September 1, 2009 Recent Legal News

Peer Review





Peer Review

El-Attar v Hollywood Hosp
Filed Ca Ct. Appeal

Dr. El-Attar was up for reappointment at the hospital and was granted same by the MEC after a peer review .  The hospital board then appointed a new peer review panel with members with economic ties to the hospital.  That panel not surprising denied Dr. El-Attar's privileges and also to no one's surprise the board upheld the decision.  The trial court stated they were within the state laws allowing the MEC to delegate its authority.  The MEC did no such thing.  The appeal is with the help of the California Medical Association.  The case has been filed with the court of appeals to decide whether or not the panel was impartial and if the board overstepped its bounds. 

Jadwin v Kern County

Dr. Jadwin was placed on administrative leave and not given any hearing or notice.  He sued under several theories and won monies under the Federal Leave Act.  He therefore was barred from getting any more money from the hospital for their illegal administrative leave with no due process. The courts do not allow double dipping. 

Bd. Registration v Hallmark Health
Supreme Ct. Massachusetts

The medical board was investigating a physician and wanted information from the hospital.  In Massachusetts there are two statutes regarding peer review protections.  The first one would not allow the information to be sent to the Board and the second one would.  The Supreme Court said that the under court should determine which information falls under each statute.

Landsberg v Maine Coast Health
D Me

Dr. Lansberg, a locum tenens OB, was accused of illegally touching a CNM.  Without any due process the hospital told the locum company to remove the physician.  The company complied and then could not place the physician in any hospital.  The physician sued Maine Coast for tortious interference with business.  The hospital said they never told the locum company not to shop the physician or had they even sent an explanation letter to the company.  The court explained that if the accusation was false, which was possible, the tortious claim could be successful and this needs to go to trial along with an uncontested defamation claim. This the hospital later stated was a he said she said matter.  This case shows that a full investigation needs to be held prior to potentially depriving a person of his livilihood.    Top


US v Soto-Cora

The OIG settled with Dr. Ediberto Soto-Cora for $534,000 for allegedly upcoding or submitting claims without any supporting documentation.

US v Inova

Inova agreed to pay the OIG $528,158 for allegedly making payments to Arrhythmia Associates for PA services without having the needed contracts in place.        

US v Kahuku Hospital

The hospital paid $75,000 to the OIG for making illegal payment to ED physicians above that allowed by contract. 

US v Covenant Health

In a strange case the feds claim that Waterloo Iowa's Covenant Health paid too much money to employed physicians therefore disqualifying them from receiving Medicare reimbursements.  The feds claim that it is much more than the fair market value for the physicians but they give no indication as to how they arrived at the fair market value.  The physicians, who are not involved in the case, are a gastroenterologist, two neurosurgeons and two orthopods.  The hospital agreed to pay a fine of $4,5 million.  The five physicians were among the highest paid in the entire United States.  One orthopod was paid over $2 million per year and the other over $1 million.  The gastroenterologist made over $2 million.  The hospital stated that the salary was reasonable since the work was personally done by the physicians and they were highly productive. This case started in 2005 and drew a round of boos from its competing hospitals for the large amount of money paid to the physicians.        Top


Patients v VA
To Be Filed

The Philadelphia VA continues its problems in cancer treatments.  Six more patients have been given erroneous radiation doses for their prostate cancer.  The total number of cases mistreated is now up to 98 out of 114 total patients.  You usually get one chance at a cure and if you blow it the patient loses his chance for a cure.        Top


Smith v Albert Einstein

In what sounds like the world's dumbest lawyer, he or she sued the hospital and multiple physicians under EMTALA and did not claim any EMTALA mistreatment in the ED.  All happened in the hospital.  The attorney also filed the case under malpractice but did not do the required certificate of merit.  The attorney also did not state any claim against any state actor for constitutional relief.  It sounds like a great case for the plaintiffs for a legal malpractice case.  

OIG v St. Joseph Medical Center

The hospital contested the $50,000 fine by the OIG for non triage of a patient.  This is unusual.  The ALJ blasted the hospital for their non care of the individual and fully agreed with the OIG.  The patient had difficulty breathing and was taken to the ED by the family.  An hour and a half after arriving a temperature could not be obtained by the triage nurse due to a swollen tongue. She labeled the patient routine.  An hour later the patient had more difficulty breathing and the family stated he might be having a heart attack.  The charge nurse ordered the patient to be put on a cardiac monitor and given oxygen.  This never happened.  The patient went into arrest and could not be resuscitated.  The hospital argued that the rule is not a federal medical malpractice rule.  The ALJ stated that the patient did not get a screening exam as required under the rules.  Also the person performing the triage was not qualified under the hospital rules.         Top


West Penn Allegheny Health v Colelia
Penn Superior Ct.

Dr. Colelia left his employer and went to work for a competitor.  The employer sued for an injunction under a restrictive covenant.  The court ruled for the employer but did state their might be an exception to the covenant if the area had a legitimate shortage of practitioners.  There was not a shortage in this case.        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.