Brazil v Furtado
Dr. Denis Furtado, AKA Dr. Bum Bum, was arrested along with his mother, maid and girlfriend and charged with murder. A patient Lilian Calixxto died in Rio after a butt implant. The police say he is not a plastic surgeon and his mother posed as a physician but has an suspended license. He did it inside his home and used a synthetic resin that the Plastic Surgical Society says is too risky. When she got ill he rushed her to a hospital but she had a heart attack and died. Top
Integra v Providence
The insurer is suing the hospital system for what they allege is upcoding. The allege that Providence St. Joseph routinely uses major complications and comorbidity codes to get more money. They claim these were intentional to get more Medicare money.
US v Paulus
Dr. Richard Paulus was convicted of fraud for doing unnecessary cardiac stents and making false statements. The court then overruled the jury stating that the statements in the medical records were subjective and could not be false or fraudulent. The 6th Circ reversed and reinstated the conviction. They state the degree of blockage of an artery was capable of being determined and is a fact.
US v Post Acute Medical LLC
The company agreed to pay $13 million to settle allegations that they billed fed med for claims that resulted from illegal kickbacks. The company formed in 2006 to do physician service contracts with hospitals but the feds say these were really inducements to refer patients. They also entered into contacts with home health agencies to have them refer patients to PAM's facilities. This is a qui tam and he will get $2,345.670.
US v Gibson
Steven Gibson, the pharmacist and owner of Gibson's Discount Drugs pleaded guilty to fraud. The 29 year old submitted prescriptions that were not authorized by physicians. The make believe drugs were only to make money.
US v Chamberlain
Dr. Donald Chamberlain and his wife agreed to pay $428,000 to settle allegations that their Tennessee practice purchased foreign drugs and billed for them as if they were the US brands.
US v Tyler
Dr. April Tyler along with Patrick Wittbrodt and Jeffery Fillmore were indicted for fraud and money laundering by a grand jury. The allegation is the trio would go to UAW meetings and tout prescription pain relief. This would be prescribed right there with no exam by the physician.
US v Antoine
Dr. Ewald Antoine of New York state was sentenced to one year and one day in prison for his role in posing as the owner for two clinics in order to bilk moneyy from fed med. He had previously pleaded guilty to the fraud charges.
US v Leach
Dr. Charles Leach of Arlington, Texas, pleaded guilty of fraud. He has already surrendered his medical license. He falsified documents including pre-signing prescription pads in bulk. These were then used by the nurses to get narcotics and hasten patient deaths in hospice. This was increase profits. He also admitted patents to the hospice even if they were not eligible. Top
Patients v Anthem
A federal judge has signed off on a class action suit by patients against Anthem for their 2015 data breach which involved over 79 million customers. They agreed to pay $115 million for not doing enough to safeguard data. They also lied about the adequacy of their security and did not notify customers timely.
Patients v Augusta University
Augusta University in Georgia had a potential compromise of over 4117,000 patient records one year ago. They are only now notifying patients of the problem. They say it took so long due to the need to manually go through emails for some reason. The are now do security which should have been done prior to the problem but it cost money.
Russell v McAlester Regional
A couple had just lost their son by drowning when the child's birth mother called them and started threatening them. She said she found out via a call from the hospital. The parents say that the problems with the birth mother could have been avoided if the hospital would have followed HIPAA. An investigation showed that multiple people accessed the son's medical records including a cafeteria worker. Very bad. Top
Williams v Beaumont Health
Teoka Williams, a black RN at the hospital, has filed a discrimination suit against the hospital for being taken off a case because of her race. A patient was overheard by Williams stating that she did not want a black bitch taking care of her. Williams relayed what she heard to the clinical manager who talked to the patient and then took Williams off the case. Williams went to HR and was allegedly told the patient is always right. It is inconceivable that any hospital would do such a thing as it can never win. I just finished the book "all things great and small", which I thought was well written but only done for a biased point of view. It was to me inconceivable that a hospital would do the things mentioned in the book but maybe Beaumont did not get the memo.
Crystal Run Healthcare v Orange
Regional Medical Center
The suit accuses Orange of attempting to dominate local healthcare. The plaintiff is the area's largest physician practice and Orange is the largest health system. Orange attempted to hire a physician away from Crystal and doing it by offering above market rate kickbacks. They accuse Orange of paying incentives to physicians to send patients to their facilities. There is a side problem and that is the non-compete clauses that Crystal has with its physicians. About six physicians already left Crystal after they were semi-purchased by Montefiore Hospital and accused Crystal of ceasing to exist at that point. The Crystal physician were supposed to refer patients to Montefiore. Top
Cochrum v Costa Victoria
Cochrum was in a SNF for care while undergoing cancer therapy. He was having difficulty swallowing and was changed to a different diet. This was not told to the kitchen and he died following aspiration after his next meal. His family sued. The jury gave a verdict for the plaintiff but hte court overruled on the elder abuse claim. The court said there was no recklessness. The appellate court affirmed. The court said the facility had the legal amount of staffing but they also went of to say that recklessness may be found if the facility's understaffing is sufficiently egregious, what ever that is.
Twenty two Women v J&J
In a case headed for appeal a trial judge affirmed the judgment of $4.69 BILLION to the plaintiffs for the company causing their ovarian cancer due to them using J&J talc with asbestos. There is no asbestos in the talc or there is a miniscule amount. Let us hope the state appellate court is smarter in science than this judge.
Dolin v GSK
In a blow for sanity the appellate court overturned a $3 million jury verdict against GlaxoSmithKline for causing the death of the husband of the plaintiff. He committed suicide after taking generic Paxil. The court said that generic drug companies cannot be sued for failing to provide adequate label warning since they must use the brand name warnings. GSK had asked the FDA to update their warning about adult suicide but failed to do so. Only the blue states of California and New York have allowed such suits. Top
Strang v LRGHHealthcare
Dr. David Strang was terminated by the hospital after he reported a drug-impaired patient he was treating was a vendor doing transport for the hospital. The physician attempted to do the right thing via channels and eventually called the patient's employer to pick up the patient. The suit says that the patient then notified the employer of his drug use. The hospital will have a problem with this and will settle in the end.
Clark v LT Medical LLC
In another suit Dr. Robert Clark sued the behavioral health company after he was reported to the NPDB. He submitted his resignation to take a position in Arizona. The LLC then reported him as resigned while under investigation. The LLC privileging committee had received a report about him but had notified him of the complaint and had scheduled any review of the case. He sued alleging due process violation and all the other state usual stuff. The hospital filed a motion to dismiss as they are mandated to make the report. The court did keep jurisdiction for only the due process claim. They say that an investigation is not a protected property interested as a actual formal sanction but agreed to let Clark amend his complaint. 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.