of falsifying records in a home health case. She made up records for patients she never saw and billed for hundreds of thousands of dollars.  She faces five years in jail.

US v Ijwere

Sylvester Ijewere, the owner of a DME establishment in Arleta, California, was sentenced to 46 months in prison and pay $212,000 in restitution to the government.  He billed for $471,000 in false claims by purchasing fraudulent prescriptions and medical documents to bill Medicare.         Top

Peer Review

Smith v Selma Hospital
Ca Ct App

Dr. Smith was removed from the staff of the hospital and sued.  He won his case and then sued for attorney fees.  The trial court ruled for the hospital and the court of appeal reversed and remanded.  The court ruled that California had opted out of the federal plan and had it's own rules.  These rules allow attorney fees and costs if certain conditions are found.  The fee award is mandatory.  The original action must be frivolous, unreasonable, without foundation OR in bad faith.  All are objective findings except bad faith.  This is subjective and therefore the actions both pre and post litigation are admissible.        

Thomas v Henry Ford Hospital
Mich. Ct. App.

The hospital made a rule that only board certified physicians could cover in the ICU.  Two physicians that were currently covering the unit were not certified.  The hospital gave them six months to become so but both failed the exam.  They were removed and sued.  The court agreed with the hospital as did the appellate court.   

Genchi v Lower Florida Keys Hosp
Fl App Ct

The hospital had a rule that all practitioners must be board certified within seven years of joining the staff.  There were exceptions to that rule.  After seven years Dr. Genchi was not board certified and the MEC took away his privileges and the Board concurred.  The MEC were not aware of the exceptions and when they found out they reconvened and agreed to allow him to rejoin the staff.  The Board did not agree.  The suit was on for an injunction.  The trial court and the court of appeal both ruled for the hospital since the Bylaws stated the hospital MAY allow the practitioner to stay on the staff if certain things were done.          

Uppal v HCA
MD Fla

Dr. Neelam Uppal was an employee of HCA in three hospitals and one additional hospital.  She claimed sexual harassment and reported Dr. Stele of Largo Medical Center.  She was then peer reviewed off all the medial staffs.  She sued for retaliation and other matters.  Apparently her lawyer did not do a top flight job as the summary judgment was upheld in all cases but she can re-file the charges correctly.  Let us hope that she does so.        Top


Thomas More Institute v US

A Michigan federal judge has issued the first ruling on the US mandate to force all to buy health insurance.  He stated that the commerce clause is the basis for the legality of the rule.  The major case is still in Florida.  No matter what any judge rules the case will wind up in the US Supreme Court.  

Virginia v Sebelius

The US attorney general arguing the case for the US had no facts or law so he argued procedure and the court had no problem telling the attorney, he had no case.  The case will go on. 

Attorney Generals v US
Fla DC

 In the major suit against Obamacare, there were six causes of action to be heard.  The federal judge tossed four of them but allowed the two most important to go forward to the next stage, summary judgment.  The two allowed to go forward were the legality of forcing people to purchase insurance and whether or not the law interferes with the state's sovereignty.  

Bloomfield Health Pavilion v New Jersey
NJ Ct App

The mental health


Patients v Providence Hospital
Oregon App Ct

The Oregon Appellate Court ruled against a class action suit against Providence Hospital who had medical records stolen.  The records were unencrypted and the hospital paid $100,000 with CMS and the Office of Civil Rights for its error.  The trial and the court of appeal both stated that since the patients had no injury there would be no case.  It's always good to see class action attorneys lose their own money.        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.