August 1, 2015 Recent Legal News


Peer Review and Employment






Howard v Arkansas Children's Hospital
ED Ark.

The court denied a motion for summary judgment by the hospital.  Former employees were allowed to continue with their suit regarding the potential wrongful billing by the hospital to the feds. They were also accused of HIPAA violations for turning over patient information to their attorneys.  They were vindicated on this.

US v Regional Hospital of Jackson Tennessee

The hospital has agreed to pay a fine of $510,000 for billing the feds for unnecessary cardiac procedures over eight years. They were accused of placing unnecessary stents by whistleblower Dr. Wood Deming.  

BRF v Willis-Knighton Health System

Biomedical Research Foundation, the operator of LSU's Shreveport hospital, sued its competitor for antitrust.  The research foundation runs two hospitals in the privatization of the state's hospitals.  The local insurer is expected to also enter the suit.  Research believes that if the clinics run by its competitor provide specialty care it will give them monopoly power.

Insurers v Baltimore Washington Medical Center

Several insurers have flied suit against the hospital and Dr. Randy Davis for billing for fake parts and billing as if they are the real thing.  They also accuse the physician of accepting $ 458,962 in payments as consulting fees to implant the fake devices.  The suit goes on to accuse multiple hospitals and physicians, 17 and 15 respectively, of the same fraud.  At the same time the local shysters are lining up patients to line their pockets.

US v Kinetic Concepts
9th Circuit

The 9th Circuit over ruled its earlier ruling in 1992 and now says that original source whistleblowers only need to meet two requirements 1) before filing the action they must voluntarily inform the feds of the facts underlying the complaint and 2) the whistleblower must have direct and independent knowledge of the allegations in the complaint.  It is no longer required for the whistleblower to have a hand in the public disclosure of the fraud.

US v Carter

Dr. Robert Carter of Joplin, Missouri, was sentenced to five years probation and ordered to pay $971,854 in restitution along with a criminal forfeiture of $1.2 million.  He also is to cease practicing oncology in Missouri for the five years.  This was for buying and reselling misbranded prescription drugs.  He ordered drugs from Quality Specialty Products in Canada which were administered to his patients and he charged as if they were the FDA approved ones. 

US v Margossian

Dr. Haroutyoun Margossian, an OB in Brooklyn settled with the government and will pay over $8 million.  He had the audacity to do urodynamics with an unlicensed staff without proper physician supervision.  At the same time a criminal indictment was filed against him with a deferred prosecution agreement.  If he pays his money and keeps his nose clean the criminal prosecution will be dropped.

US v Bangalore

Oncologist Neelesh Bangalore of Stockton, California, will pay $736,000 for purchasing drugs from Warwick healthcare Solutions of the UK and billing the feds as if the drugs were FDA approved.  Some of the drugs purchased did not have the active ingredients. 

US v Barson

Dr. Dennis Barson of Austin, Texas, has been sentenced to ten years in prison and must repay $1.2 million for fraudulently billing for tests not done.

US v Novak

Edward Novak, the former CEO of Sacred heart Hospital in Chicago has been sentenced to 4 1/2 years in prison and fined $770,000 plus ordered to forfeit $10.4 million in a massive kickback scheme where he paid physicians thousands of dollars to refer patients to the now defunct hospital.

US v Badawy

Pediatrician Badawy Badawy of Jersey City, New Jersey, was sentenced to 21 months in prison for over 1000 wound repaid procedures that were never performed.  He was also fined $5000 and pay restitution of $196,911.        Top

Peer Review and Employment

El Paso Healthcare v Murphy
Texas Ct app

The nurse reported an OB for failing to obtain an informed consent.  Several hours later she was informed that she would not be working at any hospital in the system until the complaint was resolved.  She was contacted by the chair of the Credentialing committee and when she requested and was denied the opportunity to have her attorney present she sued.  At trial she was awarded over $800,000 for lost wages as well as past and future compensatory damages and attorney fees.  On appeal the court affirmed the retaliatory discharge and the damages.  It seems that the Texas hospitals are overly represented in these pages and are exceptionally stupid or think that they can do no wrong.

Kohn v FirstHealth of the Carolinas
NC Ct. App

This decision is legally correct but shows the idiocy of the hospital and to some respect the physician.  The doctor was denied application for the hospital medical staff since he was Canadian and did not have a residency that was ACGME accepted.  It was certified by the Royal College of Canada which is recognized by the ACGME.  No go.  The bylaws say one thing and therefore nothing else matters.  Instead of just going to another hospital he sued.  The hospital won summary judgment since the hospital has the right if not the smarts to pick its admission criteria.  

Robinson v Care Alliance Health Services

Dr. Robinson is an OB who is diabetic.  Due to his illness he can not sand for any significant length of time so he does surgery sitting on a stool.  After a reported incident he had to undergo multiple exams and passed them all to be able to provide safe care to his patients.  Two months later he did a difficult C-Section while on a rolling chair.  The assistant surgeon reported him as a danger to patients.  An investigatory committee recommended that he not be allowed to sit during a C-Section for any period of time.  The MEC reviewed the report and also asked for a comprehensive physical as well as any accommodation asked for.  He was also ordered to take a medical leave within 10 days.  He requested a 30 day leave but was told he was on a six week leave and needed to do a functional competency exam.  His attorney then said he pulled his medical leave and requested the hospital allow him to be accommodated by using the rolling stool.  The CMO said he could not come back until cleared by the MEC.  Eventually he filed suit.  The court found without difficulty that he was disabled and needed accommodation which was denied.  Therefore, he won summary judgment against the hospital on the ADA claim.,  However, he lost his state law claims since although all was true the hospital had HCQIA immunity.  He was also rebuked for quickly assuming the posture of an impending litigant.

Bartow HMA v Edwards
Fla DC

The patient was injured during a gallbladder surgery and requested the hospital produce peer review documents, including outside peer review.  The hospital refused and the court agreed that under Florida's Amendment 7 these documents were produced outside of the course of business. 

LaFlamme v Rumford Hospital
D Me

 A nurse was promoted to full time status and then had back surgery.  Post operatively she requested a reduction in her hours and then a medical leave.  After six months leave the parties agreed to move her to per diem.  The hospital attempted to schedule her for shifts but she was never cleared for work by her physician.  After six months she was terminated under the policy of termination per diem nurses if they have not worked in six months.  She sued and the hospital lost the summary judgment motion since it was triable whether it was reasonable to keep her position open for another four weeks as that was when she had said she would be cleared for work.  Her absenteeism was due to a disability and that was also triable.  The nurse had also made her case for retaliation for the firing due to unavailability and poor work performance.  Bad HR at this hospital.

Simpson v St. James Hospital
ND Ill

A nurse was fired and she sued since she was female, black and over 40.  However, she had a long history of rudeness and inappropriate behavior.  The court ruled correctly and tossed her case.

Anderson v E. Conn. Health Network
D Conn

The surgeon sued after he was terminated.  He has a history of depression and was on meds for same.  He was reported for performance issues.  It was recommended that he take a medical leave and when he returns he would be proctored.  The surgeon rejected the plan due to NPDB reporting for the proctor.  An alternative surgeon plan for preceptor was refused by the hospital.  He then lost privileges and sued under the ADA.  The hospital was granted summary judgment since the surgeon could not reject the hospitals accommodation just because it would be reportable.  Age discrimination also lost since he was 64 when hired and discharged at 65 by the same person that hired him.

Okum v Montefiore Med Ctr.
2nd Circuit

The physician was terminated from the staff for cause after telling them he would be leaving in four months.  He had been employed on the staff for 23 years.   The center had a policy that all full time physicians employed prior to August 1, 1996 who were terminated for other than cause would be entitled to either 12 months notice or six months' severance pay.  Those with over 15 years of service were entitled to an automatic review of severance by the CEO.  It is hard to believe but the court actually sided with the physician that his severance was entitled to pay and the for cause was pretextual.    Don't you love when justice is served?        Top


Taylor v Intuitive Surgical Inc.
Washington Ct App

The patient sued the maker of the Da Vinci robot for failure to warn the the hospital and the surgeon of the risks.  He had a robotic prostatectomy by a Urologist who was doing his first without a proctor.  He opted to use the robot even though the patient was morbidly obese and the manufacturer warned against using the devise on those patients.  The surgery took 15 hours and the patient was harmed.  He sued and settled with the surgeon and dropped the hospital from the suit but kept the manufacturer.  He said they had a duty to warn.  The court said the patient placed primary reliance on the physician not the manufacturer of a device.  He lost the case.

In Re Weaver
Fla Ct App

The plaintiff was going to file a med mal case against a physician but the attorney wanted to prove how smart or in this case how dumb he or she was.  They tested the " ex parte communication" aspect of the Florida med mal law and found it was AOK.  This is the second court to OK this aspect of the law, as a federal court did last year.  The court said, as do all others, that when you file a suit you waive all protections of your privacy.  The court also ruled that the legislature has the right to set pre procedural rules.        Top


Patients v UPMC
To Be Filed

For the third time the idiot hospital has had their information compromised.  This time they did it themselves.  They sent an email to someone with the information of over 700 people.  When will they be fined.

Patients v UCLA

UCLA should be ashamed of itself.  A cyberhacker has gotten the information on 4.5 million patients over many months and was not detected.  Again the security of personal information is non-existent.  The suit alleges breach of contract.

Patients v Elyria medical Center
To Be Filed

The hospital discovered( unlike UCLA) that an employee unlawfully hacked about 300 medical records.  The employee was fired.  

Patients v Georgia
To Be Filed

Georgia's Community Care Services Program screwed up by emailing information illegally of 3000 seniors to a contracted provider who did not have legal access to the information.  

Patients v Healthfirst
To Be Filed

An individual stole the information of 5300 members.  Healthfirst notified the Department of Justice of the theft and after investigation they told Healthfirst that 5300 were affected.        Top


Little Sisters of the Poor Home for the Aged v HHS
10th Circuit

In a case heading for the Supreme Court the 10th Circuit refused to let the nuns not pay for birth control of their employees.  The court said the administrations allowing the opt out by signing a paper was adequate.  This is the fifth circuit to refuse faith based organizations relief.  Last year the Supremes allowed Hobby Lobby, a faith based organization, to get out from Obamacare's contraception mandate.  We will now see if the administrations new requirement is the least restrictive means to achieve its aims.

Northern Arapaho v US

A district court has said a native American tribe is an employer under Obamacare and therefore must purchase Obamacare insurance for its employees.  They have subsidized its employees to help with insurance and also they qualified for help via tax credits.  This is now all gone.  The individual Indians are exempt from any penalties if they fail to purchase insurance.  The appeal should be interesting.

Jane Doe v England

An 18 year old from Northern Ireland went to England for an abortion.  Abortions are illegal in Northern Ireland but free in England.  She was excluded from the free abortion and had to pay 600 pounds.  She sued and lost as others have.

Taylor v Women's Clinic 
8th Circuit

The Circuit Court upheld the lower court in striking down the North Dakota law that bans most abortions as soon as a fetal heartbeat is heard.  The court had no choice but to go with the past Supreme Court decision but said the high court needs to reevaluate its standard.  The high court ruled that viability is tied to development in obstetrics not to developments in the unborn.  

Sargent Shriver National Center on Poverty v Illinois Department of Healthcare

The judge has ruled that Illinois must pay healthcare providers in Cook County monies owed during a budget impasse.          Top


Ross v Integra Health Management
OSHA Judge

The administrative law judge ruled that Integra did not protect Ross, a social service coordinator, from the brutal murder by a mentally deranged client.  The attack happened outside of her home.  The company was liable since they did not provide commonly recognized safety practices and protocols according to the judge.  An OSHA investigator found that Integra knew the client had a history of violence but took no steps to protect its employee.  This means the penalties levied by OSHA are justified and total all of $10,500.  

California v Gammill

Vincent Gammill was arrested for practicing medicine without a license.  His clients were stupid enough to believe he was an oncologist when they were being treated with strange concoctions including expired drugs and a bag of dirt.  He never had a medical license.        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.