June 15, 2008 Recent Legal News


Peer Review






LA v Hollywood Pres Med Ctr

Los Angeles has fined and Hollywood Medical Center has agreed to pay $1 million for the illegal dumping of a paraplegic man in skid row.  He had a colostomy and was dressed only in a hospital gown.  The city continues to investigate other hospitals for the same illegal activity.  Kaiser was fined last year for the same thing. 

John Hopkins v Caremark

 John Hopkins Hospital has filed suit against Caremark insurance for non payment of about $2 million since October 2004.  The hospital had requested arbitration of the dispute but had received no answer in one year. 

Sterman v Kaiser

Sterman was the public affairs director of Kaiser Permanente for ten years.  He is gay and has AIDS.  His physician told him to reduce his workload from 60-70 hours per week to 40 hours per week.  He states that Kaiser responded to his request to scale back by adding more work.  He accuses Kaiser of a toxic corporate culture.  He is suing for harassment, retaliation, failure to accommodate, breach of contract and wrongful demotion.       Top

Peer Review

In re: Peer Review
Minn Ct App

In this case the physician and hospital are not identified.  The hospital put a 120 day suspension on the physician for "disruptive behavior".  The hospital VPMS decided without speaking to the physician that he was disruptive.  He lied and said he had spoken to the physician when he reported to the hospital president.  The leadership then sent a letter to the credential committee for a peer review investigation.  None of this was sanctioned by the bylaws or policy.  The physician was never given a chance to modify his behavior.  He was sentenced to suspension and probation and appealed.  The peer review panel did not issue any report of significance without factual findings. The Board rubber stamped the action.  The physician then sued and won a temporary injunction.  The hospital appealed the injunction but lost since not following its own policies was indicative of malice and therefore negated the state and federal immunity laws.  This is another example of sham peer review and the sheep mentality of following blindly with no or little original thought. 

Ray v Pinnacle Health

The fed courts are consistent. This is a case of discrimination filed in the federal court system by a physician against a hospital.  He asked for quality information on other physicians and the hospital fought it.  The court stated that there is no peer review privilege in fed courts and it balances the right of the physician's need for the information against the hospital concern to protect individual physician names.  The plaintiff physician won.

  Huntsman v Aultman Hosp
Ohio Ct App

 Huntsman filed a med mal suit against a physician and the hospital.  Huntsman asked for a list of peer review documents. The court stated that even the list was protected.  Huntsman then asked for the physician's reports to the peer review committees, admission to the hospital, NPDB, Medical Board.  The court ruled that any report by the physician regarding any peer review was privileged.  The same was not true for any report filed to the State Medical Board or the NPDB as outside agencies.        Top


US v Walgreen

Walgreen Drug has agreed to pay $35 million in a whistleblower case where it substituted capsules for pills when Zantec was ordered.  This resulted in a major increase of payments to the drug chain from Medicaid.  This is the third qui tam from a pharmacist who was working temp jobs and found fraud by various chains.  CVS and Omnicare paid fines earlier.  The pharmacist is getting a cool $5 million for this one alone.  The others were more.  Temp pharmacists that are alert make great money.    

In re Evanston Northwestern Healthcare

Individuals bought a class action suit against the above relating to the acquisition of Highland Park Hospital.  The courts have already ruled that the acquisition violated antitrust law.  This suit asks for damages.  The hospital attempted to get rid of the suit on statute of limitation grounds since it was filed after 4 years after the merger.  The court denied the hospital's logic and stated that the filing was within the 4 years after the FTC filed against the hospital.        Top


Catholic Health v Gross
D Col

A physician resigned during a medical executive committee inquiry into his practice.  He had been recruited to the hospital.  He filed multiple claims against the hospital and lost.  The hospital sued the physician asking for attorney fees for defending against his claims as well as for collection of monies owed to the hospital due to his resignation prior to the end of the recruitment agreement.  The hospital won on all counts.

Bray v St. John Health
Oklahoma Supreme Ct.

A nurse was abducted from the hospital's parking garage at knifepoint and raped.  She sued for negligence.  The hospital won on summary judgment as she was an invitee.  The Supreme Court ruled that the lower court must determine if the hospital had notice of prior events (the court stated they did) that may have required them to provide protection and if they breached by not providing that protection.         Top 


Conn v Peters
Connecticut Supreme Ct.

Peters was injured in a motorcycle accident and awarded a net $526,000 after deduction for attorney fees and costs.  The state went after him for $70,000 to cover his medical bills for the accident. The court stated the federal rules were plain.  The state can get its money from either the tortfeaser or the person injured and the state had a right to a lien on the money.  There was in Connecticut no law allowing for a reduction in the lean to take into consideration any reduction of the damages by costs and attorney fees.

Panayiotou v Johnson
Alabama Supreme Ct.

In a med mal case the plaintiff had an expert that was not an interventional cardiologist like the defendant.  The trial court allowed his testimony but that was overturned by the Supreme Court and gave summary judgment to the physician.  The plaintiff expert was board certified in Internal Medicine but not interventional cardiology which was the issue.

US v Red Cross

The Red Cross was again fined for their poor handling of the nation's blood supply.  This time it was $1.7 million.  This totals over $21 million in fines over the past five years for their problems.  I must say this fine was for a minuscule problem.  They washed 6 units of blood in the wrong solution but it was without harm to anybody.        Top


Summers v Touchpoint Health Plan
Wisconsin Supreme Ct.

The Wisconsin Supreme Court battered the HMO and ordered it to pay retoactively to the date it cancelled the coverage for high dose chemotherapy and stem cell transplant for a boy with brain cancer.  By a 3-2 decision they stated the HMO decision was arbitrary and capricious.  The child was enrolled by his cancer specialist in a study and the HMO decided that the therapy was experimental.  The history was that after the initial rejection by the HMO an expedited review by an outside organization was requested.  They agreed that it was experimental but since there was no alternative therapy that gave better results they stated it should be covered as medically necessary.  The child was them removed from the study and given the same therapy as if he were in the study.  The HMO continued to deny payment and the appeals continued.  The trial court agreed with the HMO and this was reversed by the court of appeals.  Clearly the high court wanted to do what was right and made up the law to cover their decision.         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.