Senators Want National Investigation of State Medical Boards

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

A bipartisan effort has been initiated by three U.S. Senators to launch a national evaluation of state medical boards. Senators Charles Grassley (R-Iowa), Orrin Hatch (R-Utah) and Max Baucus (D-Mont.) sent a letter to the director of the Office of the Inspector General (OIG) for the Department of Health and Human Services (HHS) requesting an investigation into state medical boards at the end of February 2012.

In the letter the senators ask the OIG to launch a national investigation of state medical boards in which the OIG would:

  • Identify challenges and process improvements for state medical boards, including those that occur across state boundaries;
  • Identify legislative changes that would better facilitate the transfer of information from federal agencies to state medical boards and between state medical boards, including as it affects those physicians needing multiple state licenses such as those practicing telemedicine;
  • Evaluate state medical board performance, including the timeliness and consistency of decision making; and
  • Determine whether the Centers for Medicare & Medicaid Services'(CMS) Quality Improvement Organizations (QIOs) and/or Part A/Part B Medicare Administrative Contractors (MACs) report adverse information, including Medicare revocations based on felony convictions, to state medical boards or the National Practitioner Data Bank (NPDB).

The OIG has not undertaken an investigation of this magnitude of state medical boards in over fifteen (15) years.

The U.S. Senate letter dated February 15, 2012 can be seen here.

If this proposed federal investigation proceeds, it is likely that more disciplinary actions will be filed against health professionals. State medical boards may feel pressure to suspend or revoke more health care licenses, which could result in a slower administrative proceeding process.

For more information about state medical boards and disciplinary actions against health providers, visit our website at www.TheHealthLawFirm.com.

Sources Include:

Christensen, Pia. “Senators Request Inquiry Into State Medical Boards.” American Association of Health Journalists. (Feb. 15, 2012). From
http://www.healthjournalism.org/blog/2012/02/senators-request-inquiry-into-state-medical-boards/

Oh, Jaime. “U.S. Senators Call for Federal Investigation Into State Boards’ Action on Physicians.” Becker’s Hospital Review. (Feb. 22, 2012). From
http://www.beckershospitalreview.com/quality/us-senators-call-for-federal-investigation-into-state-boards-action-on-physicians.html

Walker, Emily P. “Senators Want Medical Boards Investigated.” MedPage Today. (Feb. 21, 2012). From http://www.medpagetoday.com/PublicHealthPolicy/GeneralProfessionalIssues/31288

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.

Negligence Will Determine the Success or Failure of the Meningitis Lawsuits Against Doctors and Clinics

6 Indest-2008-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The victims and survivors of the meningitis outbreak are now filing lawsuits against the physicians and clinics that administered the tainted steroids. According to an article in The Tennessean, on January 29, 2013, a husband who lost his wife to fungal meningitis filed the first lawsuit against a Nashville outpatient clinic. It’s believed hundreds of people were injected at the same clinic with the tainted steroids. The man is now seeking $12.5 million in damages.

Click here to read the entire article from The Tennessean.

This lawsuit is just one in what is expected to be a series of lawsuits, in not just Tennessee, but across the country.

Compounding Pharmacy Allegedly Behind the Meningitis Outbreak is Out of Business.

The meningitis outbreak was at a peak in the fall of 2012. Contaminated steroid injections were allegedly made at the New England Compounding Center (NECC) in Framingham, Massachusetts. NECC is accused of shipping thousands of vials of tainted drugs across the country. There are allegedly 45 deaths nationwide from the steroids. The company shut down in October 2012, and filed for bankruptcy in December, according to an article in American Medical News.

Tennessee Complaint Alleges Outpatient Clinic Put Money Before Patients.

The man suing the Nashville outpatient clinic believes, among other things, that officials at the clinic put the company’s bottom line before patient care. The lawsuit specifically alleges:

1. The outpatient clinic ignored important information when it chose NECC to purchase thousands of vials of steroids,
2. That clinic officials failed to properly notify the victim that she had been injected with a potentially contaminated steroid,
3. That clinic officials failed to recommend the victim should receive treatment,
4. The clinic chose to purchase drugs from NECC because it was a cheaper than the safer alternatives.

Click here to read the entire complaint.

The Responsibility of Doctors and Clinics.

Negligence is the most common claim used against doctors in cases of defective medication. The assumption is that the physician breached the standard of care because he or she knew or should have known that NECC was not meeting applicable standards in compounding the medications. Another legal theory is that the physician should have known that certain medications should not have been compounded, but rather obtained directly from a manufacturer. I believe the liability of physicians and clinics might be established to the extent that the physicians were aware that the steroids distributed by NECC violated regulations on compounding prescription medications.

It’s imperative physicians and clinics are sure of the credentials of all vendors and suppliers.

I was recently quoted in an American Medical News article about physicians and clinics that are entangled in tainted drugs lawsuits. To read the entire article, click here.

Florida Compounding Pharmacy No Stranger to Fungal Outbreaks.

Florida has seen its share of fungal outbreaks. I previously blogged about the problems encountered by Franck’s pharmacy in Ocala, Florida. It was accused of distributing eye medications that contained a fungal infection. Click here for the first blog and here for the second blog.

Pharmacists Need to Obtain Good Professional Liability Insurance.

Many pharmacists, especially those who work for state agencies, large hospitals, pharmacy chains or other large institutions, scrimp on their purchase of professional liability insurance. Many mistakenly believe their employer will cover any legal defense expenses. This is not true and is often found out too late.

A pharmacist should always carry his/her own professional negligence insurance. It is inexpensive and can cover many types of legal actions other than just civil negligence cases. Always, always, always be sure your insurance includes at least $25,000 in professional license defense coverage. Get this in writing!

Contact Health Law Attorneys Experienced in Representing Pharmacies and Pharmacists.

The Health Law Firm represents pharmacists and pharmacies in investigations, regulatory matters, licensing issues, litigation, inspections and audits. The firm’s 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?

What do you think about the lawsuits against these doctors and clinics? Who do you think should be help responsible: the compounding pharmacy that shipped the contaminated steroids, or the doctors and clinics that administered the steroid shots? Please leave any thoughtful comments below.

Sources:

Roche Jr., Walter. “Meningitis Outbreak: Victim’s Husband Sues Saint Thomas Clinic.” The Tennessean. (January 31, 2013). From: http://www.tennessean.com/apps/pbcs.dll/article?AID=2013301300211&nclick_check=1

Wayne A. Reed v. Saint Thomas Outpatient Neurosurgical Center. Case Number 13C-417. Complaint. (January 29, 2013). From: http://www.thehealthlawfirm.com/uploads/Reed%20v.%20St.%20Thomas%20Outpatient.pdf

Gallegos, Alicia. “Physicians Entangled in Tainted Drugs Lawsuits.” American Medical News. (February 11, 2013). From: http://www.thehealthlawfirm.com/uploads/AMN_PhysicianLawsuits.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.

Traveling Nurses Must Have Appropriate Professional Liability Insurance

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

We are often asked what we consider to be the biggest problem that a nurse has in defending herself in a complaint against her license.  In our opinion, it is not having the financial resources to retain the services of an experienced attorney to defend her.  Because of this, we believe that any nurse, especially traveling nurses working at a hospital, skilled nursing facility, home health agency, assisted living facility, medical group, or any other organization must have her own personal professional liability policy that provides ample insurance coverage for professional license defense expenses.

Most Complaints Made Against Nurses are Filed by Employers.

In our experience, most of the complaints filed against nurse professionals come from employers.  In many cases, a patient will complain to the employer and the employer will file the complaint.  In others, the employer initiates the complaint because of substandard performance, documentation problems, allegations of theft or drug diversion, allegations of falsification of documents or records, etc.  When this happens, in most cases the employer terminates the nurse.  This is why we say that a nurse must have her own professional liability insurance policy.

We see a great many more complaints filed against a nurse’s license that she then must defend, than we ever see civil claims for damages.

Many nurses work under the incorrect assumption that they are “insured” by their employer or their agency or that their employer’s or agency’s insurance covers them.  This is a fallacy, especially when it comes to defending against a complaint made against one’s nursing license.  If your employer or agency is the one that files the complaint against you, you don’t really think that your employer or agency is going to cover the legal expenses associated with your defense, do you?

Some hospitals and health organizations are notorious about firing nurses who have any discrepancies in drug counts or who have documentation errors.  This often results in a complaint to the Department of Health (DOH) against the nurse’s license.

Furthermore, we are all aware of the phenomenon with the traveling nurse, the person who is no longer there, getting all of the blame for any problem or incident that come up.  The ones that are still at the facility, the ones who are conducting the investigation on the incident, are far less likely to find blame with their friends and colleagues who are still there.

Just when you need it the most, you may find yourself out of a job, with no income, and no money to pay for a legal defense.  This may ultimately lead to your losing your nursing license and your ability to ever work as a health professional again.

If You Don’t Have Personal Professional Liability Insurance-Get It.

Professional liability insurance policies for nurses are very cheap.  Often policies are only about ten dollars a month.  Usual limits of coverage for this small premium payment are one million dollars of coverage for civil suits and $25,000 or more coverage for professional license defense.

But wait, it is not as simple as just purchasing the first professional liability insurance policy you find.  Many professional liability insurance policies do not offer license defense coverage.  Or, if they do, it is limited to only complaints where there is also the threat that a patient is going to sue for money.  Still others provide such low limits of coverage for license defense expenses (e.g., $5,000 or $10,000) that it is not worth the money paid for it, while others do not allow you to choose your own attorney.

Insurance Companies We Recommend.

We usually tout insurance companies such as that provided by Nurses Service Organization (NSO) and Healthcare Professionals Service Organization (HPSO) as providing great bang for the buck.  But here lately, we’ve been seeing (and hearing) more and more about CPH & Associates insurance.  Not only does it provide one million dollars in coverage if you are sued in a civil court, but it also provides up to $35,000 in coverage for professional license defense.  Additionally, for a very small additional payment, with CPH & Associates Insurance you can increase that coverage to $100,000 for professional license defense.  The other company we hear good things about is Lloyd’s of London.

If you have a complaint filed against your nursing license and you have to prove your innocence through a formal administrative hearing (trial), this can be very, very expensive.  Additionally, if you lose at this level, you may have to appeal the results to a higher court.  These expenses can easily cost $75,000, even if you win.  And you are not ever assured that you will get any of this money paid back to you, even if you are innocent and you win the case.  Inexpensive insurance coverage is the only thing that makes since.  Buy it!

In Conclusion.

We urge all nurses, especially traveling nurses, to purchase and maintain their own personal professional liability insurance policy.  It’s tax deductible.  But check to make sure you have coverage for professional license defense, even when there is no claim for damages expected from a patient.  Additionally, pay the extra premium to purchase a higher limit of coverage for professional license defense cases, or buy a second insurance policy for this additional coverage.

Contact Health Law Attorneys Experienced in Representing Nurses.

The Health Law Firm’s attorneys routinely represent nurses in Department of Health (DOH) investigations, in appearances before the Board of Nursing in licensing matters and in many other legal matters. We represent nurses across the U.S., and throughout Florida.

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

Comments?

Do you have personal professional liability insurance? Will you consider purchasing a personal policy now? 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.

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