November 1, 2014 Recent Legal News





Peer Review and Employment




US v Hadley

Dr. Robert Hadley, a psychiatrist in San Angelo, Texas, was arrested at his office on charges on health fraud.  He is accused of submitting false claims to Medicare for services never rendered or using the wrong CPT codes.  The indictment ran to 52 counts.  

US v Wijetilaka

Dr. Rohan Wijetilaka of Yonkers, New York, was sentenced to three years in prison for health care fraud.  He had previously pled guilty of fraud and ordered to pay $2 million in restitution and forfeiture.  He was guilty of doing cardiac tests not needed and giving out narcotics to patients who would agree to unnecessary tests.

US v Millennium Radiology
SD Ohio

The court allowed a case to proceed against the radiology group and the affiliated hospital for anti kick back.  The radiology group got to read the films at the hospital and the hospital got free medical directorship.  The stupid hospital had been warned by counsel that the relationship could be illegal.  

US v Gibson

The jury convicted past CEO of Riverside Hospital in Houston Earnest Gibson III, his son  and a group home owner of Medicare fraud.  This was for sham psychiatric treatments.  The Gibsons were also convicted of money laundering.  The CEO also paid kickbacks to group homes for referring patients to Riverside.  Other co-conspirators have already pled guilty.

US v Kolbusz

Lombard Illinois dermatologist Robert Kolbusz was convicted of health fraud for billing for removal of actinic lesions when none were present.  

US v Harper

This "physician" Dr. Adolph Harper along with his co-conspirators pled guilty of not only health care fraud but running a narcotic pill mill in the Akron, Ohio, area.

US v St Joseph Health System

Cardiologists Satyabrata Chaterjee and Ashwini Anand of London, Kentucky agreed to pay the government $380,000 to resolve allegations that the hospital paid them to be medical directors but they provided no services.  They had an exclusive contract to refer Cumberland Clinic cardiology patients to the hospital in exchange for the directorship money.  The feds had prior got a $16 million settlement from the hospital.  Three outside cardiologists will split the $68,000 bounty for starting the qui tam case.

US v DaVita

DaVita paid the feds in a whistleblower suit $350 million to settle allegations that they paid kickbacks to get dialysis patients.  They identified physicians and groups that could refer to their facilities and offered them partnerships and medical directorships.  Part of the agreements were to forbid the physicians from referring patients to other facilities.

US v Dignity Health

The hospital company has agreed to pay $38 million to settle claims of fraud for admitting patients that could and should have been treated as outpatients.  The procedures were for cardiac stents or pacemakers that should be outpatient procedures.  There were also some orthopedic procedures that should have been outpatient that the hospital treated as inpatient.

US v Bennett

Dr. Charles Bennett of Northwestern University will pay the feds $475,000 to settle allegations that he filed false claims under a research grant.  The University had paid $2.93 million prior to settle their part of the suit.  This is a whistleblower case.  She got almost half million from the hospital settlement and this one nets her about $81,000.         Top


Italy v Poggiali

The Italian police arrested Daniela Poggiali, a nurse in Umburto, for allegedly killing 37 people who annoyed her while she cared for them in the hospital.  She denied the charges and said she was a victim of a conspiracy organized by her enemies.

Drobot v Plaintiff Attorney

The convicted past CEO of Pacific Hospital sued the attorneys that went after him for defamation.  He claims the attorneys defamed him by stating he and the hospital directed surgeons to put in counterfeit orthopedic screws in patients.         Top 


Center for Reproductive Rights v Texas
US Supreme Court

The high court blocked a 5th Circuit order allowing the state law to go into effect.  The order blocking the law meant six justices agreed on the order.  There was no comment other than the order.  This means the abortion centers previously closed will reopen until the case is finally decided.

Mccullum v Orlando Regional Healthcare 
11th Circuit

Relatives of a deaf child sued the hospital for using them as interpreters and not hiring real ones.  They also sued for direct discrimination for not providing interpretive services to their son.  The lower and circuit court ruled that the family had no standing to sue.  The direct discrimination suit was also dismissed since there was not any evidence that the hospital intentionally discriminated.  They believed the child did not want an interpreter and preferred his family.

Jimmo v CMS

Jimmo, the lead plaintiff in a 2011 class action suit against Medicare, won again.  CMS has agreed that its ruling earlier this year against Jimmo's claim for home care was invalid.  They agreed to pay for the care in full as well as all attorney fees.  Jimmo sued in 2011 over the issue of needed improvement in home care for it to be covered.  

Hickox v Maine
Superior Court

The nurse who apparently does not care about the community sued to have her home quarantine lifted won her case in court.  Nothing more needed.        Top


Falkenberg v Alere Home Monitoring 

Alere had a laptop with the information of 116,000 people stolen.  This precipitated the instant class action suit.  This case followed the precedent of two other cases which dismissed the suits as long as there was not any evidence that the information had been seen by any third party.  The court did allow the plaintiff to amend their suit.        Top

Peer Review and Employment

Langenberg v Warren General Hospital
ED Penn

The vascular surgeon lost his privileges at the hospital for "disruptive conduct". He made multiple allegations of poor quality at the hospital and the hospital fired him for it.  The wonderful hospital then reported him to the NPDB.  He then sued for breach of contract and not following the bylaws as he was given no peer review process.  The court erroneously ruled that when fired for employment they did not promise not to report him.  The court went on to erroneously refuse to look at the HCQIA definition of professional review action.  The court really screwed this up at the expense of the physician.  About the only thing the court did get right was the refusal to dismiss the physician's claims of defamation, invasion of privacy, misrepresentation and tortious interference.  These will go to trial.

Marotto v Ohio State University Med Ctr
Ohio Ct app

The plaintiff sued an OB who claimed immunity as a state actor.  His claim was due to a position at the University as a courtesy staff member at the hospital.  Stupid claim and of course a losing one.

MacGlashan v ABS Lincs Ky

A nurse manager took portions of a patient's medical record home without authorization.  She was terminated and applied for unemployment benefits.  they were denied after the hospital notified the state that she was terminated for violating HIPAA.  She sued for defamation and won against a dismissal filing by proving the hospital with malice published the untruth that she was fired for HIPAA violation to the state.

Copeland v Good Samaritan Hospital
Ca Ct App

The RN sued for wrongful termination.  She was terminated according to the hospital for patient care issues.  She claims she was fired for reporting patient care issues and for requesting leave to attend a state mandated alcohol rehab.  The court believed the hospital and the appellate court agreed.  She never reported patient care issues until after termination.  She also attempted to sue another nurse but that is illegal under the law.  One would think an attorney would or should know that.

Shah v U. Texas SW Med School
ND Texas

Shah, a medical student with ADHD, was released from school for both professionalism and academic reasons.  He sued after his appeal was not granted.  He lost since the school was immune from suit due to the 11th Amendment and he had no case.  Again, an attorney should have known this.

Bluestein v Central Wisconsin Anesthesia
7th Circuit

This attorney and client were so off base that the court had them pay the group's attorney fees.  The anesthesia shareholder sued her group for gender and disability discrimination.  She injured herself and needed time off.  She requested and was denied an open ended leave of absence.  The group asked her to resign but she refused and was fired.  She lost for the obvious reason that she is not an employee but an employer.          Top


SEIU v Daughters of Charity

The union is pissed that the organization snubbed them and agreed to sell six hospitals to Prime Healthcare, the best suitor. They have now filed suit against the hospital chain over the pension plans.  This is even in the face of Prime's stating they will take full responsibility for all pension obligations for the past and current employees including full compliance of the current plan with federal requirements. The real reason for the suit is to add fuel to their future argument to the Democratic Secretary of State to delay or stop the sale.        Top


Herlihy-Paoli v DuPuy
Trial Verdict

A jury in Dallas, usually a plaintiff gold mine city, went against the plaintiff in the first of 6000 suits about metal on metal hip replacement surgery.  Johnson and Johnson the parent company of DuPuy won the initial case against a well known plaintiff attorney which means the remaining cases do not look good.  The jury included an engineer and a real estate attorney.  The plaintiff alleged that Chromium and Cobalt got into her blood stream from the operation causing the devices to be removed.  The defense showed the problems were from the surgeon implanting the devices wrongly and not from the devices per se. 

Lebel v Thornton

Mrs. Lebel and her husband have been awarded $9.5 million raised to $11.3 million due to interest for not being diagnosed with ovarian cancer by her fertility physician, Dr. Kim Thornton of Boston IVF.  The Massachusetts woman said the physician did not diagnose the cancer from June 2008 to May 2009.  The attorney for the physician said the physician followed the standard protocols and will seek legal recourse.  The attorney is shocked shocked I tell you at the amount awarded in this state of high awards for pain and suffering.

Sanders v Legacy Emanual Medical Ctr.
D Or

Sanders has hyperamoniumemia.  He presented to the hospital and had some tests performed but the tests did not reveal his real condition of infection.  He sued the hospital and the physicians for EMTALA violations.  He, of course, lost since he got a screening exam but it did not reveal his condition.  He can not sue the physicians under EMTALA only the hospitals.  The attorney should know that prior to filing a suit.  Attorney malpractice?          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.