Spalding v. Spring View Hosp., LLC — Mar. 2016 (Summary)

NEGLIGENT CREDENTIALING

Spalding v. Spring View Hosp., LLC
No. 2013-CA-000842-MR (Ky. Ct. App. Mar. 11, 2016)

The Court of Appeals of Kentucky consolidated three cases with similar claims of negligent credentialing.  Prior to these cases, the Commonwealth of Kentucky did not recognize the tort of negligent credentialing.  However, because the court saw no legal or policy-based argument persuasive enough to continue not recognizing the tort, it reasoned that it should recognize negligent credentialing as a cause of action and as a means by which individuals can hold hospitals liable for the hospital’s negligent extension or renewal of staff privileges and credentials to independent contractor physicians.

The first of the consolidated cases dealt with an orthopedic surgeon whose knee replacement surgery resulted in numerous complications for a patient. Here, the court affirmed summary judgment granted to the hospital because the patient failed to establish a proper standard of care and a deviation therefrom.

The second consolidated case dealt with the same orthopedic surgeon whose separate patient also experienced numerous complications after receiving knee surgery. Here, the court affirmed the denial of the hospital’s motion for summary judgment emphasizing that the statute of limitations did not bar the patient’s claims.

The final consolidated case dealt with a different surgeon and a patient whose spinal stabilization procedure resulted in complications. Here, the court reversed the circuit court’s dismissal of this patient’s negligent credentialing claim and remanded the case for further proceedings.

U.S. ex rel. Phillips v. Pediatric Services of America — Nov. 2000 (Summary only)

U.S. ex rel. Phillips v. Pediatric Services of America
No. 3:97CV360-P (W.D.N.C. Nov. 30, 2000)

A former employee of a pediatric group filed a Medicare False Claims Act (“FCA”) complaint as a qui tam relator alleging that the group allowed non-physician employees to complete charts. The government declined to intervene. The U.S. District Court for the Western District of North Carolina denied the group’s motion to dismiss, holding that qui tam relators are subject to enough specific controls by the government, including intervention and management of the suit, as to avoid the possibility that the qui tam relator will “impermissibly undermine” the government to such a degree that it would violate the doctrine of separation of powers or the “take care” clause of the Constitution.

Wyttenbach v. Board of Tennessee Medical Examiners — Mar. 2016 (no Summary)

Gallagher v. Penobscot Cmty. Healthcare — Mar. 2016 (Summary)

ADEA

Gallagher v. Penobscot Cmty. Healthcare
Civil No. 1:15-CV-244-DBH (D. Me. Mar. 15, 2016)

The United States District Court for the District of Maine granted a health center’s motion to dismiss age discrimination claims made by one of its physicians whose employment was terminated.  The physician practiced dermatology and received complaints, including that he was “old school.” The court dismissed the physician’s Age Discrimination in Employment Act (“ADEA”) and constitutional claims because he failed to file a timely complaint with the Equal Employment Opportunity Commission.  The court also dismissed the physician’s suit against the federal government, holding that even though the health center and its employees were entitled to Federal Torts Claim Act immunity, this did not permit the physician to sue the government in an employment or peer review matter.  The court dismissed the physician’s state law claims without prejudice.

Liu v. Cook Cnty. — Mar. 2016 (Summary)

DISCRIMINATION AND RETALIATION

Liu v. Cook Cnty.
No. 14-1775 (7th Cir. Mar. 15, 2016)

The United States Court of Appeals for the Seventh Circuit affirmed a lower court’s grant of summary judgment for a government hospital on claims of Title VII and section 1981 discrimination and retaliation brought by a former employed physician of Chinese descent.  The court concluded that defendants honestly believed that the employee posed a danger to patients and that reprimands were not related to her membership in any protected class.  The hospital took the challenged action based on the surgeon’s repeated refusal to operate on patients with appendicitis, which she allegedly refused to do so over several years.

Nahas v. Shore Med. Ctr. — Mar. 2016 (Summary)

HCQIA

Nahas v. Shore Med. Ctr.
Civil No. 13-6537 (RBK/AMD) (D.N.J. Mar. 15, 2016)

The United States District Court for the District of New Jersey denied a hospital’s motion to dismiss, finding that it had subject matter jurisdiction and that a physician sufficiently pleaded that the hospital acted out of malice rather than in the furtherance of health care sufficient to overcome the hospital’s presumptive immunity under HCQIA.  However, the court allowed the hospital to file a motion for summary judgment on the HCQIA issue based on an extensive record of disputes with the physician for over 10 years.  The court also allowed the physician to file an amended complaint alleging violation of New Jersey’s anti-discrimination statute.

Parkview Hosp. v. Frost — Mar. 2016 (Summary)

DISCOVERY AND ADMISSIBILITY

Parkview Hosp. v. Frost
No. 02A03-1507-PL-959 (Ind. Ct. App. Mar. 14, 2016)

The Indiana Court of Appeals held that evidence of discounts provided to patients who either have private health insurance or are covered by government healthcare reimbursement programs is relevant and admissible evidence regarding the determination of reasonable charges under the Indiana Hospital Lien Act (“Act”).  Under the Act, a patient may contest the lien or the reasonableness of the charges by filing a motion to quash or reduce the claim in the court where the lien was perfected.  The court upheld a lower court order denying the hospital summary judgment.  The hospital had argued that because the patient agreed to be responsible for full charges as stated on the hospital’s charge-master, the patient had agreed that those charges were reasonable.

Ritchie v. Cmty. Howard Reg’l Health, Inc. — Mar. 2016 (Summary)

PRECAUTIONARY SUSPENSION

Ritchie v. Cmty. Howard Reg’l Health, Inc.
No. 34A02-1505-PL-385 (Ind. Ct. App. Mar. 10, 2016)

A cardiologist whose privileges were precautionarily suspended was denied preliminary injunctive relief.  The Indiana Court of Appeals upheld the trial court’s denial of the injunction, based on the Indiana Peer Review Act which prohibits peer review actions to be enjoined unless they were taken with malice and also because the cardiologist failed to exhaust administrative remedies under the medical staff bylaws.

Murfin v. St. Mary’s Hosp. — Mar. 2016 (Summary)

HCQIA AND STATE IMMUNITY

Murfin v. St. Mary’s Hosp.
No. 5-14-0136 (Ill. App. Ct. Mar. 8, 2016)

A physician’s staff membership and clinical privileges were revoked by a hospital board following two incidents involving allegedly disruptive conduct.  The trial court enjoined the revocation, finding that the physician had been terminated without a hearing.  The trial court also granted summary judgment in favor of the hospital on the issue of damages, based on federal (HCQIA) and state immunity.  The court of appeals reversed the injunction and upheld the summary judgment in favor of the hospital on the immunity issue, holding that the undisputed facts in the record show that the hospital board’s decision to revoke the plaintiff’s privileges was made in compliance with section 10.4 of the Illinois Hospital Licensing Act and the applicable provisions in the bylaws and credentials manual, and that there was nothing in the record to demonstrate that the hospital engaged in willful and wanton conduct in making or reviewing that decision.

Bastidas v. Good Samaritan Hosp. LP — Mar. 2016 (Summary)

RETALIATION

Bastidas v. Good Samaritan Hosp. LP
Case No. 13-cv-04388-SI (N.D. Cal. Mar. 15, 2016)

The United States District Court for the Northern District of California granted in part and denied in part a hospital’s motion to dismiss a retaliation claim made by a surgeon.  This litigation arose following a complicated surgery at a hospital that resulted in the death of a patient and the suspension of the surgeon’s privileges.

After peer review proceedings, the Board of Trustees issued a final report on the matter, recommending that the surgeon be proctored for a number of surgeries prior to regaining his surgical privileges.  The surgeon asserted retaliation claims across three separate complaints, and this specific case dealt with the fourth amended complaint.

The surgeon argued that he was subject to retaliation by the hospital in four separate instances: a failure to update an entry in the National Practitioner Data Bank, a continued delay in allowing the surgeon to satisfy proctoring requirements, the disqualification of the surgeon from chief of surgery election, and the removal of the surgeon as chair of a cancer committee.  The court reasoned that the surgeon failed to plead facts that demonstrated that these instances constituted retaliation.