October 15, 2018 Recent Legal News
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US v AmerisourcBergen
Settlement
The drug wholesaler will pay $629 million to settle allegations that a Alabama unit shipped syringes for chemo patients prepared in unsterile environments. They would harvest overfill from original vials of drugs and therefore could sell more than they purchased. They also were accused of over billing physicians for profit. Four whistleblowers will pocket $99 million for this.
US v DaVita
Settlement
The company will pay $270 million to settle allegations that they lied to the feds on insurance to get more money. This was done by a medical unit. The money for this was set aside from the purchase of HealthCare Partners. They searched patients medical records for diagnoses its providers didn't record and then reported the missed diagnoses for larger payments. DaVita found this and self disclosed this to the feds.
US v Kalispell Regional Healthcare
Settlement
The Montana organization has agreed to pay $24 million to settle allegations that they billed for care by physicians that they overpaid for referrals. They paid more than FMV to employed physicians for full time work even though they worked part time. They also proved admin services below FMV to reduce expenses for a clinic and give more money to physicians.
US v Fleckner
Settlement
Dr. Mark Fleckner, an ophthalmologist, agreed to pay almost $7 million to the feds to settle allegations that he administered drugs to patients that were not approved in the US. He billed as if the drugs were the FDA approved ones.
US v Keller
Indicted
Dr. Thomas Keller of Santa Rosa, California, was indicted on charges of unlawful distribution of painkiller. He was also indicted for fraud for two claims.
US v Traylor
Sentenced
Dr. Millicent Traylor of Detroit was sentenced to over 11 years in prison for her role in defrauding Medicare of almost $9 million. She acted as a physician for fraudulent companies and billed for services even though she was not licensed at the time. She also lied about medical necessity. She signed other physicians names to controlled substances prescriptions.
US v Barker
Guilty
Bariatric surgeon Dr. Wad Barker of Mesquite, Texas, has plead guilty of conspiracy to pay and receive bribes. He stated that he helped Forest Park Medical Center commit fraud. He received bribes to operate at the hospital.
US v Five MDs
Filed
Five New York physicians were arrested for running an illegal prescription drug mill. They are Dante Cubangbang who along with his nurse John Gargan and office manager Michael Kellerman and "crew chief" Loran Piquant prescribed for 4.6 million oxycodone, Dr. Carl Anderson distributed over 1 million oxycodone from his home office, Dr. Anthony Pietropinto a psychiatrist who prescribed thousands of pills, Nadem Sayegh a endocrinologist prescribed over 50,000 oxycodone from his offices, Dr. Nkanga Nkanga was charged with distributing over 500,000 oxycodone and pharmacist Marc Klein who distributed over 10,000 oxycodone from his pharmacy.
US v Williamson
Sentenced
A&G Spinal Solutions, a DME company, of south Florida owners Ryan Williamson and William Pierce were each sentenced to prison for paying physicians kickbacks for referrals. Williamson also was ordered to pay $1,593,564 and Pierce $803,007 for repayment.
US v Ainabe
Sentenced
Mercy Ainabe of Houston was sentenced to 108 months in prison for her role in providing information to home health agencies which she should not have. The agencies then submitted claims to the feds for treatments not provided.
US v Mangano
11th Circuit
Pedro Mangano, the owner of PVRX Pharmacy, had been sentenced to 48 months in prison for paying kickbacks to people who referred fraudulent prescriptions to the pharmacy without ever getting the drugs. He appealed the sentence and the Circuit court affirmed.
US v Bomer
Guilty
Starsky Bomer of Harris County, Texas, was convicted of conspiracy to pay and receive kickbacks from group home owners for a PHP services. Top
EEOC v Saint Thomas Health
Filed
The fed agency filed suit against the Tennessee organization for requiring all workers to receive a flu shot. Originally the organization allowed one worker at Touchpoint Support Services, a food service provider, to wear a mask due to religious beliefs. They now took that away and the feds say the hospitals should not force an employee to choose between employment and his religious belief unless doing so would cause an undue hardship on the employer.
Andrews v Wisconsin
Jury
Shannon Andrews and Alina Boyden are both transgender females who wanted surgical sex changes. The Wisconsin state health insurance plan refused to insure them and were sued. Wisconsin lost $750,000 in the jury trial in federal court.
Plaintiffs v Regence Blue Shield
WD Washington
The plaintiffs had been diagnosed with hearing loss and sued to get coverage. They were denied not due to discrimination but due to the fact that it is not a covered benefit. The class action was rightfully denied. Top
Patients v Pulse Systems
To Be Filed
Pulse Systems of Kansas City breached confidentiality by sending patient information to the wrong people. This affected 722 people.
New Jersey v Aetna
Settlement
Aetna agreed to pay $365,000 for violating HIPAA. they sent out envelopes with extra large windows that revealed the HIV status of 12,000 patients.
Wylie v Hartford Healthcare
Error
Wylie had surgery and then went for a follow-up. She had her medical records from the follow-up visit and found 10 pages of another person's record mixed in with hers. She immediately contacted her physician and several days later received a request to mail the records back and sign a confidentiality agreement. She contacted a TV station instead to publicize the error. This is a warning to others who want an agreement signed. Do not do it. Also talk to people, do not send a request by mail.
Barry v Feshour
5th Circuit
Gene Barry, MD sued the Texas Medical Board who along with the US DEA agents subpoenaed his medical and billing records of certain patients. He said this was a violation of his 4th Amendment rights and the district court agreed. The 5th said the physician does not have a reasonable right of privacy in his patient records. The court reasoned that Barry was not the owner of the records and did not possessory interest in them. They belonged to the patients only. Top
AH v California Department of
State Hospitals
Ca Ct App
AH, a patient in a mental hospital, was the sole prophet and worshiper of Zahara. He says this prohibited him from taking any synthetic meds. He was prescribed antipsychotic meds. The hospital conducted two admin hearing which confirmed the meds were required. AH sued and lost and appealed and lost again. The court found his religious beliefs were not genuine as he wrote the requirements of the religion and did take another psych med, also synthetic.
Plaintiffs v Zwiacher
Alaska Supreme Court
Two patients sued Dr. John Zwiacher for med mal. The plaintiffs wanted original source material that the peer review body had received regarding the physician. The high court said this was privileged after the lower courts said they were discoverable. Zweicher was said to have lied when he applied for hospital staff privileges but this did not bear on the med mal case.
Velasquez v Ruiz and NYC Health
and Hospitals
Jury Verdict
Amanda Velasquez was 7 months pregnant and 20 years old when she complained to her OB Dr. Reginald Ruiz of blurred vision. She was seen at the hospital six times after that each time noting blurry vision. Two months later she could not see her newborn when he was born. Several months post partum she went to the New York Eye and Ear and was diagnosed with glaucoma and she was 90% blind. She was awarded $15 million. Ruiz is in the wind and the hospital will appeal the excessive verdict.
Patients v Hoffmann-LaRoche
New Jersey Supreme Court
The court tossed all the cases against the manufacturer of Accutane that the patients said caused irritable bowel syndrome. The patients say the label should have said cause the disease not associated with the disease. The 6-0 finding showed that no one misled the FDA.
Gutierrez v Santa Rosa Memorial
Hospital
ND Ca
The plaintiff sued the hospital and Dr. Elliott Brandwene, the ED physician, for med mal and EMTALA violations. The physician had petitioned the court to bifurcate the trial into EMTALA and med mal. The court said in the interest of judicial economy they would not allow the bifurcation.
Women v Huntington Memorial
Hospital
Filed
The metoo movement is alive and well. The same attorneys that sued USC for complaints of sexual abuse by Dr. George Tyndall. Now the same attorneys have found three women to say that they were sexually abused by Dr. Patrick Sutton by being subjected to sexual remarks. Not groping but remarks. And in the 1990s. And suing now. There is no question Dr. Sutton has a history of problems as he has settled four of five suits against him for sexual misconduct. The suits came one week after the settlements were made public. Coincidence???
Johnson v Bayer
JNOV
It has been about one month since Mr. Johnson won a trial against Bayer for not telling people about the cancer risks of Roundup and glyphosate. The judge has ordered a new trial on the punitive damages at least.
Henry v J&J
Jury
A New Jersey jury tossed a suit by a woman who claimed she got cancer (mesothelioma) from baby powder. It took this jury less than a day to come to this decision. There is no asbestos in the talc. A separate trial in New Jersey gave a patient $117 for the same thing as did a California jury. They are rightfully under appeal. In Missouri the jury gave billions to five women. To date no one has seen a penny from J&J from these trials.
Florez v NorthShore University
Helath System
Jury
A jury found that there was malpractice in the treatment of the mother of a child born with brain injuries. They said if the mother had an earlier C-Section there would not have been a drop in the fetal heart rate and that the physician Dr. Armin Drachler should not have prescribed Pitocin to strengthen contractions. This will be appealed.
Elmhirst v McLaren Northern
Michigan
US Supreme Court
The high court declined to review a decision by the 6th Circuit that said a hospital can only be sued for EMTALA if there is "improper motive". This is opposite the decisions in the 1st, 4th, 8th and 10th courts. Top
Weber v Valley Medical Center
Jury Trial
Dr. Jan Weber, the prior head of the hospital child and adolescent psych division, was fired after he complained to the Santa Clara, California county about unsafe work conditions and substandard care. He won $1.5 million. Good on ya mate.
Brovont v EmCare
Jury Trial
Looks like juries are believing more that hospitals are not only bad places for patients but also for physicians. This jury gave Dr. Raymond Brovont $almost $29 million after he was fired for raising concerns regarding that a single physician was used at night to cover both the regular and pediatric ER of Overland Park Regional Medical Center. He was told to resign and he refused so he was fired. The hospital issued a statement wanting to make sure all knew they were not the defendant but in fact they were even if not legally.
Chopra v Pontiac General Hospital
Jury Trial
Dr. Varun Chopra won $484,000 from the hospital for charging him to be admitted to the hospital medical residency program. Never heard of this before.
Rios v St. Luke's
Filed
The Houston Chronicle has a major story regarding this suit. It blasts the hospital for using peer review to threaten physicians who criticize the hospital care. Rios was critical of the care in the ICU and said so. He was called into his supervisor's office, a private practitioner who said that hospital officials had been in touch with him to take punitive action against Rios if he did not resign. Rios did not resign and was fired. Rios recorded the conversation and his boss believes the case against Rios is an assassination. Would a hospital really use peer review to punish an outspoken physician? You bet your sweet bippy it would. This is the same hospital who just got their Medicare funding for their heart transplants removed. 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.