August 1, 2014 Recent Legal News






Peer Review and Employment



US v St Vincent Jennings

I don't understand how this could still happen but the hospital paid $25,000 to HHS for not doing a stabilizing exam on a patient who came to the hospital in an ambulance.

Freedman v Fischer

The court ruled in this case of malpractice and EMTALA violation that the request for records of similar cases redacted was OK but not the records of a single person.          Top


Pt v Palmer Community Hospital
Should Be Filed

The elderly woman walked into the hospital stating she was having a heart attack.  the receptionist told her to call her own ambulance.  She did and was taken to another hospital where she was hospitalized for several weeks with her second heart attack.  This case will not be filed.  It happened to a British patient at a British hospital.  In Britain.  

Strout v Central Maine Medical Center
Maine Supreme Court

The state high court ruled that a letter sent by a the CEO of the hospital to the plaintiff that was apologetic for a premature diagnosis that turned out to be incorrect was admissible against the hospital since it also contained an admission of guilt.  The trial court had admitted a redacted one sentence of the letter with the admission.

Jones v Weight

Jones was 24 weeks old when he was born at MetroHealth Medical enter.  The mother had a prior C-Section at 32 weeks and now went into labor three times.  She was admitted to the hospital and after the labor was stopped she was discharged.  When her water broke she was admitted at 12:30 pm and asked to be delivered.  The nurses and resident disagreed.  The attending arrived at 5:30 pm and said no delivery since the monitors showed the baby was healthy.  The mother and her OB had discussed another C-Section prior to labor.  She had an emergency C-Section due to fetal distress at 9 pm.  Jones was born with a cerebral hemorrhage that was determined to have occurred after 5:30 pm.  Jones is left at age 11 with CP and cognitive impairments.  The jury awarded $8 million for future care, $5 million for pain and suffering, $1 million for the mother's cost of services and $500,000 for past economic losses.  The jury found there was medical negligence and the mother was not informed there was a significant risk of brain hemorrhage if the baby goes into fetal distress.  On Sermo the contention was there was no med mal since nothing would have changed if she was delivered earlier.  

Verdugo v Target
California Supreme Court

In a good common sense verdict the California high court ruled that private business does not have a duty of care to its customers to have an AED on premises.  The family of a woman who died at Target sued because the store had no AED.  I am a great believer in AED in all businesses but not to the extent of loss of the private business autonomy.  

Taylor v Jewish Hosp & St. Mary' Healthcare
WD Kent.

In an interesting case the patient went to Jewish Hospital with acute abdominal pain and diagnosed with pneumonia.  He was treated and released.  Soon after he went to the second hospital also diagnosed him with pneumonia and treated him and discharged him.  He died soon after.  The patient's mother sued both hospitals for med mal and EMTALA claims.  The court of course got rid of the EMTALA claims rapidly.  The med mal was more interesting.  The first hospital had some controlling issues over the independent ED physician.  This goes to trial.  The second hospital had a signed form that said the patient knows the ED physician is an independent contractor and the hospital won summary judgment.         Top 


Children's Hospital Central California v Anthem Blue Cross
Ca App Ct

In 2007 state and federal law required the hospital to provide emergency care to Anthem members even though the two entities had no contract due to reimbursement differences.  The hospital billed the insurer for the post stabilization care in the 10 months where there was no contract.  They billed the full service rate and not the discounted rate since they had no contract.  The bill was $10.8 million for the 800 patients.  Anthem paid $4.8 million based on Medicaid rates.  The hospital sued and the jury awarded them $6.6 million.  The court of appeal ruled that payments should not be more than the actual value of the services not the "chargemaster rate".   They ordered a new trial on the reasonable value of the services.        Top


US v Wayne

Christopher Wayne DO of Miami Beach was sentenced to 70 months in prison, forfeiture of $1.6 million, loss of a home and a car, and restitution of $1.6 million to CMS.  This was for health care fraud and illegal narcotics.

US v Global Cardio Care Centers

The WSJ reports that the FBI is investigation Global Cardio Care Centers and its affiliated lab for doing a large number of enhanced external counterpulsation procedures.  The procedure involved rotating tourniquets on the extremity and is useful in patients with angina who can not be treated with other means.  The owner of the clinic Dr. Ronald Weaver, a non cardiologist, is using it on other cardiac patients as a "preventative procedure".  His practice has collected approximately $17.5 million for this procedure between 2006 and late 2013.  It appears that no one else in the country is doing this procedure to the extent that it is being used in this clinic.  

US v Johnson
Arkansas Probate Court

In 2013 the feds got a order on a physician that had died.  The order against the estate of Dr. Stacey Johnson was for Medicare fraud.  The probate court then ordered an IOU to the estate of $2.5 million and real estate amounting to almost $1 million to be turned over to the feds.  This included $600,000 from his ex-wife for her share of the house she is was living in.

US v Le

Dr. Mark Le of Huntersville, North Carolina, pled guilty to criminal charges of fraud.  He billed for services not provided or were not medically necessary.  He will be sentenced at a later date.  He had previously agreed to pay $6.2 million in restitution for fraud in a civil case.

US v Omnicare

A whistleblower got $17.24 million out of the settlement amount of $124.24 for allegedly paying providers via illegal discounts for the continued use of Omnicare for their pharmaceuticals. This is a former employee who no longer has to work. 

US v Ajrawat

The feds have indicted a husband and wife physician team for fraud.  The couple are from Potomac Maryland and are accused of false billing related to a pain clinic.

US v Chen
To Be Sentenced

 Dr. John Chen of Seattle is being tried and a plea bargain of Medicare fraud for making nursing home visits to dead people.  His attorney wants the court to give him probation instead of jail time as part of the plea bargain to be guilty of a lesser offense.  Hope the judge does not go along.

US v Continuum Health Partners

The feds have charged the medical group and various hospitals with fraud for not returning money owed to the government in a timely manner.  They have know about the overpayments  refused to repay for over two years.  They are supposed to pay within 60 days.  The institutions repaid but only after threatened with civil charges.  They say this is fraud.        Top


HHS v Concentra

Concentra Health Services agreed to pay a fine of $1.7 million and a corrective action plan for the loss of a laptop computer from its center in Springfield, Missouri.  The computer was not encrypted.  The HHS issued a statement in April when this was announced about the evils of unencrypted data.  Concentra then was found to have again screwed up when records of theirs were found in a public recycling bin.  However, the place where the records were generated went defunct in 2013 and the records transferred to another facility.

US v Parkview Health Systems

Parkview Health Systems in Indiana and Ohio has agreed to pay the feds $800,000 for their unbelievable screwup.  They knowingly left 71 cardboard boxes of medical records in front of a retiring physician's house who they knew was not at home.  The physician turned the organization into the feds.  That must have felt good.  Parkview also got a deserved corrective action plan requirement.

Patients v Rady Children's Hospital
To Be Filed

While investigating a recent breach of HIPAA by an employee erroneously emailing data it was discovered that in 2012 a similar breach took place with a different employee.  In 2012 the number was over 6000 records breached.

Patients v NRAD Medical Associates
To Be Filed

The New Jersey radiology group sent letters to 97,000 patients regarding an unauthorized access and obtaining of information by an employed radiologist who is no longer employed.  The group also notified the local police and the DA.

Patients v Montana
To Be Filed

The state of Montana has notified 1.3 million people that their computer system was hacked but to their knowledge no information was obtained.  They did not stated whether the computer information was encrypted.  There are only 1 million people in the state but they are notifying the estates of people who have died and the people who have moved out of state.

Tabata v Charlestown Area Med Ctr
West Virginia Supreme Court

The Supreme Court allowed the plaintiffs class action law suit against the hospital for the hospital placing their information on line where it could be accessed by all. Invasion of privacy is a compensatory tort. Therefore all 3600+ patients whose information was negligently displayed have a cause of action.  This type case relating to standing and not the merits should hopefully slow down the EHR joke.        Top

Peer Review and Employment

King v Garfield County Public Hospital
ED Washington

The nurse had a dental procedure and was prescribed codeine for pain relief after.  The hospital was found to be missing morphine at the same time and the nurse had high levels in his urine.  The nurse was fired with no hearing but the test showed different types of narcotic in the urine than what was taken.  The nurse found another job but sued and won the right to a hearing.  The hospital should have allowed it to begin with.  Another CYA by an attorney and CEO.

Marsh v Anesthesia Services Med Grp.
Ca Ct App

The anesthesiologist sued the group for prospective interference with economic advantage due to the groups speaking about her caused several plastic surgeons to stop using her for anesthesia.  The lower court ruled in favor of the group but the court of appeals reversed stating she had linked the two.  Dumb group.

Hagen v Souixland OB
ND Iowa

In this longstanding case (three prior decisions) the physician was pissed after a patient of his died while under the care of another physician in the group.  He complained to the group and agreed to testify for the patient in a medical malpractice law suit.  He also stated that the nurses at the hospital killed the baby.  To no one's surprise Hagen was fired.  He sued and won over $1 million for past earnings.  The court ruled initially that his conduct was protected but realized that this had not been decided prior and certified the case to the Iowa Supreme Court who refused it.  The district court then ruled it protected and allowed the verdict to stand.  It should be noted that the Horty interjection in this case wanted people to believe the termination was legitimate since he was "disruptive".  The court refused rightly to allow testimony regarding something not relevant to the proceeding. 

MRI Associates v St. Alphonsus Regional Medical Center
Idaho Supreme Court

The case is back and it still is terrible news for the hospital.  The state Supreme Court again ruled against the hospital in their wrongful conduct against their one time partner.  The MRI business won a breach of contract suit against the hospital for $52 million.  Sounds like they got very poor legal advise years ago when they decided to screw the MRI company.  MORAL:   DO NOT DO BUSINESS WITH THIS HOSPITAL.

Frances v Nexion Healthcare
ED Texas

A 61 year old male nurse with satisfactory performance reviews was told to either be demoted or terminated.  He resigned and sued.  He was replaced by a younger person.  The court at summary judgment allowed the case to go to trial for age discrimination.  Another dumb hospital attorney.

Copeland v MidMichigan Med Center
MI Ct App

An anonymous person reported the neurosurgeon to the hospital for allegedly slurring his speech during surgery (his first two of five during the day).  The hospital did not do any testing at the time but cancelled the remainder of the cases and summarily suspended him.  He had to go out of town to a substance abuse clinic where he was found to have no problems.  The neurosurgeon was allowed back on the staff and after several proctored surgeries was allowed to resume his practice.  He had a prior Hepatitis C and had taken in the past a leave to help.  He sued the hospital for breach of contract, ADA and defamation.  He lost all three in the appellate court.  The only thing he won was the name of the person who reported him in the first place.  The report occurred prior to peer review and was not protected.  His claims were dismissed because he had signed a release when he joined the hospital years prior that he would not sue for any peer review related issues.  The ADA claim was dismissed since the hospital suspended him for perceived substance abuse and not for his hepatitis.        Top


Patient v Louisiana
State Court

The state court has ruled that the administration's closing of a public hospital and moving the patients to a nearby private hospital is unconstitutional.  They then certified the ruling to state supreme court for an expedited hearing.  The closure is to continue the following week.        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.