April 1, 2004 Recent Legal News

Economic Credentialing

Arbitration

Fraud and Abuse

Employment

Privacy

Antitrust

Negligence

Malpractice

Pharmacy

EMTALA

Right to Die

HMO Negligence

Family Law Fraud    

Economic Credentialing

Physicians v Baptist Hospital
Ark. Superior Ct.

The judge that heard the case regarding the six physician who were removed from the hospital staff has ruled that the physicians may remain on the staff until the merits of the case are heard in the future.  The physician had already lost in federal court but now have at least won a stay in the state courts.  The judge wrote that the physician may prevail at trial on key legal issues.         Top

Arbitration

Yedalian v Kaiser and PacifiCare
Settlement

In a settlement signed off by a judge Kaiser and PacifiCare can no longer force patients who claim malpractice from using forced arbitration.  The patients may now use the court system.  Aetna was also named in the original suit but was not a party to this settlement.  In 1992 Yedalian won a ruling in a Los Angeles court in Yedalian v Southern California Permanente Medical Group to allow his suit to go forward due to the arbitration clause being unconscionable.  It is unknown if the ruling affects all Kaiser in the state or only Southern California.        Top

Fraud and Abuse

US v Yedid
SC Cal.

Joseph Yadid a San Diego psychologist has pled guilty of defrauding Medicare of $30,000.  He billed for sessions that never happened or for long sessions that were really short ones.  He faces five years and $250,000 in fines.   

US v Tenet
Settlement

 Tenet has agreed to pay $30.75 million in fines to the government for physician employment contracts in Florida and for payment of claims for transfer of Medicare patients.  

Tenet may also say bye to Santa Barbara as its home office.  

US v Campbell
Sentenced

Dr. Anne Campbell of Gadsden, Alabama was convicted of falsifying information in an antibiotic drug study.  She was an investigator for Keteck, an antibiotic for respiratory infections.  She falsified the number of participants and the information.  Her attorney then had the gall to suggest that any penalty be lessened because some of her participants were valid.  The judge did not go along and sentenced her to four years and nine months in prison.  She will also give up her license.         Top

Employment

Sacramento Hematology v Harrison
Ca. Superior Ct.

The medical group sued Kathryn Harrison, RN for fraud.  They lost in a jury trial and then appealed several issues including the payment of the defendant's legal fees.  The medical group then asked for a reconsideration of the case.  The judge refused.  To date the potential attorney fees and costs the group must pay the nurse is about $400,000.  The group may appeal.        Top

Privacy

California Consumer Health Care Council V Kaiser
Filed

The lawsuit states Kaiser is invading their patient's privacy by turning over the entire patient chart to their attorney when they receive a claim.  This is done without patient notification and private medical information irrelevant to the case is sent instead of the minimum necessary amount. 

US v Hospitals
USDC New York

Ashcroft does win one every once in a while.  He won last month in Michigan and has won in several New York cases, the latest against New York- Presbyterian Hospital.  A federal judge has ordered the hospital to turn over their medical records of some patients in connection with the partial birth debate.  He has had no luck in California getting any records.

The government lost another case recently when it tried to appeal the Illinois District Court decision not to let hem have the medical records at Northwestern.  The Appeals Court voted quickly in a 2-1 decision not to allow the government to get the records but not on the same grounds as the District Court.  The Appeals Court stated the government did not prove its case as to why it needed the medical records.  The actual trial by the physicians against the Government's ban on partial birth abortions has started in the Federal Courts of New York, San Francisco and Lincoln, Nebraska simultaneously. 

Law v Zuckerman
USDC Maryland

The court has prohibited a physician from releasing his patient's medical record to an attorney for the defendant in a malpractice action.  This is a bad decision made by a judge who does not understand the law.         Top

Antitrust

Medical Saving Ins. v 9 Florida Hospitals
Filed

Medical Savings has filed a lawsuit in federal court against nine Florida Hospitals for refusing to deal with Medical.  Medical has refused to give in to the demands of the hospitals for their fees.  It seems that the hospitals are all independent agents and unless the plaintiff can show some type of conspiracy, they will lose.        Top

Negligence

Williams v National Medical Services
Filed

Williams, a nurse who was incarcerated by the Missouri authorities for 14 months for ten counts of murder at Truman Memorial Veterans Hospital was freed last year.  The authorities stated that the charges were dropped after asking for the death penalty since the lab admitted their tests could not prove a drug had been injected into the bodies.  The lab stated the drug succinylcholine could have entered the samples in another unknown way.  Williams is now suing the lab for $10 million. 

Bartosh v Galveston Gulf Health Care Center
Texas Superior Ct.

Bartosh, the daughter of the patient was awarded $136,000 for her mother's being bitten hundreds of times by fire ants.  The nursing home where the mother was living knew about the ants as they had been eradicated in the next room.  The daughter stated the ants had been responsible for the mother's death. The hospital physicians where the mother was taken stated that there was no evidence that the bites caused infection and that the mother did not complain of pain.  The mother had severe emphysema and heart disease.  The daughter had asked for $2.5 million.  After not receiving her Texas jackpot justice she stated she would appeal since the judge did not allow a physician to appear as an expert witness in the probate court.

The University of Mississippi has documented South American fire ant attacks in nursing homes in four southern states and four of the victims have died within one week of the attack. The ants are quickly heading north and are expected to cover the entire contiguous United States in the next year or two. 

Maryland v Maryland General Hospital
Complaint

Maryland has investigated the hospital and has found more defects in their lab.  Besides the prior deficiencies they found tests for Legionella were not done for weeks instead of within 24 hours as required.  This will cost the hospital's lab director a job and will also cause consternation in the upper echelons of the vice president in charge of the lab.         Top

Malpractice

Levine v Wyeth Pharmaceutical
Vt. Superior Ct.

In a jury verdict that stands a good chance of being overturned, Diana Levine won $7 million from the drug company.  She is a musician and lost her right arm following an injection of Phenergan, an anti-emetic.  This happened when she went to Plainfield Health Center in 2999 for a migraine.  She received an injection of a painkiller and Phenergan.  The problem was the injection entered her artery instead of her vein.  The Phenergan label states not to inject into an artery and the label was approved by the FDA.  Wyeth will appeal and should win due to an intervening cause and adequate warning.  The true culprit was the hospital.      

Jones v Kadlec Medical Ctr.
Washington Superior Ct.

The case between the woman who was left essentially brain dead after a tubal ligation and the hospital and anesthesiologist has been settled for $8.5 million.  The physician was accused of removed the patient's ET tube while she was still paralyzed from sedatives.  The anesthesiologist was under the influence of drugs while doing the case.  The anesthesiologist was working temporarily at the hospital.  His previous employer in Louisiana knew about his habit but failed to disclose it to the Washington hospital.  They also failed to disclose that he was fired for drug diversion.  

Vargas v Santa Teresita Hospital
Tentative Settlement

There has been a tentative settlement between the hospital and a child injured at birth.  The case continues against the OB and the nurse is getting her license revoked.  The case was a VBAC and the fetal monitoring strip was abnormal.  The physician was notified at 6 am and no information was given regarding the abnormal strip.  At 6:45 an attempt to reach the doctor failed due to a busy signal and no other number was tried. The nurse did not follow protocol and notify the ED physicians nor get things ready for a possible section.  The baby was born at 7:07 and need resuscitation by the nurse. The child has CP with multiple defects. This is the second episode occurring in the same fashion by the same nurse.  The nurse was let go with the closing of the hospital's acute care facility and hired by Kaiser.  She is now on administrative leave until the outcome of her license has been determined.    

Guinan v Alfred duPont Hosp. 
Delaware (not yet filed)

 The child had a heart stent placed that had not been approved by the FDA and without informed consent of the parents.  They were asked and refused to sign a backdated consent form and went to the FDA.  The hospital admits lapses in their procedure.     Top

Pharmacy   

Pharmacy v New Hampshire
Filed

The New Hampshire pharmacists have filled suit against the state for cuts in Medicaid reimbursement.  The basis is the cuts were done without legislative approval.  The state has cut reimbursement from 12.5% below average wholesale price to 16% and decreased the dispensing fee fro $2.50 to $1.75.  Many pharmacies have dropped out of the state's Medicaid system.  The cuts were initially supposed to be for six months but have now been made permanent.        Top

EMTALA

US v St. Mary's Med. Ctr.
Fined

The feds have threatened St. Mary's in West Palm Beach with removal from the Medicare program for EMTALA violations as well as fined them $40,000.  A nurse told the patient he had to pre-pay or he would not be cared for, a clear violation of law.  The patient left and walked down the street to another hospital for treatment.  The hospital  also transferred patients to other hospitals because there was no neurosurgeon on call to care for the patients.  The hospital denies the charges and states neurosurgeons are on call.  In the entire county there are 10 neurosurgeons but only 4 take call. When the neurosurgeon is on call for trauma they will not see non-trauma patients.  This will now change as the hospital will change its contract with the doctors to allow them to see both and will pay for the additional malpractice insurance necessary for the change.  This is another example of how the hospital must pay their physicians to take call.         Top 

Right to Die

Mass. General v Howe
Mass. Probate Ct.

This case revolves around the wishes of the eldest daughter of a woman with Lou Gehrig Disease hospitalized at Massachusetts General Hospital.  The physicians believe that continued care for the woman is not in the patient's best interest.  She cannot speak, eat, indicate if she is suffering and has been on ventilatory breathing since 1997.  The daughter has the power of attorney for health care and wishes her mother to continue to get full care.  The judge stated that the hospital must continue to give care to the patient according to the proxies wishes but does not have to go beyond the current care by doing CPR.  The patient is fully conscious but has the limitations set forth above.        Top

HMO Negligence 

Physicians v Blue Cross
Damages reduced

Six pediatricians sued Blue Cross and Blue Shield of Kansas City for intentional negligent underpayment of claims.  They won $3 million in compensatory and $3 million in punitive damages.  The appeals court has reduced the payment to $3 million by tossing the punitive damage award.  The court stated there was no breach of fiduciary duty above and beyond breach of contract.  Both sides are considering taking the case to the Missouri Supreme Court.  The claim originally made and proven in court was that the capitation payments were artificially low and the physicians were charged excessive administrative fees. 

Physicians in South Carolina are organizing to sue Blue Cross Blue Shield for manipulating the codes and claims processes to pay less than what they owe.  They will go for class action status.

Aetna has agreed to pay dentists $6.25 million for their intentional underpayment of claims.  The dentists would receive $4 million, the ADA $1 million and attorneys $1.25 million.  Aetna also agreed to promptly pay claims in the future and allow tracking of claims by the dentists on the internet.         Top 

Family Law Fraud     

Ohio v Milbrandt
Sentenced

Mrs. Milbrandt of Urbana, Ohio, thought the best way o keep her husband was by having him believe their daughter had cancer.  She shaved the daughter's head to look like chemotherapy.  She also mad eth mistake of collecting $31,999 for the daughter's treatment of the leukemia she didn't have.  This fraud put her in jail for the next 6.5 years and her daughter in a foster home.

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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.