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Hospital Negligence Lawsuit Dropped by Florida High Court

The Health Law Firm Attorney George F. Indest III HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On November 30, 2016, The Florida Supreme Court announced the decision to dismiss a negligence suit filed against a hospital over the death of patient Ashley Lawson.  Lawson escaped from Shands Teaching Hospital and Clinic, Inc.  The Shands psychiatric hospital is now known as the UF Health Shands Psychiatric Hospital and is located in Gainesville, Florida.

The main legal issue in this case was whether the conduct of the hospital was ordinary negligence or was medical negligence (medical malpractice).  In Florida, if the facts alleged constitute a claim for simple negligence, then there are no pre-suit proceedings required, no medical expert witnesses required, and it is usually much easier and much less expensive to try the case.  However, if the facts stated in the suit are medical negligence allegations, then there are a number of procedural hurdles that a plaintiff must overcome.  Additionally, the case is usually much more expensive and time consuming to try.

Patient Was Mentally Ill.

Ashley Lawson was admitted to the hospital on November 1, 2012, because of a psychiatric illness, impulsive behavior, drug abuse and several suicide attempts, according to reports.  According to her estate’s initial jurisdictional brief, Lawson was transferred to the locked impatient unit at Shands for her own safety.

Lawson Allegedly Freed Herself.

According to reports, an employee’s badge and keys were left unattended, which gave Lawson the opportunity to free herself and escape on January 23, 2013.  Lawson died soon after she had escaped.  She was struck and killed by a tractor trailer on Interstate 75.

A Request To Reconsider The Ruling.

On November 15, 2016, the Florida Supreme Court abandoned its denial of a motion from defendant-appellee Shands Teaching Hospital and Clinics, Inc. asking it to reconsider its ruling from September 13, 2016.  The earlier ruling denied a motion for voluntary dismissal filed by the plaintiff, the Estate of Ashley Lawson.  The court’s earlier denials had decided not to dismiss the case by a 4 to 3 split decision, with Chief of Justice Jorge Labarga and Justices Barbara J. Pariente, James F.C. Perry and R. Fred Lewis in the majority and Justices Ricky Polston, Charles Canady and Peggy Quince dissenting.

Since the ruling on November 15, 2016, Lawson’s estate had relinquished its right to file a brief on the merits, noting that the parties are “contractually prohibited from further litigation in this matter.”  This language seems to indicate that a settlement had been reached between the parties.  Shands Hospital filed a motion on November 27, 2016, looking for instructions on its due process rights and its counsel’s duty to proceed.  Shands stated:  “Respondent believes it should be entitled to submit a merits brief to this court and present oral argument since, as this court has made apparent through its orders, it views this case as involving an important issue of statewide impact.”

Where Do You Draw The Line?

This case in particular has raised questions on where the line should be drawn between medical negligence and ordinary negligence.  However, in the motion for reconsideration, Shands Hospital stated that there was no certification of a question of great public importance or a certified district conflict made in the lower court’s decision in the case.

Shands Hospital’s motion to dismiss the case had been denied by the trial court.  Shands then appealed the Florida First District Court of Appeal. The three-judge panel on the Court of Appeal was unable to come up with a definitive result, so the entire Court of Appeal decided to review the case and final reached a 8-6 decision to trump the lower court’s denial.

After that, Lawson’s estate brought the case to the Florida Supreme Court, seeking reversal based on its argument that the First District Court of Appeal’s decision allegedly conflicted with two Fifth District Court of Appeal decisions on what constitutes ordinary negligence versus medical malpractice (medical negligence).  The estate asked for an extension to file its initial merits brief, stating that the parties were discussing a settlement. On July 28, 2016, the estate filed a notice for voluntary dismissal because a deal was in place.

The Supreme Court took the position that the settlement notwithstanding, the Supreme Court should move forward with the case.  Court’s will often do this when they expect that the legal question will come up again and again in the future, unless they go ahead and decide it.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.  We represent medical students, interns, residents, and fellows in disputes with their graduate medical education (GME) programs.  We represent clinical professors and instructors in contract disputes, employment disputes, clinical privileges matters and other disputes with their employers.  We often act as the physician’s personal counsel in medical malpractice litigation.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com

Sources:
“Shands Teaching Hospital and Clinic Inc. v. Estate of Ashley Lawson.” FindLaw. (August 28, 2015). Web.

Hale, Nathan. “In Shift, Fla. High Court Drops Hospital Negligence Suit.” Law360. (November 30, 2016). Web.

“Justice Won’t Drop Case In Shands Vista Patients Death.” The Gainesville Sun. (September 16, 2016). Web.

“Court Sides With Hospital In Death of Escaped Patient.” Health News Florida. (August 31, 2015). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2018 The Health Law Firm. All rights reserved.

By |2018-06-21T22:37:37+00:00May 15th, 2018|Medical Education Law Blog|0 Comments

Memorial Sloan-Kettering Cancer Center Enters Business Alliance to Expand Into Florida

Attorney George F. Indest III HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On Wednesday, February 10, 2016, Memorial Sloan Kettering Cancer Center (MSK) and Miami Cancer Institute at Baptist Health South Florida (Baptist) announced a new “Cancer Alliance.” This unique alliance gives MSK a chance to expand its reach to Florida and bring the latest in clinical trials along with it. Hospitals such as Baptist, benefit greatly from Sloan-Kettering’s resources and impressive reputation. Memorial Sloan-Kettering Cancer Center is one of the most renowned cancer centers in the world and rated second for cancer care in the nation, according to a report by U.S. News & World.

Alliance Fulfills Fundamental Needs of Cancer Care in Florida.

Community hospitals in Florida, such as Baptist not only benefit from new resources, they will now have access to MSK’s physicians, latest treatment protocols and education resources. Baptist President and CEO Brian E. Keeley said its collaboration with MSK will save lives by bringing evidence-based, world-class treatment to its seven hospitals and more than 50 outpatient facilities throughout South Florida.

Baptist, which is based in Miami, is building a new $430 million cancer center on its main campus. It will feature South Florida’s first proton therapy center and will host advanced cancer fighting technologies.

Benefits For Both Institutions.

Baptist is not the only institution gaining from the alliance. MSK will gain access to hundreds of patients across the country for which clinical trials may be beneficial. The New York-based hospital will collaborate with physicians at Baptist on cancer treatments and clinical trials to introduce the latest and greatest therapies. In a statement, Dr. Craig B. Thompson, president and CEO of MSK said, “Today, we recognize the need to do more. Central to our mission is eradicating cancer, and through the MSK Cancer Alliance – and in collaboration with Miami Cancer Institute – we have a unique opportunity to share our knowledge and best practices with a wider patient population.”

In addition, clinical trials often attract more patients who are facing rare cancers and do not respond to conventional treatments. Which in return, gives the local hospitals the ability to gain valuable experience and become a well-known resource themselves.

To read the press release issued by MSK, click here.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At The Health Law Firm we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other health care provider. We represent facilities, individuals, groups and institutions in contracts, sales, mergers and acquisitions.

To contact The Health Law Firm, please call (407) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Goldberg, Dan. “Memorial Sloan-Kettering Cancer Alliance Expands to Florida.” Politico New York/AHLA. (February 10, 2016). Web.

Bendell, Brian. “Baptist Health’s cancer institute aligns with Memorial Sloan Kettering.” South Florida Business Journal. (February 10, 2016). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealth Lawfirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone; (407) 331-6620

KeyWords: Cancer Alliance, cancer business collaboration, Memorial Sloan-Kettering (MSK), Baptist Health South Florida (Baptist), Miami Cancer Institute, cancer research, clinical trials, advanced cancer therapies, advanced cancer fighting technologies, clinical trial defense attorney, health law attorney, Florida health lawyer, The Health Law Firm

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

By |2018-07-06T01:54:24+00:00May 15th, 2018|Medical Education Law Blog|0 Comments

Texas Appeals Court Affirms$1.37 Million in Sanctions Against Doctor who Sued Hospital Former Employers

Attorney George F. Indest III Headshot By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On November 16, 2016, an appeals court in Texas affirmed a $1.37 million sanction against a doctor. The physician was ordered to pay the fine after the dismissal of a defamation lawsuit he filed against his former employers. The decision affirmed that the actions of his former employers, Baylor College of Medicine (Baylor) and Texas Children’s Hospital, did not cause the litigation fees which the court assessed to the doctor as sanctions.

The case had previously made its way up to the Texas Supreme Court, which makes the November 16, 2016, opinion the second time the Texas Fourteenth Court of Appeals has weighed in on the case. Additionally, it is the second time it has held the sanctions were merited for Dr. Rahul K. Nath.

The Back Story of the Case.

According to the opinion, Dr. Nath was employed by Baylor as a plastic surgeon and was affiliated with Texas Children’s Hospital. He was fired in 2004 and in February 2006 filed a lawsuit against his former supervisor at Baylor and Texas Children’s. According to court documents, Dr. Nath had accused his former supervisor of making defamatory statements about him after he stopped working. The alleged defamatory statements included that Dr. Nath had been fired, was unqualified and lacked professional ethics and integrity. (Note: We are just stating what was alleged in the lawsuit.)

To read the opinion in full, click here.

Were the Former Employers Responsible for the Accumulated Attorney and Litigation Fees?

The court was considering whether the behavior of Baylor or Texas Children’s was ultimately responsible for the fees accumulated litigation fees and expenses in the case. Previously, the trial court found that both Texas Children’s and Baylor’s actions had not caused the expenses for which Dr. Nath was sanctioned. The trial court wrote that the amount was appropriate as it was “far less” than the actual fees incurred by either party in defending Dr. Nath’s claims.

On appeal, Dr. Nath argued that the trial court hadn’t held a proper evidentiary inquiry, that it had based its sanctions award on “conclusory and self-serving” affidavits. Dr. Nath claimed that he was wrongly denied discovery in the case. To learn more about Dr. Nath’s challenge, click here.

Despite Dr. Nath’s arguments, the Fourteenth Court disagreed, holding that the trial court followed the exact instructions from the Supreme Court before deciding to impose the sanctions. Additionally, the court found that there was evidence in the record to support the conclusion that neither Texas Children’s nor Baylor’s conduct caused the expenses that were passed on to Dr. Nath as sanctions.

Adequate Supporting Evidence.

The first time the case came before the Fourteenth Court of Appeals, it affirmed the sanctions against Dr. Nath. The high court held that there was evidence to support the trial court’s finding of bad faith and improper purpose on Dr. Nath’s part with regard to certain filings in the case.

Dr. Nath appealed, and the Texas Supreme Court held that the trial court didn’t abuse its discretion in finding the doctor had exercised bad faith and improper purpose in certain filings. The high court remanded it back to the trial court to consider to what extent, if any, Texas Children’s and Baylor’s actions may have “caused the expenses for which recovery is sought.”

After a hearing, the trial court determined that neither employer’s behavior caused the expenses, and again imposed the sanctions against Nath. In appealing that ruling to the Fourteenth Court of Appeals, Dr. Nath argued that the trial court had made procedural errors in hearings and evidence submission in reaffirming the sanctions.

The trial court granted Texas Children’s and Baylor’s motions in June 2010, and also sanctioned Dr. Nath $726,000 for a portion of Texas Children’s fees in defending the suit and $644,500 for a portion of Baylor’s. The Fourteenth Court of Appeals affirmed that ruling, and Dr. Nath appealed to the state Supreme Court.
To learn more about defamatory statements and how to handle such claims, click here to read one of my prior blogs.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in Centers for Medicare and Medicaid Services (CMS) investigations, Medicare Audit defense, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Knaub, Kelly. “Texas Appeals Court Affirms Doc’s $1.3M Sanction.” Law360. (November 16, 2016). Web.

Knaub, Kelly. “Doc To Challenge $1.3M Sanction Before Texas High Court.” Law360. (January 15, 2014). Web.

“Texas Appeals Court Affirms Doc’s $1.3M Sanction.” LexisNexis. (November 16, 2016). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for health care professionals, health law defense attorney, legal representation for defamatory statements against health care professionals, legal representation for defamation lawsuit against a healthcare professional, healthcare litigation defense attorney, legal counsel for health care professionals, Legal representation for clients involved in the health care industry, reviews of The Health Law Firm, The Health Law Firm attorney reviews, The Health Law Firm
“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

By |2018-07-09T19:54:20+00:00May 15th, 2018|Medical Education Law Blog|0 Comments

Contracting 101: Tips for Physicians and Health Professionals – Part 3

Attorney George F. Indest III Headshot By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

This blog is the first in a series intended to provide an introductory review of the basics of contracting for medical graduates entering the work force as residents and fellows, primarily by discussing employment agreements. We will highlight many of the common provisions found in employment contracts, along with many of the mistakes and pitfalls that we see in our day-to-day practice.

By the end of this series it is our hope that medical graduates will better understand the common language and terms found in employment contracts for professionals. These tips purpose to assist new professionals in recognizing common mistakes made by physicians and health professionals when negotiating contract terms. We hope to help make both employers and employees more knowledgeable about employment contracts so they can avoid potential problem areas and legal entanglements.

Our comments here are meant to provide general rules we have learned from our experience. However, please remember, every situation is different and there are exceptions to every rule. These tips are not intended to constitute legal advice. We recommend contacting an experienced health attorney for questions or concerns regarding specific employment contracts, or to thoroughly review all of the contract terms prior to acceptance.

The first part of the series can be found here. The second part of the series can be found here.

Tip 6 – Be Sure That You Receive a Signed, Dated Copy Back Before You First Start Working.

If you are an employee, be sure that you receive a copy of the contract back that has actually been signed and dated by the employer. One of the most common legal problems we encounter when we consult with an employee whose employer has broken the contract is the absence of a signed or dated copy of the contract. Anyone can type up a blank contract. There may be many preliminary drafts of a contract that are not agreed to or executed by the parties. How can you prove that this is the actual agreement between the parties if you do not have a copy that is signed by the parties?

Tip 7 – Make Sure That all Exhibits, Schedules, Addendums and Referenced Documents are Attached to the Contract.

We often see contracts which refer to attached exhibits for job requirements, bonus calculations, benefits, employer handbooks, employer code of ethics or conduct, etc. However, in many cases these are not completed or not attached to the contract when it is signed. Make sure that any documents that are referred to by the contract are actually attached to it and are completed.

These are part of the contract. Your copy of the contract is not complete without them.

Tip 8 – Amend the Contract, By Hand if Necessary, to Make It Consistent with the Agreement of the Parties.

A contract is not a sacred document. You may write on it, if necessary, to amend it. You may also attach separate handwritten amendments to it. Just make sure any handwritten changes on the contract itself are initialed by each party. Make sure any amendments attached to it are signed and dated by each party to the contract. Remember, also, that the changes must be understandable. If a judge is later called on to read it and interpret it, it must be clear to the judge.

Under the general rules used to construe contracts, typed changes and amendments to preprinted forms take precedence over the preprinted portions. Handwritten changes and amendments take precedence over typed or preprinted portions, and spelled out numbers and dates supercede numerical ones (if there is a conflict). However, there must be evidence that these were agreed to by both parties (such as initials or signatures prove).

Future Blogs on Employment Contracting.

In our future blogs, we will continue to provide tips on various issues to watch for in health care employment contracts.

Contact a Health Care Attorney Experienced in Negotiating and Evaluating Physician and Health Professional’s Business Transactions.

At the Health Law Firm we provide legal services for all health care providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, durable medical equipment suppliers (DME), medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other health care provider.

The services we provide include reviewing and negotiating contracts, preparing contracts, helping employers and employees enforce contracts, advice on setting aside or voiding contracts, litigation of contracts (in start or federal court), business transactions, professional license defense, opinion letters, representation in investigations, fair hearing defense, representation in peer review and clinical privileges hearings, litigation of restrictive covenant (covenants not to compete), Medicare and Medicaid audits, commercial litigation, and administrative hearings.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: physician employment agreement, physician employment contract, health professional contracting, negotiating business transactions, physician contracts, contracting tips, contract attorney, business law attorney, business lawyer, contract lawyer, contract litigation, business litigation, contract terms, physician agreements, business transactions, restrictive covenants, noncompetition agreements, covenants not to compete, business ventures

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

By |2018-07-09T19:57:06+00:00May 15th, 2018|Medical Education Law Blog|0 Comments

New Analysis Shows Number of Residency Positions Keeping Up With Increase in Medical Graduates

i4Perfection150429-1A6A0291-Edit-EditBy Ritisha K. Chhaganlal, J.D.
According to a study done by the Association of American Medical Colleges (AAMC), the number of students enrolling in medical schools has reached an all-time high.

In 2014, the total number of applicants rose by 3.1 percent. AAMC President, Darrel G. Kirch M.D., expressed concerns regarding the availability of residency training positions for aspiring doctors. Dr. Kirch stated: “As we face a worsening shortage of both primary and speciality physicians over the next two decades, Congress must increase federal support for residency training by lifting the 17-year-old cap on residency training positions imposed under the Balanced Budget Act.” To read the AAMC’s press release in its entirety, click here.

It is unsurprising that medical students across the nation are concerned about securing a residency position after graduation. However, an analysis conducted by The New England Journal of Medicine (NEJM) suggests that this General Medical Education (GME) “squeeze” is actually not as severe as many believe.

History Behind Medicare Resident Limit Caps.

The Balanced Budget Act of 1997 (BBA) was established to cap the number of residents and fellows for the purposes of calculating Medicare reimbursements against each hospital’s most recent cost report. There are a few exceptions; the BBA cap on the number of residents does not apply to new programs in underserved rural areas for three years. After three years, these programs are considered to have enough time to fill their residency cohorts.

The Medicare program is the largest source of funding for GME. Given this limit of funding, many believe that it will also limit the number of residents and fellows.

Analysis Indicates Growth in Entry-Level GME Positions.

The NEJM studied data from the Accreditation Council for Graduate Medical Education (ACGME), AAMC, and the American Association of Colleges of Osteopathic Medicine (AACOM), for the time periods of 2004-2005 and 2013-2014. The NEJM found that entry-level GME positions increased from roughly 25,000 in 2004-2005, to about 29,000 in 2013-2014. This is a total increase of approximately 4,000 positions. Additionally, the number of U.S. graduates with M.D. and D.O. degrees grew from about 19,000 in 2004-2005, to roughly 23,000 in 2013-2014. This is an increase of approximately 4,000 graduates.

If the number of GME positions increases as it has been over the past decade, it is projected that there will be approximately 34,000 positions for medical graduates entering their first year of residency in 2023-2024. The number of medical students is expected to increase due to newly opened M.D. and D.O. schools. As a result, it is assumed by AAMC that a 2.4% annual growth of medical graduates will continue onto 2023-2024.

In 2023-2024, the number of graduates projected will be marginally more than 29,500. With these numbers, there will be approximately 4,500 more open positions for residency than U.S. medical graduates in 2023-2024. While the number of positions available to graduates compared to 2013-2014 is less, the amount of GME positions will still significantly exceed the amount of U.S. medical graduates.

What Does this Mean for Medical Graduates?

Although the amount of GME positions will exceed the amount of medical graduates, the gap is still narrowing over the years. Over the past 50 years, medical graduates benefitted from “selection subsidy,” which allowed them to start residency at the location and in the speciality of their own choosing. However, the likelihood of a medical graduate finding the exact location and speciality he or she desires may not be an option anymore. Despite this, the most intense competition for these residency positions lies amongst the International Medical Graduates (IMGs). Although U.S. graduates will be affected by this slight “squeeze,” IMGs face an overall tougher road. To read one of our previous blogs focusing on future physicians, click here.

Comments?

Do you think there is not enough residency positions to meet the influx of medical graduates? Do you think Congress should fund more GME positions in order to create a larger margin for U.S. graduates?

Contact a Health Care Attorney that is Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education.

The Health Law Firm and its attorneys represent interns, residents, fellows and medical school students in disputes with their medical schools, supervisors, residency programs and in dismissal hearings. We have experience representing such indiviuals and those in graduate medical education programs in various disputes regarding their academic and clinical performance, allegations of substance abuse, failure to complete integral parts training, alleged false or incomplete statements on applications, allegations of impairment (because of abuse or addiction to drugs or alcohol or because of mental or physical issues), because of discrimination due to race, sex, national origin, sexual orientation and any other matters.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Vernon, Jamila. “More Students Going to Medical School Than Ever Before.” AAMC. October 29, 2015. Web.

“Why a GME Squeeze in UNlikely.” NEJM. November 4, 2015. Web.

“Medicare Resident Limits.” AAMC. Web.

“US Residency Training Before and After the 1997 Balanced Budget Act.” JAMA. September 10, 2008. Web.

About the Author: Ritisha K. Chhaganlal, J.D., is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone (407) 331-6620.

KeyWords: Graduate medical education (GME) positions, international medical graduate attorney, Association of American Medical Colleges (AAMC), Medicare resident limit caps, Accreditation Council for Graduate Medical Education (ACGME), American Association of Colleges of Osteopathic Medicine (AACOM), graduate medical education attorney, lawyer for medical students, medical resident attorney, residency program legal dispute, residency program litigation, medical school litigation, legal representation for medical residents, legal dispute with medical school, medical students legal counsel, disruptive physician attorney, impaired medical student legal counsel, impaired resident legal defense attorney, United States Medical Examiners (NBME) lawyer, teaching hospital plaintiff attorney, health law attorney, The Health Law Firm

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2015 The Health Law Firm. All rights reserved.

By |2015-12-10T19:18:12+00:00May 15th, 2018|Medical Education Law|0 Comments

Medical Students, Residents and Fellows Need to Properly Disclose Medical Disabilities in advance of problems

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

We are often retained to provide legal representation to medical school students, residents and fellows who run into difficulties and have disputes with their medical schools or programs. This may be after they are required to repeat a year, terminated from the program, or have other adverse action taken against them. When this occurs and we investigate the details, occasionally we find that the individual we are representing has a medical history of mental health issues that may have caused or contributed to the problems they are facing.

In many situations, the troubles that are faced could have been avoided if the student or resident had disclosed their medical condition to the school, program, or institution, and requested reasonable accommodations. However, after the adverse action has been taken it is often (but not always) too late to do this.

Use the institution’s forms to report a medical condition or disability.

All major medical schools, universities, residency programs, and hospitals in the United States have offices or departments to receive reports of medical conditions and disabilities and to assist the student/resident in obtaining support, resources and reasonable accommodations to help the student/resident be successful. However, if the institution is never notified of the medical condition or disability and is never given the opportunity to provide reasonable accommodations, then the student/resident has failed to take advantage of an opportunity that exists which may have helped prevent the adverse action that was taken.

If you have a medical condition or disability of any kind, especially one such as depression, learning disability, bipolar disorder, anxiety disorder, ADHD, a disease or illness which may affect your performance, or other condition that classifies as an illness or disability, you should be sure that this is diagnosed by the appropriate physician. You must also have that physician formulate reasonable accommodations that your institution, program, school or hospital can take that would help you to accommodate your condition. You should then complete the forms that your institution uses to report this and request reasonable accommodations to help you.

Don’t fear stigma from reporting a medical condition or illness.

We most often find that our clients have failed to report a medical condition or illness and request reasonable accommodations out of a fear that their program, professors, attendings and colleagues will discriminate against them and see them in a lesser light. Actually, the opposite is true. If a medical student our resident is failing academically, is unable to pass exams, or does not appear to be able to handle clinical rotations, it is more likely that the institution will feel that the person does not have the capability or motivation to succeed. However, by disclosing the medical condition or disability, this helps to explain such matters.

 

Illegal to discriminate based on disability or illness.

There are a number of federal laws and often state laws which protect a student or resident who has a medical disability or illness against discrimination. Additionally, almost all major colleges, universities and institutions have policies and procedures in place which prevent this. However, if the resident or student has not disclosed the medical condition or disability to anyone, there can be no argument made that the person was discriminated against because of this. Therefore, disclosure and a request for reasonable accommodation may be a big benefit in challenging adverse actions.

 

Contact Experienced Health Law Attorneys Representing Medical Students, Residents and Fellows.

The Health Law Firm routinely represents medical students, residents and fellows who run into difficulties and have disputes with their medical schools or programs. We also represent other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

 

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for medical students, legal representation for residents, legal representation for fellows, legal representation for disputes with medical programs and institutions, investigation by National Board of Medical Examiners (NBME), United States Medical Licensing Examination (USMLE), USMLE preparation course, USMLE hearings, USMLE appeals, foreign medical student defense lawyer, medical graduate defense attorney, defense lawyer for doctors, legal representation fro physicians, residents and intern legal representation, medical student attorney, medical resident lawyer, medical intern lawyer, civil proceeding, criminal proceeding, administrative proceeding, medical administrative hearings, administrative law, medical student legal defense counsel, medical resident lawyer, medical resident defense attorney, medical intern lawyer, medical intern attorney, accused of irregular behavior, The Health Law Firm reviews

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

 

By |2017-03-24T20:38:46+00:00May 15th, 2018|Medical Education Law Blog|1 Comment

Study Finds States That Allow Medical Marijuana May Have Less Opioid Use

8 Indest-2008-5By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On September 15, 2016, a new study was released from Columbia University Mailman School of Public Health, that suggests people in states that allow medical marijuana may be using fewer opioid painkillers. Researchers analyzed crash data in 18 states from 1999 to 2013 and revealed that states that allow medical marijuana use saw a reduction in opioid involvement in fatal car accidents.

The Relationship Between Medical Marijuana Laws and Opioid Use.

The study, published in the American Journal of Public Health, is the first look at how the relationship of medical marijuana laws might affect the use of opioid painkillers. “After the implementation of a medical marijuana law, there appears to be less opioid use, at least among young and middle-aged adults,” study lead author June Kim said. He’s a graduate student in epidemiology at Columbia University Mailman School of Public Health in New York City.

The researchers used data from the Fatality Analysis Reporting System database of about 69,000 drivers from 18 states who died in auto accidents between the years 1999 and 2013. Tests for alcohol and other drugs had been conducted on the drivers.

In states where medical marijuana law was legal and easily accessible, the study found that drivers between the ages of 21 and 40, had almost half the chances of testing positive for opioid painkillers, than those who crashed before such a law was implemented. The results further add to evidence suggesting that patients with chronic pain may substitute marijuana for a prescription painkiller in states where the option is available.

The study authors stressed that it’s not clear if the opioid painkillers — or, for that matter, marijuana — contributed to any of the car accidents.

Click here to read the published article in the American Journal of Public Health.

To read one of my prior blogs on the use of medical marijuana as a treatment for opioid addiction, click here.

Contact Experienced Health Law Attorneys for Medical Marijuana Concerns.

The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists and pharmacies, wanting to participate in the medical marijuana industry. We can properly draft and complete the applications for registration, permitting and/or licensing, while complying with Florida law. We can also represent doctors, pharmacies and pharmacists facing proceedings brought by state regulators or agencies.

To contact The Health Law Firm please call (407) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Ingraham, Christopher. “Study: medical pot means less opioid use.” Orlando Sentinel. (September 16, 2016). Print.

Dotinga, Randy. “Do medical pot states have less opioid abuse?” WebMD News from HealthDay. (September 15, 2016). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

KeyWords: Marijuana treatment for opioid addiction, alternative addiction treatment, alternative for painkillers, medical marijuana defense attorney, American Journal of Public Health, medical marijuana for patients with chronic pain, substituting medical marijuana for prescription opioid painkillers, lawyer for medical marijuana growers and distributors, health lawyers for marijuana distributors, legal counsel for marijuana growers and distributors, medical marijuana laws, medical marijuana legalization, medical marijuana lawyer, defense attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, The Health Law Firm, attorneys for physicians, pharmacist legal defense attorney, Board of Medicine defense lawyer, Department of Health defense counsel

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

By |2016-11-08T08:41:34+00:00May 15th, 2018|Medical Education Law Blog|0 Comments

Gradual Increase in the Number of Baker Acts Among Students at the University of Central Florida Comes As No Surprise to Law Enforcement

By Ritisha K. Chhaganlal, J.D. and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Christmas is flooding the department stores and malls with candy canes and toys, holly and trees, and bells and carols.  It’s the most wonderful time of the year…right?  Perhaps for some.  But according to University of Central Florida (UCF) police Cpl. Peter Osterrieder, a rise in Baker Acts (involuntary confinement for mental health issues) is to be expected among college students around the winter holidays.

Not only do UCF police expect to see more Baker Acts during this “feel-good” time of year, but as reported by statistics within the police department, Baker Acts among college students are on the rise overall.  Just this year, UCF police have committed 94 individuals, mostly college students.  That’s triple the number of cases from 2010, and up from 76 cases just last year.  UCF police Chief Richard Beary said several factors are likely to have contributed to the annual rise.

What Does it Mean to be “Baker Acted”?

Baker Acts are necessary when a person is mentally unstable and considered a danger to themselves or someone else.  Individuals who are Baker Acted can be held for up to three days against their will for an emergency medical evaluation.  To be held beyond the 72-hour period, which often happens, the psychiatric treatment facility requires either the voluntary consent of the individual or court intervention.  For more information and statistics on Baker Acts, please view the Florida’s Baker Act: 2013 Fact Sheet by the Department of Children and Families (DCF) here.

In our experience representing individuals who have been wrongfully confined, however, we find the law if often violated.

Factors Contributing to Baker Acts Among College Students.

Osterrieder said the stress brought on by semester finals can push students to their breaking point.  This is especially true for college freshman spending their first semester away from home, family and friends.  Osterrieder commented to reporters for the Orlando Sentinel, “They [college students] don’t have mom and dad to lean on every day, the best friends they’ve had their entire life growing up.  That challenge is very difficult for them.”  All things considered, college life can become quite overwhelming.

Beary noted the growing student body at UCF as a contributing factor as well.  With 63,000 students currently enrolled, UCF is among one of the largest universities in the nation.  Beary also acknowledged the increase in public awareness of mental health conditions which results in more calls for help from those suffering, their loved ones or others observing concerning behaviors.

Baker Acts: Naughty or Nice?

While the intention of the involuntary confinement of individuals requiring emergency mental health assistance is pure, erroneous confinement can actually exacerbate the underlying medical or mental health condition for some.  Still for others, the existence of a mental health condition is purely speculative and therefore treatment is unnecessary and even harmful.

Knowing your rights as a patient or as the parent of a student under a Baker Act restraint is essential in such cases.  Consulting with an experienced health attorney can better guarantee adequate help for you or your loved one.

To read more about Baker Act cases and issues about which to be concerned, read one of our previous blogs here.

For more information on a similar law in the state of Florida for involuntary confinement for individuals with substance abuse problems (called the Marchman Act), click here.

Comments?

Do you have a student who is being involuntarily confined under the Baker Acted?  Do you believe their confinement is erroneous or they are not being adequately treated for their mental health condition?

Contact Health Law Attorneys Experienced in Handling Victims of Involuntary Confinement Through the Baker Act and Marchman Act.

The Health Law Firm represents individuals, families and friends in challenges to and hearings related to the Florida Baker Act and Marchman Act, when the basic criteria for confinement are not met and there is no medical necessity for further confinement.

Our firm has a process we follow to make sure that a person who should not be held under the Baker Act may be released in a very short time.  If the basic criteria for a Baker Act confinement are not present, the person is not required to be held and should be released.  If the person has been living independently for decades, has family and a support system available, and has had no prior mental health problems, the odds are he or she should not be involuntarily confined.  We act immediately to begin our representation, to make the hospital and its physicians aware that we are representing you, and to take measures to obtain release.  If required, we are prepared to file an emergency Petition for Writ of Habeas Corpus with the local Circuit Court to have you brought before the judge for an emergency release hearing.  These cases can be time intensive, require a great deal of immediate work, but can yield fast results in most cases.

To contact The Health Law Firm, please call (407) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Russon, Gabrielle.  “Baker Act Cases at UCF Are Soaring.”  Orlando Sentinel: Orlando: 5 Dec. 2015.  Final ed., sec. A: 1+.  Print.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida area.  www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

Keywords: Baker Act defense attorney, mental health lawyer, involuntary confinement lawyer, health law, Marchman Act defense, Baker Act defense lawyer, Marchman Act lawyer, Marchman Act attorney, health lawyer, substance abuse confinement, Baker Act confinement, mental health treatment, Baker Act confinement criteria, mental instability, involuntary confinement of student, legal representation for Baker Acts, The Health Law Firm, health law attorney

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2015 The Health Law Firm. All rights reserved.

By |2018-05-17T21:54:18+00:00May 15th, 2018|Medical Education Law Blog|0 Comments

Virginia Medical Board Wins Appeal Concerning Doctor’s Revoked Medical License

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On March 21, 2017, a Virginia appellate court ruled that a doctor’s state medical license was properly revoked for various reasons including allowing medical students to perform unauthorized medical procedures. The appellate court said the doctor’s due process rights weren’t violated because he had three months to prepare for an administrative hearing before the Virginia Board of Medicine.

Medical License Was Properly Revoked.

When the doctor originally presented his case in the trial court, the trial judge ruled that Dr. John Hagmann’s constitutional rights were violated. The trial court decided that when the Virginia Board of Medicine denied the doctor’s second request for a postponement of an administrative proceeding it erred. The trial court judge reversed the Virginia Board of Medicine’s decision revoking his license.

The court of appeals later decided that the trial judge’s decision was erroneous and reversed it. The appellate court based its ruling on the fact that Dr. Hagmann had already received one continuance and had more than three months to prepare for his hearing. According to the appellate court, the medical board’s denial of a second continuance didn’t violate Dr. Hagmann’s due process rights.

While teaching courses at a federal military school in 2012 and 2013, Dr. Hagmann allegedly allowed the students to perform invasive medical procedures on himself and on each other. These medical procedures were allegedly unapproved and had no medicinal or therapeutic purposes, according to the medical board.

According to the court’s opinion, Dr. Hagmann was also accused of encouraging students to use alcohol and various drugs in unapproved and dangerous ways. It indicated that he also provided medical treatment, including writing prescriptions, without keeping adequate records.

To read the court’s opinion in full, click here.

Conclusion.

The Virginia appellate court decided that the circuit court, the lower court in the case, erred by substituting its discretion for the Board’s discretion. However, the court of appeal also held that the circuit court did not err in rejecting Dr. Hagmann’s claims that the Board violated his due process rights.

Therefore, the court of appeal reversed the circuit court’s ruling and remanded with directions that the decision of the Medical Board revoking Dr. Hagmann’s license to practice medicine should be reinstated.

To learn more about the consequences of having your professional medical license revoked, click here to read one of my prior blogs.

Author’s Comments:

The problem I have with this decision is that the board of medicine usually takes years to investigate such cases. Once the charges are filed, they want to rush to a hearing, often without giving the defense adequate time to prepare. I have experienced this time and time again. It behooves the defense to make a clear record of the time that the port of medicine has had to prepare, the prejudice that will occur to the defense, and the lack of prejudice to the board.

Additionally, since there was a trial in a trial court decision, the trial court judge was in a much better position to weigh the credibility of the witnesses and make the decisions that were made. In a case where there is only been one prior continuance granted, for the appellate court to reverse the trial court judge, seems unfair to me, especially since the result is the revocation of the Doctor’s license. I often refer to this as the “death sentence” for the Doctor’s career. There isn’t a harsher sentence that a board of medicine can give.

Contact Health Law Attorneys With Experience Handling Licensing Issues.

If you have had a license suspended or revoked, or are facing imminent action against your license, it is imperative that you contact an experienced healthcare attorney to assist you in defending your career. Remember, your license is your livelihood, it is not recommended that you attempt to pursue these matters without the assistance of an attorney.

The Health Law Firm routinely represents physicians, dentists, nurses, medical groups, clinics, and other healthcare providers in personal and facility licensing issues. To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Kang, Peter. “Va. Med Board Wins Appeal Over Doc’s License Revocation.” Law360. (March 21, 2017). Web.

 

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

 

KeyWords: Legal representation for licensing issues, medical license defense attorney, legal representation for revoked license, legal representation for Board of Medicine investigation, Board of Medicine investigation defense attorney, medical board appeals, legal representation for administrative law hearing, administrative hearing defense attorney, legal counsel for Board of Medicine hearing, legal representation for Department of Health investigations, Department of Health investigation defense attorney, appeal of revocations, legal representation for Administrative Law Judge (ALJ) Hearings, administrative litigation defense attorney, legal representation for Federal Administrative Hearings, legal representation for Formal Administrative Hearings and Informal Administrative Hearings, legal representation for revocation hearings, The Health Law Firm reviews, reviews of The Health Law Firm

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2017 The Health Law Firm. All rights reserved.

By |2017-04-24T07:27:24+00:00May 15th, 2018|Medical Education Law Blog|0 Comments

Normalization Of Business Relations With Cuba Could Lead To U.S. Patients Seeing Lower Drug Prices

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Obama administration announced on October 14, 2016 its decision to lift a long-standing ban on importing Cuban pharmaceuticals into the United States.  If the policy change is approved by the Food and Drug Administration (FDA), this could bring Cuba’s low-cost, creditable medicines to the U.S.  This presents an interesting side effect for the normalization of business relationships that we have not seen before.  That is, if patients will be able to obtain drugs at the much lower prices that Cuba pays for them by importing them from Cuba?

Benefits Of A Policy Change.

This policy change could allow American researchers the chance to lead joint research with Cuba’s researchers and the opportunity for Cuba’s care-delivery models. These models are known worldwide for their essential care and conveying solid results in spite of their lack of resources.  Dr. Pedro Greer, a Cuban-American who is associate dean for community engagement at the Herbert Wertheim College of Medicine at Florida International University, made a statement that Cuban vaccines are recognized for there high quality.

According to the Cuba Business Report, multiple Cuban drugs have already been approved or trialed in countries like Europe, Asia and Canada. To read the full report, click here.

What Are The Changes?

The Obama administration’s changes would also include legalizing imported Cuban merchandise such as alcohol and cigars. The administration feels that this change would open a world of business, as well as research opportunities, for American manufacturers and academic institutions.  Dr. Greer said that the Cuban biotech industry is mature and ready for a joint venture with a U.S. company or even an academic institute.

Dr. Ross McKinney, chief scientific officer at the Association of American Medical Colleges believes this policy change could be an opportunity to gain knowledge from one of the most cultured healthcare delivery and training programs in Latin America.

Dr. McKinney said, in terms of research, Cuban academics have a lot of knowledge to provide Americans, especially when it comes to vector-borne illness such as the Zika virus.  Dr. McKinney predicts U.S. medical researchers will want to engage in joint clinical trails with Cuba, as they have already done so with Caribbean islands such as Puerto Rico and the Bahamas.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:
Rubenfire, Adam. “Cuban Pharmaceutical Imports To U.S. Could Lead To Lower Drug Prices. “Vital Signs. (October 26, 2016). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords:  U.S. Food and Drug Administration (FDA), Obama administration lifting ban on Cuban imported pharmaceuticals, The Health Law Firm, Cuban imports of medical products and equipment, complex health care business transaction attorneys, defense of pharmacy and pharmacists attorney, reviews of The Health Law Firm, The Health Law Firm attorney reviews, consumer reports of Cuban medical business, consumers reducing prices of medications, legal representation for pharmaceutical companies, legal representation for FDA investigations, doing business with Cuba legal counsel, legal counsel for research studies, medical research defense attorney, legal opinion on complex medical business transactions, legal opinion on complex health care business transactions

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

By |2016-11-22T07:00:51+00:00May 15th, 2018|Medical Education Law Blog|0 Comments
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