May 1, 2019 Recent Legal News






Peer Review and Employment


Ohio v Jones

Nurse Dana Jones of Akron, has been charged with involuntary manslaughter in the death of a patient at a rehab unit.  It is alleged that he told a nursing aide that he had sweating, fever and blood pressure concerns.  The nurse's aide allegedly told Jones but she did not do anything for 20 or 30 minutes.  The patient died.  Related??        Top


US v 53 People

Of those arrested almost half were physicians who traded opiod prescriptions for sex or money.  The scheme was in Appalachia as well as Alabama.  One dentist is actually accused of pulling goood teeth in order to justify the opiod prescriptions.  

US v CVS Health

CVS has agreed to pay $535,000 to settle allegations that it filled Percocet prescriptions that they should have know were forged.  

US v Allonce

Etienne Allonce has finally been captured after 10 years on the run in Haiti.  He has plead guilty to one count of health care fraud.  His wife went into multiple nursing home posing as a doctor or other professional so she could get patient information on over 1000 patients.  They would then submit invoices to the feds for phony DME.  

US  v Cardiac Associates

The Maryland medical group agreed to pay $399,000 to settle allegations that they submitted false claims.  They billed for two or more procedures on the same patient the same day when only one was performed.  This involved deep vein testing.

US v Sutter Health

Sutter agreed to pay $30 million to settle allegations that it inflated diagnosis in the Medicare HMO arena.  They inflated the risk scores and received extra money not due them.

US v Roskovski

Stephanie and Scott Roskovski of Butler County , Pennsylvania, were indicted on charged hat they defrauded Butler Healthcare Providers of over 1.3 million.  They allegedly submitted requests to Butler Hospital for business related things that were actually personal items.  

US v Doud II

The former CEO of Rochester Drug Co-Operative Laurence Doud II was indicted on charges of conspiracy in drug trafficking.  He allegedly allowed and encouraged is company to sell large amounts of opiates to pharmacies who other middle men would not sell to.  They did not tell the feds about these pharmacies as they were supposed to.  

US v Wu

Dr. John Van Wu of Golden Colorado, was convicted of health care fraud.  He is still to stand trial on illegal distribution of oxycodone.  He billed for services not rendered or not needed.  

US v Amgen

Amgen and Astellas Pharma agreed to pay about $125 million to settle allegations that they used charities to kickback money to physicians for using their meds.  Astellas will pay $110 million and Amgen will kick in $24.75 million.  

US v Primero

Former physician Camilo Primero of San Dimas, California and his business partner Aurora Beltran of Glendora each were sentenced to 33 months in prison for their roles in a scheme to defraud Medicare.  They lied about patients needing hospice when they did not for the extra money as well as billing for procedures never performed.

US v Kumar

Dr. Sheetla Kumar of Stuart, florida, was sentenced to 24 month in prison for health care fraud.  She was convicted of submitting claims for procedures not performed.

US v Wallace

David Wallace and Timothy Stocksdale of Florida were execs at Arriva Medical and agreed to pay $500,000 each to settle allegations that they as the heads and founders of Arriva Medical violated the False Claims Act by selling blood glucose meters for free or low cost to get the medical glucose strip business.          Top


Cook County v Pipeline Health
Court Order

A judge ordered Pipeline Health to keep open Westlake Hospital and restore services or face a fine of $200,000 per day.  Pipeline closed the hospital in violation of a court order to keep it open for a certain length of time.  

Patients v New York City
Brooklyn Court

Five patients sued to stop the mandatory vaccination of religious Jews and lost.  

UPMC v Shapiro

The suit against the Pennsylvania AG was dismissed by a judge who stated the AG acted properly when he attempted to modify UPMC's contracts with Medicare.  The judge ruled that the suit is not yet "ripe".  Nicely done.  Avoids a messy political scene.

FTC v Surescripts

The feds claim the health information network illegally maintained a monopoly on routing and eligibility e-prescribing markets.  They have over a 95% share of the market.

Hodes v Kansas
Kansas Supreme Court

Dr. Herbert Hodes and his daughter Dr. Traci Nauser do abortions.  They sued the state to stop a law that would have banned second trimester abortions.  The high court ruled that women in the state have a right to abortion no matter what the feds decide.    

Washington v Aetna

Washington has a rare immune disorder and was denied coverage.  During depo the medical director who denied the coverage said he never looked at the medical records.  Aetna is now settling the case to the mutual satisfaction.  This means the patient and his attorney got a big pay day plus coverage.          Top


Patients v Blue Cross of Idaho
To Be Filed

The insurer was hacked and 5600 people were compromised.  To its credit the insurer did report this to the FBI and to the public quickly as opposed to others who waited months to over a year to report the hack.  

Patients v Prisma Health
To Be Filed

Prisma Health, used to be Palmetto Health, in California, had a phishing attack.  This occurred in November of last year.  he number of people affected were not disclosed.

Patients v Northern Light Acadia Hospital
To Be Filed

An official at the hospital was negligent and emailed the names of 300 patients with prescriptions for opiod use treatment along with their providers to the editor at the local newspaper.  The hospital is only now putting in safeguard to make sure this doesn't happen again.  They broke many federal laws and deserve a huge fine.

Patients v EmCare
To Be Filed

The staffing company had a breach of their EMR.  This company supplies ED physicians accross the country.  

Plaintiffs v Washington State University

The university agreed to pay the class action plaintiffs a total of $5.26 million to settle allegations that it had a safe broken into and the information on a hard  drive of 1.2 million people were compromised.  The school no longer stores information in rented self storage units.  

Torresis v Baystate Health
Class action Filed

The plaintiff says she is heightened risk for identity theft after phishing compromised the data of 12,000 patients.

Cortez v Indiana University Health

The retired police officer sued Indiana University and settled a med mal case for the care of his wounds.  After the case he found that his records had been altered by persons unknown to favor the hospital.  He is suing them again for the alterations of his records.        Top


Redish v St. Barnabas Hospital
Jury Verdict

The patient as in the hospital for an unknown disease and was not transferred to a different hospital with better equipment soon enough according to the suit.  She would up spending 328 days in the hospital and nursing homes and is now in a wheelchair with slurred speech.  She won a ridiculous amount of money, $110.6 million.  This will never be seen by the patient as a settlement will be reached.

Porter v AG Arcadia
Ca Ct App

In an interesting case Porter sued the skilled nursing facility for elder abuse and wrongful death.  In an arbitration the arbitrator ruled that there was recklessness and awarded $1 million in non-economic damages.  The nursing home appealed due to the $250,000 cap on non-economic damages.  The court ruled they have no jurisdiction over the ruling in arbitration as it was only a misinterpretation of the law and not against public policy.  No review is allowed.

Galuten v Williamson Medical Center
MD Tenn

The plaintiff's mother was admitted to the hospital from the ED and stayed for nine days.  She then went to a rehab facility where she died within hours.  The suit contended discrimination due to age and EMTALA violation.  The court tossed the discrimination cause but kept the EMTALA violation even though she had been hospitalized for the nine days.  They reasoned that since the 6th Circuit has ruled that emergency care must continue until stabilized and extends past the ED and the hospital did not show that her conditions which caused her to be admitted had been stabilized.  Proceed to trial.

Washington v J&J

J&J agreed to pay the state $9.9 million to settle allegations that they misrepresented the risks of mesh implants.  The money is supposed to help women in the state harmed by the mesh.  We will see about that.  To the general fund.

Mallidi v U. Wisconsin American Family Hospital

The family sued after a surgery to release a tethered spinal cord and woke up with brian damage.  The resident giving anesthesia failed to react to low blood pressure.  There is no med mal cap for suits against the state as there is with private med mal cases.  The family won $22.5 million.  

Gay v Swedish Medical Center

The family of a 10 year old who died after being released from the Denver hospital is suing after being allegedly told that the physician who treated the son was a known drug user.  They are also trying but will fail to get the internal disciplinary records.

Ward v Lutheran Medical Center
10th Circuit

Ward sought emergency medical treatment at the hospital in Colorado for abdominal pain  They did a CT and EKG and then dismissed him.  Hours later he was hospitalized at another hospital for renal failure.  He sued for all the usual stuff including EMTALA.  The federal court tossed all the claims and the 10th agreed except for the EMTALA claim.  His BP was not stabilized prior to discharge.

Marzorati v MedStar Georgetown Hospital

The plaintiff had a neurectomy for chronic headaches.  She says she was worse after and sued the hospital who employed the physician.  The court dismissed the claim for negligent supervision.  There was no evidence that the physician ever acted in any way that was dangerous or incompetently.  

Williams v Johnston
Tennessee App Ct

Following a hysterectomy the patient developed a DVT and died.  The husband filed suit against the physician along with a pre-suit notice and a defective HIPAA authorization.  The authorization did not have a description of the information to be disclosed.  The physician, an independent practitioner, could not get the information to defend from the hospital due to the deficient authorization.  The court and the appeals court ruled the authorization was deficient and so the case is dismissed.  Attorney malpractice??

Gutierrez v Santa Rosa Memorial Hospital

The hospital has agreed to pay the family of the patient $3.8 million to settle allegations of med mal.  She came to the ED with labored breathing and went into cardiac arrest in the waiting room after being given a narcotic and discharged.          Top

Peer Review and Employment

Etcheverry v Harrison Medical Center

A nurse filed a class action suit against the Bremerton, Washington, hospital for non compensation for lunch and other work breaks.  The nurses were not asked to sign out and then back in for breaks but just find time when they could.  

EEOC v Saint Thomas Health

The Tennessee hospital agreed to pay $75,000 to an employee to settle allegations that it discriminated against an employee for not getting a flu shot.  The employee who worked in food handling was granted permission to wear a mask instead of getting the shot for two years based on religious objections.  The hospital did not allow the mask the next year and will now pay the price.  They will also provide training for their employees.

Stajic v NY City

The plaintiff was in the office of Chief Medical Examiner in New York City.  She raised concerns with her superiors regarding the type of DNA testing they were using in criminal cases had had its reliability verified.  Six months later she was fired from her position as the director of the toxicology laboratory.  She sued and the city agreed to pay her $1 million. The city had really never performed the way it said it did.  This was phased out in 2017 and this lab was the only one in the country to use the test.  City has a lot of egg on its face.        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.