September 1, 2015 Recent Legal News





Peer Review and Employment



US (States) v Amgen

Amgen, without any admission of wrongdoing, has settled litigation against it for allegedly improperly marketing Aranesp.  The agreed to pay $71 million to the states and DC to settle claims.  It had previously agreed to pay the feds $762 million for the same thing.  They advertised it for non FDA approved things. I wonder if they would do the same after the recent ruling that let another pharma off for the same thing due to the 1st Amendment.

US v Umana

Dr. Okon Umana of West Haven, Connecticut had pled guilty of health care fraud earlier this year.  He was a medical director of a clinic that allowed non physicians to see patients and bill as if the physician had seen them.  Eight others have also pled guilty is this scam.  Umana was sentenced to pay $6,429,330 in restitution and to forfeit $6,550,036.  This was on top of the two years in prison.

California v Walgreens

Walgreens agreed to pay California $500,000 for failing to give all new pharmacy prescription customers a consultation as required by California law.

US v Quest

Quest Diagnostics has agreed to pay $1.8 million to settle Medicare fraud charges.  They allegedly billed duplicate reimbursement claims for blood draws, and diagnostic and panel tests.  This is a whistleblower suit and the former employee will get $358,000.  

US v Carillo

Dr. Eduardo Carillo of the McAllen, Texas, community had been previous indicted in an illegal kickback scheme and now has been charged with fraud and taken into custody.  He was out on bond.  He is now alleged to have others bill for dead patients.  He should be living and voting in Chicago.

US v Broward Health

The health system in Florida continues to pay out big bucks.  Originally they paid $10.2 million to an out of state law firm when they made huge gaffes. Now they are paying an additional $69.5 million to settle the original complaint of massive fraud.  This huge offer to settle usually comes when the fed has a lot of evidence against the defendant.  This all stems from a single whistleblower who is about to become very rich ($17 million).  Last year several of the physicians took big pay cuts to make their salary commercially reasonable.  This is a district in political and financial trouble for their own stupidity.

 US v Wisniewski

Dr. Peter Wisniewski of Huntingtown, Maryland, pled guilty of writing prescriptions for controlled substances in the name of patients for his own use.  He is to be sentenced later.

US v Singh

Dr. Paul Singh of Tehachapi, California, pled guilty of fraud by inserting non-FDA IUDs into women and charging for FDA approved devices.  He is to be sentenced at a later date.

US v Kolbusz

A dermatologist from the Chicago area was sentenced to 7 years in prison for submitting false claims for services never performed.  He was convicted by a jury last year of the fraud.  He was also ordered to pay back $3,,764,381.69.  He had already been told by a representative of the American Academy of Dermatology that he was likely committing fraud.  That was in 2007.        Top


Patients v Colorado
To Be Filed

Colorado allowed in letters mailed to wrong addresses the leaking of about 3000 people's PMI.  This is the second time this year that this state has done this.  Dumb does as dumb is.

Patients v Advocate Medical Group
Ill Ct App

The medical group was rightly sued for failing to protect patient data after four unencrypted laptop computers with patient identification were stolen.  A class suit was filed and the court of appeals finally let them off since there was no present harm.  It is a unknown how much this legal foray cost them but it was not enough.

Patients v Lawrence General Hospital
To Be Filed

The Massachusetts hospital lost an unencrypted flash drive with the information of an unknown number of patients.  The also deserve to be sued for their lack of caring about their patient's privacy.

Patients v Backus Hospital
To Be Filed

The Norwich, Conn., hospital said an employee took information on 360 people home from work and an unauthorized person may have seen the records.  The employee has been appropriately disciplined and told not do do it again.  Dumb is as dumb does.

Abdale v North Shore Long Island Jewish Health Sys
NY App Div

The court ruled in summary judgment that the plaintiffs claims should be dismissed on technical pleading faults except for one.  The plaintiffs did give their PMI to the hospital and were told that the information would not be disclosed.  It was and they suffered harm via identity theft.  This is negligence.

Sheldon v Kettering Health Network
Ohio Ct App

The plaintiff sued after her medical information was disclosed by her ex husband, also the administrator of the network, illegally accessed her information and gave it to his paramour.  She claimed that if the network been monitored appropriately this could have been prevented.  The network argued there is no private right of action and therefore no common tort claims could proceed.  The court agreed with the network and also ruled that the administrator's illegal act was outside his employment so the hospital could not be liable vicariously for his illegal actions.

Patients v Akron Children's Hospital
To Be Filed

The hospital lost a recording device with communications between patients and dispatchers.  This has PMI and was not encrypted.  They will be.  It is a shame that it takes a problem to make hospitals do what is right.        Top


Maine v Doe
Maine Supreme Court

The court ruled that the mother's objection to vaccination for her child due to her belief that the mind can cure all was overruled and the child ordered vaccinated.  The child had been removed from the home due to concerns that the mother's relationship with the father put the child in jeopardy.  While in the custody of protective services they have the right to care for the child's medical needs including vaccination.  This was a 3-1 decision.

Catholic Groups v US
6th Circuit

A group that never learns.  The 6th Circuit again denied the Catholic groups relief from the Obamacare mandates.  The Supreme Court had already asked them to reconsider in light of the Hobby Lobby decision.  They reaffirmed their prior bad decision.  Back to the Supremes.

Little Sisters of the Poor v US
10th Circuit

The Circuit had previous ly denied the Catholic group to get out of the Obamacare conundrum but now is allowing the ruling to be stayed until the Supreme Court decides if it will take the case.

Miller v Mercy Hospital

The pregnant patient is due to give birth by C-Section and requests her physician do a tubal ligation at the same time.  The hospital is owned by Dignity Health, a Catholic institution that refuses to allow her physician to do the procedure due to the Catholic beliefs.  This will be decided in retrospect.        Top


Patients v Huntington Memorial Hospital
To Be Filed

There is another outbreak of pseudomonas at the hospital.  The disease is traced to the hospital's use of duodenoscopes.  This is secondary to a design flaw that makes the tip hard to clean.  To date there are three cases but more may be found.  The impotent FDA has warned the scope makers to report problems.

Lattimore v Dickey
Ca Ct App

Lattimore sued two physicians,  GI and general surgeon, for wrongful death after her father died.  The defendants produced expert witnesses in their fields but the plaintiff had an expert who was a board certified in family and emergency medicine.  The court refused to allow the plaintiff witness to testify and the appeal court said his emergency medicine background allowed him to testify in patients with internal bleeding.  This negated the summary judgment of one physician but allowed the other defendants to still have summary judgment.

Boland v Saint Luke's Health System
Missouri Supreme Court

The state supreme court tossed a wrongful death claim against the hospital in five cases where a respiratory therapist intentionally administered legal meds to patients and caused their deaths.  The problem is that it occurred years ago and the statute of limitations had expired.  The plaintiffs wanted an exception to the statute and were denied.  The court stated that this would be a legislative not a judicial fix.

Adams-Erazo v Hospital San Gerado

The family of a GSW victim sued since the hospital did not follow its own protocol for GSW patients in this case.  The court allowed the case to go forward under an EMTALA violation because of this.        Top

Peer Review and Employment

Hospital of Central Conn. v Neurosurgical Ass.
Conn App Ct

The group provided neurosurgical coverage at the hospital under contract for $8,958.33 per month.  They were required to join the staff and cover the ER and any unassigned private patients.  After the initial year contract the parties renewed the contract for two more years.  The hospital then hired a neurosurgeon and notified the group that they would canceled the contact on a date in the future. In typical hospital fashion nobody knew what they were doing so the group continued on the schedule and continued being paid.  The scum hospital attempted to get rid of the group by saying paying was not part of medical staff privileges.  The hospital demanded repayment and sued.  The trial court and the appellate court ruled against the scum hospital since the payments were just an extension of the contact.  The group did nothing to induce payments.  They simply blew away all the hospital arguments as plain stupid.  

Williams v Hospital Sev. Dist. of W. Feliciana Parish, LA

The physician was hired by the hospital as Director of the Intensive Outpatient Program.  During her stay she found illegal conduct such as patient abuse and illegal billing.  She reported this to the management company and for her trouble she had multiple write-ups and a reduction in her duties.  She eventually was fired and sued.  The hospital had the nerve to ask for summary judgment and rightfully lost.  The settlement will now come soon.

Diederich v Providence Health & Services
9th Circuit

The resident was terminated and sued for retaliation.  This was interesting since the hospital lost the summary judgment motion retaliation since it was clear that the director of the program made comments about him prior to his dismissal regarding his prior law suit.  The court then said it supported the hospital on all other matters essentially negating the suit.

Tucker v Mercy Tisomingo Hospital 
WD Okla

The PA sued for Title VII race and age discrimination.  The black 56 year old Bohemian man told a person in the ER that he could not be treated for a snake bite since they had no anti-venom.  He did not register the man in the hospital's online charting system, a violation of EMTALA.  Tucker could and did make a case for the discrimination as another white younger person was not reprimanded for the same incident.  Be that as it may, Tucker could not prove his firing was discriminatory.  The breach of contract claim was upheld but he showed mitigating circumstances.  Bottom line he lost.

Venosh v Henzes
Pa Superior Ct

This suit is about a HMO/IPA wanting peer review privilege in an underlying medical malpractice suit.  The plaintiff wanted the peer review files from the organization and they did not want to give them up.  The court ruled that they have no right to protect the peer review information as there is a state law that HMO's cannot assert peer review as they are not professional health care providers and neither are the HMO/IPAs as they do not provide healthcare services.  A committee made up of some healthcare professionals is not enough to give it peer review protective status.

Faulkner v Dartmouth Hitchcock Med Ctr.

Another resident who should not be in medicine fought to stay in and lost.  The radiology resident has insomnia and was accommodated by the program.  However, her performance was below par and then her physician warned the program about potential for patient safety.  She was terminated and, of course, sued for disability discrimination.  Thankfully, she lost as she did not file a claim with the EEOC.  

Jones v Temple University
3rd Circuit

Ah yes, more waste of judicial resources and money.  Here a physician was not employed by the University but provided radiology services via contract.  The University had a budget problem and needed to fire one person in the radiology department.  She was chosen since she was the only part-time non-faculty person.  Her contract only required a 90 day notice.  She sued claiming she was fired due to her sex and race, the usual types claims.  She lost in the lower court and had the gall to appeal and lost again.  The University had legitimate reasons to get rid of her and did not need discriminatory ones.

Gumbs v HHS
Fed Circ. Ct

Dr. Gumbs knew that his medical license had expired and he saw a patient at the hospital and prescribed meds anyway.  He was removed from his position for failure to maintain a valid medical license.  He appealed and an ALJ found for the HHS.  He then sued and of course lost.  The penalty was justified according to the court.

Lieberman v American Osteopathy Assoc
6th Circuit

In a case of how stupid are you, Arthur Lieberman failed the Osteopathy board exam twice.  Having shown he was not smart, he proved it by wasting money on suing the board and then appealing the lower court decision against him.  The reason for suing was that it was arbitrary and capricious to require him to pass a test on material that he alleged was not related to his actual practice.  It should be noted that he had passed the exam in 2002.  He also sued for interference with his contracts after he was no longer certified.  Duh.     

Sternberg v California Board Pharmacy
Ca App Ct

 Sternberg was a pharmacist and a pharmacist technician working with him stole thousands of Narco pills without him knowing about it.  She was caught and then the Board filed accusations against Sternberg.  The ALJ found against him in 5/6 charges and recommended public reproval.  The Board did not agree and found him liable on all six and then sentenced him to three years revocation stayed.  Sternberg went for a writ of administrative mandate in the trial court which was disallowed and he appealed.  The appellate curt sided with the board saying his lack of knowledge of the crime is not an excuse.  The penalty did not require intent.  They say it is a strict liability area so he needs to prove he created a pharmacy area where these thing could not be done, an impossible task.    Top


New York v Lee-Edwards

A person going by the name of Donald Lee-Edwards was arrested by the police for posing as a physician.  He came to the attention of the police due to unorthodox bedside manner and prescription practices.  He worked out of a basement and allegedly provided mental health services to about 100 people.  He had no medical or doctoral education.  

US v Antoine

Jada Antoine of the Dallas area was sentenced to four years in prison for fraud in attempting to be a hospice nurse.  She was not a nurse and never finished high school.  She had stolen the identity of another and ruined her credit.

Florida v Carajal-Gonzalez

In the "I don't know how a patient could be so stupid" category we have a winner.  The unnamed hair stylist had multiple procedures by the "doctor" and another fake "doctor" on his penis as well as buttocks.  She also gave the stylist facials.  Could that have been a clue?  She placed a substance in the penis of the stylist that permanently disfigured him.  The she took the dolt to see another unlicensed surgeon "Dr. Mark Schreiber in a warehouse.  He paid Schreiber $1000 to have the prosthesis removed and his penis was further mutilated.  He was told the look was normal.  Wonder how much med mal insurance the pair has?        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.