Herisko v. Tenet Healthcare Sys. Desert (Summary)

EMTALA

Herisko v. Tenet Healthcare Sys. Desert, No. EDCV 13-00136-VAP (OPx) (C.D. Cal. Apr. 11, 2013)

The United States District Court for the Central District of California granted a hospital’s motion to dismiss a patient’s claim under the Emergency Medical Treatment and Active Labor Act (“EMTALA”).

The patient presented to the hospital’s emergency department with chest pain, was diagnosed with a heart attack and, although he was successfully treated, he suffered heart damage.  The patient filed suit under EMTALA claiming that the hospital’s handling of his case failed to meet EMTALA’s medical screening requirement.

The district court held that the patient failed to demonstrate that the hospital did not meet the medical screening requirements, finding that he was screened less than 40 minutes after arriving at the emergency department and his condition was correctly diagnosed.  The district court rejected the patient’s argument that the hospital did not conduct an appropriate screening, stating that EMTALA does not entitle the patient to demand a specific method of screening nor does it require that a patient be screened within a certain amount of time.

Santiago-Rodriguez v. Sistema San Juan Capestrano (Summary)

AMERICANS WITH DISABILITIES ACT

Santiago-Rodriguez v. Sistema San Juan Capestrano, Civil No. 11-1128 (DRD) (D. P.R. Apr. 11, 2013)

The United States District Court for the District of Puerto Rico granted a hospital’s motion for summary judgment in a lawsuit filed by a former nurse under the Americans with Disabilities Act, among other things.

The nurse, who was employed by the hospital, brought suit after she claimed she was forced to resign.  The nurse was demoted from her position as supervisor after a reporting error at work. While being interviewed about this error, the nurse mentioned that she would be having surgery at the end of the year.  After the surgery, the nurse never returned to work but sent in a letter of resignation.  The nurse claimed that she was discriminated against based on disability, among other things.

The district court held that the nurse’s disability discrimination claim was insufficient to survive summary judgment, since she was never perceived as being disabled, never worked with any condition that could be seen as a disability, and that since she was demoted before the surgery, her perceived disability had nothing to do with the demotion and subsequent resignation.

Cornu-Labat v. Hosp. Dist. No. 2 Grant Cnty. (Summary)

PEER REVIEW RECORDS DISCLOSURE

Cornu-Labat v. Hosp. Dist. No. 2 Grant Cnty., No. 86842-5 (Wash. Apr. 11, 2013)

The Supreme Court of Washington affirmed in part and remanded in part a lower court’s grant of summary judgment in favor of a physician after the physician filed a lawsuit under the state Public Records Act.  The physician was seeking the disclosure of records from investigations performed by a public hospital district that followed complaints regarding his competency to practice medicine.

The lower court held that records of a peer review committee that contained non-physicians could not qualify for a non-disclosure records exemption and that the exemption for quality improvement committees did not apply to this case.

The supreme court held that the lower court’s finding that committees containing non-physicians was in error, since state law indicates that non-physicians such as officers, directors or employees acting within the scope of their employment can be part of a peer review committee. The court stated that not allowing these individuals to be part of a committee would frustrate the legislative intent of the law.  There was still an issue of fact as to whether the committee put together by the hospital was a regularly constituted committee or an ad hoc investigative team, and this issue was remanded to the lower court.

The supreme court also held that the written records of committee meetings were also protected, but that this only applied to formal meetings and proceedings, not casual discussions.

Lopez v. Contra Costa Reg’l Med. Ctr. (Summary)

EMTALA

Lopez v. Contra Costa Reg’l Med. Ctr., No. C 12-03726 LB (N.D. Cal. Apr. 5, 2013)

The United States District Court for the Northern District of California denied a hospital’s motion to dismiss claims of EMTALA violations and medical negligence. A widower sued the hospital after his wife died from birth complications, alleging that his wife’s admission to the hospital was not made in good faith because the hospital knew that it did not have the staff or facility to stabilize her medical condition.

The district court recognized that EMTALA does not apply to inpatients but held that the EMTALA claim was sufficient to survive a motion to dismiss, noting that there was a fact issue about the hospital’s good faith in admitting her.

Doyle v. Ky. Bd. of Med. Licensure (Summary)

PHYSICIAN LICENSURE

Doyle v. Ky. Bd. of Med. Licensure, No. 2011-CA-001915 (Ky. Ct. App. Apr. 5, 2013)

The Court of Appeals of Kentucky affirmed a lower court’s ruling denying a physician’s petition to set aside the dismissal of his lawsuit requesting judicial review of the state medical board’s decision to suspend and indefinitely restrict his license. The physician’s license was suspended after an investigation revealed the physician’s ongoing struggle with alcohol abuse. After filing two lawsuits challenging the Board’s action, the physician left the country.  Upon his return, he attempted to have his license reinstated. The state board amended its suspension in order to allow the physician to practice as a physician’s assistant. The physician’s license was later reinstated after he agreed to dismiss the lawsuits challenging the Board’s original suspension that were still pending. One year later, the physician filed a motion to set aside the dismissal of his previous suits, claiming that the dismissal was obtained through fraud and duress.

The appellate court held that the physician failed to demonstrate that the agreement to reinstate his license with restrictions (allowing him to practice as a physician’s assistant) harmed him in any way. He was able to earn more money and gained access to training he would not have been able to complete otherwise. The court stated that it did not find the requirement that the physician dismiss his petition of suspension fraudulent. He made a conscious choice to have his license fully reinstated, knowing the consequences of accepting the condition.

The appellate court also held that there was no evidence of coercion or misinterpretation by the Board. The physician could have rejected the Board’s offer, and the potential negative consequences of this decision were in no way concealed from him.

U.S. ex rel. Woods v. SouthernCare, Inc. (Summary)

FALSE CLAIMS ACT

U.S. ex rel. Woods v. SouthernCare, Inc., No. 3:09-CV-00313-CWR-LRA (S.D. Miss. Mar. 30, 2013)

The United States District Court for the Southern District of Mississippi granted in part and denied in part a hospice care corporation’s motion to dismiss a False Claims Act suit brought by two former employees alleging that the corporation improperly enrolled patients in hospice care who were not certified as terminally ill (having six months or less to live) and submitted false claims for hospice benefits.

This was the second qui tam suit filed against the corporation based on the same allegations.  The government intervened in the first suit and, in 2009, a settlement agreement was reached. The district court ruled that the only claims that could be brought in the second case were those that took place after September 1, 2008, noting that the settlement agreement released the corporation from all claims occurring before that date.  The court held that the claims that occurred after this date were sufficient to survive a motion to dismiss, rejecting the corporation’s argument that the relators failed to allege fraud with particularity.  The court specifically noted that the claims include patient initials, dates and patient identification numbers.

The district court dismissed the relators’ claims of companywide fraud, finding inadequate evidence to support them, as well as the claims of a conspiracy, noting that a corporation is incapable of conspiring with its own employees and agents, which was what was alleged.  Likewise, the relators’ claims based on the Stark Law and the Anti-Kickback Statute were dismissed because the relators failed to plead the claims with particularity, noting that they did not identify one physician who referred patients to the hospice provider and has a financial relationship with it or one nurse who was given inducements to recruit new patients.

Ekmark v. Matthews (Summary)

DUE PROCESS: RESIDENCY

Ekmark v. Matthews, No. 12-50808 (5th Cir. Apr. 5, 2013)

The United States Court of Appeals for the Fifth Circuit affirmed a lower court’s grant of summary judgment to a psychiatry residency program director and head of graduate medical education who were sued by a resident who was suspended from the program, lost his physician-in-training permit from the Texas Medical Board and lost his hospital privileges at the VA hospital after allegations surfaced that he had an inappropriate relationship with a VA hospital patient.  The residency program gave the resident two opportunities to “present his account of the situation” but he denied the allegations.  His request for a hearing at the VA hospital was denied.

The circuit court agreed with the lower court that the resident had no “property interest in his certification or ongoing education and was not entitled, under the Fourteenth Amendment, to a formal grievance hearing.”  The court went further and ruled that, even if the resident did have a property interest in continuing his residency, he received all the process he was due, noting that students are not entitled to the same due process protections.

Adem v. Jefferson Memorial Hosp. Assoc. –Apr. 2013 (Summary)

ATTORNEY’S FEES

Adem v. Jefferson Memorial Hosp. Assoc.
No. 4:11-CV-2102-JAR (E.D. Mo. Apr. 2, 2013)

The United States District Court for the Eastern District of Missouri denied a hospital’s motion for attorney’s fees and costs in a lawsuit brought by a physician who alleged that the termination of his medical staff privileges was motivated by racial animus.

The district court held that, although the physician’s lawsuit was dismissed, it was not frivolous or unreasonable. The court stated that the physician relied on relevant case law and had a factual basis for his claim. The court noted that awarding attorney’s fees is an extreme sanction that should be limited to extreme cases of misconduct, which the court did not find.

Budik v. Dartmouth-Hitchcock Med. Ctr. (Summary)

DUE PROCESS/EMPLOYMENT DISCRIMINATION

Budik v. Dartmouth-Hitchcock Med. Ctr., No. 12-329(RBW) (D. D.C. Apr. 5, 2013)

The United States District Court for the District of Columbia dismissed a lawsuit brought by a neuroradiologist against a hospital in New Hampshire and a retired army colonel alleging federal due process and employment discrimination violations as well as violation of certain army regulations.  The hospital defendant had ceased processing of the neuroradiologist’s application for medical staff appointment and clinical privileges after receiving a reference from the retired army colonel indicating that the plaintiff “had some problems with staff interactions” when she worked at Landstuhl Regional Army Medical Center.

The district court held that it did not have jurisdiction over the New Hampshire hospital, stating that the solicitation of business and employees from the D.C. area was not a sufficient enough link to warrant jurisdiction. Furthermore, the neuroradiologist failed to demonstrate that the hospital committed a tortious injury that required litigation in D.C.

The district court also held that the plaintiff’s claims against the retired army colonel were barred by the Federal Tort Claims Act.  Her constitutional claims were dismissed because she failed to show that she had a constitutionally protected property interest in her reputation or guarantee of employment at the defendant hospital.

OPIS Mgmt. Res. LLC v. Fla. Agency for Health Care Admin. (Summary)

HIPAA

OPIS Mgmt. Res. LLC v. Fla. Agency for Health Care Admin., No. 12-12593 (11th Cir. Apr. 9, 2013)

The United States Court of Appeals, Eleventh Circuit affirmed the lower court’s ruling that a Florida statute requiring nursing homes to release medical records to the spouse or attorney-in-fact of a deceased resident was preempted by the federal Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).

The suit was filed with the U.S. Department of Health and Human Services Office for Civil Rights (“OCR”) by spouses and attorneys-in-fact for deceased residents after several nursing homes refused to release the records because the parties requesting them were not “personal representatives” under HIPAA.  OCR concluded that the nursing homes’ actions were consistent with HIPAA.  Nonetheless, the Florida Agency for Health Care Administration fined the nursing facilities for violating Florida law by refusing to release the records.  The nursing homes filed a suit for declaratory judgment in federal district court seeking a ruling that HIPAA preempted the Florida law.  The district court issued the declaratory judgment and the Eleventh Circuit affirmed the district court’s ruling.  In doing so, the Eleventh Circuit observed that Florida law designating spouses and attorneys-in-fact as those who may demand access to a deceased resident’s medical records did not require that these individuals be acting “on behalf” of the resident to receive the medical records.  On the other hand, the HIPAA privacy regulations specifically required a personal representative to be acting on behalf of the deceased resident and that the protected health information to be released had to be relevant to such personal representation.  Based on this discrepancy, the court concluded that Florida law affords nursing home residents less protection than HIPAA and, thus, is preempted by HIPAA.