January 1, 2019 Recent Legal News

Fraud

Healthcare

HIPAA

Hospitals

Malpractice

Peer Review and Employment

Fraud

US v Phan
Indicted

Dr.Dzung Pham of Tustin, California, was arrested and charged with illegal distribution.  He is said to be the person who gave the meds prescribed to the person who did the Tustin shooting.  He is also accused of supplying the drugs to five people who died of overdoses.

US v Papachristou
Plea Deal

Dr. Marios Papachristou tried to get a pleas deal but it was rejected by the judge.  I admitted to being addicted to Vicodin after an illness 12 years ago.  He also wrote fake prescriptions for himself and a fellow UPMC physician.  He sentenced the physician to two years in prison and a fine of $15,000.

US v Olympus
Guilty

The company and a former senior exec Hisao Yabe pleaded guilty of failing to file the required adverse events reports for infections connected with their endoscopes.  The judge fined the company $80,000,000 and $5,000,000 in criminal forfeiture.  Yabe is to be sentenced later.

US v Perez
Sentenced

Antonio Perez, Jr., a pharmacist in Miami Beach, was sentenced to seven years in prison and ordered to pay restitution of over $8 million.  He had to forfeit four properties and multiple bank accounts.  He was the owner of ARA Medical Services or Valles Pharmacy Discount.  He billed for meds not given to patients.  

US v Knopf
Indicted

Jonas Knopf, was charged with conspiring to defraud Blue Cross of New Jersey of over $10 million.  He was the CEO of Madison Financial Services, a licensed company to sell insurance products.  He made up companies to market health insurance to people not his employees.  

US v Fingerhut
Sentenced

Gary Fingerhut of Solon, Ohio, was sentenced to 30 months in prison for his role in defrauding the Cleveland Clinic of $2.7 million.  He worked at Cleveland Clinic Innovations.  He and others established a shell company to get payments for referrals for which they were not entitled. 

US v Wheeling Hospital
Intervened

The feds have intervened in a law suit against Wheeling Hospital, R&V Associates and Ronald Violi. the hospital CEO for billing under the kickback law.  The originally suit filed by the prior hospital Executive Vice President contends that the hospital paid physicians based on the volume or value of the physicians referrals or was above FMV.

US v Professional Ambulance LLC
Settlement

The Providence, Rhode Island, ambulance provider agreed to pay $300,000 to settle allegations that it billed for medical unnecessary ambulance runs.  The people were sufficiently mobile to go on their own without ambulances. 

 US v Babich
Guilty

Michael Babich, the prior CEO of Insys Therapeutics, has plead guilty of participation in a plan to bribe physicians to use its medicines.  The feds claim that Insys paid fees to physicians to speak if they would prescribe their drug, Subsys.          Top

Healthcare

Healthcare Distribution Alliance v New York
Federal Judge

The federal judge ruled against New York state.  The state attempted to tax drug manufacturers and distributors $600,000,000 to defray the costs of combating opioid addiction.  The state violated the interstate commerce clause by regulation the companies out of state consumers.

DC v Ascension
Judge Decision

The District of Columbia tried to get a TRO to keep Ascension's Providence Health System hospital from closing.  It failed.  The hospital stated it needed to close for financial reasons and there were adequate options for acute care at other facilities.

AHA v HHS
DC Fed Judge

A DC federal judge has finally given the AHA a win.  After the courts said last year that the hospitals had to try other things prior to coming to court to overturn the HHS cutting its precious drug bonanza they refiled and found a friendly judge to go along with them.  The judge however, is not Solomon and does not know how or if the hospitals can collect back payments.  HHS is deciding whether to appeal.

Texas v US
Stay

The federal judge who declare Ocare illegal has issued a stay allowing the law to remain in place during appeal.           Top     

HIPAA

Patients v Flowers Hospital
Settlement

A judge finally dismissed a lawsuit against the hospital five years after filing.  The dismissal was secondary to a settlement of a suit filed after a policeman found patient files in a lab employee auto.  The hospital agreed to pay $150,000 or about $250 per person affected.        Top

Hospitals

Bradley v Southern Regional Medical Center
Countersuit

The family of a deceased woman filed suit against the hospital for sending the wrong body for cremation.  The hospital has now filed a countersuit against the family and the attorney for defamation.  They state they offered to the attorney proof they sent the correct body but the attorney refused to obtain the information.        Top

Malpractice

Kveton v Baylor St. Luke's Medical Center
Filed

Judy Kveton is suing for the death of her husband in the hands of the physicians and staff of the hospital.  This suit was filed after the hospital was railed against by newspapers and others for their heart transplant program which lost accreditation.  

22 women v J&J
JNOV Denied

The circuit judge upheld the $4.69 billion verdict in Missouri against J&J in a case where the company was found guilty of causing the women's ovarian cancer via the use of talc.  This will go to the appeals court and then to the state supreme court.  

Patients v Kaiser Foundation Health Plan
Settlement

Kaiser has settled the class action suit accusing Kaiser of illegally shifting mentally ill patients from Kaiser insurance to fed med. They allegedly told conservators that those mentally ill patients could only continue treatment if they changed insurance.  They would then allegedly transfer them to other facilities that took medicaid.  In the settlement Kaiser denied all but will pay attorneys up to $1.2 million and $10,000 to the two plaintiffs.  Anything wrong with that??  

Cotter v Cincinnati Children's Hospital
Jury 

The jury found for the plaintiff in the amount of $2 million.  The jury found the hospital guilty of allowing Dr. Atiq Durrani to perform surgery.  The jury stated they found the hospital acted with malice.  They allowed him to operate after stating he was let go.  Durrani has fled the country.

Denisenko v Sentara Norfolk Hospital
Trial Court


After the patient checked into the ED and was sitting in the waiting room when he was attacked by another patient who had been seen by the triage nurse.  The patient sued the hospital positing the hospital had a duty to protect him from a known and violent patient.  The court ruled that it was up to a jury to determine if the hospital owed  duty to the patient.  They are under state law a business owner-invitee relationship and EMTALA open door is not a reason to overcome the relationship.

Gilmore v Geisinger Medical Center
3rd Circuit

The patient went to the hospital for a planned cardiac procedure and post procedure he worsened sustaining lasting injuries.  His attorney sued in federal court under EMTALA and of course it was dismissed and the case remanded to state court.  The hospital is not required to stabilize a patient under EMTALA as an inpatient.  Let us hope the patient paid none of the costs and the attorney lost a bunch of money.

Marrero v HealthPlus Surgery Center
To Be Filed

The New Jersey center has warned over 3700 patients that they should get tested for HIV and Hepatitis C due to faulty sterilization procedures .  The center will pay for all testing.  An "attorney" has found a patsy to file a class action case.      Top

Peer Review and Employment

Carbone v CNN
Defamation

Dr. David Carbone was allowed to have his defamation suit go forward after the judge ruled that CNN acted recklessly and with actual malice.  CNN reported that St. Mary's Hospital in West Palm Beach, Florida, had triple the mortality rates than the national average for pediatric procedures.  Carbone was the CEO of the hospital and he lost his job because of the report.  He states that CNN did not use the risk adjusted mortality figures that they should have used.

Wayt v Affinity Medical
Ohio Supreme Court

Ann Wayt, RN, sued the hospital for defamation and won $800,000 in compensation damages and $750,000 in punis.  The state supreme court ruled the amount was too much under the state cap on non-economic damages.  She got $250,000 as per the cap. 

Moustafa v Board of Registered Nursing
Ca Ct App

 Radwa Moustafa applied to become a Registered Nurse and disclosed her prior four dismissed misdemeanor charges for shoplifting.  She was granted a probationary license not a full license.  She petitioned for the full license and the trial court ruled for her.  The Court of Appeals reversed since the board as digression and the underlying conduct was unprofessional.

Gerard v Orange Coast Memorial Medical Center
California Supreme Court

The state supreme court ruled that employees who work over 12 hours per day may waive their second meal period. 

  Physicians v Prime Health
To Be Filed 

The ED physicians working in three Prime Healthcare hospitals have come together after Prime unilaterally cancelled the contract with legacy Physician Partners, a staffing company used to fill the ERs and small community hospitals.  They want the physicians to sign with Progressive Emergency Room Physicians and be paid 20% less plus have the pay being withheld used as a signing bonus.  If you do not sign you will not be paid for the time worked without pay.  If you sign and leave within a year you must pay the bonus back.  Prime states they paid the physicians salary to Legacy and have no idea what happened to the money.  Legacy is in bankruptcy and is being dismantled.       Top

Archive

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.