Practice Areas

Health Care Fraud, Medical Malpractice, Mental Health and Birth Trauma Litigation -- Health Law Attorney Providing Personalized, Professional Legal Services for Corporations and Individuals in Washington, DC, Florida, Maryland, New York and Virginia

One aspect of my practice has benefitted enormously from my experience as a federal prosecutor - my cases that involve medical issues. As a prosecutor, I routinely analyzed crimes involving medical evidence such as autopsy reports in homicide cases, serology reports in rape cases, toxicology reports in homicide and drug cases and worked with medical professionals to present expert testimony on those issues. In addition, I spent a year representing St. Elizabeths Hospital in mental health civil commitment cases. So, I learned a great deal about mental illnesses and personality disorders.

As health care becomes more expensive and the laws applicable to providers more complicated, the need for experienced health care fraud defense counsel to guard against the loss of a business or of a medical license is increasing. Charges of medicare fraud, medicaid fraud, health insurance fraud, fraud in billing, violations of anti-kickback regulations, and other health care-related crimes have become common. Patients or employees who suspect that providers are billing for services not rendered, prescribing services or medical devices that are not necessary, are referring them to medical laboratories affiliated with their doctors' medical practice, or other fraudulent costs may have a federal or state False Claims Act case.

Beginning in the early 1990's, I represented plaintiffs in medical malpractice cases involving, among other things, failure to diagnose breast cancer, failure to diagnose an aortic aneuryism, and failure to diagnose common variable immune disorder. Upon establishing my own practice in 1992, I, in conjunction with another firm, prosecuted a birth trauma case in which an infant was injured because of the failure of the hospital's nurse and treating obstetrician to diagnose a placental abruption. As a result, I learned the stages of labor, to recognize the signs of fetal distress on fetal monitor strips and recognize the other signs and symptoms of birth trauma which may be revealed in analyses of cord blood and by the presence of meconium in amniotic fluid or in neurological testing. Of course a variety of problems can occur during labor and delivery that can result in life-long disability for the child and substantial financial and emotional costs to the parents. These cases are among the most challenging that a lawyer may undertake.

My experience with mental health issues has been invaluable in nearly all aspects of my legal practice. Clients who come to me sometimes have done things or had charges raised against them that bring into question their own mental status or that of those who have lodged a complaint against them. Often the stress of a legal problem may suggest the advisability of consultation with a mental health professional. I work with nationally-prominent psychiatrists to address these issues.

Medical malpractice cases involve a question of whether the health care provider rendered treatment that was substandard in comparison to the recognized standard of care within his or her profession. Determining what the standard of care is can be somewhat difficult due to the tendency of the medical profession to obscure recognizable standards as "guidelines" so that they may be challenged at trial. The National Guidelines Clearinghouse is a government-sponsored database set up by the Agency for Healthcare Research and Quality that allows one to search for guidelines and standards of care applicable to a variety of conditions, diseases, and treatments. You may search for guidelines by disease, type of treatment, and by medical organizations. Go to www.guideline.gov.

Another government resource you may wish to use to research medical literature and conditions is PubMed, a compilation of information on medical topics and medical journals maintained by the National Institutes of Health. You may search by topic, author or journal. While abstracts of the articles are available on PubMed, you may have to go to the nearest medical library such as the National Library of Medicine to review the actual article or pay for it online by accessing the journal's website.

There are a variety of websites that contain information concerning physicians and health care organizations. The Federation of State Medical Boards maintains a website, www.fsmb.org, that has a physician data center. The Administrators in Medicine (AIM) website, www.docboard.org, has articles about physician specialization and a database linked to state medical licensing boards. Health Grades, at www.healthgrades.com, provides a means for researching physicians and health care provider organizations such as hospitals and nursing facilities. The Joint Commission is the nation's principal evaluator and standard setter for health care organizations. You may search its "quality check" website at www.jointcommission.org/qualitycheck. Finally, the American Medical Association, www.ama-assn.org, provides information on physicians as well.

In a few cases I have been called upon to represent or advise physicians who have been charged with misconduct or challenged in other ways in credentialing proceedings at a hospital or in the military. In those instances, my clients went on to continue their careers in medicine. I successfully have represented a physician charged with health care fraud for violations of the anti-kickback rules promulgated by the Department of Health and Human Services. I welcome inquiries from potential clients concerning those cases.

Another area where my medical knowledge has been helpful is in cases in which I have assisted those who need to retire on the basis of disability. I have found that it is extremely useful to present an application package that is prepared, in large part, by a lawyer because so often it is otherwise much easier for the insurance company or the Social Security Administration to deny the claim in the first instance. By having the application prepared by a lawyer who understands not only the medical issues involved but also the insurance issues and is able to assist the physicians in preparing the forms they are required to sign, it greatly reduces the possibility that the claim will be denied arbitrarily.

If you suspect that you or a family member has become a victim of medical malpractice or preventable birth injury, if you have been charged with or implicated in health care fraud or misconduct or have knowledge of it that has not yet become known to the Government, contact health law attorney Pamela B. Stuart.