August 1, 2011 Recent Legal News

Peer Review and Employment






Peer Review and Employment

County Kern v Jadwin
Ca Ct App

Dr. Jadwin was Chief of Pathology at Kern County Hospital which is owned by the county.  He complained about deficient patient care and hospital regulatory violations and was placed on administrative leave.  He sued the County for retaliation and other causes.  While the case was pending and he was on leave he took CME courses and billed the County for over $3000 for the courses and transportation.  The County then sued Jadwin for falsely filing a claim for reimbursement.  The suit was assigned to mandatory arbitration.  The physician won the retaliatory suit and also won the arbitration.  The County appealed the arbitration even though they did every underhanded trick including stating they had a witness that would prove their case.  They never produced the witness and refused to state the nature of the witnesses testimony.  They also lost the appeal and the Court without saying so said they were liars.  The physician also won attorney fees along with everything else.

Daigle v Stule
D Ma

Daigle was a medical secretary for a physician.  Daigle complained about sexual harassment and the hospital put the physician on administrative leave.  While the physician was away Daigle went through his desk and found that he had been previously disciplined for sexual harassment in another state.  She copied the papers and sent them to the medical board.  The hospital gave her a formal warning about medical confidentiality.  She filed a sexual harassment claim with the Feds.  Another physician had asked Daigle to give a consent form to a patient for a colotomy.  She thought the physician made a mistake and changed it to a colostomy.  The physician caught the error and recalled the patient to sign a different form.  When confronted Daigle attempted to blame a co worker without success.  She was terminated and sued for retaliation.  The courts said that the sexual harassment had been handled correctly by the hospital and dismissed that suit.  The retaliation suit was allowed to go to trial but the court stated there appeared to be adequate reason for her termination outside of retaliation. 

Grain v Trinity Health
6th Circ

Dr. Grain had been recruited to do neurosurgery at the hospital.  It became quickly obvious is was a bad fit.  The hospital unilaterally stopped paying Dr. Grain and he sued for multiple causes of actions including contract problems and civil right issues.  There were many problems with depositions and severe issues on both sides.  Finally the contract issue was sent to arbitration and the physician won over a million dollars.  He then sued in federal court for the racial discrimination and lost here.  In the interim he also lost money to a firm that was hired to do a back search of the hospital computers.  This cost the plaintiffs $245,000.  I can not imagine the attorney fees on both sides.

Leramo v Premier Anesthesia

Dr. Leramo was a part time independent contractor to Premier.  The group said her work was substandard and offered to send her to remedial course.  She refused and her contract was not renewed.  She sued and of course lost in the court and on appeal.  She attempted to sue for discrimination but she was not an employee and she had no facts to support her claim.   

Ghaphery v Wheeling Hospital

 Dr. Ghaphery was let go from his position at Wheeling Hospital for complaining about what he perceived as a violation of Medicare rules.  He sued Wheeling for state claims and also sued an Ohio Hospital for for interference with his contract.  Wheeling Hospital sent the case to federal court on diversity. The federal court said nice try but the case goes back to state court and since both Ohio and West Virginia have basically the same laws regarding the state claims it does not matter whose state laws hold.

Peavey v Univ. of Louisville
WD Kentucky

 A resident was released from the program and sued the university and the professors individually for racial discrimination.  On summary judgment she lost against the university since it had sovereign immunity.  She lost against the professors since they told the truth about the resident who failed to get her license due to not fulfilling what the university told her she would need to do.

Jablonsky v Sierra Kings Healthcare

 This long standing case is finally drawing to a close.  Dr. Jablonsky was summarily suspended from the hospital for disruptive conduct that interfered with patient care.  There was a long battle regarding discovery. Finally, the case came to court and Dr. Jablonsy lost since the hospital can summarily suspend someone whose behavior is sufficiently disruptive to potentially jeopardize the flow of care to any patient in the hospital.  The peers felt his behavior met this standard.  He also refused an offer to help him.  Top


Sekerez v Rush Med Ctr.
Ill App Ct.

This is a story of hospital stupidity.  The patient was admitted for possible blood clots.  The patient expressly and continuously refused Lovanox.  The hospital physician continued to give Lovanox.  The patient died possibly due to Lovanox.  Unbelievably the lower court granted a summary judgment to the hospital due to overwhelming evidence for the hospital.  The higher court had more sight and overturned the lower court to let the case go to trial for battery due to lack of consent.  The hospital needs to settle otherwise they may lose big money.

Renaissance Healthcare v Swan
Tex. Ct App

The hospital was sued for negligent credentialing by the plaintiff estate.  The physician involved had a long history of med mal suits, substance abuse, mental health problems and several wrong sided surgeries.  The hospital continued to let him practice unsupervised.  The estate also sued the referring physician who should have known the surgeon's reputation and referred the patient to someone else.  The trial court denied the motion to dismiss.  The hospital appealed and again lost.  Hope they settle soon as a trial would be terrible publicity for the hospital.     

Nightengale v Timmel
Idaho Supreme Court

Nightengale sued the doctor for med mal.  When she asked the hospital for her records they inadvertently sent her the medical records plus several letters sent by the physician questioning what occurred.  The court stated that the letters were for peer review and could not be used in court. 

Engel v Univ. of Toledo School Med 
Ohio Supreme Ct

In an act of persistence that paid off Engel lost in the two lower courts but won in the Supreme Court.  Engel had three procedures on his scrotum.  The first two were vasectomies and the third was the removal of his necrotic testicle.  He obviously sued the physician who performed the procedures but the doctor claimed immunity since he was volunteering at the medical school ad teaching at the time.  The lower courts granted the immunity but the Supreme Court stated that since he was a volunteer he was not elected, appointed or employed by the state.  His clinical appointment did not count.  He therefore has no personal immunity.  

Patients v Tenet

In a class action law suit Tenet was sued for not being prepared for Katrina and the breaking of the levee.  The settlement is $25 million.  This is a terrible case as it sets a precedent for hospitals to be ready for all contingencies no matter how far fetched.

Wilson v Grant
Wash Ct. App

 Dr. Wilson was a member of the hospital staff of the hospital.  She went to  the ED with headache, vertigo and a history of migraine headaches.  She was seen by the ED physician Dr. Grant.  Dr. Grant gave Dr. Wilson treatment for migraine IV x2.  After the second one Dr. Wilson became comatose and eventually died.  She was not married and had no children.  Her father was appointed executor of her estate.  The estate then filed suit against both Dr. Grant for malpractice and the hospital under vicarious liability.  The court ruled the estate could sue for economic damages.  It then ruled that even though Dr. Wilson worked in the hospital as an independent contractor she may or may not have know Dr. Grant was an independent contractor.  The consent form signed by Dr. Wilson's significant other only stated that the hospital has independent contractors and did not name Dr. Grant.  The court also stated that Dr. Wilson came to the hospital ED not to see Dr. Grant.  The suit for vicarious liability can go forward.    Top 


US v Foster

Dr. Allen Foster of Gatinburg, Tennessee, was sentenced to one year in jail for health care fraud and tax offenses.  He was also ordered to pay Medicare $74,000, TennCare $65,000 and the IRS $596,000.  He failed to file a tax return for 2005 and billed for 15 minute sessions on fast track patients that did not take 15 minutes.  

US v Gupta

Drs. Gupta and Wahi of Rockford Illinois, were indicted by a federal grand jury for health care fraud.  Gupta fled and is a fugitive.  They ran weight loss clinics in northern Illinois and ordered and billed for unnecessary tests.   

Washington v  Pirouzkar

 Dr. Behrouz Pirouzkar of Olympia, an Ophalmologist, was accused of Medicaid fraud due to billing for procedures never performed and for using Medicaid numbers of patients to bill for the procedures.  

US v Justice

Dr. Glen Justice of Corona Del Mar, California, was sentenced to 15 months in prison and to pay $1 million in restitution.  This was for a guilty plea of billing for oncological injections never given or updcoded.

US v Riggs

Debrorah Riggs, RN, of Goddard, Kansas, was sentenced to four years in prison for diluting morphine to be given to patients for self use.

US v McGee

Ernest McGee, pharmacist in Dorchester, MA, and the pharmacy owner Amadiegwu Onujiogu were guilty of paying patients to bring prescriptions to their pharmacy so they could bill for filling the prescriptions.  the prescriptions were never filled.

US v Guerra-Nistal

Miami's Vicente Guerra-Nistal pled guilty of paying kickbacks and bribes to Medicare beneficiaries so ABC Home Health could bill for services never received or were medically unnecessary.

US v McLean

A federal jury convicted Dr. John McLean of Salisbury, Maryland, of fraud for placing cardiac stents in patients that did not need them.  He also was convicted of ordering tests not necessary and making false notes in patient records.      Top


Patients v Spartanburg Hospital
To Be Filed

The hospital sent a letter to patients stating that a computer was stolen.  The computer had names, addresses, medical codes and SSNs but was password protected.  They wrote the letter several months after the computer was stolen.          Top


Peoria Tazwell Pathology v Messmore

A suit was filed challenging the Illinois law that states non participating pathologists, ED physicians, radiologists or neonatologists seeing patients in provider hospitals can only charge patients the same co-pays as participating physicians.  The remainder must be received from the insurer via arbitration.  

Tampa General v Campbell

In one of the weirdest cases I have ever seen, the hospital is suing the estate of Tameka Jaqway Campbell, age 29, who died.  She was hospitalized in Tampa General for two years with progressive demyelinating neuropathy.  They are suing for $9.2 million.  The mother states that there are no resources and that the hospital is suing to prevent a wrongful death suit.  This may be the largest hospital bill ever filed.     Top


Prime Health v California Watch

California Health has published several pieces accusing Prime of fraudulent activity.  Prime has filed a defamation suit against California Watch.  It accuses California Watch of relying on untrue information fed to it by the Service Employees International Union which has had a long standing feud with Prime.  Prime states that the accusation that it is being investigated by the feds for fraud is untrue.        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.