August 15, 2004 Recent Legal News

Peer Review
Non Profits
Fraud and Abuse

Peer Review

Pancoast v Sharp Memorial
CA Ct. App.

The physician was a depressed and distraught person.  She could not practice medicine in her current condition.  She was on suspension for medical records and then after she finished her medical records was summarily suspended for imminent patient danger.  She was given a post suspension hearing to the MEC and lost.  She was informed that if she immediately resigned she would not be reported to the Data Bank.  She wrote a wishy-washy letter that never actually stated she resigned and then was reported.  Dr. Pancoast then tried to get back on staff but the hospital stated that she had resigned and needed to reapply, a contradictory statement.  She was also refused a "fair hearing" because she resigned under investigation.   She sued at trial court and won since the hospital suspended her for a threat to prospective and not actual patients.  The hospital appealed and won since all patients need protections and the hospital was right in the summary suspension.  The Court left open the door for the doctor to continue her claims against the chief of staff for post-suspension statements and her reliance on those statements and the validity of the post med record suspension resignation from the staff.    

Cooperman v Tenet
CA Ct. App.

 In an unpublished case, Dr. Cooperman received a letter from the Department Chief regarding Dr. Cooperman's inappropriate behavior.  The letter quoted the bylaws in issuing the letter of admonition.  After the letter was sent, Dr. Cooperman's attorney sent a letter to the Department Chief to have him invalidate the letter of admonition.  The Chief did not reply.  Four years later, Dr. Cooperman asked for and received a hearing before the MEC.  Following that meeting the Chief of Staff wrote a letter to Dr. Cooperman agreeing to delete the reference to the bylaws in the letter to his file.  They did this by drawing a line thru the reference to the bylaws.  This was not good enough for the Doctor.  He filed a writ of mandate to remove the letter from the Doctor's file.  The claim was that the letter was not authorized and should be removed.  The trial court agreed with the hospital and issued summary judgment for the hospital.  The Court of Appeals agreed.  Since there has been no harm Dr. Cooperman is entitled to no verdict.        

Physicians v HCA
DC Idaho

The four physician who were to lose their privileges due to economic credentialing had sued the hospital to remain on staff.  The District Court agreed with the physician and turned down a summary judgment for the hospital.  The case will now go to trial.         Top

Non Profits

Patients v Non-Profits

A six hospital system, North Mississippi Health Services, has settled with Mr. Scruggs regarding the billing of uninsured patients.  The hospital agreed to provide $150 million in refunds, debt forgiveness, discounts and free care to 48,000 eligible uninsured patients.  The hospitals had not been named in any suits but did not want a suit.        Top


Trial to Continue

The US prosecutors reeling from severe losses in attempting to convict TAP officials has decided to continue to attempt to prosecute a physician, Dr. Romano, a urologist from Massachusetts.  The judge is also considering dropping a guilty plea by another TAP person who was accused of conspiring with Dr. Romano by giving free samples to the doctor and knowing the doctor would sell them.  If that happens, the feds may be truly up a creek without a paddle.         Top


California Nurses v Cedar Sinai

The National Labor Relations Board has voided the unionization attempt by the California Nurses Association to unionize the nurses at the hospital.  The reason was intimidating phone calls to anti-union nurses.  The vote to unionize was 695 to 627.  The intimidating factor may have swayed enough votes to swing the election.  The local NLRB had denied the request to overturn the election but he national did not.  It is rare for the Board to do anything anti-union.    

US V Tenet

 Yep, same Tenet.  This time the feds are after them for potential problems in their recruiting of physicians.  The St. Louis US attorney general office has asked for physician relocation agreements with physicians.  This is an extension of the investigations of Tenet already in progress in California, Texas and Louisiana.   Top  

Fraud and Abuse

US v Mercy Commun. Hosp

In a whistleblower case by the physician's office manager, an ophthalmologist and a hospital paid fines for an allegedly illegal payment of multiple items by the hospital to Dr. L. Ginsburg of Springfield, PA, in return for Dr. Ginsburg's use of the hospital.  The physician and the now defunct hospital's parent each will pay $250,000 and the now defunct hospital pays $1 million.  

US v Travelers & United Healthcare

The two insurance companies will pay to settle whistleblower suits.  They allegedly falsified expense reports wit Travelers actually keeping two sets of books, not ever a good idea.  United will pay $9.7 million and Travelers, now Citigroup, will pay a cool $10 million.  Neither company admitted wrongdoing.



Valie v Cleveland Clinic

The family of Valie has filed a malpractice and wrongful death suit against the Clinic and her physician.  She underwent lung reduction surgery at the Cleveland Clinic in 1995 for emphysema.  She died in 2002 and at dissection a towel was found behind her left lung.  Her physician wrote the clinic that he did not believe the towel had contributed to her death.  I have a feeling that this will settle soon.   

Patients v Leben Home for the Aged

Six years ago twenty four people residing in the home for the mentally ill were coerced into having prostate surgery at Parkway Hospital in Queens, New York.  The inmates did not need the surgery and 17 of the 24 sued.  The final settlement was $7 million.  The home went belly up, the two urologists lost their licenses and Parkway hospital was fined by the state.   

Patients v Jewish Hospital
Ky. trial Ct. Filed

Three more patients have filed suit against the hospital for hospital based infections.  This brings the total number to 28 suits to date.  The patients claim the rooms had not been cleaned when they placed in them, which caused their infections. 

Cappel-Coffey v Wyeth

A Texas jury awarded the plaintiff's family $113 million for compensatory damages and $900 million in punis for the death of the plaintiff in a fen-phen case.  The judge refused to toss the verdict or set a new trial and therefore the case will be appealed.  The plaintiff did not develop the symptoms of heart disease until four years after she took the drug for three months. 

Wyeth has come up with a plan to put a fund together of $1.275 Billion to compensate about 40,000 people who claim to have minor heart defects from their medication.  Their original $3.75 billion dollar reserve for payments still has $3.3 billion.  

Gehrke v Walgreens
Trial Court

A jury has awarded $29 million to the family of a newborn who is now six years old and cannot walk or feed herself.  The cause of the problem is either the prematurity that Walgreens says it is or giving the baby a wrong medication, Glipizide for diabetes instead of Phenobarbitol for seizures, as the plaintiff states it was.  The jury obviously believed the plaintiff's version. 

Badger v McGregor
Ohio Ct. App.

Badger sued for not giving informed consent for an antibiotic prescribed by Dr. McGregor.  The court said that the physician has a duty to tell the patient material information about the antibiotic but the patient had failed in presenting evidence that the physician fell below the standard of the reasonably prudent physician. 

Del Ins. v Burke
Delaware Supreme Ct.

Alls well that ends well.  Burke was sued for breach of privacy.  he malpractice carrier refused to defend the suit stating it was not malpractice.  The court agreed but in their discussion stated that the practices general commercial liability carrier should cover the claim. 

Rodriguez v 1201 Realty LLC
NY App Ct.

Rodriguez, an infant, was injured in the building where the family lived.  The child was taken to a hospital for care and was injured again by a five year old whose mother was with a sibling being treated.  This was an intervening event and the realty company was not responsible for the hospital emergency.  The hospital was responsible for the injury for not controlling the five year old child.        Top


Rome ASC v Rome Memorial Hosp
Oral Arguments

The ASC has filed suit in federal court against the hospital for antitrust violations.  The 23 physician investors had to close their ASC after the potential claim that the hospital would not let health plans contract with the center.  Also the suit claims the hospital intimidated physicians by passing a bylaw that allowed it to revoke the privileges of anyone who invested in competing facilities.

Arnett Clinic v Greater Lafayette Health Services
Indiana Trial Ct.

The 82 year old Clinic was to build a competing hospital with 150 physicians.  The Greater Lafayette Health Services were accused of defamation to discredit the leaders of the new hospital when they were attempting to get financing.        Top


Med Students v MCAT
Injunction request

An Oakland, California judge has denied the injunction request of several medical students with some learning disabilities to have extra time for the MCAT examination.  After the original injunctions was filed two of the four plaintiffs were given the requested extra time due to new information.  The remaining two continued on the case. 

Physicians v Match

 The federal judge dismissed the case against Match after Congress passed the Pension Funding Equity Act which declared that Match was lawful and not antitrust.        

Chatham Podiatrist v Blue Cross
Ill. Ct. Appeal

 Chatham Podiatry, a group of eight podiatrists, incorporated but did not register their corporation with the state for the $50 filing fee.  Since they are not state registered, they are illegal and the contract between Chatham and Illinois Blue Cross is illegal.  This has cost Chatham $1 million in lost fees plus five podiatrists plus their ongoing relationship with Blue Cross plus legal fees.  All for not registering with the state for $50. The next step is an appeal to the state Supreme Court. The group paid the money early on but not until they were told it's too late.  

US v Lonergan, MD
Jail Time

This stupid physician went into concierge medicine.  He billed for many visits he never made and for services that were for more than 24 hours.  He pled guilty to mail and healthcare fraud and also falsified his taxes.  He got two years in prison and a $350,000 fine.  When he gets out he will have to do 180 hours of community service, hopefully not as a physician as his license should be removed.   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.