Recently in Medical Category

Now that U.S. District Court Judge Roger Vinson has declared the entire Patient Protection and Affordable Care Act (PPACA) void because it is unconstitutional, implementation should cease, states the Association of American Physicians and Surgeons.

While the Judge did not issue an injunction prohibiting implementation, he stated that his "declaratory judgment is the functional equivalent of an injunction." This is so because of the long-standing presumption "that officials of the Executive Branch will adhere to the law as declared by the court."

The Obama White House, however, called the decision "a plain case of judicial overreaching," and intends to proceed without interruption to carry out the law. Two courts have now declared the individual mandate unconstitutional, while two have upheld it. The Supreme Court will ultimately resolve the issue.

"Whenever the legislature passes a law that progressives object to, such as regulations on abortion, courts immediately stay enforcement," notes AAPS executive director Jane M. Orient, M.D. But this case is apparently very different.

"Congress defied the will of American voters in passing the Act," she stated, "and now the Administration will defy the Court, spending billions of dollars on implementing the Act while the courts proceed."

Individuals and businesses are already being forced to alter their financial decisions in anticipation of the mandate's taking effect in 2014, the Judge noted.

The harm that many anticipate from the Act is shown by the 773 waivers that HHS has already issued to protect current benefits.

The Judge cited Congress itself concerning the dependence of the Act on the individual mandate. In fact, in including it, Congress was "essentially admitting that the Act will have serious negative consequences, e.g., encouraging people to forego health insurance until medical services are needed, increasing premiums and costs for everybody, and thereby bankrupting the health insurance industry."

The individual mandate is imposed to try to avert adverse consequences of the Act itself. Applying the Necessary and Proper Clause to justify it would have the perverse effect that the more disruptive a statute is, the more "necessary" a statutory fix would be.

"Senators need to abide by their oath to uphold the Constitution, and act promptly to repeal this unconstitutional bill," Dr. Orient stated.

SOURCE Association of American Physicians and Surgeons (AAPS)

A new report released today by the American Association for Justice (AAJ) illustrates how the civil justice system is the most effective force in uncovering abuses by corporate nursing homes and insurance companies that target elderly Americans.

There are 1.5 million elderly Americans currently residing in nursing homes - facilities that are now operated by mostly large corporate chains banking on the upcoming influx of baby boomers. Many of these vulnerable residents have suffered abuse by staff members and even died from dehydration or infection caused by inadequate care. The report explains how litigation has revealed this neglect and abuse and allowed residents and their families to hold offending corporations accountable.

"Corporate nursing homes and insurance companies have continually chosen to put profits ahead of the well-being of our most vulnerable population," said AAJ President Gibson Vance. "Where regulatory and legislative bodies have been unable to cope with this distressing rise of neglect and abuse of our elderly, the civil justice system has stepped into the breach."

A common theme in the report is abuse by insurance companies taking advantage of senior citizens. It highlights the story of a South Dakota farmer named Rudy, who was one of a flood of patients that companies signed up for long-term care insurance in the 1990s. Rudy moved into a nursing home at his doctor's suggestion, only to have his benefits cut after three years when the company declared his care was no longer "medically necessary," despite faithfully paying his monthly premium.

Thousands of seniors met similar fates as insurance companies miscalculated mortality rates and searched for ways to deny claims and cut off benefits, figuring few of their terminated policyholders would fight back. Trial attorneys across the country eventually found evidence of corporate programs aimed at terminating seniors' benefits, and helped stop these deplorable practices.

Unfortunately, while litigation has revealed incidences of abuse and neglect, many other offenses never see the light of day due to nursing homes inserting forced arbitration clauses in the fine print of lengthy admission contracts. Residents and their families often sign these contracts while under considerable stress and anxiety without realizing they are being stripped of their access to court. Congress has introduced legislation to ban forced arbitration in nursing home and other consumer contracts.

The report, titled "Standing up For Seniors: How the Civil Justice System Protects Elderly Americans," can be found at www.justice.org/seniors.  AAJ has previously released reports examining the role of the civil justice system in improving cars and the environment, which can also be found in the Research section of www.justice.org.

As the world's largest trial bar, the American Association for Justice (formerly known as the Association of Trial Lawyers of America) works to make sure people have a fair chance to receive justice through the legal system when they are injured by the negligence or misconduct of others--even when it means taking on the most powerful corporations.  Visit http://www.justice.org.

SOURCE American Association for Justice

SHARP INCREASE IN WHISTLE-BLOWER ACTIONS EXPECTED AS GOVERNMENT RAMPS UP EFFORTS AGAINST PHARMA COMPANIES

Fresh off his victory for a whistle-blower in the Forest Pharmaceuticals, Inc. lawsuit, attorney David Stone is setting his sights on the billions of dollars of settlements he expects awarded in future legal actions involving off-labeling marketing practices.

"The award of $313 million in the Forest Pharmaceuticals case is just the tip of the iceberg in comparison to the amount of off-label marketing kick-back settlements we'll see in the future," Stone said. "Pharmaceutical companies are under increasing competitive pressures. Unfortunately, in their attempts to increase product sales, many are engaging in deceptive and illegal conduct, which has endangered patients' health and even their lives, as well as cost taxpayers billions of healthcare dollars."

Stone, managing partner of Short Hills, NJ-based law firm Stone & Magnanini LLP, represented a physician who originally brought Forest Pharmaceuticals' illegal marketing practices to the government's attention in a 2001 False Claims Act lawsuit. Stone previously served as head of the False Claims Act department for renowned litigator, David Boies, and headed that firm's New Jersey office.

Stone explained that the Federal government is focusing more broadly on pharmaceutical industry marketing practices. The Department of Justice and the Office of the Inspector General are scrutinizing practices tied to relations between drug makers and the physicians who endorse their products; the content and distribution of product promotional materials; and the complex inter-relationship of manufacturers, physicians, insurers and others in the drug-delivery chain.

Forest Pharmaceuticals recently agreed to settle civil and criminal claims based on off-label marketing and kick-backs to physicians for the antidepressant drugs Celexa and Lexapro, and Levothoid, a drug used to treat hypothyroidism, for more than $313 million.  

Stone & Magnanini LLP specializes in False Claims Act cases in the pharmaceutical fraud area - initiating legal actions on behalf of individuals, as well as for third-party payers such as insurance companies and HMOs. The firm also works with pharmaceutical companies to review their existing practices and procedures in light of current DOJ and OIG policy-related initiatives. Visit www.StoneMagnaLaw.com.

On Thursday, July 22, a federal court jury found that Cornell University's Weill Medical College and a former faculty member submitted false claims to the National Institutes of Health on three separate occasions from 1999-2001 arising from a grant designed to train neuropsychologists for a research career in HIV/AIDS.

The grant was awarded by the NIH from funds specifically allocated by Congress for HIV/AIDS research.    A clinical neuropsychologist then at Cornell, Wilfred van Gorp, now at Columbia, applied for a training grant from NIH, promising to train post-doctoral fellows committed to a career in research in the neuropsychology of HIV/AIDS.

One of those fellows, Daniel Feldman, brought suit under a federal whistleblower statute, known as the False Claims Act, alleging that van Gorp and Cornell instead used the funds for inappropriate purposes, including requiring the fellows to see an excess of private fee-for-service patients with other medical conditions.  At trial, Dr. Feldman showed that of approximately 160 clinical patients seen by the fellows over five years on the NIH-grant, only three patients were HIV- positive.  Instead of seeing HIV- patients, the fellows often evaluated "medicolegal" cases, referred by insurance companies or attorneys who were in litigation over disability or worker's compensation claims, or criminal defendants.  Indeed, Dr. van Gorp was well-known for his expert witness testimonies for the defense of several high-profile criminal defendants in New York during that period, including mob boss Vincente Gigante and Andrew Goldstein, the "subway pusher."

The jury specifically found that, over the course of the five-year grant, Dr. van Gorp and Cornell knowingly submitted three progress reports containing false or fraudulent statements to NIH in order to continue the funding of the grant.  The original grant application had described a rich program of faculty and research resources, along with a detailed core curriculum, including courses in HIV/AIDS.  Dr. Feldman and his counsel, Michael J. Salmanson, of Salmanson Goldshaw, P.C. of Philadelphia, argued during the course of the 8-day trial that the original grant application and the subsequent progress reports contained numerous false statements designed to convince NIH to originally secure and then continue the funding.

Dr. Feldman agreed that the fellows had spent some of their time in research-related activities, but at least as much of that activity was related to medicolegal research as it was to HIV.  Indeed, Dr. van Gorp had argued in his initial grant application to the NIH that clinical work is a "springboard" for developing research activities, and considering the disproportionate number of medicolegal cases that the fellows evaluated, the focus of the their research followed.  Other key issues argued in the suit over the grant application and its progress reports were formal HIV-courses that were never taught, key faculty on the grant who were never introduced to the fellows, and a breadth of HIV-research to which the fellows were never exposed.

Although the jury concluded that the original application and the first progress report, which were submitted prior to the arrival of the fellows, did not contain any materially false statements, it apparently decided that once the training program was underway, the defendants falsely described the fellows' actual activities under the grant in a way that was capable of influencing the government to continue the funding.

Defendants denied making any false statements, and contended that, based on the subsequent career paths of the fellows, the grant had achieved its ultimate objective.  They argued that the program was akin to a car trip, and that it did not matter what route one took, as long as some of the fellows ultimately arrived at the desired destination - a career in HIV-related research. 

In his closing argument, Salmanson responded by asking the jurors to imagine that they had bought a car for a trip to California.  Although they make it to California, they then discover that the seller had rolled back the odometer to misrepresent the mileage. Salmanson argued, in essence, "Just because you made it across the country, does that mean you haven't been defrauded?  Of course you have." The nine jurors apparently agreed.

The issue of damages must now be decided by Judge William H. Pauley III, who presided over the trial.  Judge Pauley had previously ruled that the proper measure of damages is the amount of money paid by NIH as the result of the false claims.  Based upon the verdict, that is expected to be several hundred thousand dollars which, under the False Claims Act, will be automatically tripled.  Although the bulk of the money is returned to the government, Dr. Feldman will be entitled to what is known as a "relator's share" of the funds as a reward for bringing the fraud to the government's attention.  Defendants are also liable for reimbursement of his attorneys' fees and costs, which over the seven years of litigation since the case was filed in 2003, has reached several hundred thousand dollars.

Cornell was represented by Tracey Tiska, Brian Black and Eva Dietz at Hogan Lovells, Llp in New York.  Dr. van Gorp was represented by Nina Beattie of Brune & Richard.  Hogan Lovells had represented Cornell/Weill in two other whistleblower fraud cases.  One of those cases had been settled in part last year for $2.6 million, although the case is still ongoing.  In 2005, the New York City-based medical school paid a $4.4 million settlement to resolve charges raised by Kyriakie Sarafoglou, a pediatric endocrinologist, that it was using part of a $23 million NIH research grant for private patient care.

Dr. Feldman says he is relieved that the case has finally been decided, having first raised concerns to Dr. van Gorp and Cornell during his fellowship from 1998-1999.  In the ensuing years, he was compelled to abandon his academic career.  In 2003, Dr. Feldman went into the pharmaceutical industry where he has built a successful second career.  In 2008, Dr. Feldman was elected President of the Pharmaceutical Management Science Association and last year he was awarded the Pharmaceutical Market Researcher of the Year Award from the Pharmaceutical Market Research Group.  Happily, he resides with his partner near Princeton, NJ, where they rescue animals and do organic gardening.

Despite the outcome of the trial, Dr. Feldman is still disappointed by the lack of oversight of billions of taxpayer dollars awarded by the NIH to large academic institutions.  He feels that this remains a larger, unresolved issue.  "And being a federal whistleblower is not something you undertake without tremendous sacrifice.  Whistleblowers have to be willing to risk their careers, lose many of their work and social relationships, and wait for many years for justice.  In the end, prevailing certainly feels great and worth the cost to do the right thing."

Prime Healthcare Services (PHS) recently settled its long standing dispute with the Department of Managed Health Care (DMHC) related to a single instance of alleged "balance billing" as to Kaiser commercial enrollees.  At the time, "balance billing" was not illegal.  PHS' hospitals do not "balance bill," did not and do not report HMO enrollees to credit reporting agencies, and never collected a penny from the alleged "balance billing."  However frivolous the lawsuit, PHS felt it was in the best interest of all involved, including the taxpayers of the State of California, to resolve this matter.  The donations to community clinics provided for in the settlement are part of PHS' long standing commitment to community clinics.  PHS has already donated hundreds of thousands of dollars to community clinics and operates three free clinics in the Inland Empire.  The donation of $600,000 to the community clinics and $600,000 to the Prime Healthcare Services Foundation for the development of community clinics is but a small portion of PHS' planned charitable giving in 2010.  PHS' hospitals provided more than $120 Million in charity care to the uninsured and indigent in 2009 and PHS' founder, Dr. Prem Reddy, has donated hundreds of millions of dollars to charity.

Now that no "balance billing" is the law (which PHS supported so as to keep patients out of the middle of disputes between HMOs and providers), the root cause of balance billing (i.e., unfair payment practices by HMOs) must be addressed.  Unfortunately, the DMHC and its Director, Lucinda Ehnes, have done nothing to address the unfair payment practices of HMOs.  To the contrary, Director Ehnes has used her tenure as Director of the DMHC to create a "safe haven" for HMOs and their unfair business practices.  A culture has developed at the DMHC where HMOs feel protected and free to commit unfair payment practices knowing that the DMHC will take no action.  This leaves the providers on the frontline of healthcare delivery (hospitals and emergency physicians) to fall victim to the HMOs' unfair practices.  In these economic times where the ranks of the uninsured seeking care in emergency departments is ever increasing, the escalating abusive practices of HMOs are putting the already fragile healthcare safety net at risk of failure.  Many hospitals are financially faltering and closing their doors as a result.  The department that is supposed to curb these abusive practices has gone "native" and become the protector of HMOs.  If the DMHC does not take action to address such unfair practices, the healthcare safety net will be threatened.

PHS is the largest for profit hospital system in California and was recently ranked among the Top 10 Health Systems in the Nation by Thomson Reuters for quality patient care.  PHS is the only for profit system to receive this recognition and the only health system west of the Mississippi to be among the Top 10.

A Miami-area resident who owned and operated an HIV infusion clinic was arrested today and charged for her alleged participation in a $23 million HIV infusion Medicare fraud scheme, the Departments of Justice and Health and Human Services (HHS) announced.

An indictment unsealed today in U.S. District Court in Miami charges Flor Crisologo, 58, with one count of conspiracy to defraud the United States, to cause the submission of false claims to the Medicare program, and to pay health care kickbacks; one count of conspiracy to commit health care fraud; and three counts of submitting false claims to the Medicare program.  Crisologo also is charged with one count of conspiracy to launder the proceeds of her crimes and four counts of money laundering.  Crisologo made her initial appearance today in U.S. District Court in Miami before Magistrate Judge William C. Turnoff. 

According to the indictment, Crisologo was the owner and operator of J & F Community Medical Center Inc.  The indictment alleges that Crisologo submitted approximately $23 million in false and fraudulent claims to the Medicare program for HIV injection and infusion services purportedly provided through J & F.  According to the indictment, Crisologo hired a physician at J & F and caused the physician to order unnecessary tests, sign false medical analyses and diagnosis forms, and authorize treatments to make it appear that medical services were being provided to patients who were Medicare beneficiaries.  The services included medically unnecessary injection and infusion therapies.  The indictment alleges that Crisologo and her co-conspirators paid Medicare beneficiaries kickbacks to induce the beneficiaries to claim they received legitimate services at the clinic when in fact the HIV infusion services were either not provided or were not medically necessary. 

According to the indictment, Crisologo engaged in a scheme to launder the proceeds of the fraudulent Medicare claims by, among other things, transferring thousands of dollars in proceeds to two shell corporations that she owned and controlled, ABC Med Way Inc., and MSG Investment and Services Corp.

The maximum sentence for each count of conspiracy to defraud the United States and filing false claims is five years in prison.  The maximum sentence for each count of conspiracy to commit health care fraud, conspiracy to commit money laundering and money laundering is 10 years in prison.  The indictment seeks forfeiture of assets held by the defendant. 

An indictment is merely a charge and defendants are presumed innocent until proven guilty.

Today's charges were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; John V. Gillies, Special Agent-in-Charge of the FBI's Miami field office; and Special Agent-in-Charge Christopher Dennis of the HHS Office of Inspector General (HHS-OIG), Office of Investigations Miami office.

This case is being prosecuted by Trial Attorney Joseph S. Beemsterboer of the Criminal Division's Fraud Section.  The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division's Fraud Section and the U.S. Attorney's Office for the Southern District of Miami.  

Since their inception in March 2007, Strike Force operations in seven districts have obtained indictments of more than 560 individuals who collectively have falsely billed the Medicare program for more than $1.2 billion.  In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to:www.stopmedicarefraud.gov.

SOURCE U.S. Department of Justice

The debate over physician-assisted suicide and the right of incurably suffering people to end their own lives has again been brought to national attention by the HBO premiere of "You Don't Know Jack," on the HBO pay-channel, April 24th. The film is based on the book "Between the Dying and the Dead: Dr. Jack Kevorkian's Life and the Battle to Legalize Euthanasia," by Neal Nicol and Harry Wylie.

Jerry Dincin, president of Final Exit Network (FEN), urges watching (or taping!) this important movie: "While the right to die exists for residents in Oregon, Washington, and Montana, most states still have laws specifically against assisted suicide. Regulators in many parts of the country have ramped up efforts to restrict the right to die with dignity. Groups that simply provide information and counseling have come under the gun-sights of zealots, and a witch-hunt has ensued."  

The needs of mentally competent, suffering patients who have not been declared "terminal" (having fewer than six months to live) have especially not been addressed. "Non-terminal" is an awesome designation when accompanied by the diagnosis of a lethal disease, in spite of the phrase's encouraging sound. It means that for that patient, a process has already begun: a deadly, inexorable deterioration that will likely multiply exponentially past the limit of most human beings to endure. Its merciful end is death, though that destination lies currently off the map. Quality of life for these people is a distant memory; all that remains is the reality of an indefinite and hopeless future. Dincin says, "Our organization is their only advocate."

Advances made in medicine over the last 50 years have been astonishing. Thanks to sophisticated new technologies and treatments, diseases once considered death sentences are now manageable conditions. The progress is often, however, a mixed blessing. Doctors' once-revered vow to keep patients alive - no matter what - often results not in extending life but extending death. Perpetuating "life" in a nightmare of powerlessness, constant pain, social isolation, and mental deterioration is tantamount to torture.

FEN is an all-volunteer organization dedicated to counseling, support, and guidance for those clients, who themselves choose the when, how, under what circumstances, and especially IF, to proceed. Dincin stresses that "FEN does not encourage anyone to end their life, does not provide the means to do so and does not actively assist in the person's death. We do, however, believe in the ultimate human right of people to end their lives when circumstances justify, and to have support in carrying out their plan," said Dincin.

Kaiser Foundation Hospitals - Kaiser Sunnyside Medical Center, Kaiser Foundation Health Plan of the Northwest and Northwest Permanente P.C., Physicians & Surgeons (collectively, Kaiser NW) has agreed to pay the United States $1,830,322.41 to settle False Claims Act liability, the Justice Department announced today. The United States contends that Kaiser NW billed Medicare between 2000 and 2004 for hospice services that had been provided by the Kaiser Northwest Region Hospice without obtaining written certifications of terminal illness required under the federal health care program.

Medicare hospice care providers like Kaiser Northwest Region Hospice must obtain written certifications of terminal illness for each hospice beneficiary's initial certification period (the first 90 days of care) from the medical director of the hospice and the individual beneficiary's attending physician, if the beneficiary has one. Medicare requires a hospice to obtain these certifications prior to billing Medicare in order to help ensure that hospice care is medically necessary.

In June 2005, Kaiser NW submitted a report to the Department of Health and Human Service's Office of Inspector General disclosing that between October 2000 and March 2004, there were instances in which Kaiser NW did not obtain written certifications of terminal illness for hospice beneficiaries prior to billing Medicare for the beneficiaries' initial certification period. The settlement announced today resulted from the company's disclosure.

"By requiring that health care providers comply with Medicare's standards, we ensure that beneficiaries receive hospice care that is medically necessary and meets appropriate medical standards," said Tony West, Assistant Attorney General for the Justice Department's Civil Division. "We encourage disclosures of this nature and we consider them essential to ensuring the protection of the Medicare Trust Fund."

"This settlement furthers the strong public interest in protecting the integrity of the Medicare program and ensuring the appropriateness of hospice care for Medicare beneficiaries," said Kent Robinson, Acting U.S. Attorney for the District of Oregon.

The case was handled by the Justice Department's Civil Division, the Acting U.S. Attorney for the District of Oregon and the Office of Inspector General of the Department of Health and Human Services.

SOURCE U.S. Department of Justice

Attorneys with the personal injury law firm of Sheldon J. Schlesinger P.A., won a $14 million jury verdict on behalf of a local father and optometrist left bed-ridden and paralyzed resulting from a botched, unnecessary procedure seven years ago.

According to the suit, heard by Judge Charles Green in Broward County Circuit Court, Francis Ziadie was suffering dizziness and slurred speech when he arrived at the emergency room at Memorial Regional Hospital in Hollywood in May 2002. Doctors there gave him aspirin and the anti-platelet medication, Plavix. His symptoms subsided on medical therapy. Ziadie was admitted overnight for observation.

The next morning, Ziadie complained of short-term slurred speech and numbness in his hand. A CAT scan and magnetic resonance angiography showed no evidence of a stroke. Doctors diagnosed transient ischemic attacks caused by left internal carotid artery dissection, or a separation of the inner layer of the carotid artery. The aspirin / Plavix regimen is considered standard of care, as in most cases, the dissection will heal itself within three to six months, said Crane Johnstone, Ziadie's lead trial attorney from Schlesinger Law Firm in Fort Lauderdale. Valerie Conzo was co-counsel on the case.

Hoang Dinh Doung, M.D., an interventional neuroradiologist from Radiology Associates of Hollywood, P.A. was consulted. Doung recommended an immediate procedure to insert a stent into the artery. During the procedure, Doung punctured the arterial wall. Because Ziadie was on large doses of blood thinners, blood flowed from the puncture, pooling around his brain. In the recovery room, Ziadie had slurred speech and right-sided weakness. Instead of addressing his problems, nurses sedated him. By the time doctors realized the problem hours later, the bleeding had caused massive pressure damage to the brain stem and caustic damage to brain tissue. Ziadie, at one time an active 46-year-old optician and father of four, was discharged almost three months later after extensive rehab. Today, he spends his days in a hospital bed and wheelchair in the home of his 76-year-old mother, Olivia, who cares for him round-the-clock.

"The jury realized that this was a preventable injury, and that Mr. Ziadie should never have undergone that procedure," Johnstone said. "His legs are paralyzed, he has no bowel or bladder control. He struggles to string sentences together. He can't even get out of bed or feed himself."

Defense counsel from Bunnell, Woulfe claimed Mr. Ziadie suffered from a rare "reperfusion injury." Another defendant, David M. Feldbaum, MD, a surgeon who was part of the team treating Mr. Ziadie, was found not liable.

The five-man, one-woman jury didn't buy Dr. Duong's argument, and returned a verdict in under six hours. In determining damages, the jury found that Ziadie, now 53, will require skilled nursing care for the rest of his life. Johnstone also argued successfully that the best care will be provided to Mr. Ziadie in his home, as opposed to a nursing facility. The jury awarded $5 million to Mr. Ziadie for his future care needs, and $8 million for pain, suffering and mental anguish. Francis Ziadie's minor sons were each awarded $250,000.

SOURCE Boardroom Communications

In response to President Obama's remarks on medical liability reform in his address to Congress, DMLR Chairman Stuart L. Weinstein, M.D. issued the following statement:

"In his address to Congress, I was pleased to hear President Obama acknowledge that medical liability reform is needed to lower costs and reduce the practice of defensive medicine. While I appreciate his commitment to state demonstration projects, it is my hope that Congress will heed the President's words and take action to include comprehensive federal medical liability reform in pending health care legislation.

"Medical liability reform is not a Republican or Democratic issue. It is a patient issue. Members of Congress on both sides of the political aisle, health care policy experts, opinion leaders, and patients across the country agree that our nation's medical liability system is broken and needs to be fixed. Most recently, Senate Majority Leader Harry Reid, and House Majority Leader Steny Hoyer have both talked about the problems with the current system -- problems like excessive jury awards, and too frivolous lawsuits. This hurts patients by threatening their access to quality medical care when they need it and by increasing health care costs for all Americans. These are issues that must be addressed if true health care reform is to be achieved.

"We must work together to find a solution to our health care and medical liability systems that first and foremost protect patients -- one that is more effective, more efficient, and one that puts more money in the hands of patients, not personal injury lawyers. States across the country have enacted medical liability reforms with a proven track record of success that should be a model for federal reform efforts.

"On behalf of Doctors for Medical Liability Reform and Protect Patients Now, I look forward to working with the President and the Congress as the health care reform debate evolves in the coming months, and hope that leaders from both parties in Congress step forward to stop medical lawsuit abuse once and for all."

SOURCE Doctors for Medical Liability Reform

When New York State and City agreed on July 20th to repay the federal government nearly $540 million to settle whistleblower-sparked Medicaid false claims allegations, it ended a lone whistleblower's long struggle to correct speech therapy billing problems in an upstate New York county and across the state. When improper billing wasn't corrected, the whistleblower sued on behalf of the federal government under the qui tam provisions of the federal False Claims Act ("FCA"), New York City qui tam whistleblower attorney David A. Koenigsberg of Menz Bonner & Komar LLP revealed.

"The information and cooperation that my client provided led directly to the U.S. Department of Health and Human Services' audits that ultimately confirmed the state-wide billing problems that are the subject of this historic settlement," Koenigsberg said.

"As a result, New York State and City agreed to pay the seventh largest whistleblower settlement in the largest government False Claims Act Medicaid case in United States history," Koenigsberg added. "The value of whistleblower law in repatriating federal dollars back to United States taxpayers should be crystal clear."

An April 2000 report by the former U.S. General Accounting Office, now called the Government Accountability Office, stated that Illinois, Michigan, and New York accounted for more than 60 percent of total school-based medical claims, while New York accounted for 44 percent of that total. When the Inspector General's audits were released New York officials loudly criticized the agency's methodology and conclusions. With today's settlement the city and state did not admit liability, nor did the federal government concede that its claims were not well founded.

Under the agreement settling allegations of improperly billed pre-school and older students' speech, physical and occupational therapy, psychological counseling and transportation over a seven-year period, New York State will pay approximately $331,879,000 and allow the federal government to retain approximately $108,000,000 of nearly $303,000,000 it withheld for questionable billing during a seven-year period ending in December 2008. New York City will pay $100,000,000.

Additionally, New York State agreed to enter into a "Program Compliance Agreement" with the federal Centers for Medicare & Medicaid Services ("CMS") governing the manner in which the state Department of Education offers future School and Preschool Supportive Health Services Programs. This agreement is believed to be the first of its kind between the federal government and a state or local government. It is similar to Corporate Integrity Agreements reached with private entities settling Medicaid fraud allegations.

"Billions and billions of stimulus, bailout, TARP and related recovery dollars are being pumped into the economy now by the federal government. In the years to come, the money-saving value of the False Claims Act and concerned-citizen qui tam whistleblowers who step forward to do the right thing will be proven again and again," John Menz, name partner of Koenigsberg's firm predicted.

Federal lawsuits unsealed in the United States District for the Northern District of New York with the settlement:

98-CV-1929 (TJM) (DEP), U.S. ex rel. Cirrincione v. Larry D. Tingley, et al.; and 99 CV 2082 (TJM) (DEP), U.S. ex rel.. Cirrincione v. Thomas Hamel, et al.

The complete Menz Bonner & Komar LLP news release will be posted athttp://www.PRforLAW.com and on a new Menz Bonner & Komar LLP Web site to be launched in the near future.

SOURCE Menz Bonner & Komar LLP

PARKER WAICHMAN ALONSO LLP, one of the nation's premier plaintiffs' litigation firms today obtained a monumental Sixty Million ($60,000,000) Dollar verdict in a medical malpractice action awarded to a Bronx woman, Allison Hugh against Ferdinand A. Ofodile, M.D., a Queens County Plastic Surgeon.

Alison Hugh went to Dr. Ofodile for a thigh lift procedure. As a result of the procedure, Ms. Hugh sustained significant injury and deformity to the labia of her vagina which is permanent and cannot be surgically corrected.

Dr. Ofodile failed to inform and provide Ms. Hugh with informed consent and failed to inform her of the risks involved in this type of procedure including the risk of vaginal opening and deformity. Dr. Ofodile failed to use proper surgical techniques by leaving too much tension in the skin of her groin area.

The Bronx jury found that Dr. Ofodile failed to appropriately advise Ms. Hugh about the risks of this type of procedure and that Dr. Ofodile deviated from good and accepted medical practices in his surgical technique.

The jury unanimously awarded Ms. Hugh Ten Million ($10,000,000) Dollars in past pain and suffering and Fifty Million ($50,000,000) Dollars in future pain and suffering.

The case was tried by Andres F. Alonso, a partner in the law firm of Parker Waichman Alonso LLP who has consistently obtained large verdicts and multi-million dollar settlements.

SOURCE Parker Waichman Alonso LLP

The mother of an autistic child joined Consumer Watchdog and its attorneys today to announce a lawsuit against the California Department of Managed Health Care ("DMHC"), the Schwarzenegger Administration agency responsible for regulating many of California's health insurers. The suit alleges that the DMHC has wrongfully allowed insurance companies to refuse to pay for autism treatments, resulting in the denial of critically needed, medically necessary treatment for autistic children.

The suit, filed by Consumer Watchdog and Strumwasser & Woocher LLP, alleges that the DMHC, and its Director Cindy Ehnes, recently changed the state agency's policy to permit insurers to deny coverage for Applied Behavioral Analysis ("ABA"), an essential treatment for autism, in plain violation of the California Mental Health Parity Act. That law requires health insurers to cover and pay for all medically necessary treatments for autism, including ABA. If successful, the suit would require the DMHC to bar insurers from refusing to cover medically necessary ABA treatments. The suit also seeks to compel the DMHC to turn over records that would expose the full extent of the DMHC's violations of the California Mental Health Parity Act and the Knox-Keene Act.

"Californians, including those stricken by autism, and their parents and caregivers, expect regulators to enforce the law, not to side with insurance companies seeking to boost their profits by denying patients the care they need," said Harvey Rosenfield, founder of the non-profit advocacy group Consumer Watchdog and author of the landmark insurance reform initiative Proposition 103. "Governor Schwarzenegger, a longtime and vocal supporter of the Special Olympics and developmentally disabled children, will now have to explain in court why his administration is allowing health insurers to evade state mental health laws and shift health care costs to already beleaguered taxpayers."

Governor Schwarzenegger, who appointed the current Director of the DMHC, has received $711,200 in campaign contributions from Blue Cross, Kaiser and Blue Shield -- three health insurers regulated by the DMHC that commonly deny coverage for autism treatments.

The DMHC's actions upholding heath insurance denials for medically necessary autism treatment puts children at risk by forcing parents to seek treatment through over-stretched taxpayer-funded programs, or to forgo treatment altogether.

"HMOs and health insurers are denying autistic children the most effective medical treatment that is available, with severe consequences for them, their families, and the state's taxpayers," said Fredric D. Woocher, lead counsel in the suit. "Insurance companies are blatantly violating California law. Yet the Department of Managed Health Care is not only standing by and doing nothing to prevent these violations; it is actually supporting the insurers as they abandon autistic children and their families."

Insurer's New Tactic in the Battle to Avoid Paying for Autism

ABA is a form of behavioral therapy that has been scientifically proven to improve brain function in autistic children. For years, insurance companies refused to pay for ABA on the grounds that it was "experimental" and that there was insufficient medical evidence to show that it was an effective treatment for autism. But the evidence supporting the efficacy of ABA is now overwhelming. The Centers for Disease Control and Prevention, the National Institute of Mental Health, and the United States Surgeon General all agree that behavioral interventions, such as ABA, are a critical component of any comprehensive autism treatment program.

According to the lawsuit, until March of this year, health care consumers were able to appeal an insurer's denial of ABA through the DMHC's Independent Medical Review ("IMR") system, in which a treatment denial is reviewed by a team of doctors that is unaffiliated with the insurance company that denied the treatment and independent of the DMHC.

The suit alleges that as the IMR doctors increasingly overturned insurer treatment denials, compelling the insurers to pay for ABA, insurers privately urged the DMHC to change its procedures and process the treatment denials through the DMHC's own internal grievance review system. Unlike the IMR system, in which independent doctors evaluate whether a treatment should be provided on the basis of whether it is medically necessary and effective, the grievance system is conducted by DMHC staff, who are not doctors and who simply defer to the insurers' determination of whether the claim is even covered by their health care policies.

"Health insurers want to re-write the law to benefit their bottom line and the regulators are holding the pen," said Pam Pressley, Consumer Watchdog's Litigation Director. "California's mental health laws are clear: doctors get to decide whether care is needed, not insurance company bureaucrats or government lawyers."

Consumer Watchdog has learned that the health insurance industry mounted a lobbying campaign to convince the Schwarzenegger Administration that ABA is an "educational" program not covered by health insurance policies. On March 9, 2009, the DMHC issued a memo indicating that the agency would review ABA and other autism treatment denials through the DMHC's internal grievance system as urged by insurers.

Consumer Watchdog has evidence that the DMHC has in fact upheld the insurers' denials of ABA on coverage grounds in violation of the Mental Health Parity Act. That law requires insurers to pay for any "medically necessary" and effective autism treatment -- a decision that must be made by independent doctors, not by insurance company bureaucrats or government lawyers.

Kristie Sepulveda Burchit, mother of Aidan who suffers from autism, joined the group to announce the lawsuit. Kristie's insurer, Blue Cross, first refused to provide ABA in 2008 on the ground that it was not medically effective as a treatment for autism. Kristie requested an IMR and the independent physicians who reviewed her appeal overturned the Blue Cross denial. Then, in 2009, shortly after the DMHC issued its March 9 memo, Blue Cross again refused to pay for Burchit's continued ABA autism treatment, this time on the basis that it supposedly was "not covered" by Kristie's health insurance policy because ABA is an "educational service." Burchit has now appealed the denial to the DMHC through the grievance system and is awaiting a decision from the regulator. Consumer Watchdog said that if it wins the lawsuit, the DMHC would have to order Blue Cross to provide ABA treatment for Aidan.

The suit also alleges that the DMHC and its Director Cindy Ehnes:

• Illegally instituted a policy of denying ABA treatment on the ground that providers were inadequately licensed, despite the fact that the law clearly requires health insurers to cover all medically necessary treatments for autism, including ABA, whenever such services are either provided or supervised by a licensed or certified professional.
• Illegally withheld public documents properly requested under the California Public Records Act, which would expose how the DMHC conducts its "grievance system" and would reveal the full extent of the DMHC's violations of the mental health parity law.

Nearly 1 out of every 150 children born in the United States is diagnosed with autism. As of December 2007, the California Department of Developmental Services provided care to nearly 37,000 Californians with autism.

SOURCE Consumer Watchdog

One of America's leading health-care multinationals, Baxter Healthcare Corp., now faces a class action lawsuit over the effects of its blood thinning drug, Heparin. The lawsuit alleges that the multinational substituted safer, natural ingredients with cheaper chemical ingredients that were not approved by the United Stated FDA.
Joyce Ann Osteen, a class plaintiff, is suing Baxter over Heparin in St. Clair County Circuit Court. Her claim is that, the company began substituting organically prepared Heparin with a more dangerous ingredient in order to make greater profits.
Originally the drug is made from pork intestines that have been cooked and dried. The lawsuit states that, the intestines of about 3,500 pigs are required to produce a mere 2.2 pounds of raw Heparin. This crude Heparin is then processed to remove impurities and results in the production of an active pharmaceutical ingredient (API) such as Heparin Sodium or Heparin Lithium.
The suit further states that the company found a much cheaper way to make their products. They identified a molecule similar to Heparin in Heparin Sodium. Around March 19, 2008, the Heparin-like molecule was identified as over-sulphated chondroitin sulphate (OSCS).
The cheaper alternative is not natural and is not approved by the United States.
Soon after Baxter discovered this new substitute, there was an abnormal increase in the number of patients who were adversely reacting to Heparin. During this time, around January 17, 2008, Baxter issued several press releases recalling nine lots of Heparin Sodium injection multiple dose vials. On February 28, 2008 they expanded their recall to include all lots and sizes of their Heparin products.
Osteen states that, the FDA announced their discovery of the mysterious contaminant on March 19, 2008.
The lawsuit alleges that, as of April 8, 2008, there have been 103 reported deaths in connection with the administration of Heparin to patients since January 1, 2007. Of those deaths, 91 were reported to have occurred after January 1, 2008.
To read more about the case click here.

Four trainers who were wrongfully notified that they had EPO positives and were hence prevented from entering events at the Red Mile, have filed a lawsuit against the premier, harness- racing institution, for the adverse publicity they received as a result of the declaration.
Jan Johnson, Jim Arledge, Jr., Bob McIntosh and Joe Seekman are suing the Red Mile for defamation. They are seeking a reimbursement for the cost of the additional testing, lost entry fees, potential lost purse earnings and attorney costs.
The four trainers were cleared of the doping allegation after more stringent and dependable tests were conducted to detect the hormone erythropoietin which is used to boost the formation of RBCs in the bloodstream. This form of doping is called blood doping and is used to improve an athlete's aerobic capacity and endurance. That because an increased RBC count directly causes an increase in the oxygenation of muscles. Blood doping can be done in several ways. To read about blood doping click here.
To read more about the case first reported in the Lexington Herald-Leader click here.

We have all heard about punitive damaged being awarded in civil cases. In a malpractice lawsuit against a physician however, juries rarely award punitive damages to a plaintiff. Such claims are not covered under traditional medical liability insurance. So a verdict for punitive damages would mean that the physician has to pay the amount from his own resources.
That is exactly what unfortunately befell New Jersey rheumatologist, Robert A.Fogari. A Hudson County jury unanimously handed out a $400,000 award against him in October last year for his alleged refusal to pay for a sign language interpreter for a patient who is hearing impaired. Half of the amount has been awarded to the plaintiff as punitive damages.
This verdict is amongst the largest of its kinds and has got physicians worrying about it being an indicator of a trend.
Fogari's was treating Irma Gerena for lupus since the beginning of May 2004. Gerena alleges that on more than one occasion she requested Dr Fogari to provide her with a sign language interpreter which she further claims he refused.
Dr Fogari's argument was that the cost of an interpreter was one that he, as a solo physician, was unable to afford (the estimated cost for this service is around $150 to $200 per visit). Besides, Medicare only reimbursed him with $49 per visit. To compensate for the lack of an interpreter, Dr Fogari claims that he exchanged written notes with Gerena with the help of her family members.  
Gerena has not claimed medical negligence. Her only allegation is, that because of the lack of an interpreter, she never fully understood the diagnosis, treatment or prognosis for her illness. Thus, she claims, she was not able to fully participate in her medical treatment.
To read more about the case click here.

A rare malpractice lawsuit has been filed against two Broward County doctors allowing punitive damages. Normally, patients who file malpractice cases are allowed to seek only compensatory damages covering medical expenses, lost pay and pain and suffering. However, in this case, the judge allowed punitive damages meaning that the conduct of the doctors was above and beyond the normal malpractice warranting the payment of damages as a punitive measure.
Thomas Glasson, a former lawyer, claims his plastic surgeon lied to him about his role in the surgery. His surgeon, Hollywood Fla. Plastic surgeon Jonathan Weiser, failed to inform Glasson about his peripheral role in his surgery which was performed by Pembroke Pines, Fla. Surgeon Jason Frost. Glasson alleges that the surgery was being performed to remove a small growth under his enlarged breasts but the surgeon completely removed both his breasts, leaving his chest disfigured. Glasson further alleges that Weiser, who was supposed to work with Frost on the surgery, to provide an 'acceptable cosmetic result', did not participate in the surgery at all. However, he billed Glasson's insurance company for performing the surgery with Frost.
Attorney Spencer Aronfeld of Aronfeld & Associates of Coral Gables, Fla., who represents Glasson, stated that Weiser altered hospital records as well as his office records in order to hide his misconduct. Aronfeld also stated that Weiser destroyed his hard drive with Glasson's records.
In his complaint, Glasson stated that he would not have agreed to the surgery if he knew that only Frost would be performing it.
To read more about the case click here.

Hollywood star, Dennis Quaid and his wife, Kimberly will get $750,000 from Cedars-Sinai Medical Center where their newborn twins were administered lethal doses of the anticoagulant heparin, last year.

Workers at the medial center administered the newborn twins a dose of the blood thinner, 1000 times the normal dose.

The settlement only covers the parent's damages but the Quaids can still file lawsuits on behalf of their children.

The hospital on its part, denied any wrongdoing although, at the time of the overdose, which was administered to several patients apart from the twins, the hospital's chief medical officer called the incident a 'preventable error, involving a failure to follow standard policies and procedures'.

The Quaids had also filed a lawsuit against the maker of the blood thinner saying that their packaging was confusing but their claim was dismissed.

Pic courtesy public citizen from flickr.com

 

Allstate insurance company recently filed a lawsuit against Haranath Policherla M.D. P.C. d/b/a Pointe Neurology, Advanced Neuro-Rehab services based in Michigan, as well as against Dr. Haranath Policherla, seeking the return of money paid by them against insurance claims for services rendered by the institution.
The insurance corporation alleged that the individuals and entities of the institution were involved in the fabrication of medical procedures and diagnoses for the sole purpose of charging their patients money that would in turn be paid by their insurance companies. They also alleged that the institution billed patients for services not rendered, that they gave unnecessary referral for medical services and that they related non-existent medical symptoms to motor vehicle accidents.
Allstate seeks damages in excess of $25,000 to reimburse the money they have spent in funding false claims.

An Alabama based Attorney General recently filed a lawsuit against the Centers for Medicare and Medicaid Services for making policy changes that allegedly help them grab portions of settlements and awards that have not been collected by the state yet.
Attorney General Troy King says that the federal Medicaid agency ignores and refuses to comply with his Freedom of Information Act (FOIA) request to view records pertaining to its recent policy change. These changes comprise the subject of his lawsuit against CMS.
King has also filed a lawsuit against CMS on behalf of Alabama's Medicaid agency. This was done five days after the state submitted its FOIA request to CMS.
To read the whole article click here.

An official document filed by the Los Angeles County while assessing the death of Edith Rodriguez in the waiting room of Martin Luther King Jr.- Harbor Medical Center on May 9, 2007, has declared that her life could have been saved if only she had been properly treated.
Rodriguez's last moments of agony were captured on security videotape as she waited for over 45 minutes for someone to listen to her. The video shows how a triage nurse dismissed her complaints and how a janitor mopped the floor around her. This evidence of the indifference shown to Rodriguez made national news and angered county supervisors and national health authorities as well as residents of the county.
Rodriguez's boyfriend who accompanied her to the hospital and called 911 from a nearby pay phone after no one would help her, received $250,000 as a settlement from county supervisors. Her children are filing a separate lawsuit which could prove to be costlier for the hospital.
Shortly after she was arrested on an outstanding warrant - instead of being treated- Rodriguez died from a perforated bowel. 
This payout would be the latest in a long history of settlements that the hospital has had to make in the past for poor patient care. The hospital has been closed for a while now.
The internal county assessment was not meant for public circulation but was made public when lawyers working for the county mistakenly included it in a recent court filing.
Rodriguez's children have asked for $1 million for every minute that she was denied treatment, totalling $45 million.
To read the whole article click here.

A nursing home patient is suing Huntsville Emergency Medical Services Inc., Huntsville, Alabama, after she was accidently dropped from a gurney on a sidewalk on November 25 this year. Ruby Crocker, 95, is suing HEMSI for punitive and compensatory damages for the incident which took place last month while she was being taken to Madison Manor Nursing Home in Madison.
The lawsuit which does not list the alleged injuries that Crocker suffered from, states that on arriving at the Madison Manor Nursing Home from an undisclosed location, staff of HEMSI dropped Crocker on a concrete sidewalk causing her to suffer from painful physical injuries and mental anguish.
The suit asks for a jury trial and seeks unspecified monetary damages.

Doctors, who failed to diagnose a patient suffering from sepsis in time, are now facing a lawsuit that seeks unspecified damages. The patient, Tabitha Mullings, 32, was left a quadruple amputee as well as partially blind, after suffering from severe sepsis.
In a separate lawsuit, Mullings who is a mother of three, had passed the court officer's exam and was looking forward to a career in the court system. She is also suing the city and emergency medical services and the fire department for $100 million in damages.
On September 14, Mullings was admitted to the Brooklyn Hospital Center in Fort Greene complaining of serious pain. Doctors diagnosed her as having a kidney stone and discharged her. The following day, Mullings called 911 twice as she was still in severe pain but both times paramedics told her that she did not require hospitalization. It was only when her fiancée brought her back to the hospital that doctors diagnosed a severe septic infection. Mullings was put into a medically induced coma for approximately two weeks. During this time, the sepsis had progressed quite far and she lost blood circulation to all of her extremities. Thus both her hands and feet had to be amputated. She was also left legally blind.
The lawsuit alleges that the two doctors who interacted with her when she first visited the hospital, failed to perform blood tests or complete physical examinations on her despite the fact that she had tell- tale symptoms of nausea, and pain in her right flank.
In her Notice of Claim, Mullings alleges that paramedics failed to follow procedure when they did not hospitalize her after she made two 911 calls within 24 hours.    
She is represented by Sanford A. Rubenstein of Brooklyn.

More than five companies, who produce drugs to combat symptoms of menopause, have decided to reach settlements with angry patients, who claim that their products cause cancer.
Bristol- Myers Squibb Co. and Solvay SA are amongst the seven companies whose drugs, Estrace and Estratest respectively, have landed them in a lawsuit with over 1,000 women who contend that the drugs caused them to develop breast cancer.
These estrogen- based drugs offer hormone replacement treatment for women with menopause to alleviate symptoms such as hot flashes, night sweats and mood swings.
A 2002 study linked the use of these drugs with the prevalence of breast cancer amongst women certain age.
Zoe Littlepage, a Houston based attorney representing some of the women, stated that the trial did not include Wyeth and Pfizer Inc., the two largest manufacturers of HRT drugs. Bristol- Myers and Solvay face the most claims over their HRT drugs, more so than Wyeth or Pfizer.
The trial which has been going on for three months will be presided over by judge William Wilson of the U.S. District Court.

A former top official at Staten Island University Hospital who filed a defamation lawsuit against the hospital suffered defeat when jurors in Long Island federal court denied his claims.

Former executive vice president Joseph A.Psani filed a case against SIUH claiming that he had been made a scapegoat in a Medicaid fraud case. Jurors declined to award Pisani damages, fidning that the SIUH had not libelled him as he had alleged.

In his lawsuit Pisani alleges that the hospital, its president, Anthony C.Ferreri and its chief executive officer, had publicly humiliated him when they announced a $76.5 million settlement with Eliot Spitzer, then state attorney general, over fraudulent billing practices from 1998 to 2000. As a result of the settlement, Pisani was relieved from hi $480,000 position as executive vice president of Westchester County Health Care Corp. where he was working at the time of the SIUH settlement in May 2005.

For further details of the case read the complete article on SILive.com here.

Acne medication Accutane manufactured by pharmaceutical maker, Hoffman- La Roche has put the company in trouble yet again. Three Florida based residents who used the medication as teenagers developed acute long term Inflamatory Bowel Disease (IBD). The plaintiffs, represented jointly by law firms Hook Bolton, Seeger Weiss and Beggs & Lane, alleged that the manufacturer failed to provide adequate warning of the possible condition to the three patients who developed IBD as soon as they began using the product in their teens.
An eight person jury in Atlantic City found the pharmaceutical company guilty and awarded compensatory damages of $12.8 million to be divided between the three individuals.
This trial, which lasted five weeks, is one of several that links the use of Accutane to IBD. Nutley, NJ based Roche is fighting cases all over the country over allegations that Accutane was a cause of severe bowel maladies.
Kelly Mace, 25, of Pensacola, along with Jordan Speisman, 27, of Gainesville and Lance Sager, 28, of Ft Lauderdale were prescribed the drug nearly a decade ago to relieve adolescent acne. All three succumbed to various forms of IBD as a result of which, Mr Speisman will undergo a surgical removal of his colon while all three of them face an elevated rick of colon cancer in the future.
To read a complete account of the negligence of the pharmaceutical company that was forewarned about the dangers of the medication, click here.

Reaching an $894 million deal, drug giant Pfizer Inc has settled most of its lawsuits over the withdrawal of its pain reliever Bextra which has been linked to an elevated risk of heart attacks and strokes. Not having to pay as much as its rival, Merck & Co, Pfizer is planning on ending 92 percent of its law suits with this agreement.

To read the complete article click here.

A spate of cases involving divorced people who are suing former spouses for giving them potentially deadly diseases such as AIDS is throwing up a number of ethic related questions.

Is a person liable for giving a sexually transmitted disease to a partner? What if a person doesn't know if that she or he is infected? What if the person does not know for sure, but has behavioral patterns that increase the risk of infection?

The law states that a person who knows that he or she has an infectious disease and either deliberately or recklessly passes on the infection to another can be civilly, and sometimes criminally, liable.

In one case, the Maine Supreme Judicial Court ruled that a wife who sued her husband for giving her  HPV was not entitled to damages because the husband had no symptoms and may not have known he had the disease.

Recently, a jury in Iowa awarded $ 1.5 million to a woman who sued her dentist boyfriend for infecting her with HPV.

William Gilson of New York City sued the Westchester Square Hospital for allowing his mother's corpse to decompose. The suit said that the body of Veronica Gilson was left in a heated hallway for 38 hours because the hospital's morgue was overcrowded.

Gilson said the corpse had decomposed so badly that he couldn't hold an open casket wake and funeral.

A jury has awarded Gilson $1 million and the hospital says it may appeal.

The trial of a lawsuit filed by Linda Reeves of Benton against Wyeth Pharmaceuticals, claiming that the hormone replacement therapy drug Prempro caused her breast cancer, is scheduled to begin on August 21 at Little Rock, Arkansas.

This trial is the first of about 4500 lawsuits against Prempro, and will be watched with interest by consumers, the pharmaceutical and legal communities. Millions of women have taken Prempro, to ease the symptoms of menopause such as hot flashes or osteoporosis.

A clinical study of the drug in 2002 found that Prempro users faced an increased risk of breast cancer, stroke and heart disease.

Read

Sutter Health has settled a class-action lawsuit brought by uninsured patients who said they were overcharged for care and targets of aggressive billing practices.

The settlement of over $ 275 million was approved by a Sacramento Superior Court judge. This allows thousands of patients to make refund claims of between 25 percent and 45 percent of their prior hospital bills.

As a condition of the settlement, Sutter Health's pricing policies for the uninsured must be comparable to insured patients for the next three years, and its hospitals must adopt more compassionate bill collection policies for patients who fall behind on payments.

The class action includes anyone who received hospital services from a Sutter-affiliated hospital between Sept. 3, 2000, and Aug. 3, 2006 and were uninsured at the time of treatment.

The settlement is valued at $275 million, but could increase substantially as the number of plaintiffs could reach into the hundreds of thousands.

Sacramento-based nonprofit Sutter Health is Northern California's largest hospital chain. Among its 26 affiliated hospitals are Alta Bates Summit Medical Center in Oakland and Berkeley, Eden Medical Center in Castro Valley, Mills-Peninsula in Burlingame, California Pacific Medical Center in San Francisco and Sutter Antioch.

The lawsuit was initiated in September 2004 on behalf of uninsured patients, including a Berkeley man who was billed $4,600 for treatment of a minor hip injury.

Read our previous post about Catholic Healthcare West in a similar settlement.

A Florida jury awarded almost $4 million to Kathleen Leer who suffered a brain injury when an intravenous tube was removed at a hospital three years ago.

The lawsuit claimed that Leer suffered a stroke and brain damage when removal of a central line at Largo Medical Center caused an air embolism. Her lawyer said Leer now suffers from left-side paralysis and cognition problems that require 24-hour care from her husband. 

Attorneys for the hospital argued that the line's removal did not cause Leer's injury and that "some or all of these damages" were based on pre-existing conditions. Leer, a chronic pain patient, was admitted to the hospital with a dislodged catheter in her lower back.

Hospital officials said they are considering an appeal.

Margaret Mueller and her partner Charlotte Stacey are suing two doctors who treated Mueller for ovarian cancer when she actually had cancer of the appendix. The suit says that she underwent years of unnecessary and devastating treatment while the cancer spread.

Mueller and Stacey have been domestic partners for 21 years and were joined in a civil union in Connecticut in 2005. Now Stacey is also suing the doctors for the harm to her relationship, known as a loss of consortium claim. Before the law granted gay couples the same rights as heterosexual married coupled in Connecticut, only a married partner could seek that compensation.

Attorneys for the doctors said they have no plans to challenge Stacey's right to be included in the lawsuit.

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A Houston jury has ruled that Johnson & Johnson are to pay $ 773,000 to the family of Michaelynn Thompson, who died after wearing a defective drug patch. No punitive damages were awarded in this case, the first one involving drug patches.

Thompson was wearing a patch that delivers controlled, hourly doses of fentanyl, a commonly used anesthetic that in high doses can turn off the respiratory center in the brain.

A lawyer for the Thompson family says that a leak on the patch she was wearing greatly increased the dose of the painkiller Thompson received. A test by a private-lab showed the level of fentanyl in Thompson's blood was about ten times what it would have normally been for pain-killing.

Johnson and Johnson said it disagrees with the outcome of the wrongful-death trial, in which eleven out of 12 jurors decided the Duragesic patch Thompson wore was defective.

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In 2004, the Wisconsin Supreme Court had ruled that families of malpractice victims who die could collect damages only for wrongful death and not for pain and suffering.

On Friday, the court overturned its own ruling and reinstated a $ 1.2 million award to the family of Helen Bartholomew, who suffered a heart attack and died after a doctor misdiagnosed her.

Victims should be eligible for both wrongful death damages and pain and suffering damages because they are separate causes of action, Chief Justice Shirley Abrahamson wrote in the majority opinion for four justices. The damages are capped under Wisconsin law - to $350,000 for wrongful death for adults, $500,000 for wrongful death for children and $750,000 for pain and suffering.

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Charles Lennon, the North Providence man who had sued Dacomed Corporation over a faulty penile implant, has decided to accept a $400,000 judgment instead of a retrial. With interest dating from 1996, he will receive about $ 1 million.

Lennon was implanted with a Dacomed Dura-II penile prosthesis in 1996. The implant would not remain in the down position and Lennon experienced pain during intercourse.

In 2004, a jury awarded Lennon $750,000. Later a judge lowered that to a $400,000 judgment. After appeals by both sides, the Rhode Island Supreme Court on Friday gave Lennon 20 days to decide whether to take the $400,000 or have a new trial on damages.

Lennon, 68, a retired handyman, decided to take the money. Lawyer Albert R. Romano said Lennon did not want to face the "agony" of another trial. Also, the company that made the implant, Dacomed Corporation, is bankrupt, and it had a limited insurance policy, he said.

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A class action lawsuit against a number of health insurers filed by a group of physicians has been dismissed by a Miami federal judge. The lawsuit claimed that the insurers had used claims processing software to delay, reduce and deny payments to hundreds of thousands of physicians

The judge dismissed all claims against UnitedHealthcare Inc., UnitedHealth Group Inc. and Coventry Health Care Inc.. These three companies were the last defendants as some of the other insurers in the case -- including Aetna, Cigna, HealthNet, Humana, Prudential and Wellpoint -- had settled for hundreds of millions of dollars during the past few years.

But United and Coventry continued to fight, and U.S. District Judge Federico A. Moreno has ruled that there is not enough evidence that the two insurers conspired to underpay doctors.

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California and 10 local prosecutors have reached a $1 million settlement with diet-pill maker Nutraquest Inc., manufacturer of the best-selling diet pill, Xenadrine RFA-1. The lawsuit accused the company of using deceptive techniques to sell weight-loss products that contained ephedra.

Nutraquest had claimed that the drug was "clinically proven to increase fat-loss by an unprecedented 1,700 percent," and is "the only diet supplement in the world clinically proven to increase fat loss by an extraordinary 38.6 times more than diet and exercise alone."

The Food and Drug Administration banned ephedra in April 2004 after it was linked to dozens of deaths and thousands of reports of health problems such as heart attack or increased blood pressure. Nutraquest filed for bankruptcy protection in 2003 after a flood of lawsuits claiming the ephedra in Xenadrine caused medical problems, including at least one death.

As part of the settlement announced Thursday, Nutraquest president Robert Chinery has to pay $600,000 in civil penalties and $400,000 in costs.

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Catholic Healthcare West, that has 40 hospitals in California, Nevada and Arizona, has agreed to reimburse approximately 800,000 uninsured patients for excessive charges. This will settle a class action lawsuit that the hospital group faced, claiming that uninsured patients were routinely charged up to five times the amount paid by insurers or government programs for the same services.

The settlement amount is expected to run into hundreds of millions of dollars. The settlement also allows the patients to be compensated in medical care.

Catholic Healthcare West spokeswoman Tricia Griffin said the company had altered its billing methods in 2004 and agreed as part of the settlement never to overcharge the uninsured.

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Goldie Claude, 86,  of Waverly, is suing her doctors for malpractice after they removed a healthy kidney from her body during surgery instead of one with a cancerous tumor.

In a CT scan done in February, Dr. Kenneth Hawkins at the Horizon Medical Center in Dickson first correctly identified that the left kidney had the cancer.  But later in his report, Hawkins wrote that the right kidney had the cancer. The error was not noticed during transcription or review of the report.

Claude is suing both Hawkins and Dr. Michael Spalding, the surgeon who removed her right kidney at Centennial Medical Center in Nashville. Both hospitals and their parent company, HCA Inc., are named in the lawsuit, which seeks unspecified monetary damages.

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A Washington hospital and its insurance carrier have won $4.1 million against a Louisiana hospital and two doctors who gave excellent recommendations for a doctor without disclosing his drug problem.

Dr. Robert Lee Berry had been diverting the narcotic Demerol from patients for his own use while working in Louisiana. Two of his partners and the administration at Lakeview Regional Medical Center in New Orleans knew of his drug problem, but failed to disclose it to officials at Kadlec Medical Center.

Instead, they offered "glowing letters of recommendation" for him to Kadlec. Dr Berry, an anesthesiologist, was involved in a 2002 surgery at Kadlec Medical Center  that left a woman severely brain-damaged. Kadlec Medical Center and Seattle-based Western Professional Insurance filed suit in U.S. District Court in Louisiana, alleging fraud and misrepresentation.

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The Manhattan Institute Center has published a report 'Trial Lawyers, Inc.: Health Care ' examines the impact of the "litigation industry" on health care. This is the third in a series of reports published by the center on 'Trial Lawyers, Inc."

The report finds that litigation is a large contributor to the health care bill, and pharmaceutical litigation also exacts a staggering cost on the economy. Litigation exposure is many times more than the annual research and development budgets of the pharmaceutical companies. Litigation has targeted all levels of health care, including nonprofit hospitals, nursing homes and managed-care providers.

Malpractice suits have inflated the cost of health care by encouraging "defensive medicine" - unnecessary procedures and referrals that doctors prescribe in order to limit their liability.

Product liability lawsuits are also frightening companies away from innovations that would lead to health improvements, not only for American society, but for the entire world.

Finally, the report concludes that medical litigation hardly protects or compensates the actual victims, who often receive less than 50% of the damages, the rest going to lawyers and administrative fees.

Read "Harvard Study Finds 40% Malpractice Suits Baseless" posted on May 11.

Read the Manhattan Institute Center report

Mary Stewart, 72, had to have her foot amputated after an 18-day-stay at Renova Health Center resulted in maggot infestation.  Stewart sued the nursing home and its parent company, Universal Health Management. A Palm Beach County Circuit Court jury awarded her about $1.3 million in damages.

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A Harvard University study has found that 40 percent of the medical malpractice cases filed in the U.S. are groundless. The report said that many of the lawsuits analyzed contained no evidence that a medical error was committed or that the patient suffered any injury.  While most of these dubious cases were dismissed with no payout to the patient, groundless lawsuits still accounted for 15 percent of the money paid out in settlements or verdicts.

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The Senate will soon be deliberating on two bills that would cap the damages juries can award in medical malpractice cases.

One of the bills seeks to limit damages on all types of medical malpractice litigation and another would apply only to cases brought against obstetrician-gynecologists.

Sen. John Ensign's bill would cap judgments against a physician or health care professional at $250,000. It also would allow patients to be awarded up to $250,000 against one health care institution. Judgments against more than one institution would be capped at $750,000.

The other bill, sponsored by Sen. Rick Santorum, would impose similar caps on awards against doctors and institutions providing gynecological and obstetric care. The cap on awards from multiple defendants would be $500,000.

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A jury awarded damages of $ 2.9 million to a woman for the wrongful death of her son.  Tabatha Smith's 21-month-old son died in January from severe brain injuries suffered during birth.  The obstetrician, Dr. Brett Zimmerman, the hospital, Bay Park Women's Health, and ProMedica Health System were the defendants.  Ms Smith's attorney, Robin Smith, said the baby was deprived of oxygen for nearly six minutes during delivery and that the hospital could have prepared for a safe delivery if a thorough diagnosis and examination of her client had been done.

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A jury has awarded $ 20 million to the estate of Loren Richards who died while in the care of Beverly Health and Rehabilitation of Frankfort.  The nursing home had "deprived or infringed upon" the patient rights of Richards to be free from mental and physical abuse and had not immediately informed relatives of a downward turn in his health. The jury awarded total compensatory damages of $200,000. Two nurses were also found culpable in the death of Richards and must pay $ 500 each in punitive damages. Richards' daughter, Wanda Delaplane, had sued the home, alleging that nurses had ignored her father's repeated complaints of abdominal pain. Richards later died of a heart attack and a blood clot in his left lung.

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An appeals court has affirmed the verdict in a medical malpractice suit involving a Caesarean delivery that caused brain-damage to the baby, but has asked the opposing sides to reduce the $ 30 million award. Regina Harris of Cleveland was in labor in 1987, when she was forced to wait for two hours for an emergency Caesarean delivery. The resultant lack of oxygen caused her son to be born with brain damage. In May 2004, a jury in Cuyahoga County Common Pleas Court awarded Harris and her son $15 million in economic damages and an additional $15 million for pain and suffering. After the appeals court asked the opposing sides to reduce the damages awarded, the plaintiff’s attorney predicted that the total damages would not reduce substantially, while the lawyers representing the medical center and the pediatrician said a resolution would not be easy.

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Bausch & Lomb already face a number of lawsuits alleging it failed to warn the public about a contamination problem with its Renu with MoistureLoc solution. Now a 69 year old woman has filed the first lawsuit that claims the product caused the loss of an eye. Zoe Wade alleges that she developed a fungal infection within a few weeks of starting to use the product, and seven months later, had to have her eye removed. Seven other people are seeking class-action status to their suits against Bausch & Lomb.

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Candice Cross of St. Charles, who suffered a burn during breast augmentation surgery two years ago was awarded $127,920 by a jury in St. Louis County Circuit Court . Cross suffered burns when a hot “sizer” was placed on her breast by the surgeon, Dr Scheu. A sizer is a device placed on the breast at the start of the procedure to size the implant to be used, and is sterilized by washing and heat treatment. The jury awarded Cross $100,000 for future noneconomic damages, such as mental anguish and embarrassment, and $25,000 for past noneconomic damages, such as pain and suffering. It also gave her $2,920 for past economic damages - half the cost of her surgery.

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