identying LEGAL ASPECTS OF HEALTHCARE

Directions: This is an exercise in issue identification. It is worth 28 points. Each question is worth 7 points. Please answer 5 of the 7 hypotheticals posed. I will drop your lowest scoring question.
Please identify all legal issues raised in the hypotheticals regardless of whether you feel the issue is one-sided. Identify relevant causes of action, defenses and issues of damages consistent with the query posed in the hypothetical.

1. Drs. Seymour Foote and Harry Amkles are podiatrists who practiced at Smallville General Hospital, the only acute care hospital in a 75 mile radius of the town of Smallville. They practiced foot surgery in the hospital’s same day surgery suite. The podiatrists decided to open their own ambulatory surgery center for their practice and the practice of others. When BewRocat, the hospital’s administrator, heard of their venture, he sent the podiatrists a letter. The letter stated that their privileges at the hospital were immediately terminated. He further stated that the hospital would no longer grant privileges to podiatrists and would never permit a member of its medical staff to go into competition with the hospital. Drs. Foote and Amkles consulted their counsel on getting their privileges reinstated. What issues should counsel review in defending his clients?

2. Ms. ImaGona was referred by her primary care physician, Dr. Mark Mewerds to a surgeon, Dr. Bill Max for a hard lump on her arm. Dr. Max examined the lump and told Ms. Gona: “I will remove that lump and your arm will be good as new.” Two weeks later, Dr. Max performed the surgery, removing a mole on the wrong arm. Ms. Gona went to another surgeon, Dr. Dewey Wright, who removed the lump and had a biopsy performed on it. The lump was cancerous. Subsequent testing showed that the cancer had metastasized. Ms. Gona had her arm removed below the site of the lump and had various treatments including a bone marrow transplant. She survived. Describe the potential causes of action and damages Ms. Gona has against each physicians.

3. Smallville General has come upon hard times. The rising cost of labor and supplies has created significant negative margins. Humanity Hospital Corporation, a for-profit hospital chain, is eager to enter markets where a single hospital has a monopoly on local hospital care. It made an offer to purchase SGH to Smallville’s board. The board believed that many of its pet projects, which lose money but provide community benefit, will be ended if Humanity buys the hospital. In turn, the board offered Humanity (1) a 49% interest in the hospital (2) 11 of the 24 board seats and (3) half of any annual margin in return for (1) a large cash infusion and (2) the use of Humanity’s group purchasing for supplies and employee benefits. Humanity agreed. The ability of pre-sale SGH board members to control the board assured the continuation of the pet projects. In one year, the hospital turned around and achieved a positive margin. In turn, the federal government moved to terminate Millville’s determination as a tax exempt entity and the town of Smallville moved to tax Millville’s real property. The Smallville board asked its counsel to fight these actions. What issues must counsel tackle and what position should counsel take?

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4. Ophelia Richey, the administrator of Yuppia Medical Center, has built a strong teaching hospital system through development of close ties with her medical staff. Since “every case is a teaching case,” she pays an annual stipend for educating her residents to each member of the voluntary medical staff, whether or not they ever discuss a case with housestaff. She has entered YMC into joint ventures with many of her voluntary staff to build outpatient laboratory and imaging centers. Most of the work at these centers is generated by referrals from the hospital’s faculty, who are employees of the hospital, and the hospital’s physician partners. Daisy Grontle is an accountant at YMC. After being fired for excessive absenteeism, she filed a complaint under the False Claims Act charging YMC and its physician partners with various violations. What potential issues face YMC? Its doctors? Daisy Grontle?

5. Connie Fluse was sitting on Main Street in Smallville. She was disheveled, urinating and defecating on herself. She would call out to passersby: “You’re the Devil and I’m going to stick my knife in your chest.” The local police took her to the Smallville General Hospital ER where Dr. Mark Mewerd was in charge. Dr. Mewerd took a look at Ms. Fluse in the police car. He heard her call him the Devil. He then told the police that SGH did not accept involuntary psychiatric patients and to take her to Metropolis Psychiatric Center, 75 miles away. The police did so. Ms. Fluse was admitted to MPC. She immediately asked to leave. She was told by Nurse Ratchet that she would leave when the hospital felt she could leave. Ms. Fluse refused medication. It was forcibly administered. After a week of forcible medication administration, Ms. Fluse was discharged to the streets of Metropolis. She sat down in front of the offices of Dewey Sooham, a local attorney. As he was entering his office, Ms. Fluse said to him: “I’ve seen the Devil everywhere, but you’re a lawyer. You’re an angel.” She proceeded to tell Sooham of her experiences at SGH and MPC. He, in turn, filed a complaint charging both institutions with various violations of Ms. Fluse’s rights. What are SBH and MPC’s potential liabilities and defenses?

6. Mr. Funder Mentalis and his wife and five-year old child are devout Jehovah’s Witnesses. One day a tornado leveled their home. While Funder escaped with minor injuries, his son sustained injuries resulting in massive internal bleeding. His wife was unconscious with head trauma. When his son was brought to the Smallville ER, Dr. Mark Mewerd told Mr. Mentalis that he was going to transfuse his son. Mr. Mentalis in turn told Dr. Mewerd that as Jehovah’s Witness, he could not permit the transfusion. Dr. Mewerd asked the hospital’s counsel to get a court order permitting the transfusion. The court order was obtained, but the child had succumbed to the bleeding by the time the order was issued. Ms. Mentalis never regained consciousness. She eventually entered a long-term care facility where her breathing was maintained by respirator. She was fed with a feeding tube. Her parents, who are not Jehovah’s Witnesses, petitioned the court to remove her from the respirator and feeding tube. Their complaint noted that their daughter told them: ?I never want to be kept alive by machines if I’m a vegetable. Please don’t let that ever happen to me.” Mr. Mentalis sued SGH for its treatment of his son. He also fought his in-laws suit. What are SGH’s liabilities and defenses in its suit with Mr. Mentalis? What are Mr. Mentalis’s in-laws claims and Mr. Mentalis’s defenses in the action over his wife’s treatment?

7. Dr. Bill Max is a surgeon in private practice. He has privileges at Smallville General Hospital. Purdy Singh is the Nurse Manager of Smallville’s Same Day Surgery Unit. Dr. Max told Ms. Singh that she is a “beautiful person” on two occasions. On a third occasion, he asked her to go out on a date with him. She did not accept. After she declined, she informed BewRocat, the hospital’s administrator. She also told Rocat that she did not appreciate Dr. Max’s advances. Rocat did not want to risk offending a member of the medical staff over a personal matter between an employee and a non-employee. He did nothing with the information. Two weeks later, Dr. Max and Ms. Singh were both working late. They were alone in the Same Day Surgery office. Dr. Max kissed Ms. Singh gently on the cheek and again asked her to go on a date with him. Ms. Singh exploded. She told Dr. Max that he was harassing her. The next day she drove to the law offices of Dewey Sooham in Metropolis. Suit was filed against Dr. Max, Smallville General and BewRocat. What are Ms. Singh’s causes of action? What defenses are available to Dr. Max, Smallville General and BewRocat?