US v Glenbeigh Hospital
The hospital had to pay a patient $32,000 and a $5000 fine for refusing admission to a patient who had problems from his HIV meds. The hospital could not prove the patient was a threat to others.
Prime Health v Hudson Health
Prime has sued the Pennsylvania company for blocking its entry into New Jersey. The suit alleges that Hudson told prime that New Jersey was theirs and they would use political muscle to keep Prime out. Prime had previously been left out when they bid for Christ Hospital and then withdrew its bid. Christ went bankrupt and was awarded to Hudson for less than Prime had originally offered. This time Prime is after St. Mary's Hospital. Prime is also accusing St. Joseph Hospital of helping Hudson since the closing of the hospital would be more business for St. Joseph.
US v Univ. California Irvine
Cal Irvine is again in the news for their anesthesiology department doing things they shouldn't. In 2008, the medical board chastised the head of the department for gross negligence and incompetence. In 2010, he was accused of falsifying medical records. He is still the head of the department and is now the reason the university has to pay a fine of $1.2 million in a whistleblower case. The charge is that patients were put under anesthesia by mid levels without the required MD supervision and fraudulently filling out the forms. This University has had other problems in the past with quality of care including the stealing of patient's eggs and embryos and botched liver transplants. Top
Sutter v Oxford Health
The high court will take up the case of Dr. Sutter who found that Oxford had been fraudulently underpaying him for years. He sued but had an arbitration agreement written by the insurer. He went to arbitration for himself and 20,000 others who he states were underpaid as a class action. The arbiter agreed that arbitration could hear all the cases as a class matter since there was nothing in the contract to say it could not happen. Oxford then took the case to trial and lost and also lost at the Court of Appeals. Since there is a split among the courts the Supreme Court took the case and will hear it in the future.
US v Echols
Dr. Ben Echols of Houston was sentenced to 63 months in prison for his part in signing fraudulent DME orders. He must also pay almost $3 million in restitution.
US v Lehiji
In another Houston court Dr Lehiji and his wife were indicted on charges of healthcare fraud and using the money illegally. They were sending the money to Iran which is against the law of the embargo on the country. He was accused of upcoding, seeing over 100 patients a day and billing for patients when he was out of town. A good trick even for a urologist. He and his wife each face 10 years in prison.
US v Cooper
RN Beverly Cooper of Detroit pled guilty of healthcare fraud by fabricating nursing notes for home health services never done. She faces 10 years in prison and a fine of $250,000.
US v Ryser
Dr. Carol Ryser and her husband owned a medical clinic in Kansas City specializing in chronic diseases. They pled guilty of healthcare fraud. She gave up her license and they closed their clinic as part of the plea deal. They also did one year of income tax fraud. He will get prison and she gets probation with home detention. They also must pay $50,000 in restitution.
US v 5 Physicians
Multiple people have already gone to jail and more are on the way in Detroit. A pharmacist got multiple physicians and other providers to send patients to his shops to get unnecessary prescriptions filled. The patients were then rewarded with narcotics. The investigations are ongoing with five physicians and four pharmacists recently indicted. Top
Sesso v Mercy Suburban Hosp
The physician, Dr. Sesso, a 63 year old pulmonologist, was denied employment and sued for age discrimination. The hospital went for summary judgment and the court denied it. The physician provided enough evidence to show that they may prevail at trial. The hospital that employed the physician did not ask him if he wanted to be in the new hospitalist group that was taking his place in the hospital. The hospital also expected the physician to retire but he did not.
Bennett v Kaiser Permanente
A nurse was fired for multiple errors and after the hospital attempted to alleviate a disability. She sued and of course lost. Will they never learn? I hope the case was on contingency so the attorney lost money.
Shannon v Roane Med Ctr
Shannon, a surgical tech, had finished her shift when she was called back to the hospital for a case. Afterward she was going home when she was injured in an auto accident. She was terminate from the hospital after exhausting her leave benefits. She sued for obtaining worker compensation and lost in trial court since one can not get worker compensation if you are on your way to or from your employment. The panel reversed stating that this was part of the employment since she would not have been on the road at 2:30 A.M. if not for her employment and being on call. She was paid for her time on call and the hospital had restrictions on people on call.
Trott v HD Goodall Hosp
The nurse was fired by the hospital. The issue is why. They claim it is for falsifying records and she claims it is for testifying against the hospital in a wrongful death claim. The high court said that this is an issue for the jury and not for summary judgment. The problem for the nurse is that she testified in a deposition that she may have entered wrong information in the patient's chart, a terminating offense. Since they both met their burden of proof it should be up to the jury to make a decision.
Soriano v Neshoba County Gen Hosp.
The high court refused the case and let the determination of the 5th Circuit stand. The physician was terminated after a hearing in which he claims went against the bylaws and HCQIA. The trial court and the 5th Circuit both ruled for the hospital in a summary judgment. The 5th Circuit stated that the attorney for the physician failed to brief the issue of HCQIA adequately.
Dookeran v County of Cook
Dookeran was a physician at Stroger Hospital and was terminated for not disclosing a prior action against him and for abuse of patients. While the hearing on the issue was going on the physician filed a case with the trial court. The court ruled for the hospital in summary judgment. After the hearing was over the physician again filed a law suit against the hospital. This was also denied but this time for res judicata, the case had already been tried. Top
Cisneros v Metro Nashville
In a case that shows physicians should not work for this hospital, a patient sued the physicians in the ED and the hospital for medical malpractice. The patient sued under EMTALA and the physicians were removed from the suit since they can not be sued under this cause of action. The hospital then sued the physicians for indemnity if they lost the claim. The court ruled that this would be the same as the patient suing and would not be allowed. Bad Hospital.
Machario v City of Revere
In the reverse of the above, the patient sued the physician for medical malpractice. The physician claimed that she was an employee and therefore had the immunity of the city owned hospital. She sued for summary judgment. She indeed was employed by the hospital but when the court wants a certain decision they will find a way to finagle it. The court wanted the patient to be able to sue so they said the hospital did not control the final decisions of the physician so there was a question of fact as to whether she was an employee or not and denied the summary judgment.
Patients v Corning Hospital
At least 14 patients have filed suit after it was found that an employed nurse used the same syringe to flush IV tubing for hundreds of patients. The nurse was fired and the chance for infection is close to zero but the attorneys want their due and are pushing emotional distress in hopes for a settlement. The attorneys will make money and the patients will get a pittance.
Ramirez v Long Beach Memorial Med
The mother of a patient who died on gunshot wounds after waiting three hours to go to the OR after the vascular surgeon was late showing up. All physicians were independent contractors and the mother signed a form that stated same. The trial court noting the above gave summary judgment to the hospital. The court of appeals overruled and said to trial. The rationale was the signed conditions of participation is a matter of fact that needs to be decided if it is valid or if the hospital acted in such a manner as to make a reasonable person believe that the physicians were agents. Also there was no evidence that the son authorized the mother to sign the form. In other words the court had come to a conclusion and then looked for ways to make that conclusion legal.
Byrne v Cleveland Clinic
Byrne entered the ED with chest pains and had a workup but did not go to the cath lab for three hours. He died. The family sued for EMTALA and lost since he had the work-up and not treated differently than others. This means the hospital has committed medical malpractice on all. All who come to a medical center should be able to be in the cath lab within 90 minutes. If not the patients should be sent to other hospitals by the ambulance where they can be treated. I have no idea why any sane attorney would file under EMTALA instead of medical malpractice.
Patients v Harrington
About 7000 patients of Oklahoma dentist W. Scott Harrington have been notified that they may have been exposed to HIV and Hepatitis B&C. The state found multiple violation of the Dental Act and are advising the patients to get tested. The dentist has closed his practice and is cooperating with the state. It is very very very rare to pass the viruses from a medical or dental provider to a patient. Top
Alsager v Bd of Osteopathic
One lives by the sword and dies by the sword. The DO had his ability to practice medicine investigated by the Board and sued the Board under the 4th, 5th and 14th Amendment. He contended that these amendments precluded the actions of the Board. The court ruled that the 11th Amendment ruled. This does not let anyone sue a state unless the state agrees and the state did not agree. Case dismissed. 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.