September 15, 2015 Recent Legal News





Peer Review and Employment


March for Life v HHS

The pro life group, non religious, sued for equal rights and won in the lower court.  They say just because they are not a religious organization they should still be afforded the same rights to be free from Obamacare contraception rules if their members do not want it.  The judge said they were correct.  The judge called it regulatory favoritism.  Watch for this to be into Supreme Court .

House of Representatives v HHS

The House Republicans have won a victory in the courts.  They have proven their ability to have standing to sue.  The suit allows the part of the case that challenges the spending of money on healthcare subsidies that was not appropriated by Congress.  The lost the ability to sue for a claim that delays in enacting the employer mandate violated the Constitution.        Top


Patients v UCLA
To Be Filed

Another screw-up by UCLA, which has had several.  This time the idiots had an idiot faculty member have his laptop stolen.  They did not say if the information was encrypted.  It affected over 1400 patients.

Lozano v UCLA
Not Guilty

At the same time the above was disclosed the university was in court defending itself from another HIPAA suit.  They were found not guilty since an employee accessed another's record for malicious harm.  They were not responsible for what the temp did outside of her scope of employment.

Patients v 56 Dean St Clinic
Will Not Be Filed

This blatant HIPAA violation will not be filed since it was done in London, England.  The Clinic send an email to "cc" instead of BCC" with the names and email of hundreds of HIV positive patients.  The Clinic is one of Europe's busiest sexual health providers and failed to hide the email addresses of the recipients of its E newsletter.

HHS v Cancer Care Group

The group has agreed to pay $750,000 for an employee's stolen laptop with unencrypted data.  The theft put 55,000 people at risk and the Group had not complied with the security rule under HIPAA.  Glad to see the fine and I wish to see more.

Patients v Excellus Blue Cross Blue Shield
To Be Filed

Ten million records were compromised due to a cyberattack.  They were hacked in December 201 but just found it.  Not a up to date company.  They are offering two years monitoring.        Top


Winkler v Advocate Lutheran General

A third law suit has been filed against the hospital and Pentax for CRE from an infected duodenoscope.  The patient died from the illness.  They say Pentax used a defective design .  The CDC found 38 cases of CRE at the hospital .

Scaife v Lakewood Hospital
 ND Ohio

The patient was pregnant and went to the hospital for abdominal pain.  She was transferred to another hospital.  She alleges this illegal transfer caused physical injuries to her and the death of her unborn twins.  She alleges that the hospital did not do the necessary screening tests and transferred her due to no insurance.  The court said that she has shown enough to survive the motion to dismiss but did dismiss the statutory since only the feds can enforce EMTALA civil statutory penalties.  

Midkiff v LifeSouth Community blood centers
Alabama Trial Court

Mr. Midkiff is an 83 year old male who had an open heart surgery at Baptist Medical Center in Montgomery.  Six months later he was asked to get an HIV test by the hospital.  It was positive.  he had serious depression and sued.  A jury awarded him $3 million and his wife an additional $1 million.  The donor was an EMT whose blood initially tested negative for HIV but when he donated six months later he was positive.  

Green v Pennsylvania Hospital
Pennsylvania Supreme Court

The patient died after complications from a tracheotomy.  The trial court granted a non-suit after the plaintiff did not establish the surgeon was an ostensible agent of the hospital.  The supreme court said that a reasonable patient would be justified that the surgeon was acting as a hospital agent as he entered the hospital via the ED and admitted to the ICU.  The patient was treated there by nurses and physicians so it is conceivable as a jury     question as to whether the surgeon is the ostensible agent or not.        Top


Oregon v Insys

Insys Pharmaceuticals has settled a claim by Oregon that it paid kickbacks to physicians to prescribe Subsys.  They agreed to pay the state $1.1 million to settle the allegations.  A nurse in Connecticut has already been found guilty and is awaiting sentencing for accepting money from Insys for promoting the drug.  Connecticut has not yet gone after the drug company but it seems reasonable that they will. 

Parish Medical Center v Health First

The hospital says that Health First has tried to monopolize the area cancer care market and has filed an antitrust suit.  The suit is to prevent Health First from acquiring another center with three locations in Brevard County, Florida.  Health First has been sued twice for this in the past.

US v Qualium Corporation

A false claims claim has been filed against the owners of Bay Sleep Clinic and its subsidiaries, Qualium, CPAP Specialist, and Amerind Corporation.  The feds allege that owners Anooshiravan Mostowfipour and Tahereh Nader billed for tests done at unapproved locations by unlicensed technicians.  

US v Lucas

Dr. Mel Lucas of the St. Louis area was sentenced to three years probation and has already repaid $185,799.  He and Patterson Medical Clinic, which he owns, made false statements in patient records and used non FDA drugs.

US v Ajawat

Drs. Paramjit Ajawat and his wife Sukhveen Ajrawat were convicted by a jury of health care fraud and identity theft.  They owned and operated a pain clinic, Washington Pain Management Center in Greenbelt, Maryland.  They filed claims for services not rendered by doing lesser items and billing for the more expensive ones.  They submitted claims for the pain injections under fluoroscopy but he owned no machine.  They also destroyed patient files to not get caught in the scheme.  That worked well.

US v Columbus Regional Healthcare System

The system and Dr. Andrew Pippas have agreed to settle a whistleblower claim for $35 million.  He has agreed as medical director of the John Amos Cancer Center to pay $425,000 to settle his claim.  The hospital agreed to pay at least $26 million but could reach the $35 million mark over the next five years.  The suit was filed by a former administrator.  He gets his retirement paid for.

US v Davida

Dr. Arthur Davida of Bloomingdale, Illinois, pled guilty of fraud for saying that people were confined to their home when they were not.  This led to unnecessary treatments.  

US v Deverman
NOT Guilty

In a rare case a person was actually found not guilty of fraud the judge found that Gelena Deverman, the program director at Northern Manor Adult Day Health Care, did not have adequate grand jury evidence that she played any part in a Medicare scam at the facility.  The grand jury evidence only showed she was doing her job and had not submitted fake bills to Medicare.          Top

Peer Review and Employment

Emerick v Cardiac Study Center
Wash App Ct

Dr. Emerick worked at the Center for two years and then became a shareholder.  The agreement had a non-compete clause that said for five years after termination for any reason he would not compete within a certain geographic area.  He was terminated and sued to have the non compete invalidated.  In trial court he won.  The Center appealed and the court remanded.  The trial court reformed the agreement.  In the meantime Emerick relying on the original invalidation opened an office in the restricted area.  He sued again on the new non compete and lost.  He also lost an argument that the five year statute of limitation was stayed during the appeal.  The appeals court said that Emerick was in violation of the new non compete and that he should not get the benefit of being able to be in the new location for the time of the appeal.  Since the Center won the court also awarded attorney fees.

Fitsimmons v Cardiology Assoc of Fredericksburg
Ed Va

Cardiologist was terminated after he alleged Medicare fraud and not surprisingly he sued.  He lost part of the case but his retaliation survived to be decided another day.

Thomas v Emcare
SD Ind

The ED physician made formal complaints about possible federal and state False Claims.  Five days later he was fired without explanation.  He sued under anti-retaliation.  He won the motion to dismiss since he had never received a complaint about his performance during his time at the hospital.  Seems like a very dumb hospital or hospital attorney.

Vnuk v Berwick Hospital

A nurse sued the hospital and a physician for sexual harassment.  She claimed the physician Chief of Staff sexually harassed her for years by touching her and making sexually suggestive remarks.  She also alleged many of the staff knew and she had reported it to supervisors and HR.  The hospital did not conduct an investigation according to its own policies but interviewed hospital employees.  She also said the hospital reduced her hours by not scheduling her when the physician would be present.  The physician filed a motion to dismiss since she did not exhaust administrative remedies.  The court tossed his motion as she had done enough.  The court did dismiss the case against the hospital since Worker Comp provided the sole remedy for injuries sustained during employment.  There was no personal animus for an exemption to this.  The hospital could not be vicariously liable since the harassment was not within the scope of his employment.

Novak v Somerset Hospital
3rd Circuit

In what could be a poster child for ridiculous law suits, the surgeon sued the hospital for antitrust after he was terminated for performing two surgeries without proper authority.  He claimed the market definition for shutting him out of the area was the small community hospital.  He also said that 32% of the patients at the hospital were treated at other area hospitals.  Duh!

Perez v Doctors Hospital at Renaissance
5th Circuit

The parents of a patient sued for discrimination because they did not get as needed interpreter services.  The parents are deaf and use sign.  The lower court granted summary judgment for the hospital and the 5th reversed stating the father's affidavit was evidence of difficulty with the hospital's provision of services which determined a dispute of a material fact.

Thomas v EmCare
DC Indiana

An ER doctor complained of potential fraud to his supervisors and was fired.  He sued for retaliation and won summary judgment.  Apparently the Harrison County Hospital did not like that they were found out.        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.