June 15, 2015 Recent Legal News




Peer Review and Employment





US v Roy

Ankur Roy of Skokie, Illinois was sentenced to 75 months in prison for billing for respiratory and physical therapy that was never performed.  He and his co-conspirators are to pay $2.5 million in restitution.  

US v Goldberg

Drs. Richard Goldberg of Weston, Connecticut and Gary Lewis of Greenwich, Connecticut, were sentenced to prison for their role in the New Jersey kickback probe.  They both got 20 months in federal prison for accepting the kickbacks.  Both must also forfeit $108,000 and were fined a small amount.

US v Health Management Association

HMA paid the feds $595,000 to settle allegations that they paid kickbacks to a labor and delivery clinic to refer patients to the hospital.  The payments were disguised as payments for other services.  This is a whistleblower case from the CFO of the hospital.

US v Norbergs

The feds have charged that Dr. Diana Norbergs of Fort Lauderdale have been giving cheaper foreign drugs to patients and billing as if they are FDA approved.  She then pocketed the extra money.  She is now retired.

US v Jaffe

Dennis Jaffe, DDS, of Atlanta, agreed to give up his dental license and pay $325,000 to settle claims of billing Medicaid for work done by a dental assistant when he wasn't present and for upcoding.  

US v Tidwell

Dr. Thomas Tidwell, a radiation therapist in Georgia, was accused of false claims and kickbacks for referring cases to Columbus Regional Healthczre System.  He owned a radiation clinic that the feds found was using outdated imaging for IMRT.  The clinic was purchased by the hospital and Tidwell continued as an employee.  The claim was that he violated Stark, billed using inadequate technology and he received more than fair market value in return for referrals.  The court found no basis for the claim of Stark but, and there is usually a but, they did find that the other claims could go forward since there were questions of fact.        Top


People v UPMC

A class action suit against UPMC has been dismissed by the Pennsylvania judge.  The suit was over a attract on the hospital last year that compromised the information of their employees.  The judge said tat the hospital did not agree to the liability of such a breach and that nothing could have prevented it.

US v Lewis

Teresa Lewis was sentenced sentenced to one year in federal prison for stealing credit card information from the eye clinic where she worked.   She made $52,000 of personal purchases with those cards.

Patients v US Healthworks (Dignity Healthcare)
To Be Filed

US Healthworks, a subsidiary of Dignity Health, lost an unencrypted computer with files of employees information.  The number of those affected is not known.

People v Obamacare
To Be Filed

An Obamacare employee in Houston stole the information of at least 17 people while he worked at a call center.  He then set up accounts in the name of those victims.  He is due to be arraigned soon.        Top


Beloyianis v Presbyterian Hospital/Columbia University 

Edward Beloyianis had scoliosis surgery in 2002.  The surgery left him paralyzed and he died from complications of the paralysis eight years later.  The hospital and the surgeon Dr. David Roye, Jr. were sued.  The plaintiff attorney said that the surgery was cosmetic but would have been nodded later for protection of the internal organs from the curving spine.  The jury awarded $45 million to the parents half from both defendants.  They will not see any money for years, if ever, or until a settlement due to appeals.

Miles v Weingrad
Florida Supreme Court

The patient had a melanoma removed and was told that the excision was complete.  She sought a second opinion and had a re-excision that showed that indeed the lesion had been completely excised.  He developed compilations from the second surgery which she states has left scarring and unable to walk long distances.  The original jury awarded her $16,104 in economic damages and $1.45 million in pain and suffering. The doctor appealed and the $1.45 million was taken to the statutory cap of $500,000.  The patient appealed since the injury predated the enacting of the cap law.  The high court said the original stood since the statutory cap could not be applied retroactively.

Johnson v Mid Dakota Clinic
North Dakota Supreme Court

Johnson called the clinic for an appointment for confusion and swelling of the calves.  He was 7 minutes late for his appointment and was told the physician would not see him.  He and his daughter left and while outside he fell and hit his head.  He was taken by ambulance to a hospital where he had several episodes of respiratory arrest and died nine days later.  The widow sued the clinic claiming negligence for not seeing the patient.  The clinic said he died of unrelated causes.  The clinic won as the widow could not prove a relationship and could not prove the fall was from any medical condition untreated by the clinic.

Whitlow v Rideout Memorial Hospital
Ca Ct App

The court has set back med malpractice in the state.  The case involves a law suit against a ED physician and a hospital on the possible misdiagnosing a brain hemorrhage.  The trial court dismissed the hospital since the signed Conditions of Admissions stated that the physicians were independent practitioners and there were signs present in the Ed saying the same thing.  The Court of Appeal reversed saying this was a disputed facrt and incapable of being addressed with summary judgment.  They wondered whether a person with a brain hemorrhage could know what he was signing and whether the signage was adequate.  

Chan v Curran
Ca Ct App

The plaintiff sued a won a malpractice case.  As part of the award she got $1 million for non economic damages.  The judge reduced the amount to $250,000 under the state's med mal law.  She appealed stating the reduction violated the due process, equal protection and trial by jury.  The court of appeal rightly followed the law and the prior ruling up to and including the state supreme court and affirmed the trial court.        Top

Peer Review and Employment

Knapik v Dartmouth Hitchcock Medical Center

Dr. Theresa Knapik and Dr. Doe were residents in the surgical program.  She told another program and their state licensing board about a letter given to Dr. Doe that had quality concerns.  For her effort of telling the program and the state about the new resident 's quality concerns she was fired for ethical problems. She sued for whistleblowing protection and lost summary decision. Sounds like the ethical problems were with the medical center and not Dr. Knapik although she did send the private letter to another institution. Dr. Knapik also lost her plastic surgery fellowship and her ability to sit for the boards  I would like to thank Dr. Faria for sending me this case.

Lai v Gottlieb Memorial Hospital
Ill App Ct

Dr. Lai sued the hospital for an injunction to prevent it from reporting his summary suspension and resignation to the NPDB.  Dr. Lai was suspended for quality concerns and he resigned.  He didn't go through any peer review hearing and two reports were to filed into the Bank.  The physician lost of course.

In re Memorial Herrmann Hospital
Texas Supreme Court

A cardiovascular surgeon is suing the system for anticompetitive actions.  He alleges that the CEO publicly ridiculed him and stated that this was a warning to other s who may also consider fleeing to a competitive hospital.  He wanted in discovery documents and that is what this case is about.  The court allowed normally protected documents to be released to the surgeon for his anticompetitive case.

Nahas v Shore Medical Center
D New Jersey

This case is back.  Nahas requested permission to amend his complaint. The complaint went from 50 pages to 127 and added new issues and defendants.  The judge ruled that the new one survived summary judgment in his Sherman I antitrust claim that the MEC acted in concert to adopt new criteria that would not let him restore his privileges.  His Section 2 complaint was denied for no relevant market.  His racial issue was allowed as the hospital treated him differently from non-Arab people.  His claim for judicial review of a "arbitrary and capricious action by the hospital is review able by the court.

Stern v St. Anthony's Health
7th Circuit

Stern was chief psychologist at the hospital who was terminated for short term memory loss.  He sued for relief under the ADA.  The court ruled the hospital was correct and Stern want of reducing his time on the job was unreasonable since the action would have removed 45 to 80 percent of the required time.

Semertzides v Bethesda North Hospital
6th Circuit

The surgeon sued the usual suspects for the usual stuff.  Among his claims was the hospital did an unwarranted and unfair investigation into whether or not he provided substandard care.  The lower court dismissed the complaint stating he had not stated a claim upon which relief could be granted.  The Circuit agreed also stating his antitrust claim was no good since no fraud by the feds were alleged.  His emotional distress claim was disallowed since he was not a member of a protected class and he failed to allege defendant's conduct was extreme and outrageous.  Another in the unending string of physician suing and losing.        Top


McCormack v Herzog
9th Circuit

To nobody's surprise the 9th Circuit voided an Idaho law that banned abortion after 20 weeks.  At the same time they also struck down an Idaho law that required all second trimester abortions be performed in a hospital.  The case was started when a local prosecutor filed suit against McCormick for doing a self abortion by swallowing a pack of pills.  The case was dropped but then McCormack filed suit to get rid of the law.

The 5th Circuit upheld a strict abortion law in Texas.  The law made clinics adhere to OR standards.  Clinic physicians are now required to have hospital admitting privileges.  The losers plan on appealing to the US Supreme Court.   

Opayemi v Milford, Connecticut

The city has paid the family of the third grader $30,000 because the school wrongly would not let her come to class after she visited family in Nigeria.  This was during the Ebola scare.  She had exhibited no symptoms.  I think this was a worthy payment.



People v Cleveland Clinic

Some local people in Cleveland filed suit against the Clinic for closing a hospital and putting in an outpatient clinic in its stead.  Cleveland Clinic has a lease on the property until 2026 and he suit is to keep the hospital open until then and when the lease expires the hospital and all related assets be returned to the landlord, the city.  

East Texas Med Cr Tyler v Aetna

The hospital filed suit against Aetna, Cigna and Blue Cross Blue Shield of Texas over their exclusion from a preferred provider network.  The hospital claims it is the only hospital in Texas that is involuntarily excluded from a PPO.

Yadkin County v Yadkin Valley Community Hospital

The North Carolina county owns the building that housed the hospital.  The hospital went out of business without notifying the county.  The lease would have run out two months after the hospital closed.  The county has filed a federal lawsuit for more than $75,000 due to diversity.        Top


Olio is my basket of cases that do not fall under nice captions.

Georgia v Jones

In a shockingly stupid move 23 year old Kenlissia Jones was arrested for murder after taking meds to induce an abortion.  The DA decided that the case was unwinnable and against the law so the murder charges were dropped.  However, to save face the DA charged her with a misdemeanor for having dangerous drugs.  Ms. Jones spent three days in the jail.

Virginia v Hagmann

The Virginia authorities accuse Dr. Hagmann of drugging soldiers and having them perform experiments on one another.  Dr. John Henry Hagmann is a retired Army physician who has helped via his company Deployment Medicine International, the treatment of battlefield wounds.  The PETA folk are agin him because he uses pigs in his experiments as I did when I learned laproscopic lymph node dissection.  The assertions are by the Virginia Medical Board when they suspended his license.  Dr. Hagmann contends that all he did was approved by a government run medical school.  The school denies this.  

US v Zolot
D Mass

Finally a win for the physicians.  Dr. Joseph Zolot and NP Lisa Pliner were found not guilty by a jury.  They were accused of prescribing too much "controlled substances" to patients.  This verdict goes to the over zealousness of federal prosecutors in attempting to hang out good physicians who take care of pain patients.  Many years ago the feds finally had some guidelines as to what was too much prescribing.  Two weeks later they reneged on their own guidelines in order to hang a guilty verdict on another physician. The main reason the pair got off was the feds could not turn the NP against the MD.  Both were Russian immigrants and used to governmental overreach.         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.