Federal Health Officials Propose Medicare Paying Doctors to Discuss End-of-Life Issues

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 Centers for Medicare and Medicaid Services (CMS) released a new plan for doctors to discuss end-of-life issues with their patients. The plan is part of the CMS annual Medicare physician payment rule. This comes six years after the original controversy when President Obama first announced his health care legislation.

Doctors Will Be Paid for Discussing Treatment Options with Elderly Patients.

In what can only be described as welcomed and needed relief, the rule would reimburse doctors for discussing living wills and end-of-life medical treatment options with older patients. The medical discussions include long-term treatment options, like heart transplants. It also handles advance care planning, including a patient who desires treatment for a condition that affects his or her decision-making. These are conversations already taking place, but physicians are not currently paid for them.

The Pressure is on Medicare.

Medicare reimbursement is extremely important for elderly and disabled persons. As the second-largest insurer, many private insurers also follow the same rules Medicare adopts. Their place in the end-of-life care has long been debated. Whether or not health care professionals should be reimbursed for hospice and end-of-life treatment talks has been the center of debate. Physician groups and patient advocates have been pushing the health program to pay doctors for these consultations.

Many advocacy groups, including the American Medical Association (AMA), support the proposal. The AMA believes it’s the patient’s choice to plan advance-care decisions. Research has shown that there are great benefits to elders in advance-care planning and having their end-of-life wishes known to others. Receiving timely knowledge from physicians and health professionals can result in better decisions and ease of mind.

Rules Previously Criticized as “Death Panels” by Ignoramuses.

Sarah Palin, the towering mountain of medical knowledge and intellectual analysis, who dragged down John McCain into defeat during the elections of 2008, previously denounced similar payment provisions in the past. Sparking a great deal of unnecessary controversy, Palin claimed the health care reform legislation would create “death panels.” As a result of these and other similar accusations, the provision was removed from the final Affordable Care Act legislation. This deprived elders of useful knowledge and deprived health care providers of payment for their services. To read more about the “death panel” controversy, click here.

Comments?

What do you think of end-of-life discussions? Do you think they should be in place? Should physicians be reimbursed?  Please leave any thoughtful comments below.

Sources:

Grier, Peter. “ ‘Death Panel’ Controversy Very Much Alive.” The Christian Science Monitor. (Aug. 21, 2009). From: http://www.csmonitor.com/USA/Politics/2009/0821/death-panel-controversy-remains-very-much-alive

Sun, Lena H. “Medicare Proposes to Pay Doctors to Have End-of-Life Care Discussions.” The Washington Post. (July 8, 2015). From:
http://www.washingtonpost.com/national/health-science/medicare-proposes-to-pay-doctors-to-have-end-of-life-care-discussions/2015/07/08/1d7bb436-25a7-11e5-aae2-6c4f59b050aa_story.html

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: Medicare, federal health, health law, health law attorney, health law lawyer, end-of-life issues, The Centers for Medicare and Medicaid Services (CMS), CMS, Medicaid, healthcare, health care, health care attorney, health care lawyer, physicians, physician attorney, health care legislation, Affordable Care Act, ACA, medicine, the health law firm, death panel, death panel controversy, Medicare investigations, Medicaid investigations, elderly healthcare, senior health care, American Medical Association

“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.

Stryker Orthopaedics Facing Dozens of Hip Implant Lawsuits

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

As of February 2013, more than 80 lawsuits have been consolidated into multicounty litigation (MCL) in the Superior Court in New Jersey against Stryker Orthopaedics. Patients are claiming the company’s Rejuvenate and ABG II modular-neck femoral hip systems are defective, according to a number of news sources. The case is on track to becoming one of the largest mass-tort litigations in the country.

In July 2012, Stryker issued a voluntary recall of the Rejuvenate and ABG II modular-neck femoral hip systems. (Click here to see the press release from Stryker.) The company is currently in the process of sending out letters to surgeons urging them to perform clinical exams, such as blood work and cross sectional imaging, on patients who had implants installed. The letters state that Stryker will compensate patients for any tests or work that has to be done.

Click here to read a letter from Stryker to a surgeon.

Unfortunately, for some, this notice is too late. Hundreds of patients are already experiencing pain from the Stryker hip implants, which has forced them to have the implants removed. Even after surgery some patients alleged they have permanent damage and are demanding compensation.

Early Lawsuit Filed from Florida Patient.

According to the Palm Beach Post, one of the first lawsuits against Stryker came from a Boca Raton retiree. Her replacement came with a promise to last for decades. The device allegedly failed within months. Click here to read the patient’s entire story.

According to Drug Watch, most patients who received Stryker’s devices allegedly suffered from muscle, nerve and bone damage as the metallic components of the device rub against each other, causing metallic elements to be released into the body and be absorbed into the blood stream and body tissue. To read the entire article from Drug Watch, click here.

More Lawsuits to Come – Contact an Experienced Health Lawyer.

Since the implants were recently recalled, it’s expected that there are many more cases out there.

Many of the people who have already filed lawsuits claim Stryker marketed and sold a defective device and failed to warn the public, among other issues.

If you or a family member received a Stryker Rejuvenate or ABG II hip implant and suffered complications, you don’t have to face the medical issues alone. Contact an experienced attorney that is board certified in health law. Before you talk about settling, call an attorney.

Stryker Lawsuits Similar to DePuy.

According to an article in The Records, similar mass-tort cases in New Jersey include hundreds of lawsuits filed against DePuy Orthopaedics. More than 2,500 plaintiffs in that case alleged similar complaints due to a metallic hip part. DePuy’s product, ASR, was recalled by the company in August 2010. The cases being heard involve potentially hundreds of millions of dollars in settlements or verdicts. Click here to read the entire article from The Records.

Contact Experienced Health Law Attorneys.
If you or a family member received a Stryker Rejuvenate or ABG hip implant and suffered complications you don’t have to face the medical issues alone. Our attorneys are available seven days a week to answer your questions. We can help you decide whether filing a lawsuit is the right option for you. Our 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.

Comments?

Did you or someone you know have a Stryker Rejuvenate or ABG II modular-neck femoral hip implant? What has been your experience? Did you know about the recall? Are you in need of legal assistance? Please leave comments below.

Sources:

Markos, Kibret. “Mahwah-based Stryker Orthopaedics Faces Hip Implant Lawsuits.” The Records. (February 28, 2013). From: http://www.northjersey.com/mahwah/Over_80_lawsuits_on_hip_implants_filed_against_Mahwah-based_Stryker_Orthopaedics_.html?c=y&page=3

Singer, Stacey. “Artificial Hips Corrode, Poisoning Some Patients, Local Lawsuits Say.” The Palm Beach Post. (January 27, 2013) From: http://www.palmbeachpost.com/news/lifestyles/health/artificial-hips-corrode-poisoning-some-patients-lo/nT7jf/

Hooks, Beau. “Stryker Hip Replacement Lawsuits.” Drug Watch. (February 2013). From: http://www.drugwatch.com/stryker/lawsuit-hip-replacement/

Guilfoyle, Jeanine. “Stryker Initiates Voluntary Product Recall of Modular-Neck Stems.” Stryker. (July 6, 2012). From: http://www.stryker.com/stellent/groups/corporate/documents/web_prod/147504.pdf

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.

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 © 1996-2012 The Health Law Firm. All rights reserved.

Author Recommends Medicare Use ‘Procedural Triage’ to Eliminate Backlog of Appeals and Restore Faith in the System

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

IndestIn a recent law journal article being considered for publication, Author Matthew J. B. Lawrence of the Harvard University Petrie-Flom Center, makes some bold recommendations for Medicare. His hypothesis seems to be that the extremely long delay that health care providers now face in getting a Medicare appeal hearing might be negatively affecting these providers’ view of the fundamental fairness of the system. Currently, the backlog in obtaining a Medicare Appeal Hearing before an administrative law judge is up to approximately 27 months. Mr. Lawrence argues “procedural triage” may be in order.

Following is an abstract of this article:

Prior scholarship has assumed that the inherent value of a “day in court” is the same for all claimants, and so that when procedural resources (like a jury trial or a hearing) are scarce, they should be rationed in the same way for all claimants. That is incorrect. This Article shows that the inherent value of a “day in court” can be far greater for some claimants, such as first-time filers, than for others, such as corporate entities, and that it can be both desirable and feasible to take this variation into account in doling out scarce procedural protections. In other words, it introduces and demonstrates the usefulness of procedural triage.

The Article demonstrates the real-world potential of procedural triage by showing how Medicare should use this new tool to address a looming administrative crisis that it is facing. In the methodological tradition of Jerry Mashaw’s seminal studies of the Social Security Administration, the Article uses its in-depth study of Medicare to develop a theoretical framework that can be used to think through where and how other adjudicatory processes should engage in procedural triage. The Article concludes by applying this framework to survey other potential applications for procedural triage, from the Department of Veterans’ Affairs to the Federal Rules of Civil Procedure.

Blog Editor’s Comments:

The main point of the justice system is that everyone deserves a “day in court.” In this document, Procedural Triage, Matthew J. B. Lawrence argues that the value of a day is different for all claimants; it can be greater for some, so we shouldn’t treat everyone alike. Lawrence suggests some individuals deserve to have a hearing more than others, but sometimes the system compromises that rule.

One thing this article does is show how useful procedural triage can be. “Procedural triage” being a system that makes all medical institutions who are enrolled in Medicare use statistical tools for peoples to retain their right to a full “day in court.” He suggests Medicare uses the tool to face its current administrative crisis. In the end, it would benefit due process in the entire system.

Comments?

What do you think about procedural triage? Do you agree that Medicare should use it? Please leave any thoughtful comments below.

Contact a Health Care Attorney Experienced with Medicare and Medicaid Cases.

Attorneys with The Health Law Firm represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program. We also handle Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S.

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

Sources:

Lawrence, Matthew J. B. “Procedural Triage.” Social Science Research Network. (June 17, 2015). From: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2619864

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: procedural triage, defense attorney, defense lawyer, medical lawyer, lawsuit, medical professionals, healthcare professionals, health care attorney, health care lawyer, The Health Law Firm, Medicare, court, litigation, day in court, procedural protections, Social Security Administration, adjudicatory, procedural justice, behavioral economics, adjudication, administrative process, civil procedure, due process, justice system

“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.

First Trial Over DePuy Hip Implants Finished – Plaintiff Receives $8.3 Million

GFI Blog LabelBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm

On March 8, 2013, a California jury ruled that Johnson and Johnson’s DePuy unit designed a defective metal-on-metal ASR XL hip implant and was negligent, according to Bloomberg News. The plaintiff in this case was awarded $8.3 million in compensation damages, after the jury found that the design of the hip implant was the reason behind the plaintiff’s injuries. This is the first trial, out of 10,750 lawsuits filed against DePuy’s ASR XL hip implant. Click here to read more on the first trial against DePuy from Bloomberg News.

In August 2010, DePuy recalled 93,000 ASR XL hip implants after 12 percent (12%) failed within five years. Last year, 44 percent (44%) allegedly failed in Australia within seven years. (Click here to see the press release on the recall from DePuy.) We recently blogged on similar problems with Stryker brand hip implants and similar litigation. Click here to read that blog.

Hip Implants Allegedly Sold with Design Flaws.

During the trial, attorneys for the plaintiff argued DePuy knew that the design flaws in the defective device could cause it to shed particles into patients.

Almost all the patients who filed lawsuits complain that DePuy’s ASR XL hip implants have caused them constant pain and follow-up surgeries, according to Bloomberg News.

DePuy Believes Product is Solid.

During the trial a DePuy spokeswoman said the company believes the ASR XL was properly designed and that the actions they took concerning the product were appropriate.

According to Bloomberg News, an attorney for DePuy said three things have to work well for a successful surgery: a doctor who does his/her job; a device that works properly; and a patient whose body responds to the implant. The attorney went on to say that the bodies of some patients with existing medical conditions did not react well to the implants, and they do not know why.

Second Lawsuit in Court in Illinois.

On March 12, 2013, a second trial began in Illinois. This time a nurse claims her DePuy hip failed after three years and she needed a replacement surgery. Click here to read more on the second trial.

DePuy has a long road ahead. The company faces about 500 lawsuits in state court in Illinois, about three-quarters of the total lawsuits were consolidated in the federal court in Ohio and more than 2,000 are in the state court in California. The next trial is scheduled for May in Ohio federal court.

DePuy Cases Very Similar to Those Against Stryker Orthopaedics.

As of February 2013, more than 80 lawsuits have been consolidated into multicounty litigation (MCL) in the Superior Court in New Jersey against Stryker Orthopaedics. Patients claim the company’s Rejuvenate and ABG II modular-neck femoral hip systems are defective, according to a number of news sources. The case is on track to becoming one of the largest mass-tort litigations in the country.

In July 2012, Stryker issued a voluntary recall of the Rejuvenate and ABG II modular-neck femoral hip systems. (Click here to see the press release from Stryker.) The company is currently in the process of sending out letters to surgeons urging them to perform clinical exams, such as blood work and cross sectional imaging, on patients who had implants installed. Click here to read a letter from Stryker to a surgeon.

Contact a Health Law Attorney Experienced in Products Liability Cases.

Since the implants were recently recalled, it’s expected that there are many more cases out there.  Many of the people who have already filed lawsuits claim Stryker marketed and sold a defective device and failed to warn the public, among other issues.

If you or a family member received a Stryker Rejuvenate or ABG II hip implant and suffered complications, you don’t have to face the medical issues alone. Contact an experienced attorney that is board certified in health law. Before you talk about settling, please call an attorney. Our 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.

What Do You Think?

What do you think of the DePuy and Stryker lawsuits? Have you experienced complications for a hip implant? Please leave thoughtful comments below.

Sources:

Possley, Maurice, Voreacos, David and Pettersson, Edvard. “J&J Must Pay $8.3 Million Over Defective Hip, Jury Says.” Bloomberg. (March 8, 2013). From: http://www.bloomberg.com/news/2013-03-08/j-j-must-pay-8-3-million-in-suit-over-defective-hip-jury-says.html

Harris, Andrew and Voreacos, David. “J&J Faces Second Trial Over Recalled Hip After Loss.” Bloomberg. (March 12, 2013). From: http://www.bloomberg.com/news/2013-03-11/j-j-faces-second-trial-over-recalled-hip-after-losing-first-case.html

About the Authors: 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.

Carole C. Schriefer 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.

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 © 1996-2012 The Health Law Firm. All rights reserved.

Report: Florida Received an F in Medical Pricing Transparency

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

6 Indest-2008-3In Florida, it’s difficult to compare prices for medical services and procedures because the various prices are not made public. In part because of this, a recent study by a health-care advocacy group gave Florida an F for transparencies in pricing.


What Did the Analysis Look For?

The report analyzed whether or not states have laws and regulations that require health prices be made public.

Only One State Received an A.

The only state to receive an A in the study was New Hampshire. This is because of its NH Health-Cost site. The site provides consumers prices based on geography, type of insurance and other factors for everything from a basic visit to complicated medical tests. Consumers are able to go on the site and compare prices.

Florida Was Not the Only State to Receive an F.

Every state except five received the lowest grade from the Catalyst for Payment Reform and the Health Care Incentives Institute. So, if F was the average grade, I guess that means that Florida actually only received a C. Maybe there should be a “No State Left Behind” policy.

Comments?

Would you have given Florida an F? Do you think every state should have a health-cost website? Please leave any thoughtful comments below.

Contact Experienced Health Law 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:

Kassab, Beth. “Hidden prices for health care earn Florida an F for transparency.” Orlando Sentinel. (July 16, 2015). 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: Florida attorney, health care lawyer, health care attorney, law, health law, health care law, medical services, physician attorney, health care defense attorney, health care defense lawyer, health care, health care coverage, health law attorney, health law 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 © 1996-2015 The Health Law firm. All rights reserved.

Two National Recalls Prompt Food and Drug Administration (FDA) to Update Metal-on-Metal Hip Implant Safety Concerns

GFI Blog LabelBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Carole C. Schriefer, R.N., J.D., The Health Law Firm

On January 17, 2013, the Food and Drug Administration (FDA) issued an updated public health communication about hip replacement components that have both a metal ball and a metal socket, or metal-on-metal hip devices. This comes after two recent hip replacement recalls that are sparking thousands of lawsuits. Click here to read the FDA communication.

In August 2010, Johnson and Johnson’s DePuy Orthopaedics implemented a DePuy ASR hip recall, withdrawing more than 93,000 hip implants from the market. (Click here to read the press release on the recall from DePuy.) In July 2012, Stryker Orthopaedics implemented a similar recall on the Rejuvenate and ABG II modular neck components. (Click here to read the Stryker recall press release.)

Updated Information on Metal-on-Metal Hip Implants From the FDA. 

According to the FDA, in metal-on-metal hip implants, metal can be released into the body when two connecting components slide against each other. This can happen during daily activities. Metal release will cause some tiny metal particles to wear off of the device and into the space around the implant. Wear and corrosion at the connections may also occur. Some of the metal ions from the implant can enter the bloodstream. If this happens, patients can suffer from muscle, nerve and bone damage.

Click here to read more on metal-on-metal hip implants from the FDA.

Second Trial Over DePuy Hip Implant in Progress.

The president of DePuy testified during the second DePuy ASR hip trial. According to an article in Bloomberg News, the DePuy president said that the metal-on-metal hip implants were recalled because of a high rate of corrective surgeries required in patients, not because the device’s design was defective. Click here to read the Bloomberg article.

You may remember on March 8, 2013, in the first ASR hip recall trial, a California jury awarded the plaintiff $8.3 million in compensation damages after finding the ARS’s design defective. This result will have significant impact in the 10,750 other lawsuits against DePuy. Click here to read a previous blog on the first trial over the DePuy hip implants.

Stryker Orthopaedics Facing Similar Lawsuits.

As of February 2013, more than 80 lawsuits against Stryker have been consolidated into multicounty litigation (MCL) in the Superior Court in New Jersey. Stryker is currently in the process of sending out letters to surgeons urging them to perform clinical exams, such as blood work and cross sectional imaging, on any patient who had implants installed. Click here to read a previous blog on the Stryker lawsuits.

We’ve also learned some Stryker patients are being contacted by Broadspire. This company is trying to discuss settling with these patients. We want to encourage any metal-on-metal hip implant recipients to contact and experience attorney first, because there is still time to file a claim for injuries.

Contact an Attorney Experienced in Products Liability Litigation.

Although The Health Law Firm represents predominantly physicians and other health care providers, we are involved in products liability litigation. The Health Law Firm has recently undertaken plaintiffs’ products liability cases against the manufacturers of defective hip implants. We are now representing plaintiffs in a number of products liability cases involving both the DePuy hip and the Stryker hip implants. We are able to combine our knowledge of the health law industry with our litigation experience for the benefit of patients.

If you received a DePuy or Stryker hip replacement and have experienced pain, swelling, high levels of metal in your blood, a corrective revision surgery, or other complications, we may be able to help you.

To learn more about your legal rights, contact The Health Law Firm for a consultation by calling (407) 331-6620 or (850) 439-1001 or visit our website at www.TheHealthLawFirm.com.

Comments?

What are your thoughts on these recalls? Are you a Stryker or DePuy hip implant recipient? Please leave thoughtful comments below.

Sources:

Harris, Andrew and Voreacos, David. “J&J’s Ekdahl Says Hip Recalled for Clinical Reaons.” Bloomberg. (March 13, 2013). From: http://www.bloomberg.com/news/print/2013-03-13/depuy-chief-questioned-over-records-calling-asr-defective.html

Hooks, Beau. “Stryker Hip Replacement Lawsuits.” Drug Watch. (February 2013). From: http://www.drugwatch.com/stryker/lawsuit-hip-replacement/

Guilfoyle, Jeanine. “Stryker Initiates Voluntary Product Recall of Modular-Neck Stems.” Stryker. (July 6, 2012). From: http://www.stryker.com/stellent/groups/corporate/documents/web_prod/147504.pdf

About the Authors: 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.

Carole C. Schriefer 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.

 

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 © 1996-2012 The Health Law Firm. All rights reserved.

Tips for Medical Students and Medical Residents Accused of Irregular Behavior on the USMLE

Patricia's Photos 013By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

We frequently receive calls for consultations from students who receive a letter from the National Board of Medical Examiners (NBME) accusing the medical student or medical resident of “Irregular Behavior” on the United States Medical Licensing Examination (USMLE). In many cases these are graduates of foreign medical schools who have applied through the Examination Committee for Foreign Medical Graduates (ECFMG).

Irregular behavior can consist of many different things before, during or after taking the USMLE.  What you must know is that, in effect, you are being accused of cheating.

Examples of What The USMLE Defines  as “Irregular Behavior.”

Examples of the types of conduct which we have seen before include:

–  Attending a commercial USMLE preparation course that provides some of the actual examination questions.

–  Soliciting information on the contents or questions on the examination.

–  Using a cell phone during the examination.

–  Talking with another person during the examination.

–  Sharing information on the types of questions or cases that were on your examination with another person or on a blog over the internet.

These are just a few.  For more examples, please see an article I wrote on this by clicking here.

When Accused of Irregular Behavior Don’t Do  The Following.

We have represented students accused of irregular behavior by consulting with them before and after USMLE hearings and on appealing the results. We have represented a number of examinees at the hearings held before the NBME at its headquarters in Philadelphia, Pennsylvania.

From our experience in such cases, the following are the errors that most of you will make when accused by the USMLE of irregular behavior.

1.  You will fail to obtain an attorney experienced with such cases immediately upon receipt of a letter from the NBME accusing you of irregular behavior.  Take this as a formal charge accusing you of, in effect, cheating.  THIS IS SERIOUS.

2.  You will telephone, write or e-mail the NBME and explain “your side of the story.”  This will be full of admissions that will help prove the case against you and you will not even understand this.  (Please note that under U.S. law any statements you make, oral or written, can be used as evidence against you in any civil, criminal or administrative proceeding.  This is not the case with statements that your attorney makes on your behalf.)

3.  If you submit documents or statements to the NBME in support of your case, these will not be well-organized, well-labeled and in a form simple and easy to understand.  In many instances, you will not even understand the legal issues you are facing or how to refute them.

4.  You will fail to request or attend in person the hearing before the NBME Committee on Irregular Behavior (“The Committee”) in Philadelphia, Pennsylvania.

5.  You will fail to take an attorney experienced in such medical administrative hearings to represent you at The Committee hearing in Philadelphia.

6.  You will not know how to properly present your evidence or present your own position to The Committee, if you do attend the hearing.

7.  You will not know when or what kind of witnesses, including expert witnesses, you need to use to prove issues in your case before The Committee.

8.  You will fail to understand and correctly respond to the questions that the many different Committee members (usually 15 or more) will ask you during the hearing.

9.  You will fail to correctly follow all procedures in order to preserve your rights in the proceedings.

10.  You will falsely believe that if you lose at The Committee hearing you can win on appeal or somehow sue in court and prove you are right; this is almost never correct.  You will have only one chance at proving your case and this is at The Committee hearing in Philadelphia.

11.  You will incorrectly believe that even if you are only suspended from taking the USMLE again for a short period of time, this will have no effect on your education or career.  (Note:  Your USMLE transcript will note this fact and this will probably prevent you from ever getting into a good residency program.  See #1 above.)

 

This Is a Serious Matter, Don’t Think Otherwise.

You and your family have invested tens of thousands, if not hundreds of thousands of dollars, on your education so that you can become a physician.  You have spent years of sacrifice and studying in order to become a physician.  This is not the time to be cheap and to think that the cost of hiring an experienced legal counsel is too high.  You could lose everything you and your family has invested in this. Do not be “penny wise and pound foolish.”  You will need professional help if you are to get through this successfully.  If you don’t care about these matters or you don’t believe this is a serious matter worthy of an investment for attorney’s fees, then go ahead and ignore this advice.

If you are not reading this until after you have lost the case and been found to have committed “irregular behavior” by the USMLE Committee on Irregular Behavior, I am sorry for you, but it is probably too late to do anything about it.

Contact Experienced Health Law Attorneys Today.

The attorneys of The Health Law Firm provide legal representation to medical students, residents, interns and fellows in academic disputes, graduate medical education (GME) hearings, contract negotiations, license applications, board certification applications and hearings, credential hearings, and civil and administrative litigations.

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

Comments?

Have you faced The Committee? What was the experience like? Please leave any thoughtful comments below.

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.

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 © 1996-2012 The Health Law Firm. All rights reserved.

Colorado Surgeon Accused of Botching Multiple Robotic Arm Surgeries

CCS Blog LabelBy Carole C. Schriefer, R.N., J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A Colorado surgeon allegedly faces 14 counts of unprofessional conduct associated with the use a robotic arm used during surgeries, according to the formal administrative complaint. The Colorado Medical Board filed the complaint on April 2, 2013, alleging that from 2008 until 2010, the surgeon cut and tore blood vessels, left sponges and other instruments inside of patients, injured patients through padding and positioning, subjected some patients to overly long surgeries and had to abort kidney donation procedures because of mistakes. The surgeon is also accused of not documenting the mistakes in patient charts.

According to the Colorado Board of Medicine’s administrative complaint, the surgeon was using the da Vinci robot, manufactured by Intuitive Surgical, Inc., for surgeries.

Click here to read the formal complaint from the Colorado Medical Board.

This complaint was filed around the same time as the U.S. Food and Drug Administration (FDA) launched a review of the robotic procedures.

A Number of Patients Speak Out On Surgeries.

The complaint lists 11 patient cases allegedly mishandled by the surgeon.

In one case, a 22-year-old woman wanted to donate a kidney to her brother. She was informed by the surgeon that the robot was the “gold standard” for kidney removals and transplants. During the surgery, the surgeon allegedly injured the patient’s aorta. To stop the bleeding, the surgeon allegedly converted to an open surgery, then aborted the kidney removal. After the attempted surgery, the patient allegedly went into post-operative distress and an X-ray showed a sponge that had been left inside the patient. The patient also alleges she was left with nerve damage after being improperly padded.

In another case, the surgeon allegedly used the robot on an 86-year-old man with metastatic cancer. The surgeon allegedly injured the patient’s aorta, and the robot arm moved when it should not have, causing another tear. The patient suffered kidney failure after the operation, and the family withdrew the patient’s life support.

Surgeon Suspended for Performing Robotic Surgeries.

In the complaint, the Colorado Medical Board is asking an administrative law judge to discipline the surgeon’s license to practice medicine. An article in The Denver Post states that the surgeon had his robotic-surgery privileges suspended for three months in 2010. The hospital would not say whether or not the surgeon received new training before allowing him to use the robotic arm after his suspension.

To read the entire article from The Denver Post, click here.

FDA and Other Medical Societies Leery of Robotic Procedures.

In March 2013, the FDA began interviewing surgeons about issues with the robotic surgery units, according to Fierce Health IT. The agency is allegedly trying to figure out why there has been an uptick in adverse event reports, including damaged organs and device failures, and whether these are a result of error or design problems.

For a list of other sources discussing possible adverse outcomes from robotic surgery, please see “references” below.

The American Congress of Obstetricians and Gynecologists and the Massachusetts Quality and Patient Safety Division are also warning health care professionals about the risks associated with robotic surgeries, according to Fierce Health IT. The American Congress of Obstetricians and Gynecologists said that these types of surgeries should not be the first or second choice for women undergoing routine hysterectomies. The Massachusetts Quality and Patient Safety Division sent a letter advising doctors of the safety concerns regarding robotic surgery.

Click here to read the entire article from Fierce Health IT.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, pain management doctors, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

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

Comments?

As a health care professional, does your facility use robotic arm surgeries? Do you believe they are the safer option? Do you think the FDA should take a closer look at these machines? Please leave any thoughtful comments below.

Sources:

Booth, Michael. “Colorado Charges Doctor in Problem-Plagued Robo-Surgeries at Porter.” The Denver Post. (April 10, 2013). From: http://www.denverpost.com/breakingnews/ci_22998041/colorado-charges-doctor-botched-robo-surgeries-at-porter

Hall, Susan. “Robo-Surgery Mistakes Land Physician in Hot Water.” Fierce Health IT. (April 15, 2013). From: http://www.fiercehealthit.com/story/robo-surgery-mistakes-land-physician-hot-water/2013-04-15

Colorado Medical Board v. Warren J. Kortz, M.D. Case Number ME 2013. Formal Complaint (April 2, 2013). From:http://www.thehealthlawfirm.com/uploads/Colo%20v.%20Warren%20Kortz%20MD.pdf

Gold, Ashley. “Health Officials Warn Complications Robotic Surgeries.” Fierce Health IT. (March 26, 2013). From: http://www.fiercehealthit.com/story/health-officials-warn-complications-robotic-surgeries/2013-03-26

Hall, Susan. “OBGYN Group: Robotic Surgeries Not Best Choice for Routine Hysterectomies.” (March 15, 2013). From: http://www.fiercehealthit.com/story/obgyn-group-robotic-surgery-not-best-choice-routine-hysterectomies/2013-03-15

Garde, Damian. “FDA Echoes Questions Over Intuitives’s Surgical Robot.” Fierce Medical Devices. (March 1, 2013). From: http://www.fiercemedicaldevices.com/story/fda-echoes-questions-over-intuitives-surgical-robot/2013-03-01

Bird, Julie. Much of Robo-Surgery Marketing ‘Unsubstantiated.’” Fierce Health IT. (July, 24, 2012). From”
http://www.fiercehealthit.com/story/much-robotic-surgery-marketing-unsubstantiated/2012-07-24

About the Authors: Carole C. Schriefer 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.

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.

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 © 1996-2012 The Health Law Firm. All rights reserved.

Advice for All Massage Therapists: Please Talk to a Lawyer Before You Talk to the Department of Health (DOH) Investigator

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

Massage therapists, I beseech you: please do not talk to a Department of Health (DOH) investigator until you have talked to a health lawyer who is experienced with DOH investigations and board licensing complaints.  Do not answer or respond to even the most basic questions about where you work now, what your address is or if you know patient x, until consulting with counsel.

Admitting to Anything May Hurt Your Case.

We are routinely consulted by massage therapists and other healthcare providers for representation after they have discussed the case and after it is too late to undo the damage they have caused to themselves. Often they do not understand the seriousness of the matter or the possible consequences, until it is too late. Admitting to even the most basic facts causes damage to any possible defense.

Administrative Licensure Investigations are “Semi-Criminal.”

The vast majority of massage therapists and even most attorneys do not realize that DOH investigations concerning complaints against a massage therapist’s license are considered to be “penal” or “quasi-criminal” proceedings.  This means the same laws and constitutional rights apply to them as apply to criminal investigations.  However, since they are also administrative proceedings and not strictly criminal proceedings, investigators do not need to advise you of your Miranda rights or tell you you have the right to remain silent, the right to an attorney, etc.

In any criminal investigation a good criminal defense attorney would always tell you “Do not talk to the investigator” and “Tell the investigator you have a lawyer.”

How Investigators Try to Get You to Not Talk to an Attorney.

DOH investigators, police investigators, FBI investigators and other law enforcement officers, are well trained in investigative techniques and how to get information out of suspects.  Often the approach used is to catch you by surprise before you even know there is an investigation and the investigation is of you.  Another technique used is to lull you into a false sense of security that the investigation is about someone or something else and not you.  Another investigative technique is to convince you that you need to “Tell your side of the story” so that the investigation is accurate.  Yet another is that “Things will go much better for you if you cooperate.”  None of these things are true.

However, if it is truly in your best interest to cooperate or to make a statement, after you consult with your attorney, your legal counsel will surely advise you to do this.  The investigator should not mind waiting until you consult your attorney.  However, many will go to extremes to convince you that you don’t need an attorney and shouldn’t get an attorney.

Consult an Experienced Health Law Attorney.

The attorneys of The Health Law Firm are experienced in dealing with DOH investigators, AHCA surveyors, Drug Enforcement Administration (DEA) agents, FBI agents, police and sheriff’s office investigators, OIG special agents (S/As) and Medicaid Fraud Control Unit (MFCU) investigators. 

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.

Disclaimer: Please note that this article represents our opinions based on our many years of practice and experience in this area of health law. You may have a different opinion; you are welcome to it. This one is mine.

Note: This article is for informational purposes only; it is not legal advice.

“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 © 1996-2012 The Health Law Firm. All rights reserved.

Florida Man Sentenced to Prison for Role in Florida Hospital Data Theft

Lance Leider headshotBy Lance O. Leider, J.D., The Health Law Firm

A Davenport, Florida, man was sentenced to four years in prison for paying off two Florida Hospital employees to illegally access patient records, according to the Department of Justice (DOJ). A judge sentenced Sergie Kusyakov on April 10, 2013. He was charged with conspiracy and wrongful disclosure of individual identifiable health information.

Click here to read the press release from the DOJ.

Ex-Employees Sold Patient Information to a Co-Conspirator.

Mr. Kusyakov’s sentence stems from a privacy breach at Florida Hospital back in October 2011. The breach involved thousands of patient records that were illegally accessed between 2009 and 2011. Apparently Mr. Kusyakov was paying hospital employee Dale Munroe and his wife to illegally access thousands of records of patients treated at multiple Florida Hospital locations. Mr. Munroe was sentenced in January 2013. Click here to read a previous blog on that story.

Mr. Munroe was allegedly fired in July 2011, after it was learned he accessed the records of a doctor fatally shot in a parking garage. Investigators then found that Mr. Munroe had accessed more than 700,000 patient records, most of whom had been involved in vehicle accidents. Mr. Munroe then sold the records to Mr. Kusyakov, who was associated with two chiropractic clinics. The information was then used to solicit the patients for lawyers and chiropractors. After Mr. Munroe was fired, his wife began stealing patient information. She will be sentenced in July.

HIPAA Privacy Complaints Do Result in Action.

The act of accessing patient records is a direct violation of the Health Insurance Portability and Accountability Act (HIPAA). Many individuals whose privacy is breached fail to realize how effective a HIPAA Privacy Complaint can be. These complaints, which can be filed online to the Office of Civil Rights (OCR), a federal agency, are fully investigated. Stiff civil fines and even criminal prosecutions may result. In serious cases, the FBI investigates them.

Since the time period is short for filing these (180 days), the first step you should take, if your medical privacy is breached, is to file a HIPAA Privacy Complaint with the OCR. Also file a complaint with the hospital or health care provider and with the state agency that licenses the health care provider.

Contact Health Attorneys Experienced in the Confidentiality of Medical Records.

Our attorneys provide advice and legal opinions on confidentiality of medical records and medical information, including HIPAA Privacy Regulation, and are available to testify as expert witnesses on these issues.

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

Comments?

What do you think of Mr. Kusyakov’s sentence? Please leave any thoughtful comments below.

Sources:

Pavuk, Amy. “Man Sentenced to Federal Prison for Role in Florida Hospital Theft.” Orlando Sentinel. (April 11, 2013). From: http://www.orlandosentinel.com/news/local/breakingnews/os-florida-hospital-patient-data-theft-20130410,0,3261544.story

Department of Justice. “Davenport Man Sentenced to 4 Years in Prison of Theft of Patient Information.” Department of Justice. (April 10, 2013). From: http://www.justice.gov/usao/flm/press/2013/apr/20130410_Kusyakov.html

About the Author: Lance O. Leider 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.

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 © 1996-2012 The Health Law Firm. All rights reserved.

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