St. Francis v Morgan County
The law of unintended circumstances come home to roost. The community hospitals have been griping about the specialty hospitals getting their business. In Morgan County, Indiana, the Board of Stupes decided to impose a moratorium on all hospital building in the county to study the problem. The community hospital wants to build but can not since the moratorium is all encompassing. The hospital is complaining that half of the citizens now leave the county for their healthcare and they want to have them return.
SEIU v CPMC
The SEIU which is on strike against California Pacific Medical Center and Sutter Health, is suing to stop the use of employees from Modern Industrial Services from crossing the picket lines. The union contends that even though it is legal to hire non union people to do the work, it is not legal under state or city codes that prohibit the use of workers whose primary business is to help companies resist labor actions. They contend that the Modern Industrial worker fly all over the country ot cross picket lines.
Turner v Legacy Health
Uninsured patients sued the hospital system for being charged the systems highest rates. They won a class action and stated the hospitals did not tell the patients that they were being charged the highest rates which would violate the Oregon Unlawful Trade Practices Act. Top
Tracy v Freund
The survivors of Mr. Tracy will collect $2.7 million for the death of Mr. Tracy. This is half of the amount awarded at trial die to the negligence of the plaintiff in his own death. The 36 year old went to the physician for chest pain radiating into the left arm. He ordered a stress test which was not scheduled until 17 days later. He died the day prior to the test. The month prior to seeing the physician the patient went to the ED for the same problem. He went home against medical advice and did not return when he had more chest pain.
Bowman v Methodist Healthcare
Bowman had a hereditary heart disease and this was undiagnosed at the hospital. She had a cardiac arrest shortly after hospital release and is in a vegetative state. A prior jury verdict came back with a $16.6 million verdict against Methodist, Brooke Army Medical Center and a physician. The amount of the settlement was disclosed after a right to know law suit by a local newspaper. The hospital saved $2.5 million by the settlement of their portion of the case. Top
US v Missoula Radiology
The practice own its own and also was in a joint venture with the local hospital. The suit was initiated by Blue Cross who could not make a deal with the hospitals or the physicians. The reason was an exclusive contract with the hospitals, a common occurrence throughout the country. The decree breaks the exclusive contract and any other hospital that would lessen any competition. The decree last only to September 2007.
US v Northwestern
An administrative law judge has announced his decision is the antitrust case regarding Northwestern University purchasing Highland Park Hospital. The judge stated that it is against Section 7 of the Clayton Act and the hospitals must be undone. There will be an appeal. Top
Dunn v Keefe
A physician sued the hospital CEO for defamation for comments made by the CEO at a MEC. The CEO stated the comments were protected under peer review and should not be available for discovery. The state peer review act has no exception where there is bad faith. The only way to determine bad faith is to hear the comments. The comments were open to discovery but nothing else in the MEC meeting is.
Hourani v Benson Hosp.
The hospital governing board revoked the physician's privileges even though the hearing officer made no recommendation. The physician sued for an injunction and won in the trial court. At the appeals level, the court stated the lack of a recommendation was not fatal but the court still had judicial license to review the hospital decision for procedural or substantive errors. There was also an issue of fact regarding one of the members of the committee was a direct competitor in violation of the hospital bylaws.
Akers v Ohio State University
A patient sued for getting Legionnaire Disease and the hospital asserted a privilege for its quality assurance committee. The trial court denied the patient's motion for an en camera inspection. The Court of Appeals disagreed and stated the lower court could not make a decision without an en camera inspection of the documents.
Parker v St. Mary's Health
The physician won a jury verdict that was overturned by the judge due to HCQIA. The high court stated that even if conflicted physicians were involved in the peer review there was enough evidence to support the quality of care concerns and the committee did attempt to ascertain the facts.
Smego v Stamford Hosp.
A surgeon resigned from a hospital and was reported to the National Data Bank. The surgeon was under investigation at the time.
Weiss v Chester County
The estate of a prisoner who died in prison requested the report of the prison as to what happened. The prison refused due to the Pennsylvania peer review law. The law suit was in federal court so the lack of peer review protection in the federal system as a case against the civil rights of the inmate trumped the state peer review rules. The report was given to the estate. Top
McKalip v Florida
Dr. McKalip, a neurosurgeon in Florida, filed a challenge to a law passed that requires Florida hospitals to report the use of antibiotics to prevent infections before, during and after surgery. The judge stated that the physician has no standing to challenge the properly made rules. The physician is concerned that hospitals will force physicians to utilize antibiotics the way they want them used and not how physicians want to use them. Maybe, in this case, the hospital may be correct, even if for the wrong reason. It is possible they want the physicians to use the meds in a certain way not for quality but for more money for the "pay for performance." Top
Georgia v United HealthCare
Georgia has proposed a $2.4 million fine on United for their systematic non payment of medically necessary treatments by physicians. The insurer does not dispute the charge, just the high fine. It should be noted the United has recently won two lucrative contracts to provide services in the state.
Viola v CA. Dept. Managed Health
The Court stated that the Department has the power to regulate health plans that have both arbitration and non-arbitration clauses.
Physicians v Humana
Humana has agreed to pay $58 million to settle the class action cllaims against it for systematically cheating the physicians out of money. The money includes $10 million in legal fees to the plaintiff attorneys who are coming out of this to no one's surprise with huge bucks. This leaves only PacifiCare, United which is purchasing PacifiCare, and Coventry left to stand trial in January. Top
Daniel v Am. Bd. Emer. Med.
In a proposed class action suit the 2nd circuit dismissed the suit die to the fact that the physicians had no standing to sue. There are two different groups of emergency room physicians and only one is allowed to take the Boards as defined by the ABEM. The court stated they lacked jurisdiction and the physicians lacked antitrust standing. The reason they have no standing is that the plaintiffs want to be able to charge the high fees of the defendants and not disband the organization. There is no antitrust injury. Top
US v Serono
Serono Pharmaceutical of Switzerland and the feds announced a settlement of $704 million for Serono paying kickbacks to physicians to boost sales of a drug. Serono was banned from Medicare for 5 years and needed to sign a CIA. Top
California v Panner
Dr. Owen Panner, Jr. pled no contest that he secretly videotaped women during GYN exams. He hid cameras behind ceiling vents. He received 60 days jail time and probation three years on probation. There was a problem with the statute of limitation that resulted in the small time in jail. His medical license has already been suspended and he has no hospital privileges. Top
Rogers v Department of
The Appeals Court backed an ALJ opinion that was based on credible evidence and ruled for the physician and against the Medical Board. The only way the Board can overturn the decision if it could show the decision was not based on competent evidence. The doctor keeps his 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.