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November 15, 2015 Recent Legal News

Malpractice

Fraud

Healthcare

HIPAA

Peer Review and Employment

Malpractice

Hana v ISMIE Mutual Insurance
Jury Verdict

The Cook County jury awarded the Hana family $14.3 million for a malpractice case against the insurer for bad faith.  They had originally sued the OB, the hospital and the ED physicians and won $6.17 million.  They received $4.8 million in total and instead of going after the assets of the OB they went after the insurer for not settling.  The jury was out one hour after a one week trial and awarded $1.8 million in compensatory damages and $13 million in punitive damages.  This will not stand but will be settled.  The point was made.

Tillery v Children's Hospital of Philadelphia
Jury trial

Tillery was 11 months old when he was taken to the ED of the hospital three times.  The first time he was diagnosed with an upper respiratory infections and sent home.  On the visit the next he had a high fever, respiratory and cardiac symptoms.  No tests for bacterial infections ere don.  The last visit the next day he waited almost the full day prior to being treated with antibiotics.  He is now with hearing problems and mental deficiency. The jury was out all of three hours before rendering a verdict of guilty and awarding $1.5 million for future medical care, $1.1 million for loss of future earnings and $7.5 million for pain and suffering.

Leavy v Merriam
NY App Ct

The court overruled the lower court and said a resident is not liable if his treatment of a patient does not greatly deviate from normal practice.  The patient had a gall bladder surgery and then had a MI two days later.  He recovered but had a second one a month later and died.  The wife sued all the people involved but one was an anesthesiology resident.  She was under the direct supervision of an attending at the time so she should have a summary judgment.

Cornell v Parkland Hospital
5th Circ

The 5th Circuit overturned a lower court decision and ruled that the individuals at the hospital can not be liable for the death of a psyc patient.  The claim can proceed against the institution.  The reason is the psyc techs were working in an emergency medical response capacity.  They restrained the patient and he died. The restraints are for treatment purposes.        Top

Fraud

Massachusetts v Golden
Settlement

Dr. Joshua Golden and Dr. Masoud Shahidi both treat Medicaid patients for opiate addiction.  They illegally charged over and above what Medicaid paid for prescriptions for Suboxone.  Golden, a psychiatrist charged $250 cash for the initial prescription and $100 per follow-up.  He will repay $288,150 illegally collected plus $75,000 in penalties.  Shahidi, a pediatrician, charged $95 per treatment.  He has agreed to repay $57,570 in restitution plus $25,000 in penalties. 

US v Massachusetts General Hospital
To Be Filed

The feds are looking into Mass General for their orthopedic practice of double booking surgeries.  They have subpoenaed 10 years of records from the hospital and interviewed several physicians.  The patients are apparently not told all the time about the double booking of their surgeons who are only present for the "critical parts" of the cases. The hospital defends the double booking as legal and safe.  This involved about 15% of the hospital surgeries.  In fairness many hospitals allow surgeons to leave the OR and allow residents or fellows to close while they go to another surgery.  At Mass General the anesthesiologists and others have complained for years about the attending not showing up and the patients waiting under anesthesia or the resident doing the case unsupervised.  The feds are investigating the possibility of fraud not patient safety.  

US v HCA
Settlement

HCA has agreed to pay $2 million to settle the allegation that it double billed on lab claims as well as billed for tests not ordered or medically necessary.  This was a whistleblower suit where the employee was awarded $400,000 plus attorney fees.

US v Awada
Sentenced

Dr. Hussein Awada of Royal Oak, Michigan, was sentenced to 84 months in prison for health care fraud and prescribing Oxycontin without indications except for monetary gain.  He was ordered to pay the feds $2.3 million in restitution as well.  He had pleaded guilty.

US v Canedo
Guilty

The CEO James Canedo and orthopedic surgeons Philip Sobol and Mitchell Cohen along with chiropractor Alan Ivar all are pleading guilty to a kickback scheme at the now defunct Pacific Hospital in Long Beach, California.  The hospital billed worker compensation for claims for surgeries referred by physicians who were paid kickbacks for their referrals.        Top

Healthcare

Whole Women's Health v Cole
US Supreme Court

The high court has agreed to look at the Texas law not yet in effect requiring abortion providers to have hospital privileges within 30 miles and requiring clinics to have hospital grade safety equipment.  This is the first abortion related case since 2007.

Planned Parenthood of Wisconsin v Wisconsin
7th Circuit

Several days after the supreme Court agreed to take the case above the 7th Circuit ruled the Wisconsin law requiring physicians to have privileges within 30 miles of the place of abortion was illegal as a burden on women's health.  This was a 2-1 decision.  The state will appeal to the Supreme Court.

US v USPlabs
Raided

The feds raided the offices of USPlabs in Dallas and charged them as well as six officers of the company of the sale of tainted or misleading products.  The company made Jac3d and OxyElite Pro.  It illegally told customers that its products were natural when in fact they were purchased fro a Chinese chemical factory.  They were sold via GNC.

Lee v Findley
California Trial Court

Mimi Lee is an anesthesiologist who had given her eggs to be frozen.  Her husband, Findley, argued that contract law rules.  They had signed a contract stating the embryos would be destroyed if they divorced.  they did divorce. but she wanted the eggs for fertility.  He wanted them destroyed.  The court ruled for the husband.  She was not considered a reliable witness and never proved she could not conceive even though she is 46 years old.  This decision is the same as others around the country.        Top

HIPAA

Patients v UC Health
To Be Filed

UC Health in Cincinnati is another example of why EHR is dangerous.  They inadvertently sent emails containing PMI of over 1000 patients to a wrong address.        Top

Peer Review and Employment

Miller v Huron Regional Medical Center
D SD

The physician voluntarily reduced her privileges after being assured it was not reportable.  The hospital then reported her.  She sued for breach of contract.  The court denied the hospital summary decision on the issue and denied immunity under HCQIA.  She did not receive a hearing as required by the bylaws. The court found that a reasonable jury could find the surgeon was not under investigation when she agreed to reduce her privileges.  The hospital was aware of the false information in the report therefore a jury could find discrimination.  Dumb hospital.  Dumber hospital attorney.

Scott v Sarasota Doctors Hospital, Inc.
MD Fla

 The female hospitalist was assigned by her employer to the hospital for full time work.  She was found to be curt and abrupt but never formally reviewed.  She felt she was being treated differently than her male counterparts and filed a gender law suit against the hospital.  Following this she had a confrontation with HR and was escorted off the premises. She was later terminated by her employer.  The hospital moved for summary judgment and it was denied.  It was her co-employer and there was evidence of a male being offered counseling etc prior to being terminated where she was not.  The discrimination charge stands.  It is hard to fathom the idiocy of the hospitals and their attorneys.

Molleston v River Oaks Hospital
Miss Ct. App.

Poor hospital lawyering continues.  This time the neurosurgeon was denied staff privileges and asked for a fair hearing.  The hospital gave it to him but put the Chair of Credentials on the panel.  He was involved with the prior decision, which is a no no.  The trial court said the hospital substantially complied with its bylaws but the court of appeals were smarter.  His due process rights were violated.

Kim v Humboldt County Hospital District
D Nevada

Still another one.  Here the surgeon working at the hospital was elected to the hospital board.  The board passed a conflict of interest policy and then fired her from employment as a surgeon.  She sued for violation of her constitutional rights and prevailed in summary judgment.  The suit goes forward to the chagrin of the board and the terrible publicity for the hospital.          Top

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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.