September 15, 2013 Recent Legal News



Peer Review and Employment



Palmer v Kaiser

The San Francisco Business Times reports that Kaiser lost a big case in San Diego.  Palmer was stabbed and went to UCSD then transferred to Kaiser.  After transfer the endotrach tube became dislodged with a Code Blue and no pulse for 13 minutes.  This resulted in permanent brain damage.  He won a $4.2 million judgment.  This was publicized because the plaintiff's family refused an annuity if they kept quiet.  

Russell v U Kentucky

The plaintiff was apparently misdiagnosed as HIV positive and has received treatment for the disease as well as had sex with HIV positive partners since the diagnosis.  The tests came back negative but he was treated and told how to cope with the diagnosis.  He does not know if he is now HIV positive.  

Patients v Catholic Medical Center
To Be Filed

At least 13 patients at the Concord, New Hampshire, hospital were exposed to CJD, a fatal brain disease.  The hospital operated on a patient who later turned out to have the disease caused by prions and used the same instruments to operate on the other patients.  The problem is that the prion can not be sterilized with the normal hospital procedures.

Valdez v Torrance Memorial Hospital

In an act of utter stupidity an anesthesiologist decorated a patient's face with decals while she was under anesthesia and a nurse took a picture.  The patient did not think this was funny and is suing for breach of privacy.  The only question is the amount to be paid.  Incredibly, none of the people involved with the incident were fired.

Carswell v St. Catherine Hospital
Waiting for a Heart

Carswell died after surgery for kidney stones and an autopsy was performed.  During the autopsy the heart was removed and kept by the hospital.  The wife sued for med mal and won $2 million, not for med mal but for fraud in the autopsy.  The hospital still won't give back the heart the wife wants to be buried with her husband unless there is no further legal action.  This is called blackmail.        Top


US v Wahiawa Hospital

In a whistleblower case the hospital is to pay $421,000 for submitting bills for work done by residents without the requisite supervision.  The whistleblower is a physician who worked in a clinic owned by the hospital.  The hospital paid the attorney fees and then the doctor got $84,000.

US v  Executives of Hollywood Pavilion

In a firstm three execs of a hospital were found guilty of fraud and sentenced to prison for their actions.  The Florida psychiatric hospital was closed.  The execs billed Medicare after they paid cappers to get patients who did not need the hospital services to spend long periods in the hospital.  The three executives sentenced to long prison sentences and millions of dollars in restitution were Karen Kallen-Zury, Daisy Miller and Christian Coloma.  Michele Petrie is to be sentenced at a later date.

US v Onyeabor

Godwin Onyeabor was the owner of a DME store and Dr. Sri Wijegunaratne wrote false prescriptions for DME.  The DME was not medically necessary or never given.  The owner got 27 months in prison and restitution to be named later.  The physician got supervised release and $86,00 restitution.  

US v Vanderbilt Medical Center

In a filed case three anesthesiologists accused Vanderbilt of fraud by lying stating covering surgeons were in operating rooms where they were not.  They state that software developed by other anesthesiologists allowed the fraud to occur.  The government is still investigating the case to see if they wish to intervene.

Mirim v Human Services Department
State Court

Mirim, a psychiatrist, is suing the Department to get a hearing on the reasons they stopped paying him 1 1/2 years ago stating there was credible evidence of fraud but without any particulars.  The judge said it is due process to give a hearing but the Department says it will appeal to stop the hearing.  One wonders what the Department is afraid of.        Top

Peer Review and Employment

Farrow v St. Francis Med Ctr.
Missouri Supreme Court

Farrow was a nurse at the hospital who claimed sexual harassment against a physician.  She was terminated and sued the hospital.  The Supreme Court did not affirm the summary judgment for the hospital.  The nurse raised legitimate issues regarding public policy by allowing non nurses insert central lines against state law. 

Patel v St. Vincent Health Ctr
WD Penn

A resident physician was doing poorly academically and requested a FMLA absence to treat a heart problem.  She acknowledged she would be terminated if she failed to return to the program following her leave.  She, during her leave, requested an extension of the leave which the program said would be granted if she presented a note from her physician.  She did not present a note nor did she return at the end of her leave.  She was terminated and stupidly sued.  She lost since she had not properly requested an extension.  Where she found an attorney to take this case is unknown but I hope they both lost money.

Guinn v Mount Carmel Health
SD Ohio

A black cardiologist was an independent contractor who was summarily suspended and lost his electrophysiological privileges.  He sued for discrimination and showed that similarly situated non black physicians were treated differently.  The state claims against the hospital were dismissed under HCQIA but not the claims against the original complaining physician as they were false.        Top


National Union of Healthcare Workers v Kaiser

The union filed suit against the insurer to become an insurer under the Obamacare California exchange due to the problems Kaiser has had taking care of its members mental health.  They were recently fined $4 million for this problem.  

New Jersey v Aetna

The federal court in New Jersey approved a settlement of Aetna paying $120 million for their use of Ingenix in denying out of network payments.  The money will go basically to two funds, one that will pay providers without proof and another that requires proof.  This does not resolve suits against UnitedHealth nor Ingenex.         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.