January 15, 2014 Recent Legal News

HIPAA

Fraud

Peer Review and Employment

Malpractice

Electronic Medical Record

Healthcare

Criminal

HIPAA

Patients v Riverside Health
To Be Filed

Virginia's Riverside Health System found a four year old inappropriate viewing of medical records by an employed LPN.  The LPN has been fired.  This person viewed the records of almost 1000 people including SSN.

Polanco v Omnicell
Federal Court

A federal judge dismissed the federal lawsuit for HIPAA violations stating that under federal law there is no private right to sue for HIPAA violations.  He dismissed the suit without prejudice so the case could be filed in state court.  In state court the federal law may be used as the standard of care to prove negligence per se.  The Supreme Court of West Virginia as said this in St. Mary's Medical Center v RK.        Top

Fraud

US v St. James Healthcare
Settlement

Montana St. James Healthcare paid a fine of $3.85 million for providing benefits to the physicians who made referrals to the hospital.  This included below value leases and land values for medical offices.  The hospital disclosed this to the feds.

Physicians v HMA
Filed

Two ED physicians have filed a claim against Charlotte, North Carolina, area hospitals Norman Regional in Mooreville and Davis Regional in Statesville as well as their owner HMA for offering illegal kickbacks if they admit more patients and order unnecessary tests.  The government has now joined the suit.  The two physicians and their medical group were terminated in 2010 allegedly for not accepting illegal cash inducements.  The physicians claim that the hospital used a computer called Pro-Med to automatically order batteries of tests based on initial complaints and prior to being seen by physicians.  They also state they were required to admit at least 50% of Medicare patients regardless of medical necessity.  The two physicians did not have admitting privileges so they were to call a private physician for each Medicare patient and attempt to get the patient admitted.  They state they were also offered $2000 per quarter for each of 6 corporate benchmarks they met.  HMA denies all allegations and has agreed to sell its hospitals to Community Health Systems.

US v Cruz
Sentenced

Dr. Emilio Louis Cruz III of Carson, California, was sentenced to three years and two months in prison for hundreds of claims filed under his name and no patient was seen.  He had pled guilty to the fraud.  He is also to pay $601,000 in restitution.  

US v Sharma
Settlement

Dr. Ravi Sharma of Tampa, Florida, has agreed to pay the feds $400,000 in a whistleblower suit that alleges he gave orders to his office manager to do ultrasound guided procedures and that he billed for patients not seen.  He is currently still in the Medicare program as a thoracic surgeon running a vein clinic.  His office manager will get $72,000 for opening the case.  The physician will need to attend a course put on by CMS and have a practice monitor for three years.        Top

Peer Review and Employment

Lawson v Texas Presbyterian Hospital
Filed

Lawson has worked at the hospital for 20 years and she was fired for being a woman and too old, according to her.  The hospital says the reason Lawson was fired was because she actually told patients what they might be expected to pay for a service, which they say is against the Texas Health Resources code of conduct.  Bad publicity for the hospital as transparency is the buzzword of the day.

Sheikh v Grant Regional Health
WD Wisc

In yet another case of a physician getting bad legal advise, Dr. Sheikh lost a summary judgment motion to the hospital.  He was terminated from the staff and the hospital reported him to the NPDB.  The report was justified since it reflected the actual process and the report did not depend on the underlying due process.  This is under HCQIA.  He also lost a counterclaim for $50,000 that was loaned to him and he now has to repay according to the terms of the contract he signed.  

El-Attar v Hollywood Presbyterian Medical Center
California Supreme Court

I have reported on this case in the past and am now writing about this case not for the case itself but for what I call the self-aggrandizement of the attorneys who wrote an article about it in the California Health Law News.  They wrote about the case in some detail but the apparent reason for their writing came at the end of the article.  The firm had defended the hospital in this case and written an amicus brief on another case now before the California Supreme Court and they seem to be using this article to bolster their amicus brief without stating such.  This seems to me disingenuous but not unusual in my opinion for hospital biased attorneys in general.          Top

Malpractice

Boyle v Geyer
Filed

Finley Boyle is a 3 year old who went to Dr. Geyer in Hawaii for a root canal.  Why anyone would do a root canal on a 3 year old is mind boggling.  They gave the child  pre-op cocktail of meds including Demerol.  Twenty six minutes later she was in cardiac arrest.  She is now brain dead and in hospice.  These parents are grieving and in direct conflict with the parents of the McGrath child below.

McGrath v Children's Hospital
To Be Filed

In the ongoing saga of idiocy, the parents have attempted to have a judge order the hospital to do a trach and insert a feeding tube.  The court said no.  The hospital and the parents have reached a compromise.  The hospital will release the body to the parents as is if the parents agree to hold the hospital harmless for anything that happens to the body including cardiac arrest.  It will be up to the parents to find a physician and a facility that would perform a trach and insert a feeding tube, find a ambulance service to transport the body to that facility and find transportation for the body to the questionable facility in New York that would take and maintain the brain dead body.  This needs to be done by the deadline of 5 pm January 7 when the hospital may disconnect the machines and nature takes effect.  On January 5 the body was removed from the hospital to an undisclosed location.  The Alameda County Coroner listed December 12, 2013 as the date of death.   Several days later the family stated the body had been fitted with a trach and a feeding tube.  

In a direct opposite case in Texas a brain dead woman was in a hospital with the family saying their good-byes when they were told that since the woman is pregnant they would not take her off the ventilator.  There is a law in Texas that prohibits the cessation of life support if a woman is pregnant.  In this case there is a question as to whether the law takes in brain death or just persistent vegetative states.  If she is dead then she can not be a patient and the law can not apply.  This may be a case of hospital misinterpretation of the law.  No suit has been filed in this case.  The McGrath case has been litigated in state and federal court.      

Tribe v Indian Health Service
To Be Filed

 Members of the Fort McDermitt Paiute-Shoshone Tribe in Nevada have been potentially exposed to communicable diseases after a diabetic pen apparently did not have the needle changed between patients.         Top

Electronic Medical Record

Mountainview Medical Ctr v NextGen
Filed

The Montana hospital has filed suit against the electronic medical record company for failing to install a meaningful use system online.  The suit claims that NextGen failed to meet the time elements for installing meaningful use programs costing the hospital money.  This was after the hospital spent almost $450,000 on the system.        Top

Healthcare

AAPS v US
United States Supreme Court

Justice Roberts has denied the emergency case against the start of Obamacare.  He did this without any comment.         Top

Criminal

California v Barton
Guilty

Keith Barton of the San Diego area has been found guilty of impersonating a physician and stating he can cure HIV and cancer.  He faces a term of nearly nine years.        Top

Archive

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.