U.S. ex rel. Judd v. Quest Diagnostics, Inc. – Aug. 2015 (Summary)

ANTI-KICKBACK STATUTE – PUBLIC DISCLOSURE BAR

U.S. ex rel. Judd v. Quest Diagnostics, Inc., No. 14-3156 (3d Cir. Aug. 26, 2015)

A physician reported a testing company for violating the Anti-Kickback statute and the Stark Law. The district court dismissed the case against the other defendants because the facts of the kickback scheme had already been publicly disclosed in other cases. The testing company’s case was dismissed because of the failure of the physician to plead his case with specificity. He did not include enough facts to make the case plausible.

Hagen v. Siouxland Obstetrics and Gynecology, PC – Aug. 2015 (Summary)

WRONGFUL DISCHARGE – PHYSICIAN GROUP EMPLOYMENT CONTRACT

Hagen v. Siouxland Obstetrics and Gynecology, PC, Nos. 14-2580, 14-2648 (8th Cir. Aug. 20, 2015)

An OB-GYN who was formerly employed by a professional corporation brought an action against his former employer after he was terminated. The physician’s hospital privileges were suspended after an outburst when he used profanity and accused the hospital staff and one of his partners of killing an unborn baby (the high-risk mother had been admitted in premature labor). He told his partners, “I’m going to tell the patient, you know, to sue this hospital…. You know, we’re going to take [the hospital] down.” He had a history of “workplace conflict.” The other physicians in his group terminated him for cause (testifying that he was “abusive and erratic” and the subject of patient complaints). The court of appeals held that contractual protections in the physician’s employment agreement precluded the doctor from maintaining a claim for wrongful retaliatory discharge, reversing a jury verdict in favor of the physician.

Novak v. Somerset Hosp. – Aug. 2015 (Summary)

ANTITRUST

Novak v. Somerset Hosp., No. 14-4354 (3d Cir. Aug. 20, 2015)

The United States Court of Appeals for the Third Circuit affirmed an order of summary judgment in favor of a community hospital and its board members in a lawsuit brought by a general surgeon who alleged the hospital and board members conspired to terminate his privileges so the hospital could “reduce the likelihood that its patients could be treated at [a larger tertiary care hospital in the area],” illegally restraining trade in the area in violation of the Sherman Act and Clayton Act. The community hospital terminated the surgeon’s privileges after he performed two surgeries without proper authority. He still retained privileges at the tertiary care hospital and maintained a private office close to the community hospital. The court of appeals rejected the surgeon’s arguments related to antitrust standing and market definition. The district court found no rational basis for the surgeon’s argument that the surgical services performed at the community hospital were not interchangeable with the surgical services provided at the large tertiary care hospital, and were not adequate substitutes for each other. The court of appeals similarly rejected the surgeon’s argument that the community hospital “shut [him] out” of the relevant geographic market by terminating his privileges. The court held the surgeon’s definition of the relevant geographic market, the community hospital, was illogical based upon the surgeon’s expert’s own testimony: 32% of the patients at the community hospital were treated at other hospitals in the area.

Vnuk v. Berwick Hosp. Co. – Aug. 2105 (Summary)

SEXUAL HARASSMENT

Vnuk v. Berwick Hosp. Co., No. 3:14-CV-01432 (M.D. Pa. Aug. 19, 2015)

The United States District Court for the Middle District of Pennsylvania denied a defendant physician’s motion to dismiss a plaintiff nurse’s Pennsylvania Human Relations Act (“PHRA”) claims due to lack of subject matter jurisdiction, but granted the defendant hospital’s motion to dismiss the nurse’s intentional infliction of emotional distress claim. The physician, who served as Chief of Staff, allegedly sexually harassed the nurse over a two and one half year period in the emergency department, including many instances of touching and sexually suggestive remarks. The harassment was allegedly general knowledge among hospital staff. The nurse claimed she reported the harassment to supervisors and the hospital’s human resources department, but the hospital decided to only conduct interviews of hospital employees instead of conducting an investigation consistent with its internal policy. Additionally, the nurse claimed the physician and hospital allegedly retaliated against her for reporting the harassment. She also claimed the hospital attempted to deal with the harassment by not scheduling her to work on shifts when the physician would not be present, reducing her work hours.

The physician filed a motion to dismiss the nurse’s PHRA claims, because the nurse had not exhausted her administrative remedies. The district court noted the physician’s name did not need to appear in the caption of the nurse’s Pennsylvania Human Relations Commission complaint; the allegation in the body of the complaint, naming the physician and detailing the actions he allegedly committed, was enough to satisfy this requirement. Additionally, the district court denied the physician’s motion to dismiss the breach of fiduciary duty claim, noting the nurse had alleged sufficient facts to support that claim

The court granted the hospital’s motion to dismiss, explaining that while the Pennsylvania worker’s compensation statute provided the sole remedy for injuries allegedly sustained during the course of employment, a personal animus exception exists where the injury is motivated by personal reasons as opposed to generalized contempt. The district court held the alleged retaliatory actions of the hospital did not amount to personal animus for the purposes of the exception; they did not evince intent to harm the nurse for personal reasons. Nor were the alleged retaliatory actions legally sufficient to be considered “outrageous” by a member of the community. Additionally, the district court held the hospital could not be considered vicariously liable for the physician’s conduct because sexual harassment was not in the scope of the physician’s employment at the hospital. The court also noted that the nurse had filed a new administrative complaint, alleging constructive discharge, with the Pennsylvania Human Relations Commission and U.S. Equal Opportunity Commission.

Thomas v. EmCare, Inc. – Aug. 2015 (Summary)

FALSE CLAIMS ACT RETALIATION

Thomas v. EmCare, Inc., No. 4:14-cv-00130-SEB (S.D. Ind. Aug. 24, 2015)

An emergency room physician sued a hospital, alleging that the hospital violated the federal and state False Claims Act. The physician made formal complaints about the violations and five days later his employment was terminated (after only four months, throughout which he made verbal and written complaints about tests, procedures and alleged Medicare and other insurance fraud). He never received an explanation of his termination. The physician filed suit under the anti-retaliation provisions of the state and federal False Claims Act. The court denied the hospital’s motion to dismiss, holding that because the physician provided evidence that he had never received a complaint about his performance during his tenure at the hospital, he provided enough evidence for the case to go forward.

Fitzsimmons v. Cardiology Assocs. of Fredericksburg, Ltd. – Aug. 2015 (Summary)

FALSE CLAIMS ACT RETALIATION

Fitzsimmons v. Cardiology Assocs. of Fredericksburg, Ltd., Civil Action No. 3:15cv72 (E.D. Va. Aug. 18, 2015)

A cardiologist whose employment contract was terminated after he alleged improper Medicare billing practices sued his former employer (a group practice) and physician shareholders. The federal district court granted the group’s and individual physician shareholders’ motion to dismiss, in part: the quantum meruit claim failed because a claim for quantum meruit is not applicable when an express contract governs the scope of the demand; and his claim for “Dividends, Distributions, and Shareholder Rights” did not state a cause of action. However, the court held that he adequately pleaded a cause of action for retaliation under the False Claims Act because he alleged he engaged in protected activity; defendants had knowledge of his activities; and defendants took retaliatory actions as a result of his activities. The court stated that summary judgment provides a more appropriate stage to consider the group’s argument regarding post-termination retaliation and the individual shareholders’ arguments regarding individual liability.

Boland v. Saint Luke’s Health Sys., Inc. – Aug. 2015 (Summary)

WRONGFUL DEATH

Boland v. Saint Luke’s Health Sys., Inc., No. SC 93906 (Mo. Aug. 18, 2015)

The Supreme Court of Missouri affirmed a trial court’s ruling that five wrongful death lawsuits were time-barred by a three-year statute of limitations under Missouri statute. The suits were consolidated and all arose from treatment received from the same employee of a hospital. The employee was a respiratory specialist who intentionally administered a lethal dose of succinylcholine, insulin, or other medications that resulted in the death of each of the patients. The same employee’s actions are alleged to have caused at least nine suspicious deaths and 18 suspicious medical emergencies, often involving cardiac arrest or the inability to breathe. The plaintiffs argued that there should be a delayed accrual of the statute of limitations in this case, as they claim that the hospital fraudulently concealed the facts underlying the patients’ deaths or that, alternatively, an exception should be made for fraudulent concealment.

The court was not persuaded that any exceptions to the statute of limitations should apply in this matter. The court stated that while it was difficult to reach a conclusion that left the patients without a remedy, the legislative branch of the government had determined the policy of the state and clearly fixed the time when the limitation period begins to run. Also, the court must interpret the law, not disregard it, as written by the legislature.

U.S. ex rel. Bingham v. Baycare Health Sys. – Aug. 2015 (Summary)

FALSE CLAIMS ACT

U.S. ex rel. Bingham v. Baycare Health Sys., No. 8:14-cv-73-T-23EAJ (M.D. Fla. Aug. 14, 2015)

The United States District Court for the Middle District of Florida denied a health system’s motion for summary judgment on claims brought against it under the False Claims Act and the Stark Law. The alleged violation involves construction of medical office buildings, common areas, walkways and garages on a hospital’s campus, and leasing arrangements between the developer/landlord buildings. Specifically, the lease was amended to allow referring physicians, their staff, and their patients to use parking systems owned by another entity at no charge, which resulted in an estimated annual parking benefit per referring physician of more than $10,000.

The alleged violation arose out of the fact that the health system billed federally sponsored health programs and the government paid for claims based on referrals from tenant physicians who received remuneration from the system for referrals. The court held that the claims were sufficient to survive summary judgment because they were grounded in sufficient indicia of reliability.

Abdale v. N. Shore Long Island Jewish Health Sys., Inc. – Aug. 2015 (Summary)

HEALTH INFORMATION PRIVACY

Abdale v. N. Shore Long Island Jewish Health Sys., Inc., No. 2367/13 (N.Y. App. Div. Aug. 14, 2015)

The Supreme Court of Queens County, New York granted in part and denied in part a health system’s motion for summary judgment. The litigation arose when the health system allegedly failed to adequately protect the confidential, personal, and medical information of their current and former patients, which ultimately resulted in identity and medical identity data breaches. Thirteen patients alleged that they experienced repeated instances of identity theft since the data breach.

The patients’ complaint alleged 11 causes of action, including: negligence per se under five different statutes, breach of contract, breach of fiduciary duty, negligence, breach of the implied covenant of good faith and fair dealing, and misrepresentation. The court dismissed all but the negligence claim because of technical issues with the pleadings. The court refused to dismiss the negligence claim, holding that it was clear that the patients gave the system personal information, the patients were informed that their personal information would not be disclosed to third parties, and the patients sufficiently stated their injuries based on such disclosures.

Sheldon v. Kettering Health Network – Aug. 2015 (Summary)

HIPAA – HEALTH INFORMATION PRIVACY

Sheldon v. Kettering Health Network, No. 26432 (Ohio Ct. App. Aug. 14, 2015)

The Court of Appeals of Ohio affirmed a lower court’s dismissal of tort claims, including invasion of privacy, negligence, negligence per se, negligent training, negligent supervision, intentional infliction of emotional distress, and breach of fiduciary duty, all of which were based on alleged violations of the federal Health Insurance Portability and Accountability Act (“HIPAA”). The litigation involved claims made by a patient that a health network had failed to protect the privacy of her electronic medical information, which was based on allegations that the administrator of the health network, who was the patient’s former husband, had improperly accessed and disclosed her protected health information to a subordinate network employee with whom he was alleged to be having an affair. The patient claimed that had the network been running and monitoring appropriate electronic record audits, the breaches could have been prevented or minimized.

The health network argued that HIPAA does not provide a private right of action, therefore, as a matter of law, the patient could not assert her common law tort claims, all of which essentially alleged HIPAA violations. The court agreed that the unauthorized access was a HIPAA-based claim and held that allowing such a claim to proceed against the network based on claims that the network failed to take reasonable steps allegedly required under HIPAA to protect her health information and detect the breaches at issue would effectively allow an unlawful private action for damages predicated on HIPAA requirements. The court also found that the network could not be found vicariously liable for the administrator’s intentional and unauthorized access of the records for purposes of furthering his affair, as it was not conduct of the kind which he was authorized to perform or which was actuated, at least in part, to serve the purposes of his employer, the health network.