Cpcs Study

Front 1

Darling v Charleston Memorial Community Hospital, 211 N. E. 2d 263 (III. 1965)

Back 1

*Failure to have proper supervision; Case set aside the Charitable Immunity Doctrine

-Hospital liable for negligent treatment
resulting in amputation of teenager’s
leg nurses failed to monitor; physician
failed to consult; hospital claimed that
charitable immunity doctrine limited
damages to its insurance.

Front 2

Johnson v. Miseriocordia Community Hospital, 294 N.W. 2d 501, 92 Wis. 2d 521 (Wis. 1981)

Back 2

*Negligent credentialing; Failure of initial
credentialing process.

-Hospital liable to patient injured by
physician who had failed to disclose
pending malpractice cases and lied
about privileges at other hospitals;
should have verified information.

Front 3

Elam v. College Park
Hospital, 132 Cal. App.
332, 183 Cal. Rptr. 156
(Ca. 1982)

Back 3

*Negligent Credentialing

-Hospital liable for podiatrist’s
negligence; failed to obtain malpractice
claims data although medical records
department aware of claims.

Front 4

Patrick v. Burget, 800
F. 2d 1498 (1986) (9th
Cir); 108 S. Ct. 1658
(1988)

Back 4

*Anti-competitive peer review; HCQIA;
Violation of Federal Anti-trust Laws

-Physicians conducted peer review for
anti-competitive reasons liable for
violating federal anti-trust laws.

Front 5

Robinson v. Magovern,
(3rd Circuit Court of
Appeals, 1982)

Back 5

*Hospitals May Determine Proper
Limitation on Competition Within the
Hospital and Surrounding Areas -
careful and thorough adherence to
bylaws that contain objective criteria
required. Denial of application is not a
restraint of trade.

-MD brought antitrust suit because he
was denied privileges. Hospital did this
based on shortage of OR space,
unfavorable recommendation, failure to
publish MD on seven other staffs and
would probably not be able to
contribute to hospital teaching
program

Front 6

Miller v. Eisenhower
Medical Center, 166
Cal. Rptr. 826
(Ca. 1980)

Back 6

*Disruptive Behavior Must be Patient
Care Related

-Denial of application based on inability
to work with others; no quality of care
problems.

Front 7

Rao v. Auburn General
Hospital, 573 P.2d 834
(Washington Court of
Appeals, 1978)

Back 7

*Disruptive Behavior. Personality May Be
Considered If Affects Ability to Practice
or Hospital Operations - personality
problems must affect the workings of
the hospital.

-Hospital denied privileges to MD after
receiving reports from other hospitals
on termination/ restriction of privileges.
Other hospitals also reported
substandard work and emotional
instability

Front 8

Boyd v. Albert Einstein
Medical Center, 547
A.2d 1229 (Pa. 1988)

Back 8

*Ostensible agency; MCO liable for
practitioners action.

-IPA-type HMO advertised as providing
medical care held liable for member
MD’s negligence.

Front 9

Harrell v. Total Health
Care, Inc., 781 S.W. 2d
58 (Mo. 1989)

Back 9

*Negligent Credentialing; Failure to
Credential

-State law granted immunity to nonprofit
health plans; MCO not liable for
negligent credentialing.

Front 10

McClellan v. Health Maintenance Organization of
Pennsylvania, 604 A.
2d 1053
(Pa. 1992)

Back 10

*Duty to select and monitor providers;
Negligent Credentialing; Ostensible
Agency

-MCO liable for provider's action

Front 11

Mathews v. Lancaster
General Hospital, 87 F.
3d. 624 (Pa. 1996)

Back 11

*HCQIA burden on physician to prove
bad faith peer review.

-Committee including competitors found
substandard care; outside consultant
agreed; surgeon challenged summary
judgment applying HCQIA immunity;
HCQIA presumption of good faith
upheld.

Front 12

Bell v. Sharp Cabrillo
Hospital, 212 Cal.
App.3d 1034, 260 Cal.
Rptr. 886 (Ca. 1989)

Back 12

*Negligence in Reappointment; Negligent
Credentialing

-Hospital liable for physician’s actions
due to its failure to request data from
other hospital about basis for its
summary suspension. No deficiencies
had occurred at Sharp Cabrillo.

Front 13

Hongsathavij v. Queen
of the Angels
Hollywood Presbyterian
Hospital, 62 Cal App.
4th 1123, 73 Cal. Rptr.
2d 695 (Ca. 1998)

Back 13

*Governing Body is Ultimate Authority.

-Physician taken off back-up panel for
failing to accept patient; Board
overturned hearing committee
recommendation to reinstate call panel
membership due to lack of substantial
evidence.

Front 14

Mahmoodian v. United
Hospital Center, 404
S.E. 2d 750 (W.Va.
1991

Back 14

*Disruptuve Behavior

-Hospital can revoke otherwise
competent physician’s privileges when
physician’s disruptive behavior may
adversely affect patient care.

Front 15

Oskooi v. Fountain
Valley Regional
Hospital and Health
Center, 42 Cal. App.
4th 233, 49 Cal. Rptr.
2d 769 (Ca. 1996)

Back 15

* Failure to Disclose

-Ophthalmologist did not disclose all
prior hospital affiliations on application;
Hospital’s summary suspension
upheld.

Front 16

Webman v. Little
Company of Mary
Hospital, 39 Cal. App.
4th 592; 46 Cal. Rptr.
2d 90 (Ca. 1995)

Back 16

* Duty to credential; Reasonable application requirement; Burden of Proof.

-Physician refused to authorize release
of information by prior hospital; new
hospital denied application; court held
for hospital.

Front 17

Kadlec v. Lakeview
Anesthesia Assoc. and
Lakeview Medical
Center

Back 17

*Reference letters from Berry’s former
partners were false and patently
misleading, leading to liability on their
part.
Hospital did not have a legal duty to
disclose its investigation of Dr. Berry
and its knowledge of his drug problems.

-Anesthesiologist with history of subtance abuse and performance issues was granted privileges after his previous employer and hopsital failed to disclose those issues in reference letters. When negligence resulted in injury to patient, resulting in lawsuite, hospital sued prevoious hospital & employer.

Front 18

Frigo vs. Silver Cross
Hospital (Il 2007)

Back 18

*Doctrine of Corporate Negligence -
Negligent Credentialing – Breach of
duty

-Podiatrist performed surgery that she did not meet initial or revised criteria for, but held privileges in regardless. Patient claimed hospital's breech of duty caused amputation as result of podiatrists negligence. Jury agreed.