US v Northwestern
For the second time in several years the US is going after Northwestern in Chicago. The first time it accused and proved the case of antitrust due to the purchase of a Chicago suburban hospital. The feds are now investigating Northwestern for the relationship between the hospitals and their faculty practice. This is a possible whistleblower action.
US v Sabaratnam
Dr. Rudra Sabarathnam, the former CEO of Angles Medical Center in Los Angeles, California, has pled guilty of recruiting skid row people for unnecessary medical services. She paid money to the owner of a skid row recruiting storefront facility.
US v Alvarez-Jacinto
Dr. Ana Alvarez-Jacinto was sentenced to 30 years in prison for ordering multiple unnecessary tests and intravenous infusions for phony HIV patients. A nurse was sentenced the same day to seven years in prison.
The prosecutors in Florida of the above type schemes are of two minds when the issue of prosecuting the patients comes up. Some say yea and others nay. Some do not want to waste resources on the patients who are sick and elderly and are more sympathetic to juries.
US v Lessler
Paul Lessler, a former physician in Orange County, California, who forfeited his medical license after being convicted of Medicare fraud, has agreed to pay the government $2.2 million to settle the case. The fraud was bribing patients to receive unnecessary respiratory tests.
US v Feit
Dr. Frederic Feit, the owner of Modern Pain Therapy in Freehold, New Jersey, has pled guilty to theft by deception (fraud). He knowingly billed Medicare for ungiven nerve block injections. He has to repay $500,000 to the government.
US v Sharp
Rebecca Sharp led a scheme to defraud Medicare by recruiting patients and referring them to home health agencies for a fee. This led to $1.1 million in kickbacks.
US v HMS Diagnostics
The Texas sleep clinic agreed to pay the government $550,000 to settle a suit alleging that sleep tests were administered by uncertified technicians.
Oregon v PacifiCare
Oregon Department of Consumer and Business Services fined PacifiCare for failure to conduct reasonable investigations prior to denying claims. They had to pay a fine of $46,000 and pay all illegally denied claims as well as change their practices. Top
Quaid v Cedar Sinai
Dennis Quaid and his wife have settled with Los Angeles' Cedars Sinai Hospital for their malpractice in treating their twin sons by giving many times the normal dose of heparin. The hospital paid $750,000 although it was never formally sued.
Van Horn v Torti
The two women were involved in an auto accident and Torti pulled out Van Horn possibly causing a spinal cord injury. The California Supreme Court ruled that the good Samaritan Rule only applies to medical care. Those who come to the aid of others must do so with due care. It is interesting that both women are co-workers coming home in two cars after drinking and partying. The plaintiff was a rider in the car that crashed and the defendant was in the following car. The trial will be next year.
LeBlanc v Research Belton Hosp
The Missouri Court of Appeals overturned the trial court on the issue of negligent credentialing by a hospital. The higher court stated that this is a legitimate cause of action in the state. The plaintiff claimed that the physicians were not qualified by experience, education or training to do the types of surgery performed on her. They also were not credentialed to do the surgery.
Dickey v Vermette
The Maine high court rejected the continuous course of treatment argument since it would conflict with the legislature's statute of limitations. The case involved a dental technician seeing an abnormality on a mouth x-ray and the dentist not doing anything until she had a full blown oral cancer.
Wisconsin Med Soc v Wisconsin
The Wisconsin Medical Society sued the state for their hijacking of the medical malpractice fund to help balance the state budget. The judge ruled that what the state did was legal and the state does not have to immediately pay back $200 million plus interest and attorney fees. The judge stated that the society has no standing and no property rights in the fund.
Sarkisyan v Cigna
The family of a teenager with leukemia who Cigna refused a liver transplant to has sued the insurer for the death. They have hired Mark Gallegos, of the famous OJ team as their attorney. Cigna had refused the transplant until the community held a rally in front of the insurer's office. They then said the transplant could be done but the girl died an hour after getting the permission. They are being sued for breach of contract, unfair business practices and intentional infliction of emotional distress. She had received a bone marrow transplant but complications caused liver disease.
San Mateo County v Hageseth
Dr. Christian Hageseth of Colorado prescribed generic Prozac for a Stanford student and she committed suicide. The kicker is the patient was never examined by the physician who was performing telemedicine. The physician's attorney to date has been unsuccessful in getting the suit dropped for lack of jurisdiction. The California Court of Appeals has ruled that a California County can prosecute someone who writes a prescription in another state knowing that the prescription will be delivered in California. He is being accused by the county of practicing medicine without a license as the family has already settled with the pharmacy and JRB, an intermediary. The med mal case against the physician was dropped after he turned in his medical license. Top
Pharmacists v Blagojevich
The Illinois Supreme Court ruled that the lower courts must hear a suit by a pharmacist not wanting to dispense emergency contraceptives due to religious choice. Top
California v Roozrokh
Dr. Roozrokh was found not guilty of prescribing medication to speed the death of a transplant donor. He did order pain killers to relieve discomfort when the patient was taken from the ventilator. Top
Peper v St. Mary's Hosp.
Dr. Peper, a CV surgeon, was appointed to the staff of the hospital and then reappointed in the standard manner. He informed the CEO that he was forming a competing practice to the hospital and then without notice his cases were reviewed by an external reviewer paid by the hospital who found surprisingly problems with the surgeon's cases. He was summarily suspended without any notice or hearing. The hospital stated that the credentials committee stated that one whose privileges were removed during provisional staff were not entitled to a hearing. Peper sued seeking money damages. The trial court went with HCQIA and denied any damages to Peper. The higher court overturned the trial court and stated the hospital was not entitled to HCQIA protection. There was not adequate notice and hearing, a prong of HCQIA. The trial court then granted summary judgment to the hospital since the bylaws did not allow a hearing for provisional staff members. Peper again appealed and again the court stated that HCQIA was the law and he did not waive his rights to a hearing and notice. The hospital should get a new medical staff attorney.
Florida v Zakharis
In a case that is giving a black eye to the Florida Medical Board, Dr. Alex Zakharis still has his medical license. This is eight months after he promised a federal judge that he would turn in his license due to memory problems. He has no office and no hospital affiliations. The case is working its way through the Medical Board system but it is taking forever. In the meantime Dr. Zakharis is on his sixth attorney in an attempt to sue Cedar's Hospital for removing him from the staff. It should be interesting to see what the Board does since his license expires at the end of January and he can renew it on line. Top
Renitez-Rodriquez v Hosp. Pavia Hato Rey
In another poor case from Puerto Rico, another attorney that doesn't understand the EMTALA law sued the hospital for a violation. The patient presented to the ED with abdominal pain and was diagnosed with a cardiac problem. He was treated the same as other people with the same condition and sent home. Later he was diagnosed as having a ruptured gall bladder and admitted. He died after several months in the hospital. The court stated that he was not treated disparately and that the hospital's EMTALA obligation ended with admission. There was no transfer to another institution. Again, EMTALA is not a federal medical malpractice claim. Top
California v Wilson
Allen Wilson, a Cedars-Sinai Hospital in Los Angeles former biller. He had legitimate access to information but who used it to steal from insurance companies. The CFO of the hospital sent letters out to patients to monitor their credit reports. Wilson has pled not guilty and remains in jail on a $900,000 bond. This is another example of the wonders of computers both to steal. The hospital had no idea the theft was happening until they were notified by the DA. Wilson had apparently set up a fake lab and billed insurance companies for fake lab tests. When Wilson was arrested his home was searched and many records were found. 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.