June 1, 2014 Recent Legal News



Peer Review and Employment






Hi-Lex Controls v Blue Cross Blue Shield of Michigan
Fed App Ct

The Blues lost an appellate decision regarding a fee charged to insureds and the fee and what it was comprised of was hidden by the insurer.  This cost the Blues $5.1 million in damages plus another $1 million in interest.  There are many more cases lined up behind this one on the exact issue.  Therefore the only trials will be for how much not guilt or innocence.        Top


Dray v Staten Island University Hospital

The patient had two prior C-Sections and went doctor shopping to find one that would deliver her vaginally.  Using the Internet she found Dr. Dray who agreed to try to deliver her her way.  The patient hired a doula for the delivery.  After being in labor for several hours with a broken water she was taken against her desire for a C-Section at which time the bladder was inadvertently entered and repaired.  She is suing for med mal due to the C-Section.  It is interesting as patients have absolute rights regarding their body.  The law becomes murkier when a fetus in involved. She is suing the hospital and her physicians.  She is not suing the doula.

Cole v Karanfilian
NY Ct. App

Cole saw is primary care physician for a lump in his arm.  In 2001 and 2002 he had x-rays and an MRI of the arm performed.  The MRI was read as consistent with a hematoma.  He went to surgeon Karanfilian in 2002 who after exam and reading the MRI report did not believe it needed to be removed.  In 2005 at the advise of a dermatologist he returned to the surgeon where the lump was removed.  The diagnosis was round cell liposacroma.  He died of the disease in 2009.  In 2007 he sued the surgeon and others for med mal.  The case was time barred and the plaintiff could not make the case for continuous treatment so the case was dismissed.

Whitlatch v Takeda

A state court said not guilty to a case of bladder cancer in a patient taking Actos, a diabetes drug.  The plaintiff attempted to make a causation case but apparently did not.  They will appeal.  This is one of about 10,000 cases filed against the company.  Last month a Louisiana jury awarded 9 Billion for failure to warn.

Fudacz v University of Toledo Med Ctr

Believe it or not!  The patient was scheduled to receive her brother's kidney but awoke after it was noticed that the kidney had been tossed out by a nurse.  The patient later did get a transplant from a perfect match.  The hospital paid for the helping her find a new kidney and the transportation to Colorado to get the transplant.  They also paid $650,000.  

Patients v University of Minnesota
To Be Filed

The University did a screening in a building for immigrants.  Good thought.  Bad execution.  They did finger blood sticks on multiple people with the same lancet.  Potential risk of infection.          Top

Peer Review and Employment

Clark v Evergreen Sw. Behavioral Health 
SD Ohio

In a dumb hospital move that will just cost them more money they asked for summary judgment in a case they were dead wrong about.  They lost.  The plaintiff a male nurse did a great job at the hospital.  He had an affair with a female physician and then called it off.  She was spurned and wanted him fired.  She lied and manipulated to make it happen.  The nurse resigned rather than others getting fired but wanted to be paid for it.  He will get his wish. 

Babchuk v Indiana University Health
SD Indiana

It boggles the mind to know where the hospitals get their attorneys.  In this case the hospital, a state university subdivision, argues for summary judgment not on the merits but on the case that they are not a state actor and therefore can not be sued as such.  They also left out in their motion to dismiss that plaintiff failed to state a valid claim.  They then waived the argument.  To trial.

Simpson v Beaver Dam Hospital
WD Wisc

The black doctor was offered employment subject to getting on the staff of the hospital.  He applied but withdrew his application after the hospital found out red flags in his past.  After withdrawing his application to prevent data bank reporting he had the audacity to sue the hospital for racial discrimination.  He fortunately lost in summary judgment.

Long v Quorum Health
D Vt

He didn't know when to keep quiet.  Dr. Long, an orthopod, accused others of intentionally contaminating his cases.  In 2004 the hospital took away his privileges and ordered a psychiatric exam.  He resigned the next day and was reported to the NPDB for resigning while under or to avoid investigation.  In 2005 he sued and won $4 million from the hospital in settlement but did not get the NPDB removed.  In 2011 he asked HHS to remove the report.  HHS asked the hospital for information which was received and after review decided to keep the report and stated the report was properly filed.  He sued the hospital for giving information and libel along with interference.  He lost since he had  already adjudicated the matters in 2005 and the same matters may not be used again against the same defendants, res judicata.  Also he was the one who asked that the information be sent from the hospital to HHS.

Young v Tri-City Healthcare District
Ca Ct App

In an issue that needs to be determined by the state Supreme Court the splits in the courts of appeal regarding the SLAPP suits continue.  In this court the issue was the suit by the cardiac surgeon against the hospital for wrongful removal of his privileges.  The hospital requested dismissal because the issue was public.  The court said it was not and the case is remanded back to the county court.  The physician was not allowed attorney fees since the case was not malicious.

De v Catholic Healthcare West
Ca Ct App

The resident physician could not perform her work and was dismissed after nine months.  At that time she told them she had ADHD.  She was allowed to return to work but still was unsatisfactory even with reduced workloads.  Her contract was allowed to expire and she sued.  She lost.  The court said she could not perform the duties of the job even with accommodation.

Hong Yin v LIJ Health System

In another case of a resident not performing well and having a mental condition, this OB resident was accused of having a downer personality.  she was given a mentor and her performance did not improve.  She was discharged (asked to sign a letter of resignation) and sued under the federal ADA and NY Human Rights law.  She also lost.  The acts of the supervisor were too minimal to be harassment and she had not asked for reasonable accommodation.

Ridenour v Glenbeigh Hospital
Ohio Ct App

It has been fairly stable practice to consider incident reports filed by a nurse after an accident not to be peer review material.  This hospital lawyer must not have gotten the memo.  The patient fell.  The nurse wrote an incident report.  The suit was filed and the report asked for and denied.  The patient sued for the report and won.        Top


US v Martinho

In yet another of the cases tied to the referral for money scheme in New Jersey by a radiology practice, Dr. Michelle Martinho of New York pled guilty to accepting about $100,000 in bribes to refer patients to Biodiagnostic Radiology in New Jersey.  She agreed to forfeit $155,000 that she took illegally and will be sentenced later.

US v Ramirez

Dr. Roque Ramirez of Robstown, Texas, has been sentenced to 37 months in prison, a $10,000 fine and restitution of $370,368 for mail fraud in filing fraudulent Medicare and Medicaid bills.  He submitted thousands for fraudulent bills by mail for services not necessary or not performed.  He had pled guilty.

US v Farha

Wellcare CEO Todd Farha was sentenced to three years in prison and a $50,000 fine for inflating behavioral healthcare expenses in Wellcare's annual report.  This caused money to be increased to the insurer.  Two other execs also received sentences and a fourth got a fine and community service.

US v Makar

Wasfi Makar, MD., was ordered to pay $89 million in an act of absolute stupidity.  The dumb oncologist in Brevard County, Florida, decided to file bankruptcy when he knew he was going to be fined in a fraud whistleblower case.  He entered no defense and only stated that the employee that turned him in was disgruntled.  The judge said since no defense pay the full freight.  Then he hires an attorney who attempted unsuccessfully to set aside the judgment.  The bankruptcy also is problematic as his clinics have been taken over by a trustee and the judge has said there is fraud.

US v Medtronics

Medtronic has agreed to pay a fine of $9.9 million for giving kickbacks to physicians who implant devices manufactured by Medtronic.  These kickbacks made the claims false.  This is a whistleblower suit by a former employee who will receive $1.73 million.

US v King's Daughter Medical Center

The Kentucky hospital will pay $40.9 million for false claims based on kickbacks to physicians to refer patients to the hospital and for unnecessary cardiac procedures.  The physicians falsified the reports in order to get payments.  The hospital paid unreasonably high salaries to these employed physicians.

US v Halifax Health

Florida's Halifax Health System was fined by a federal judge what will probably be over $100,000 in attorney fees for destroying patient files sought in a fraud case.  The system had already lost a $85 million fraud case and a second case was to be tried.  The judge had ordered records kept but the system destroyed them anyway and lied about having a policy.  This will also go against them in the next case.  The hospital seems to be lying cheating scum.        Top


Alsager v Wash. Bd. of Osteopathic Medicine
9th Circ

In an interesting line of theory the investigated DO sought to solve the dichotomy of either giving the requesting information to the Washington Board or face penalties for noncompliance.  He sued on this premise and lost in the District court and again at the 9th Circuit.  The rationale was he had other later methods of quashing anything by the Board and the federal court should not interfere with state procedures.         Top


Loftus v Nazari

Ms. Nazari had multiple plastic surgical procedures performed by Dr. Loftus.  She was unhappy with the results and posted statements on opinion websites about Loftus.  Loftus and her group sued Nazari for libel and Nazari sued for some other nonsense.  The court tossed the case finding Nazari posted opinion not fact therefore no libel.  Nazari's claims had no evidence to support them.  In all, a waste of court time.        Top


Vides v Advocate Health 
Ill. Court

In the first of four suits against Advocate Health for the theft of four unencrypted laptops containing the information on 4 million people the judge ruled that the suit could not go forward since the plaintiffs did not give a claim certain just potential.  The class action was therefore dismissed.        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.