Palmetto v. Health Options

Summary

Four pathologist-physcians claimed that health insurer Blue Cross/Blue Shield of Florida, and its HMO, Health Options, failed to pay them for the professional component of clinical pathology, which is the responsibility for supervising the lab.

The plaintiffs asserted that he defendants only would pay for the process of actually reviewing fluids and specimens, and not for the supervisory work and quality assurance procedures that ensured the tests, equipment, and processes were accurate, effective, and in compliance with legal requirements. The plaintiffs claimed damages of $1,546,479.

The defense argued that the physicians are in fact paid for everything they do. According to the defense, the physicians were not charged for the use of the hospital's laboratory and lab equipment. In addition, the hospital provided the four plaintiff physicians with a "monopoly" -- exclusive access to the hospital's lab. In exchange for these benefits, the defendants said, the physicians were expected to maintain the lab, and received ample overall compensation for doing so.

The jury found that the plaintiff sustained damages of $1,546,479.

Outcome

Damages: 1,546,179

Case Information

Attorneys

Witnesses

Plaintiff: Palmetto Pathology Services, P.A
Defense: Health Options, Inc
Verdict: $1,546,179

Judge: Thomas Wilson
Jurisdiction: 11th Judicial Circuit of Florida
Court: Dade County Courthouse

Case Number: 05-4137 CA 09
Industry: Insurance, Health care
Practice Area: Health Law, Commercial Law, Insurance

Plaintiff

Palmetto Pathology Services, P.A

Represented By:
Gonzalez, Ervin (Colson Hicks Eidson)

Defense

Health Options, Inc

Represented By:
Siff, Steven (McDermott Will & Emery)

Expert Witnesses

Lay Witnesses

Sessions

Attorney

Witness

Type

Description

AM Session

Openings

5 Chapters

	Description	Attorney	Witness	Presence
00:00:08	General Case Activities
00:07:03	Opening Statement	Gonzalez, Ervin
00:46:58	Opening Statement	Siff, Steven
01:13:00	Witness Direct Examination	Gonzalez, Ervin	Raey, Luis	In Person
02:07:38	End of Session

APR

AM Session

Plaintiff Witness(es)

4 Chapters

	Description	Attorney	Witness	Presence
00:00:16	Witness Direct Examination	Gonzalez, Ervin	Raey, Luis	In Person
00:38:19	Witness Cross Examination	Siff, Steven	Raey, Luis	In Person
01:37:29	Witness Re-Direct Examination	Gonzalez, Ervin	Raey, Luis	In Person
01:43:12	End of Session

PM Session

Plaintiff Witness(es)

22 Chapters

	Description	Attorney	Witness	Presence
00:00:14	Witness Direct Examination	Gonzalez, Ervin	Beebe, Mr. Michael	Video Recording
00:18:01	General Case Activities
00:20:00	Witness Direct Examination	Gonzalez, Ervin	Beebe, Mr. Michael	Video Recording
00:55:15	Witness Direct Examination	Gonzalez, Arthur	Contreras-Soto, Alex	In Person
01:02:10	Witness Cross Examination	Siff, Steven	Contreras-Soto, Alex	In Person
01:09:48	Witness Re-Direct Examination	Gonzalez, Ervin	Contreras-Soto, Alex	In Person
01:11:24	Witness Re-Cross Examination	Siff, Steven	Contreras-Soto, Alex	In Person
01:13:20	Witness Direct Examination	Gonzalez, Ervin	Myranda, JS	In Person
01:18:38	Witness Cross Examination	Siff, Steven	Myranda, JS	In Person
01:26:19	Witness Re-Direct Examination	Gonzalez, Ervin	Myranda, JS	In Person
01:26:56	Break
01:38:15	Witness Direct Examination	Gonzalez, Ervin	Buskey, Ms. Katherine	In Person
01:39:01	General Case Activities
01:40:02	Witness Direct Examination	Gonzalez, Ervin	Buskey, Ms. Katherine	In Person
02:03:11	Witness Cross Examination	Siff, Steven	Buskey, Ms. Katherine	In Person
02:21:00	Witness Re-Direct Examination	Gonzalez, Ervin	Buskey, Ms. Katherine	In Person
02:23:40	Witness Direct Examination	Gonzalez, Arthur	Stoetzer, Ms. Rosaline	In Person
02:37:30	Witness Cross Examination	Siff, Steven	Stoetzer, Ms. Rosaline	In Person
02:41:03	Witness Re-Direct Examination	Gonzalez, Ervin	Stoetzer, Ms. Rosaline	In Person
02:42:30	General Case Activities	Gonzalez, Ervin	Conway, Mr. John	Read Document
02:47:14	Witness Direct Examination	Gonzalez, Ervin	Lepkowska, Mr. Andrew	Video Recording
03:15:50	End of Session

APR

AM Session

Plaintiff Witness(es)

4 Chapters

	Description	Attorney	Witness	Presence
00:00:33	Witness Direct Examination	Gonzalez, Ervin	Hausner, Richard	In Person
01:07:06	General Case Activities
01:10:15	Witness Direct Examination	Gonzalez, Ervin	Hausner, Richard	In Person
01:20:39	End of Session

PM Session

Plaintiff Witness(es)

16 Chapters

	Description	Attorney	Witness	Presence
00:00:17	Witness Cross Examination	Siff, Steven	Hausner, Richard	In Person
00:46:46	General Case Activities
00:50:21	Witness Re-Direct Examination	Gonzalez, Ervin	Hausner, Richard	In Person
00:57:42	Witness Direct Examination	Gonzalez, Ervin	Lancet, Mr. Frederick	In Person
01:13:06	Witness Cross Examination	Siff, Steven	Lancet, Mr. Frederick	In Person
01:19:17	Break
02:06:30	Witness Direct Examination	Gonzalez, Ervin		In Person
02:15:23	Witness Cross Examination	Siff, Steven		In Person
02:30:27	Witness Re-Direct Examination	Gonzalez, Ervin		In Person
02:39:46	General Case Activities
02:41:13	Witness Re-Cross Examination	Siff, Steven		In Person
02:48:14	Witness Re-Direct Examination	Gonzalez, Ervin		In Person
02:49:35	Witness Direct Examination	Gonzalez, Ervin	Volano, Mr. Andres Jr.	In Person
03:18:59	Witness Cross Examination	Siff, Steven	Volano, Mr. Andres Jr.	In Person
03:22:41	General Case Activities
03:29:04	End of Session

APR

AM Session

Plaintiff Witness(es)

6 Chapters

	Description	Attorney	Witness	Presence
00:00:21	Witness Direct Examination	Gonzalez, Ervin	Abels, Dr. Michael MD	In Person
00:47:41	Witness Cross Examination	Siff, Steven	Abels, Dr. Michael MD	In Person
01:14:44	Witness Re-Direct Examination	Gonzalez, Ervin	Abels, Dr. Michael MD	In Person
01:21:26	General Case Activities
01:22:38	General Case Activities
01:23:18	End of Session

PM Session

Defense Witness(es)

11 Chapters

	Description	Attorney	Witness	Presence
00:00:28	Witness Direct Examination	Siff, Steven	Conway, Mr. John	In Person
00:42:25	Witness Cross Examination	Gonzalez, Ervin	Conway, Mr. John	In Person
01:24:41	Witness Re-Direct Examination	Siff, Steven	Conway, Mr. John	In Person
01:28:05	Witness Direct Examination	Siff, Steven	Demaggio Peters, Ms. Amy	In Person
01:52:29	Witness Cross Examination	Gonzalez, Ervin	Demaggio Peters, Ms. Amy	In Person
02:02:27	Witness Re-Direct Examination	Siff, Steven	Demaggio Peters, Ms. Amy	In Person
02:04:04	Break
02:19:05	Witness Direct Examination	Siff, Steven	Dyckman, Mr. Zachary	In Person
03:07:35	Witness Cross Examination	Gonzalez, Ervin	Dyckman, Mr. Zachary	In Person
03:41:11	Witness Re-Direct Examination	Siff, Steven	Dyckman, Mr. Zachary	In Person
03:47:13	End of Session

APR

AM Session

Closings

7 Chapters

PM Session

Verdict

3 Chapters

APR

Palmetto v. Health Options

Summary

Outcome

Sessions

AudioCaseFiles

Essentials

Training Libraries

	Description	Attorney
00:00:21	Start of Session
00:01:21	Closing Statement	Gonzalez, Ervin
00:41:43	Closing Statement	Siff, Steven
01:06:41	Closing Statement	Gonzalez, Ervin
01:12:12	General Case Activities
01:12:48	General Case Activities
01:19:36	End of Session

			Description	Attorney	Witness	Presence
		00:00:17	Reading of the Verdict
		00:02:19	General Case Activities
		00:05:12	End of Session