November 1, 2013 Recent Legal News

Malpractice

Fraud

Peer Review and Employment

Insurers

Criminal

Hospitals

Malpractice

Bridenstine v Saint Francis Hospital
Conn Ct App

In a med mal case a physician did a gastric bypass on the patient who subsequently developed a leak.  She was taken back to surgery by Dr. Giovanni and the repair was fixed.  The patient did not recover and eventually died.  The family sued the hospital and Dr. Giovanni for not acting soon enough.  At deposition Dr. Giovanni was asked about peer review and she stood behind the privilege.  At trial her attorney attempted to ask her about the peer review in which she was not criticized for her treatment.  The plaintiff objected before the doctor could answer.  The judge ruled that the question was illegal and struck the question.  The jury acquitted the physician.  The plaintiff asked for a verdict no withstanding and a new trial was ordered.  The defense appealed the decision and the court of appeals ruled for the plaintiff.  The reasoning was the question alone without an answer was enough to sway the jury and the physician had evoked the privilege in deposition so could not waive the privilege at trial.

Martin v Huntsville Hospital
Filed

Martin is suing the hospital for given the minor Tegratol  when Trileptal was the ordered drug.  It is alleged that the family questioned the drug that they had never heard of and was told falsely the their physician had ordered it.  The child was in a coma for three days due to the drug.  The family feared for her life.

Howland v Wadsworth
Ga Ct App

The patient went to the ED of the hospital for complaints of pain and cold feet.  The patient was seen by a PA who ordered tests to rule out arterial or deep vein thrombosis.  The patient was discharged and returned the next day with bilateral popleteal arterial clots which required bilateral amputations.  She sued for ordinary and gross negligence depending on whether she was a non-urgent or urgent patient.  The jury found she was non-urgent on her first visit and used the ordinary negligence standard.  The appeal was that she was urgent and required the gross negligence standard.  The appellate court stated that whether she was urgent or non-urgent was not a legal matter but one for the jury to decide.  Therefore the $5 million verdict stands.

Dietl v Oz
NY Sup Ct.

The plaintiff watched a show by Dr. Oz where he said a home remedy to take care of sleeplessness due to cold feet was to put uncooked popcorn in socks and microwave them prior to putting the socks on.  Dietl did this and sustained second and third degree burns on his feet.  He then sued Dr. Oz for his own injury.  The court found that a television physician owed no duty of care to his audience.  Case over.

Lathan v Bridgeport Hospital
Guilty

Bridgeport Hospital in Connecticut lost a jury trial and was ordered to pay the patient $9.22 million.  The woman was admitted for a urinary tract infection and due to the hospital errors she was overdosed six times with an anticoagulant.  This caused abdominal bleeding and a cardiac arrest.  After she was revived she had emergency surgery for a clot in the abdomen and then got MRSA with multiple surgeries which left her without part of her shoulder.  Five years later her abdominal incision broke open with her intestines now against her skin.  The hospital has not said whether or not they will appeal this verdict.

Patients v AMHC Healthcare
To Be Filed

Although not a med mal case, it may be negligence.  Thieves stole laptops from a gated and patrolled 6th floor office and stole the two laptops.  The computers are password protected but the thieves obviously targeted them for a reason.  The information of 729,000 patients were stolen.  Credit monitoring has been started and the hospital organization will now make sure all laptops etc. are encrypted.  

Patients v Allina Health
To Be Filed

In another of the HIPAA cases Allina Health reported that a medical assistant at one of their clinics illegally viewed almost 4000 patient records.  These people have been offered credit monitoring.  

 

Fraud

US v Ramirez
Indicted

Dr. Roque Ramirez of Corpus Christi, Texas, has been indicted on 14 counts of fraud.  The indictment alleges billings for services not rendered.  It states that he submitted almost 1500 false billings.  The government states that some billings were for patients the died before the date of treatment, some were for times when he was out of state and others would have required him to work more than 24 hours a day to personally perform all the services he billed for.

US v Kahn
Settlement

Dr. Hafeez Kahn of Smithfield and East Providence Rhode Island will pay twice the amount that the government claimed he owed.  This comes to $1.2 million to be paid by the former physician.  He is to pay $500,000 immediately and $175,000 plus interest annually over the next five years.

US ex rel. McGowan v Kaiser Found. Heath Plan
ND Ca

In a third amended complaint McGowan was challenged by Kaiser for contradicting his prior two complaints.  The court allowed the suit to continue as the pleadings were adequate to overcome the summary judgment motion.

US v Xu
Settlement

  Dr. Jun Xu of Riverside, Connericutt, have entered in a settlement agreement where he will pay $300,000 for allegedly false billing in his physical therapy and acupuncture office.  

US v Donald Gibson II
Sentenced

The physician in the Dallas, Texas, area was sentenced to 52 months in prison and restitution of over $6 million.  The feds have already confiscated about half that amount from his banks and Medicare monies owed.  He was working with multiple clinics and authorized unnecessary medical testing.  

US v Hudson
Sentenced

Dr. Fitzgerald Anthony Hudson was sentenced to 24 months in prison and restitution of $600,000 for lying on his application to get a license in New York.  They proved he was booted from a residency program and did not even have a medical degree.  He successfully conned the state of New York as well as residency programs and the hospital where he was finally caught while working as an ED physician.  Since he had no legitimate license and therefore could not order tests or even see patients all billings were fraudulent.

US v Goldman
Sentenced

Dr. Eugene Goldman of Philadelphia was sentenced to 36 months in prison as well as a fine of $300,000 and loss of participation in federal programs.  He was the medical director of a home care facility and was paid illegally for referring patients to the facility.  

US v Siripurapu
Sentenced

Dr. Padma Siripurapu of New Jersey was caught in the illegal kickback scheme where she received money for referring patients for MRI and CT scans.  She was sentenced to six months in prison and five months of home detention for her taking of the money by the radiology office.  She is also to pay restitution of $51,000 and was fined $30,000.  She is the 12th person caught in this kickback scheme.

US v Long
Sentenced

Dr. Daniel Long of South Dallas, was sentenced to 48 months in prison and to pay over $850,000 in restitution for bilking Medicare and Medicaid.  He and his PA, who had to pay $300,000, ordered unnecessary tests and also had the "patients" say they had more pain than they had so he could give them narcotics.  This meant the "patients" would come back the next month for more tests.   

Peer Review and Employment

Granger v Christus Health Louisiana dba Cabrini
Louisiana Supreme Court

Granger, a Cardiovascular surgeon, was claimed to not have properly care for a postoperative patient at the hospital.  This included a heated exchange between the surgeon and the staff regarding the staffs' conduct of care which was overheard by the patient.  The MEC gave him a summary suspension for 21 days while an investigation was completed.  The suspension was then lifted and his privileges restored with a letter in his file.  Granger asked the the letter of reprimand be removed and that a hearing be held on his summary suspension.  Both were denied and the MEC then recommended to the Board that he be placed on a six month supervised probation and self refer to an anger management course or his membership would be revoked.  Granger did not self refer and he was terminated from the staff.  He sued and the jury found that the hospital did not comply with any of the requirements for HCQIA immunity and awarded his general damages of $1 million and loss of income of $2.9 million.  The court of appeal reversed the general damages to $100,000.  The Supreme Court stated that the bylaws are a contract between the hospital and the physician and otherwise confirmed the award.  This hospital and medical staff need to get new attorneys so that they follow their own bylaws and do not again run afoul of poor decisions.

Insurers

Promise Hospital of East LA v Cigna
CA App Ct

The hospital had a contract with Great Western to take care of the city of Long Beach employees.  They had one employee who had a bill of a million dollars and they did not get paid.  They sued the city for payment and breach of contract and then filed for arbitration as the contract between the hospital and Great Western had an arbitration clause.  They argued that the city was a third party beneficiary and bound to the arbitration clause.  The courts ruled otherwise and the case has to go to court.

Oklahoma v Sebelius
ED Okla

In the case that may knock Obamacare into yesteryear, the district court refused to dismiss the case that asked that federal funding can not be used for subsidies for Obamacare on federal exchanges.  This was not considered when Pelosi said you will find out what is in the law after it is passed.  It turned out that indeed they forgot to allow federal exchanges to do subsidies.  It will be interesting how the US Supreme Court handles this one.

Criminal

Nevada v Desai
Sentenced

Dr. Dipak Desai was sentenced to life in prison with the possibility of parole for his part in the hepatitis C and nurse anesthetist Ronald Lakeman was sentenced to eight to 21 years in prison for his part in the same outbreak.  They both had been found guilty for insurance fraud and criminal neglect of patients.  They used and reused Propofal which caused a blood borne hepatitis C outbreak in the Las Vegas area.

Hospitals

St. Agnes v Sante Physicians
Filed

The hospital is suing the medical group for antitrust.  They believe that Sante has a dominant role in the Fresno, California, area and is threatening physicians who want to retain their HMO patients via Sante from using St. Agnes Hospital.  Sante uses all the other hospitals in the area.  Of course HMOs and PPOs have the prerogative of using limited providers and hospitals depending on costs, the same as Obamacare networks. Seems like a suit destined to lose but may be filed just to get Sante to use the St. Agnes physicians and hospital.  This was done in San Francisco many years ago by St. Luke's Hospital against CPMC and it worked.

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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.