June 1, 2019 Recent Legal News
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US v Smithers
Guilty
Dr. Joel Smithers of Martinsville, Virginia, was found guilty by a jury of over 800 drug charges. He was also convicted of causing a death of a West Virginia woman. He faces sentencing of at least 20 years in prison.
New York v Wasylyshyn
2nd Circuit
There is nothing a lawyer likes more that a client that wants to fight something on principle. They almost always lose the case but the attorney always wins the money. Here Dr. Marina Wasylyshyn, an oncologic surgeon, wanted some forms from an IRS office. The rule was that all visitors needed an appointment which she did not have. The form she wanted was in plain sight but she got into a hassle with the security officers and was put in handcuffs and fined $50. She has to date wasted $60,000 to overturn the $50 fine. Interestingly, after she was released she walked into the lobby of the IRS and retrieved the forms she needed.
US v Incera
Sentenced
Alejandro Incera, Advance Practice Registered Nurse, in Las Vegas was sentenced to 78 months in prison for unlawfully dispensing opioids. He was also ordered to pay restitution of almost $4 million. He had pleaded guilty of eight counts of illegal distribution. He wrote prescriptions without a legitimate medical purpose. He also paid a pharmacy to fill the prescriptions.
US v Ghearing
Arrested
Dr. Gilbert Ghearing, a FP in Clay County Tennessee, was the second provider in the county arrested in a month for illegal distribution of narcotics. The other was a pharmacist whose store was next to Dr. Ghearing.
US v Poage
Guilty
Dr. Chad Poage DO of Morgantown WV pleaded guilty of obtaining opiates illegally. He used a colleague's DEA number and stolen ID to get drugs. He is an orthopod.
US v Akwuba
Sentenced
NP Lillian Akwuba of Montgomery was sentenced to 10 years in jail for her part in illegal distribution of opioids. She worked in Dr. Gilberto Sanchez's office who had already plead guilty to multiple charges relating to distribution of drugs. The NP induced Sanchez to split money with her and later ws fired by Sanchez. She then opened her own practice to illegally distribute drugs. Top
US v Rhodes
Guilty
Dr. Dawn Rhodes, Podiatrist in St. Louis, was convicted of Medicare fraud for claiming she did routine nail care in nursing homes when he did not or the patients did not need the care. She worked for Aggeus Healthcare whose CEO and owner both received long jail terms for fraud. Rhodes will also need to repay all illegal money received.
US v Rehfuss
Sentenced
Seth Rehfuss of Somerset, New Jersey, was sentenced to 50 months in prison along with restitution payments of $434,000 and forfeiture of $66,000. He had plead guilty of health care fraud for using The Good Samaritans of America to induce people to sign up for genetic tests without any need. He was a representative of a lab but forgot to tell the people that small fact. he also paid providers to get them to write the orders.
US v Mathieu
Guilty
A judge found Dr. Paul Mathieu and physical therapist Hatem Behiry of Brooklyn guilty of healthcare fraud. Mathieu posed as the owner of three medical clinics for the fraud of billing for medical services and supplies no needed or not provided. He also fraudulently signed false medial charts again to bilk payments. Behiry did PT on the patients where there was no need. This brings to 15 the number of people convicted to date in this huge scheme.
US v Kaganovich
Guilty
Another Brooklyn couple were convicted of healthcare fraud. The married couple Tea Kaganovich and Ramazi Mitaishvii plead guilty of fraud in their paying kickbacks for referrals to their diagnostic companies. They reported the kickbacks as legitimate business expenses in their tax forms.
US v Diaz
Sentenced
Yamilet Diaz of Hialeah, Florida, was sentenced to 87 months in prison for her role as a patient recruiter. She received kickbacks for referring patients to home health agencies.
US v Wessel
Sentenced
Podiatrist Loren Wessel of Tucson was sentenced to two years in prison and a fine of just under $1 million for defrauding Medicare. He plead guilty of fraud in billing for things he did not do.
US v White
Garnishment
Retired physician Jon White is a victim of identity theft but that means nothing to the feds. Someone posed as him and billed Medicare for $18,000. Now the feds want their pound of flesh and have begun garnishing his pension plan. The feds have not told him to whom the money was sent nor where it was sent.
US v Morris & Dickson Co
Settlement
The wholesale drug distributor agreed to pay the feds $22 million to settle allegations that it failed to report suspicious orders of opiods. The company accepted responsibility for its actions.
Massachusetts v Kiago
Sentenced
Hellen Kiago was sentenced t 18 months in jail for using her health care agency to bill the state Medicaid program for unnecessary services. She is also fined $130,000 plus will need to pay restitution. She should have stuck to her day job as a teacher.
US v Roskovski
Indicted
Scott and Stephanie Roskovski of Butler, Pennsylvania, were incited of fraud in the healthcare and embezzlement. They are also accused of income tax charges.
US v Douglas
Settlement
Dr. Donald Douglas of Texarkana, Texas, agreed to pay the feds $118,000 to settle allegations that he allowed APNs to treat and bill Medicare without proper supervision.
US v Lamont
Sentenced
Stephen and Elvia Lamont of Tucson were sentenced to 30 and 13 months respectively in prison for health care fraud. They billed for medical services by lower level practitioners as if they had been provided by a physician. This was in their home health agency. They also had to repay just over $1 million to the feds.
US v Clark
Sentenced
Dr. John Clark of Baton Rouge was sentenced to 37 months in jail for illegally billing insurances stating that procedures were done the day after an office visit when they were done at the same time. He was also ordered to repay $254,000. A co-owner Dr. Gray Barrow plead guilty as did a PA Christopher Armstrong but to illegal distribution of narcotics.
US v Mays
Guilty
Dr. Thomas Mays of Southfield, Michigan, plead guilty to charges of fraud. He admitted to providing and receiving kickbacks for home health referrals.
US v Walker
Arrested
Dr. Christopher Walker and Wesley Barber were arrested for wire fraud and conspiracy in an alleged plot to finagle women into having vaginal mesh removed so they could profit from legal cases.
Healthcare
Freeman v Honjo
Patent Dispute
A federal judge has ordered that two researchers Drs. Gordon Freeman from Dana Farber and Clive Wood of Harvard are to be named as co-patentees of a protein that stops the body's immune system from attacking both normal and cancerous cells and if that protein is blocked one's immune system could fight the cancer. This is millions of dollars in fees.
Patients v HCA Healthcare
Filed
Three patients have found an attorney or vice versa to sue HCA for the practice of adding a surcharge in the Florida hospitals for ED use. This has been litigated in the past with the hospital winning.
States v HHS
Filed
The Blues have filed suit against the HHS rule that allows businesses and individuals to refuse to participate in health care actions due to religious beliefs. The plaintiffs state that they will lose billions of dollars if they fail to comply with the rule. Top
Texas v Today's Vision
Investigation
Tomball, Texas, police are investigation Total Vision after finding thousands of pages of medical records from the organization in a dumpster. The records had been stored in a different location from the store.
Patients v Penn Medicine
To Be Filed
A spokesperson said that a contract employee misused medical records and have notified 900 patients about the breach of HIPAA. They went on to state the hospital is NOW reviewing how it uses staffing agencies and contractors to ensure that contract employees meet and maintain our high professional standards. Should have done that earlier in a BA.
Patients v Independent Health
To Be Filed
Somebody emailed the PMI of 7600 members to a member of the organization. The recipient immediately notified Independent Health and the problems was solved. It is a shame when a member needs to take care of a problem that should never have occurred. The company has SINCE conducted employee training.
North Carolina v Medical
Informatics Engineering, Inc.
Settlement
The company agreed to pay the 16 states $900,000 to settle allegations of violations of HIPAA and deceptive practice laws after hackers stole the PMI of 3.9 million people. The company also had to pay $100,000 to the HHSThe company probably got away cheap.
Doe One v Caremark
Settlement
Caremark agreed to a settlement on the class action case against them for sending out HIV status in a clear envelope where information could be seen.
Lawson v Halpern-Rice
Vermont Supreme Court
In an interesting case the Vermont Supreme Court allowed an individual's right of action for an unauthorized disclosure of medical information. However, in this case, it was done for a wonderful cause. Lawson was at the ED for a lacerations and smelled of alcohol. the nurse told a police officer that she had driven herself to the ED and was going to drive herself home. She was arrested on suspicion of drunk driving. Top
Kioutas v Northshore
Filed
The Plaintiff was injured in an auto accident and was seen at the NorthShore Hospital in Skokie, Illinois. Her insurance was Medicare and Blue Cross Medicare supplement. The hospital was in network. The hospital had a policy that treatment in accidents with third party liability would not get billed to Medicare or supplemental insurance but the hospital would bill to the third party or their insurance. Kioutas filed a claim against the driver of the other car for $13,518. The hospital filed a lien for $2958 against her. She asked that the lien be removed and Medicare be billed. The hospital did not reply so she is suing in a class action for filing liens instead of billing insurance.
University of North Carolina
v Vidant
Restraining Order
UNC won a 10 day TRO against the system that runs East Carolina Brody School of Medicine. The by laws apparently state that UNC will appoint 9 of the 20 members of the board of directors. Vidant blocked the seating of the appointed members and unilaterally stopped then from appointing members to the board. Top
Estate of Krappa v Lyons
Pa Super Ct.
I always knew Pennsylvania was strange since my son in law is from there but their Supreme Court had previously found that privilege does not extend to materials generated by committees reviewing the professional qualifications or activities of the medical staff. Here the suit was for wrongful death and the plaintiff sought the unredacted complete credentialing material of the two physicians sued. The trial court allowed the discovery as the appellate court agreed.
Guillen v Community Memorial
Hosital
Filed
The suit alleges that the 44 year old who used a ventilator to breathe was without oxygen for 30 minutes before the staff noticed. He suffered brain injury and then died. The attorney alleged that there was no indication an alarm was sounded when the breathing tube was displaced. All know alarms are tuned off.
Olson v J&J
Jury
A jury has ruled the company must pay the plaintiff $25 million for mesothelioma from baby powder. This is the compensatory with punis to follow. Watch for a settlement as this will never stand. The same day another mesothelioma trial against J&J but in South Carolina ruled for J&J.
Belden v San Bernardino County
Filed
Belden was jailed in Joshua Tree and alleges that he was denied treatment there which led to amputation of his lower limbs. The heroin addict was unable to walk and was dragged into a courtroom about a week after complaining that something was wrong. He states he did not receive any treatment while at the jail. This is one of many accusations against this county for poor treatment while in custody.
Daniel v US
US Supreme Court
Daniel, a nurse in the Navy, died post partum from vaginal bleeding. Her husband filed a wrongful death lawsuit but it was dismissed due to the prior Supreme Court ruling in Feres that active duty could not sue the government for injuries arising from activities incident to military service. The Supremes would not review the case but it led to strange bedfellows when Justices Thomas and Ginsburg actually agreed that the original case was wrongly decided and this case should go forward.
Allen v Methodist Hospital
To Be Filed
Robert Allen was a patient at the San Antonio hospital and had a cardiac arrest. the defibrillator aced and a spark ignited the room oxygen which had been left on. There were burn marks on the patient's arms and shoulder. The investigation said there was no adverse impact to patient outcomes as a result of the incident.
Gauldin v Johnson & Johnson
Filed
The family of a 6 year old that died of Stevens-Johnson Syndrome is suing because they knew their product could cause the disease and did not warn them. He died after three years of blindness and other problems from the disease. The FDA had in 2013 urged people to report any skin problems after taking acetaminophen and to immediately stop taking the med immediately and seek medical help. The FDA had previously said the same about ibuprofen. The FDA said it would require a warning be added to labels of prescriptions with the drug and request one be added to OTC drugs. The child took the meds 9 months after the FDA announcement and there were no warnings on the bottle.
West v Calvert
Filed
A patient filed a suit against Dr. Jay Calvert for faking diagnoses and operating on her 12 times over four years. She also alleges that the doctor double billed, billing both her and her insurance. She is also suing USC for allegedly having their students, interns and residents operating on her without her consent. The University says the physician is not employed.
Mason v CVS
SD Ohio
Mason sued after alleging CVS gave her the wrong med which she took and had an adverse reaction to. The court said that this was not a med mal claim since pharmacists are not within the statutory categories. The court did toss the product liability claim since the product was not defective. It did allow the negligence claim to go forward stating the statue started when she had her injury not when the med was dispensed. The court also allowed her expert even tough he is not a physician as this is a negligence and not a med mal suit. Top
Levitt v Iasis Healthcare
Utah Ct App
Dr Jodie Levitt, neurosurgeon, was suspended and requested a hearing. She was told it would be scheduled in the future. She states she was also told that if she did six proctored cases during her 28 day suspension she would not be reported to the Data Bank. If she proceeded with the hearing it would be beyond the 30 days and she would have to be reported to the Bank. She did not go ahead with the hearing and did her cases and had her privileges restored. She then sued for all sorts of dumb stuff and tried to show the hospital acted in bad faith. she failed and the hospital has immunity from suit. I am sure she now has a wonderful relationship with the hospital and medical staff.
Levitin v Northwest Community
7th Circ
Dr. Yalena Levitn, a Jewish surgeon of Russian descent, had her own practice and worked out of it. the hospital eventually took away her privileges and she sued. Her cause of action was discrimination. She lost big time since she was never an employee. Her attorney tried to make her one by saying that the call and other requirements imposed by the hospital do not make her an employee.
Obi v Exeter Hospital
DC NH
In yet another case that should never have been, Dr. Lorett-Azuka Obi was a locum tenens at Exeter and the hospital immediately got complaints regarding her behavior. Her temporary privileges were revoked and she was reported to the NPDB. She had her license suspended. She then sued for breach of contract etc. The court tossed all the complaints quickly.
Murrell v Penn Presbyterian
Medical Center
DC ED Penn
Tashana Murrell, a nursing assistant, was fired and sued in federal court for discrimination. The hospital showed she was fired for cause and she could not rebut that. 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.