November 1, 2018 Recent Legal News






Peer Review and Employment


US v Francis
Westminster Magistrate's Court

England has allowed the extradition of Donna Francis.  Francis allegedly killed Kelly Mayhew at a house by injecting her with liquid silicon.  This led to fatal systemic thrombi and the death.  She fled to England the next day.  England only allowed the extradition after the court was promised by US authorities that if convicted she will serve up to one year in prison, for homicide.  They also had to promise that she would be in a jail in Suffolk County, Long Island within one day of her arrival in the US.  

Michigan v Nasir

Dr. Iqbal Nasir of Grosse Ile was elected chief of staff of Beaumont Hospital.  He then, without permission, moved $116,000 from the medical staff fund to his own bank account.  He is charged with embezzlement.    

Germany v Hoegel

 Niels Hoegel admitted at his trial to killing over 100 patients in his care.  He killed at the clinics in Oldenburg and Delmenhorst between 2000 and 2005.  He was caught in 2005 injecting a patient with an unknown substance.  He was tried on attempted murder and sentenced to seven years.  In 2014 he was tried and convicted of murder and sentenced to the maximum of 15 years.  He has now confessed to over 200 murders.   Top


US v Aachi

Dr. Venkat Aachi of Saratoga, California, was indicted for illegal distribution of drugs.  He allegedly gave hydrocodone to two individuals as well as submitted false claims to insurance companies.

US v Kumar

Dr. Sheetal Kumar of Stuart, Florida, was indicted on 26 charges of health care fraud.  She is accused of submitting claims for incontinence treatments never received in her OB/Gyn office.

US v Assad

Four Florida men Andrew Assad, Peter Bolos, Michael Palso and Everett Smith were indicted for heath care fraud, mail fraud and introducing misbranded drugs into interstate commerce.  Also indicted were their businesses pharmacies and compounding pharmacies.  This alleged scam billed almost $1 Billion in fake charges.

US v Robinett

Drs. Kelly Robinett and Angel Claudio along with nurses Patience Okoroji, Joy Ogwuegbu and Kingsley Nwanguam were sentenced to prison for their role in defrauding Medicare in a home health scam.  The terms ran from six to 120 months.

US v Olsen Orthopedics

The Oklahoma City company agreed to p[ay $455,000 to settle allegations that they filed claims for drugs and devices that were not FDA approved.

US v Cooley Medical

The Tennessee DME provider agreed to pay $5.25 million to settle allegations that it billed for compounded medical creams with ingredients that were misrepresented.  The company self reported and also stopped operating a compounding pharmacy. Sine they self reported they will only have to repay 1.5 times the loss amount, half of the usual.  They will also repay the money over six years.

Mamalakis v TeamHealth

In a whistleblower suit Dr. John Mamalakis, who was fired from All Saints Hospital in Racine, Wisconsin, alleges that the hospital anesthesiologist group bills fraudulently.  The case was not picked up by the feds.  He claims there were blatant falsifications of the anesthesiologists who claim they were present or available when they were not.  He claims they billed for services medically directed which is higher than medically supervised.    

US v Fesen

Dr. Mark Fesen was indicted for healthcare fraud.  He is accused of illegally billing for unnecessary cancer treatments.      Top


Aetna v Mednax

Aetna accuses Mednax medical group of inflating how sick neonates are in order to increase billing.  The court recently ruled that the case may go forward as it not barred by the statute of limitations and there are issues of fact that need to be determined by a jury. They are also accused of training and requiring physicians to do more tests than necessary and to actually upcode over physicians decisions.        

HealthAllaince Hosp. Inc v Azar

The alliance of twelve Massachusetts hospitals won their case to be paid $6 million in Medicare reimbursements.  The disproportionate share hospitals sued for not being fully compensated for care provided.  Watch for this to be overturned as the appellate court has ruled differently in the past. 

HCA v Aetna

HCA has won an arbitraton against Aetna for out of network ED payments.  Te sum is $150 million but this is to be appealed.          Top


US v Anthem

Anthem agreed to pay a fine of $16 million for its bungling of private information.  They allowed a cyberattack to pilfer 79 million identities.  After they put up safeguards.

Patients v CMS
To Be Filed

About 75,000 people had their financial information compromised when a government computer that interacts with the site was hacked.  This computer was used by brokers to sign up enrollees.

UA v MD Anderson

The feds fined the Texas Center $4,348,000 for their "dilatory conduct" relating to three HIPAA violations.  They had three employees electronic drives stolen all were unencrypted.  It took the thefts to get the Center to do the right thing.  An ALJ recently upheld the fine.        Top


Mullins v Union Memorial
DC Maryland

Mullins went to hospital A with a hand injury.  He was seen in the ED and the hand surgeons could not see him.  The hand surgeon at another hospital, Union, also could not see him so  the ortho at hospital A treated him with surgery and he was told to follow up with a hand surgeon.  He got a less than perfect result so he sued all for med mal and EMTALA.  All was dismissed except Union for EMTALA.  They moved for summary judgment and won since they did not have a higher specialization than hospital A and Union did not have the capacity to treat him as the hand surgeon at Union was already involved with a multi-digit amputation case which was a higher triage than Mullins.

Pham v Black
Ga Ct. App.

Black presented to the hospital ED c/o a racing heart.  The ED physician spoke to Pham, the hospitalist on call, who was reluctant to admit the patient until his heart rate could be lowered.  Black then coded and Pham wanted him to be transferred to University Hospital for a higher level of care.  Black died at the other hospital the next day and the family sued all for both med mal and EMTALA.  The court dismissed the EMTALA claims against the physicians as this is a hospital and not a physician liability.  The med mal claims against Pham were dismissed as there was no physician patient relationship except to talk to the ED physician about the care.  The dissenting opinion argued that Pham made a medical decision when she refused admission which was an issue of fact that precluded summary judgment.

Merritt v VA

The family of Staff Sgt. Aaron Merritt was awarded $2.5 million in a settlement.  He had ulcerative colitis and was prescribed azathioprine, whose side effects is a decreased blood count.  This happened and the monitoring that was supposed to happen did not.  He died of the complication.  The Nashville VA physicians did not order the required blood tests.

Johnson v Bayer

The judge in this case reversed herself.  Originally, after the verdict she said she was heavily thinking of a new trial.  Instead she said the punis were too high and ordered either a reduction from $250 million to $35 million.  The plaintiff is considering what to do.  Bayer will appeal in any case as they believe as does the rest of the world that its weed killer glyphosate is not carcinogenic.  

Doe v Rite Aid

Joh Doe is suing a pharmacist at Rite Aid and his employer for invasion of privacy after the pharmacist allegedly said loudly that his copay was for his HIV.          Top

Peer Review and Employment

 Wilson v Alaska Native Medical Center

Dr. Paul Franke and Joan Wilson have accused the hospital of retaliation for firing them after they reported billing violations that netted the hospital millions of dollars.  They say the hospital billed for not appropriate authenticated claims, declined to fix billing practices and took no action to return unearned funds.  Wilson was the chief ethics officer and Franke was the CMO.  They also filed suit against the hospital as whistleblowers which was not pursued by the feds.

Neeley v UCSF

The University of California paid former postdoc Dr. Eunice Neeley the grand total of $150,000 to settle a suit that its employee Stanton Glantz, the director of the UCSF Center for Tobacco Control Research and Education made lurid remarks , ogled Neeley's breasts repeatedly and forced her to hug him.  She also states that he refused to include her name on a research paper.  As part of the settlement Glantz agreed to transfer ownership of the paper to Neeley.  This paper he says is the real reason the suit was filed but he has been disciplined by the University for this issue.        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.