March 1, 2020 Recent Legal News

Criminal

Fraud

Healthcare

HIPAA

Hospitals

Malpractice

Peer Review and Employment

Criminal

California v Robicheau
Pending

Dr. Grant Robicheau and his girl friend Cerissa Riley were originally charged with drugging and sexually assaulting women by Orange County DA Rackaucka.  He was defeated in the last election and the new DA Spitzer wants to drop the case for lack of evidence.  There were guns and drugs found in the home as well as the testimony of five witnesses.  The judge said not so fast and wants more information.  Spitzer accuses the last DA of wanting to make a name by going after the high profile case.        

US v Weber
Sentenced

Dr. Stanley Weber was sentenced to five lifetime sentences.  he ws convicted of sexually abusing young boys while working as a physician on Indian reservations in Montana and North Dakota.  The IHS knew about him and transferred him instead of pulling the plug and reporting him.    

US v Shaker
Sentenced

Dr. Milad Shaker of Greensberg, Pennsylvania, was sentenced to over three years in prison, three years of supervised release and a $15,000 fine.  He was convicted of dispensing opioids for sex. 

England

 Dr. Manish Shah of Romford, England, was sentenced to 15 years in prison for over 90 sexual assaults on female patients.  

Wisconsin v Kaphaem
Sentenced

Christopher Kaphaem is a former nurse in the NICU of UnityPoint Meriter Hospital.  He was convicted of abusing the children in his care and now sentenced to 13 years in prison.  

US v Patino
Indicted

Dr. Francisco Patino of Wayne County, Michigan, was indicted on a bunch of charges relating to prescribing oxycodone.  He is accused of forcing patients to get un-needed back injections and otehr procedures to get the narcotics.  

Georgia v Shilling
Indicted

 A Georgia grand jury has indicted Dr. John Schilling, an OB in Stockbridge, who also had a cosmetic surgery practice, of unauthorized distribution of narcotics.     Top  

Fraud

US v Aprahamian
Indicted

Ara Aprahamian, the former sales exec of Taro Pharmaceuticals was indicted for price fixing.  He was alleged to fix generic drug prices.

US v Agbi
Sentenced

Dr. John Agbi of Wellington, South Carolina, was sentenced to 18 months in prison, loss of his medical license and payment of $140,000.  He signed orders for ortho braces that were not necessary as part of a huge $40 million scam.  

California v Walgreens
Settlement

The company will pay the state $7.5 million to settle allegations that they allowed a person who was not a pharmacist to fill over 750,000 prescriptions for 11 years.  They failed to check her license.  

US v Kim
Sentenced

Dr. David Kim, a chiropractor was sentenced to 30 months in prison and ordered to pay $690,519 in restitution.  Kim had fled to South Korea in 2015  and extradited back to the US.  he had submitted claims for physical therapy that were not provided.  

US v Pappas
Guilty

Drs. Spillos Pappas of Lucas County Ohio, Joseph Betro of Oakland County Michigan, Tariq Omar of Oakland County and Mohammed Zahoor of Oakland County were all found guilty by a jury of health care fraud.  They had a scheme where patients were required to undergo back injections in exchange for pain meds.  

US v Edwards
Indicted

Dr. Michael Edwards of Huntington Beach California, James Bell of Anaheim Hills, Sara Samhat of Huntington Beach and Regina Piehl of Pacific Palisades were indicted for allegedly billing for unnecessary compounded cream prescriptions costing TRICARE over $22 million.  They are alleged to pay patients $200 to show up at a clinic for "treatment".  

US v Wilson
Indicted

Reinaldo Wilson and his wife Jean Wilson of Richmond Hills, Georgia, were indicted for health care fraud for allegedly kickback to recruiters, pharmacies and brace suppliers and paying bribes to providers for ordering unneeded ortho braces. 

US v Southeastern Retina Associates
Settlement

 The Tennessee medical group with offices in that state as well as Virginia and Georgia will pay $1.5 million to settle allegations that they improperly used -25 modifiers for exams that were not allowed to be billed.  They will also get the dreaded corporate compliance agreement covering all 250 employees.  

US v Tenet 
Settlement

Tenet has agreed to pay $1.41 million to settle allegations that Desert Regional Hospital in Palm Springs knowingly charged Medicare for implanting unnecessary cardiac monitors.  

US v Waldo
Sentenced

RN Donna Waldo of St. Louis was sentenced to probation and ordered to pay $48,668 for her role in billing for physician visits when the physician was out of the country.  She was working for Dr. Brij Vaid of Ladue, Missouri.  

US v deGraft-Johnson
Indicted

Dr. Moses deGraft-Johnson a Tallahassee, Florida vascular surgeon was indicted on fraud charges for billing for work he did not perform.  He was held as a flight risk as it was alleged that he was trying to become president of his home country of Ghana.  It is also alleged that the doctor has at least $1,8 million in Ghana.  

US v Zamora -Quezada
Guilty

Dr. Jorge Zamora-Quezada of San Antonio was convicted of falsely diagnosing patients with rheumatoid arthritis in order to prescribe high price drugs.  Watch for a long sentence and huge fines along with multiple civil suits by patients.   

Long v J&J
Filed

Julie Long, a former employee of Janssen, a subsidy of J&J, had a whistleblower suit unsealed.  She alleges that J&J unit helped physicians set up infusion suites for Remicade and Simponi infusions.  The feds declined to intervene.    

US v Garcia
Convicted

 Dr. Omar Garcia of Chicago was convicted by a jury of fraud for doing allergy tests tat were not necessary.  He then billed for the unnecessary tests.  

US v Cookville Regional Medical Center
Settlement

The Tennessee hospital agreed to pay $4.1 million to settle allegations that it paie physicians of a cardiology practice for referrals and then billed for those procedures.  

US v Guardian Elder Care Holdings
Settlement

The Midwest company agreed to pay $15.4 million to settle allegations that they billed for medically unnecessary rehab therapy services.  This is a whistleblower case and the two blowers will split $2.8 million with their attorneys. 

US v Vespa
Sentenced

Anthony Vespa, the former CEO of Southeast Michigan Accountable Care, was sentenced to 36 months in prison for stealing over $3 million from the insurer.  He also needs to repay all the money.  

US v Suris
Sentenced

 Aleksandr Suris and Maxim Sverdlov, the owners of Royal Oak Pharmacy in the San Fernando area, were previously convicted of fraud and money laundering.  They were sentenced to 12 years each in prison and were held responsible jointly for over $11.8 million in restitution to Medicare.  They had billed Medicare for meds never delivered.  

US v Trandahl
Guilty

Mental Health counselor from Butte, Montana, Dana Trandahl plead guilty of Medicaid fraud.  She was accused of rather than dealing with client issues she would tlk of her own as well as billing for appointments with people she had never seen. 

US v Allergan
Settlement

The company agreed to pay $51.3 million to settle allegations that it violated antitrust laws by improperly trying to delay the approval of generic competitors for Restasis. 

US v Tamarin
Sentenced

Manhantan Beach Urologist Dr. Mark Tamarin was sentenced to six years in prison and ordered to pay $345,000 in restitution.  He had billed for non-existent or un-needed treatments.        Top

Healthcare

Patients v Midlands Hospital
Filed

Three patients have filed a class action suit against the Lexington, south Carolina hospital for seizing former patient's tax refunds to pay overdue medical bills after the patient has filed for bankruptcy.  They contend this is against the federal bankruptcy rules.  

Lowe v CVS
Settlement

Two people filed suit against CVS and West Corporation over their use of robocalls to tell people flu shot were available.  they won a $15 million settlement.  Each member of the class will get about $40 but the attorneys will get $5 million.  The named plaintiff will get $15,000.    

California v US
Filed

 In the full employment act for attorneys California again filed against the administration because they are threatening to withhold federal funds unless the state stopped requiring health insurers to cover abortions.  The law was opined to be OK by Bo but it has not been held to be OK by any court.  That will change either to the detriment of the administration or California.  The left state also does not like the administration's stance on water to the farmer instead of the smelt.  They are suing here as well. 

Bonner v Rite Aid Corp. 
ED Cal

Dr. Bonner sued for unfair competition, intentional and negligent interference with prospective economic advantage, defamation, intentional infliction of emotional distress and violations of 1981 and Title VII after learning that the local Rite Aid pharmacists were not filling his prescriptions and were making "defamatory" statements about him.  The court said no emotional distress as he failed to allege any.  He also failed to allege any 1981 claim and since he was not an employee of 
Rite Aid he could not have a Title VII claim.  The court went on to dismiss his request for restitution because he failed to allege how Rite Aid was unjustly enriched and the court finally threw out his request for punitive damages under 1981 because there was no support for Rite Aid acting evilly.  Not mush left.       
Top

HIPAA

Patients v United Healthcare
To Be Filed

The company announced that some people in the South Carolina area may have had their data compromised in a Phishing scam.  

Patients v Fondren Orthopedic Group
To Be Filed

The Houston group notified over 30,000 patients that their medical records may have been damaged in a malware attack.  The found this in November and are only now notifying the people.  

Patients v Manchester Opthalmology
To Be Filed

The Connecticut medical group stated over 6000 thousand patients had their medical records tampered with and removed in November.  They too are only now notifying the patients.  

Patients v VillageCareMAX
To Be Filed

The Rehab center is notifying over 2000 patients of the breach of their medical records in a phishing scam.  

Patients v Wise Health System
To Be Filed

The Texas system is notifying almost 67,000 patients that their information may have been compromised by phishing hack.    

Patients v Hackensack Meridian Health
Filed

The patients or really the attorney looking for a class action suit filed suit against the hospital for failing to protect the patient information.  They were hit in December with a ransomware attack and paid the ransom.  

Nelson v A Place for mom
S
D Ohio

Nelson accused he employer of violating HIPAA and in so doing constructively discharging her.  The court states that HIPAA does not articulate a clear public policy sufficient to support a claim of wrongful discharge in violation of a public policy.  

Patients v Monroe County Hospital
To Be Filed

About 7500 people were notified of a breach which may have gotten their PMI.  Someone outside the organization had access to the information for three months before it was found. 

Frasier v Ciox
Filed

Patients are suing a Georgia medical records company for gouging them to obtain their medical records in violation of state law.  Frasier states she was charged $902 for he records which included a $15 basic fee, a $0.50 charge per page and a $56.80 shipping fee.  She received the file electronically.  The patients also sued the hospitals for using Ciox.

Patients v University of Washington
Filed

Several patients have filed suit and asked for a class action against the hospital for not protecting their medical information.  In February, 2019, the hospital notified almost one million patients that their information was available in internet searches.  A human error caused the problem.   

Patients v Tennessee Orthopaedic Alliance
To Be Filed

Over 81,000 patient had their PMI exposed due to a phishing attack.  It was found two months late.

Patients v Rady Childrens
To Be Filed

The San Diego hospital notified almost 2300 patients that their information had been accessed by unauthorized personnel.  This occurred for six months prior to being found   Top

Hospitals

Parish Medical Center v Health First
Filed

The Florida hospital system is accusing its rival of using the letterhead of a physician affiliated with Parish to falsely accuse two Parish board members and a former politician of fraud.  They accuse the CEO of Health First and an advertising firm of creating the documents.  They say the reason was the day prior to the defamatory letter Parish had won a law suit against Health First over seven oncologists loss of privileges.  

Patients v HCA Healthcare
Dismissed

A proposed class action suit against the Tennessee system was dismissed by the judge.  The suit alleged that the facility fees charged by the hospital were illegal since they were not disclosed.  The judge said that tow of the plaintiffs were not charged the fee so had no standing and the third person claimed the charges were not disclosed were false since they were on the chargemaster.    

EEOC v Yale New Haven
Filed

The feds have accused the hospital of discrimination by their policy that requires all over 70 who apply for or seeks to renew staff privileges to take both neuropsychological and eye medical exams.  They are required to be tested only due to their age and violates the ADA and the Age Discrimination Act.  Look out other hospitals you are next.      Top

Malpractice

Conteron v Hoboken university Medical Center
Filed

The parents of a six year old who died from H1N1 virus filed suit for negligence.  She had a headache and went to the ED.  She tested negative for strep and flu and sent home but had a temp of 105 according to the suit.  Her symptoms did not improve and the other took her to another hospital where she had seizures and died.  The suit says the hospital did not check her vital signs more than once and if they had they may have kept and treated her.  

Mohiuddin v Northwestern Med. Central DuPage Hospital
ND Ill

The plaintiff's mother ws seen int he ED for respiratory failure admitted and treated.  She died the next day and the son sued for EMTALA violations.  The judge rightly state the act was not a substitute for med mal and dismissed the claim with prejudice.  Don't you love it when the attorney loses a case that should never have been filed.

Dalo v University of California San Diego
Filed

The attorneys for the plaintiff seem to have hit the mother lode.  The plaintiff alleges that while a patient at the hospital he underwent ortho surgery and anesthesia was given by an impaired physician.  Dr. Bradley Hay had been an anesthesiologist at the hospital for years and the hospital and staff allegedly knew but did not nothing about his narcotic addiction.  This culminated on him ODing after the surgery on Dalo.  Dalo says he had awaking during surgery but could not yell and this was due to diversion of drugs by Hay.  They have now found an additional patient who also claims problems due to Hay.  How many more will they seek and find?  As many as they can.    

Hutt v Seattle Children's Hospital
Filed

The baby has died from mold infection.  She is the seventh to do so at the hospital and there have been 12 infected to date.  They blame the administration and not the physicians.  

Patton v Forest Labs
9th Circ

The usually liberal court tossed the case against Allergan for not adequately warning that Lexapro adequately warned regarding suicide.  The court said the plaintiffs did not adequately plead their case.

Women v Allergan
Filed

Six women have filed suit against the company for failing to warn the public regarding the health risks from their breast implants.  The six developed anaplastic large cell lymphoma after receiving Biocell textured breast implant.  The FDA has said that more than 80% of this cancer are attributed to the implants.  

Zaleskas v Brigham and Women's Hospital
Mass. Superior Ct.

 The appellate court ruled that when a patient has said to stop a procedure and it is feasible to do so but the procedure is not stopped the patient may sue for battery.  In this case a terminally ill patient allegedly told the radiology techs to stop but they allegedly did not.    

Floran v Doctors Ctr. Hospital
DPR

The Puerto Rican District Court tossed the EMTALA claim against the hospital.  The plaintiff fell and suffered an ankle dislocation and several broken bones.  She was examined in the ED and admitted to the hospital.  After several days she was seen by an ortho and told she needed surgery.  She was discharged to a public hospital because she had no insurance where the appropriate surgery was performed.  She sued but of course lost on all accounts.  She had the required screening and stabilizes since she was admitted to the hospital.  This type of claim is prevalent in PR and almost always is tossed.  

Pelletier v Boston Children's Hospital 
Jury Decision

 A jury acquitted the hospital stating it was not medically negligent after reporting potential abuse and keeping the teen in state custody for a year.  The parents and the hospital were at odds as to the cause of her inability to walk, talk or swallow.  The parents said it was medical or psychological per the hospital.  This occurred seven years ago and has since been diagnosed with mitochondrial disease.       Top

Peer Review and Employment

Denman v St. Vincent Carmel Hospital and Medical Group
Award

OB Dr. Rebecca Denman won a $4.75 million suit against the hospital and group.  She was accused wrongly of smelling like alcohol by a NP.  A week later she was relieved of her duties and told she had to be evaluated by the Indiana State Medical Association.  After stating she was an impaired physician and having treatment she entered a substance abuse contract with the hospital and returned to work.  She then sued for defamation, tortious interference etc.  She won on all counts except civil conspiracy.  They hospital will appeal.  She never received any peer review nor any way to defend herself.  

Williams v Doctors Medical Center
Filed

Dr. Robert Williams is being threatened with loss of hospital privileges after he complained about the treatment of patients by hospitalists owned by the hospital are having patient forego treatments and being placed on hospice.  The oncologist is not alone in his criticism of the hospital as patients and other physicians have agreed with him.  In an interesting twist the medical staff chief Mark Fahlen won a large settlement against the same hospital for then wanting to revoke his privileges.  

Costello v Valleywise Health
Filed

The suit alleges that in spite of having a legal marijuana card under state law RN Timothy Costello was told he would be fired if he tested positive for marijuana.  He is suing for no money but for declaring that the company's policy is illegal and unconstitutional.  Should be a fascinating result when it hits the state Supreme Court.     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.