Toussaint v. Hartford Hospital
The False Claims Act requires that a plaintiff serve the complaint, along with evidence, in camera, on the Attorney General, and then bring the complaint in the name of the state. Allegedly, the plaintiff patient, Benita Toussaint, expected that her hernia would be removed and an infection treated, when she went to Hartford Hospital, and was informed when her stitches were removed that she had kept the hernia. Toussaint allegedly suffered an infection after the stitches were removed. Toussaint sued Dr. John Welch and Hartford Hospital, alleging that they "experimented" on her, wrongly obtained reimbursement from Medicare and violated her rights under the Patients' Bill of Rights and the False Claims Act. The defendants moved to dismiss and argued that the plaintiff failed to attach to her complaint a written opinion from a "similar healthcare provider." In Bennett v. New Milford Hospital, a 2011 decision, the Connecticut Supreme Court held that "§52-190a(c) requires the dismissal of medical malpractice complaints that are not supported by opinion letters authored by similar health care providers." The plaintiff objected that a written opinion is only required when the complaint sounds in medical malpractice. When ruling whether a complaint sounds in medical-malpractice, courts may consider whether: 1.) the defendants are sued in their capacities as medical professionals; 2.) the alleged negligence is of a specialized medical nature that arises out of the medical, professional-patient relationship; and 3.) the alleged negligence is substantially related to medical diagnosis. Here, the plaintiff's complaint sounded in medical malpractice. The plaintiff's claims, wrote the court "are predicated on her allegations that she was not provided appropriate care." Also, the plaintiff failed to follow the procedural requirements of the False Claims Act, Connecticut General Statutes §17b-301d, which requires that the plaintiff serve the complaint, along with evidence, in camera, on the Attorney General, and then bring the complaint in the name of the state. The Health Insurance Fraud Act, C.G.S. §53-440, permits an insurance company or a state agency to file a complaint. It does not provide for a private cause of action. The court granted the defense motion to dismiss.