Legal Questions Flashcards
LEGAL QUESTION – ANTICOMPETITIVE PEER REVIEW
Case led to the development of HCQIA
Patrick v Burget, US Supreme Court 1988
Plantiff underwent cosmetic surgery with poor outcomes. Patient learned of other complaints against doctor and hospital therefore sued for negligent credentialing
Garland Community v Rose
Hospitals owe patients a duty of care
Laminectomy negligently performed.
MD had history of unnecessary of negligent surgeries
Gonzales vs Nork & Mercy Hospital, 1968
Denial of application due to physicians liability to work with others, no
quality of care issues identified
Miller vs Eisenhower Medical Center
LEGAL – PERSONALITY MAY BE CONSIDERED
MD denied privileges after reports from other hospitals on
termination/restriction of privileges
Rao vs Auburn General, 1978
LEGAL – DOCTRINE OF OSTENSIBLE AGENCY
HMO Found liable in patients death. Chest perforation during biopsy, chest pain/MI six weeks later
Boyd vs Albert Einstein Hospital, 1988
LEGAL QUESTION – NEGLIGENT CREDENTIALING
Hospital liable for failure to request data from another hospital regarding it’s summary suspension of practitioner
Bell v Sharp Cabrillo Sospital, California, 1989
LEGAL QUESTION – FAILURE TO DISCLOSE
Ophthalmologist did not disclose all prior hospital affiliations on application
Oskooi vs Fountain Valley Regional Health Center–California 1996
LEGAL QUESTION – HCQIA
Burden on physician to prove bad faith peer review
Matthews vs Lancaster General Hospital – Tennessee, 1996
LEGAL QUESTION – DUTY TO CREDENTIAL
Application denied when physician refused to authorize prior hospital to release information
Webman vs Little Company of Mary Hospital – California, 1995
LEGAL QUESTION – DISRUPTIVE BEHAVIOR
Hospital revoked physicians privileges
Mahmoodian vs United Hospital Center – West Virginia, 1991
LEGAL QUESTION –
Managed care organization found liable for providers actions due to negligent credentialing
McClellan vs health maintenance Organization of Pennsylvania, 1996
LEGAL QUESTION - GOVERNING BODY IS ULTIMATE AUTHORITY
Board overturned hearing committee recommendation to reinstate call
panel membership
Hongsathavig vs Queen of angels Hollywood Presbyterian – California, 1998
LEGAL QUESTION –
The managed care organization in this case was not held liable for negligent credentialing because state law granted immunity to not-for-profit health plans
Harrell vs Total Health Care - 1989
LEGAL QUESTION – ANTI-TRUST
MD brought anti-trust suit against the hospital after his application was
denied
Robinson vs Magovern - 1981
