December 15, 2014 Recent Legal News


Peer Review and Employment





Hughes v Pham
Ca Supreme Court

In November, California turned down a Proposition that would have changed the $250,000 pain an suffering med mal cap.  Now the state Supreme Court which on several other occasions affirmed the caps but a less liberal make up will take up the issue.  In the trial court Hughes was awarded $2.75 million in noneconomic damages against a neurosurgeon for delay in treatment causing bladder and bowel incontinence.  This was reduced to the statutory $250,000.  Should be interesting if they follow precedent.

MacPherson v St. Charles Medical System
To Be Filed

The Bend, Oregon hospital acknowledges its mistake of giving the wrong med to the patient causing death.  She was given a paralyzing agent, rocuronium instead of fosphenytoin.  They do not know how the error occurred.  The only issue is how much will be paid.

Sw. Emergency Physicians v Nguyan
Ga. Ct. App.

The infant presented to the ED after falling at home and hitting her head on a suitcase.  She was seen by a PA only and no testing was done.  She actually had a subdural and was left with severe and permanent damage.  In the trial court summary judgment was for negligence and the plaintiff.  The court of appeal reversed and stated that the summary judgment was erroneous and the jury needed to decide the case.

Moore v Grand View Hosp.
ED Pa.

An OB sent a patient to the hospital for evaluation for possible preeclampsia.  She was evaluated and discharged.  Two days later she delivered a stillborn and the tests showed the baby died of preeclampsia.  She sued but for some reason the attorney added a claim for EMTALA.  What this did was to delay the suit and hopefully cost the attorney and not the client money.  The EMTALA claim was rightfully tossed at summary judgment as she was given the same treatment as others.  Dumb attorney. 

Spaulding v San Francisco

San Francisco has agreed to pay $3 million to the family of the woman who was admitted to SF General Hospital in 2013 for a urinary infection.  She was confused and an order was written for constant monitoring.  Two days later she was missing and was found several weeks later dead in a stairwell.  She was seen by a physician four days prior to her being located and was reported to a nurse.  An autopsy showed she died several days prior to being found.  She died of liver failure and dehydration.     Top

Peer Review and Employment

Hurwitz v AHS Hospital System
NJ Superior Ct.

The surgeon sued the hospital after he lost his privileges for clinical reasons.  He also lost the case against the hospital in the trial court and in the higher court since he received a peer review and the hospital is protected under HCQIA.  Never even got to depositions.

Hansen v Jackson
Texas Ct App

A CV surgeon was hired to provide services under a five year contract.  The contract stated that in the first three years he could only be fired for cause.  After that he could be let go without cause if the practice loses was over $500,000.  The hospital was taken over by a system during the second year of the contract and wanted him gone.  At the same time he was angering referers.  The hospital let him go without cause stating the clinic losses were over $500,000.  He sued for the usual stuff and the summary judgment went to the hospital.  The higher court said that his breach of contract and tortious interference claims could go to trial.  The reason was the hospital did not cite the reason for the dismissal.  If for cause, he did not get a peer review hearing and if without cause they did not prove the clinic losses were the same as practice losses.  The ambiguity could show interference but not malice.

Rangarajan v Johns Hopkins
D Md

In an interesting case, the nurse practitioner was fired after accusing the hospital of false claims.  She sued for retaliation under the whistleblowers act and was denied.  The claims of retaliation under the state law is only for a substantial danger to public safety.  She only showed loss of money.  

Johnson v Brandon Regional Hospital
Trial Court Fla

The nurse, a Muslim, was terminated from the hospital after claiming she was harassed and suffered physical and mental anguish.  The hospital asked for summary judgment but was denied.  She alleged enough to go to trial including a physician battery which was not stopped by the hospital.        Top


US v Delgado

Husband and wife Juan Carlos Delgado and Nereyda Infante or Orlando have been charged with healthcare fraud.  The feds allege that the couple are owners of Prestige Medical Services and Rehab Center in the city and billed for chemo drugs never ordered by a physician and never given.  

US v Rite Aid

Rite aid Pharmacy has paid $almost $3 million to settle allegations of healthcare fraud for offering gift cards to Medicare and Medicaid people to transfer their prescriptions to Rite Aid.  

US v Umana

Dr. Okon Umana of New York pled guilty of healthcare fraud.  He was the medical director of Cropsey Medical Care clinic, where allegedly medically unnecessary physical therapy was being done and billed under Dr. Umana's provider number. 

US v Okoye 

Dr. Charles Okoye of Carson, California, was sentenced to two years in prison and ordered to pay $931,100 for his part in a fraud involving DME.  He ran a clinic in LA that received a kickback from Adelco for each person they referred to the DME supplier.  He will lose his ability to bill federal programs and will likely lose his medical license for at least three years.

US v Antoine

A Dallas woman stole the identity of a nurse and posed as her to get federal funds by working as a hospice nurse.  She was caught and pled guilty.  

Ingle v Janick
MD Fla

The billing clerk had worked in the hospital for 30 years.  She noted the hospital had begun billing Medicare for ultrasounds done by unlicensed personnel.  She told the hospital and refused to work until the hospital changed its billing.  The hospital did change but somehow forgot to inform the clerk.  She sued under the whistleblower part of the FCA.  She was allowed to proceed to trial since the whistleblower does not actually have to file a FCA claim to be protected under the whistleblower act.        Top


Groves v VA
US Court of Appeals for Veterans Claims

The court had previously ruled on the VA's lack of urgency on disability claim appeals and sent the case back to the Board.  Nothing was done and stonewalling was the norm.  The court now held Secretary Shinseki in contempt.  Of course he has now been canned.  

Zeman v USC University Hospital
CD California

Zeman sued the hospital for outpatient surgery and follow-ups within the 90 day global period. She was billed $95.63 for being seen during the global period.  He filed a class action suit.  The crux of her suit was the hospital's provider based status.  She did not raise this in her pleadings so it was gone and with it the rest of her case.

Texas Medical Board v Texas Dental Board

The medical board filed suit against the dental board to stop them from screening, evaluating and treating sleep disorders.  

Hale v Sharp Healthcare
Ca Ct App

The California Court of Appeals ruled that the lower court did not abuse its discretion when it initially certified the case of charging higher for uninsured than for insured and later decertified the class action ruling.

SE Pennsylvania Transportation v Gilead

The case was filed against the drug maker for exorbitant prices in violation of antitrust laws.  They do not like that it costs $1000 a pill.  They are looking for class action.  Good luck to them on this.  It is a real loser.

New York v Actavis

The pharmaceutical company was sued by the state AG for discontinuing its immediate release drug Namenda for Alzheimer's which had competition from generics.  This would force people to use the patent protected long release drug.  The injunction forbids this practice.        Top


Patients v Highlands-Cashiers Hospital
To Be Filed

A third party vendor left information on 25,000 people on line requiring the hospital to notify them their information was at risk.  They do not consider this a data breach since there is not any evidence that he information was accessed or used in any way.

Patients v University Hospitals
To Be Filed

An employee of the Ohio hospital snooped and got the private and financial information of over 600 people.  The employee has been terminated but the damage is done.  

Jackson v University of Massachusetts Memorial Med Ctr

The hospital had an employee steal private information of 2400 patients and offered all one year of credit protection.  That was not good enough for one person and he has filed a class action suit against the hospital for $3000 per person and more protection.  Mr. Jackson is claiming emotional distress and invasion of privacy.  There is no evidence that he has experienced personal information theft or medical information theft.  This may be a blatant attorney reach for money.  Some courts have tossed these cases in the past year.

US v Anchorage Community Mental Health Services 

The mental health agency agreed to pay $150,000 for its breach of information in 2012.  The reason is it had security protocols in place but did not follow them.  They also were forced into a two year corrective action plan requiring them to report its compliance.        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.