Case Studies Flashcards
1991 Case: Johnson V Misericordia
Dr. Lester salinsky Performed Orthopedic Surgery to Remove a Pin from the Johnson’s right hip during the procedure, Johnson’s femoral nerve and artery were severed causing permanent damage and paralysis to his leg.
Negligence: failure to verify credentials.
This legislation prohibits a physician with a financial arrangement with an entity from referring Medicare or Medicaid patients to that entity.
Stark Law
This federal law was enacted for the purpose of encouraging good faith professional review activities
Health Care Quality Improvement Act of 1986 (HCQIA)
Mathew V Lancaster General
Anti-trust Laws: Committee found substandard care on peer review. Burden on physician to prove bad faith peer review. Surgeon challenged judgement, presumption of good faith upheld. 1996
Patrick V Burget
Anti-trust laws: anticompetitive peer review - physician conducted peer review for anti-competitive reasons liable for violating federal anti-trust laws led to development of HCQIA 1988.
Robinson V Magovern
Anti-trust laws: doctor filed suit against the hospital after his application was denied - 1981. Court found hospitals may determine proper limitation on competition within the hospital and surrounding area. Careful and thorough adherence to bylaws that contain objective criteria required. Denial of application is not a restraint of trade. Hospital did this based on shortage of OR space.
Bell v Sharp Cabrillo
Negligent credentialing. Hospital liable due to its failure to request data from another hospital regarding summary suspension of practitioner at reappointment 1989.
Elam v College Park
Negligent credentialing: doctrine of corporate negligence - Hospital liable for podiatrist negligence, failed to obtain malpractice claims data although medical records department aware of claims 1982
Harrell v Total Health Care
Negligent credentialing: The HMO failed to conduct a reasonable credentials investigation, however a statute unique to Missouri conferred immunity on the HMO. In this case the MCO was not held liable for negligent credentialing because the state law granted immunity to non-profit health. 1989
Johnson V Misericordia Community
Negligent Credentialing: Failure to initial credentialing - hospital liable to patient injured by doctor who had failed to disclose pending malpractice cases and lied about privileges at another hospital. Should have verified information. 1981
Mahmoodian v United Hospital
Disruptive Behavior: court held that disruptive behavior must be patient care related. Denial of application due to physician inability to work with others, no quality of care issues identified. 1980
Rao v Auburn General
Disruptive Behavior: Personality may be considered - MD denied privileges after reports from other hospitals on termination/restriction of privileges. Personality may be considered if it affects ability to practice or hospital operations. 1978.
Boyd v Albert Einstein
Doctrine of ostensible: MCO/HMO found liable in patient’s death. Patients relied upon the HMO advertisement of physician and representation of quality health care. 1988
Darling v Charleston Memorial
Doctrine of charitable immunity/failure to have proper supervision - amputation of teenager’s leg. hospital’s are independently responsible for monitoring and supervision of care provided. Hospital claimed that charitable immunity doctrine limited damages to its insurance. 1965
Gonzales V Nork
1976: duty of care to patient: 36 negligent surgeries in 9 years. Joint Commission increased peer review standards because of this case.
Webman v Little Mary Hospital
Duty to credential: reasonable application requirements; burden of proof. Doctor refused to authorize prior hospital to release info - new hospital denied application. Court held for hospital. 1995
Oskoii v Fountain Valley
Failure to disclose: ophthalmology did not disclose all prior hospital affiliation on application; hospital summary suspension upheld. 1996
Hongsathavij v Queen of the Angels Hoolywood
Governing body is ultimate authority; court upheld decision. Physician taken off back up panel for failing to accept patient; board overturned hearing committee recommendation to reinstate call panel membership due to lack of substantial evidence. 1998
McClellan v Health Maintenance of PA
Ostensible agency: duty to select and monitor providers; MCO found liable for providers action due to negligent credentialing. Ostensible agency. MCO liable for providers actions. 1996.
Kadlec Medical v Lakeview Anesthesia
Hospital knowingly withheld key information about practitioner substance abuse, when it responded to another hospitals request for affiliation verification. Hospital owed a duty not to misrepresent directly or by omission of material to an inquiring hospital.
Miller v Eisenhower Medical Center (California 1980)
denial of application based on inability to work with others, no quality of care problems - disruptive behavior must be patient care related.
Frigo vs Silver Cross Hospital (Illinois 2007)
patient alleged that podiatrist negligence in performing bunionectomy on an ulcerated foot resulted in osteomyelitis and subsequent amputation of the foot. Podiatrist did not meet initial or revised criteria for level II surgical privileges, but was granted privileges regardless. No grandfathering. Frigo claimed hospital’s breach of duty caused her amputation because of Dr. Kirchner’s negligence. The jury agreed and awarded her over $7.75 million - doctrine of corporate negligence - negligent credentialing - breach of duty
