CPMSM - Key Credentialing Cases With Complete Solutions
Darling v. Charleston Memorial Community Hospital - ANS Failure to provide adequate
supervision; Case abolished the Charitable Immunity Doctrine.
Hospital found liable for negligent care leading to the amputation of a teenager's leg
nurses failed to monitor; physician failed to consult; hospital argued that charitable
immunity doctrine capped damages at its insurance
Johnson v. Misericordia Community Hospital - ANS Negligent credentialing; Failure of
initial credentialing process.
Summary: 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.
Elam v. College Park Hospital - ANSWER Negligent Credentialing
Hospital liable for podiatrist's negligence; failed to obtain malpractice claims data
although medical records department aware of claims. Podiatrist.
Patrick v. Burget - ANSWER Anti-competitive peer review; HCQIA; Violation of Federal
Anti-trust Laws
Physicians peer review for anti-competitive reasons liable for violating federal anti-trust
laws.
Robinson v. Magovern - ANSWER 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 filed antitrust suit because he had privileges denied. The hospital did this based on a
shortage of OR space, unfavorable recommendation, failure to publish MD on seven
, other staffs and probably would not be able to contribute to the hospital teaching
program.
Miller v. Eisenhower Medical Center - ANSWER Disruptive Behavior Must be Patient
Care Related
Denial of application based on an inability to work with others; no quality of care
problems.
Rao v. Auburn General Hospital - ANSWER 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
Boyd v. Albert Einstein Medical Center - ANSWER Ostensible agency; MCO liable for
practitioners action.
IPA-type HMO advertised as providing medical care held liable for member MD's
negligence.
Harrell v. Total Health Care - ANSWER Negligent Credentialing; Failure to Credential
State law granted immunity to non-profit health plans; MCO not liable for negligent
credentialing.
McClellan v. Health Maintenance Organization of Pennsylvania - ANSWER Duty to select
and monitor providers; Negligent Credentialing; Ostensible Agency.
MCO liable for provider's action. Dr. Hempsey removed the mole without sending it for a
biopsy or other histological examination
Mathews v. Lancaster General Hospital - ANSWER HCQIA burden on physician to prove
Darling v. Charleston Memorial Community Hospital - ANS Failure to provide adequate
supervision; Case abolished the Charitable Immunity Doctrine.
Hospital found liable for negligent care leading to the amputation of a teenager's leg
nurses failed to monitor; physician failed to consult; hospital argued that charitable
immunity doctrine capped damages at its insurance
Johnson v. Misericordia Community Hospital - ANS Negligent credentialing; Failure of
initial credentialing process.
Summary: 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.
Elam v. College Park Hospital - ANSWER Negligent Credentialing
Hospital liable for podiatrist's negligence; failed to obtain malpractice claims data
although medical records department aware of claims. Podiatrist.
Patrick v. Burget - ANSWER Anti-competitive peer review; HCQIA; Violation of Federal
Anti-trust Laws
Physicians peer review for anti-competitive reasons liable for violating federal anti-trust
laws.
Robinson v. Magovern - ANSWER 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 filed antitrust suit because he had privileges denied. The hospital did this based on a
shortage of OR space, unfavorable recommendation, failure to publish MD on seven
, other staffs and probably would not be able to contribute to the hospital teaching
program.
Miller v. Eisenhower Medical Center - ANSWER Disruptive Behavior Must be Patient
Care Related
Denial of application based on an inability to work with others; no quality of care
problems.
Rao v. Auburn General Hospital - ANSWER 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
Boyd v. Albert Einstein Medical Center - ANSWER Ostensible agency; MCO liable for
practitioners action.
IPA-type HMO advertised as providing medical care held liable for member MD's
negligence.
Harrell v. Total Health Care - ANSWER Negligent Credentialing; Failure to Credential
State law granted immunity to non-profit health plans; MCO not liable for negligent
credentialing.
McClellan v. Health Maintenance Organization of Pennsylvania - ANSWER Duty to select
and monitor providers; Negligent Credentialing; Ostensible Agency.
MCO liable for provider's action. Dr. Hempsey removed the mole without sending it for a
biopsy or other histological examination
Mathews v. Lancaster General Hospital - ANSWER HCQIA burden on physician to prove
