Gregory J. Minana

Healthcare – Managed-Care and Payor Litigation

• Successfully represented a large hospital system to recoup wrongfully withheld reimbursements from a self-insured plan. Pursued claims under the Missouri Prompt Pay Act and ultimately recovered 100% of the amount owed, including interest and penalties.
• Represented a large healthcare provider group in a series of disputes with a national payor system. Handled four different concurrent lawsuits arising out of improper underpayments under a series of network agreements, in both arbitration and litigation. Ultimately recovered more than $4 million for the client, including Covid adjustments.
• Successfully recovered improperly withheld Medicare Part D subsidies on behalf of physician group in lawsuit alleging that over S4 million in subsidies were wrongfully withheld by insurance company. Southside Comprehensive Medical Group v. UnitedHealthcare of the Midwest, Inc., Cause No. 16SL-CC02570 (St. Louis County, 2017).
• Represented one of the largest medical institutions in the country in arbitration against a national insurer to recover on multiple years of underpayments pursuant to a managed-care contract, with a favorable outcome.

Product Liability – Medical Device

• Represented the defendants in a product-defect case in which the plaintiff's cornea was perforated with an electric cautery unit during ophthalmic surgery. The plaintiff claimed that the cautery device was defective and arced spontaneously. Obtained a complete defense verdict.

Business Litigation – Breach of Contract

• Represented a client in federal court that was pursuing claims of fraud and unfair business practices. Obtained judgment in the amount of – and collected – $1.1 million, plus pre- and post-judgment interest. The case also involved claims against an insurer for contribution.
• Counseled a merger and acquisition company in breach of contract, fraud and other claims involving the sale of an energy consulting company. As a result of arbitration, client received a significant financial judgment in its favor, 100 percent of damages sought plus attorney fees and interest.

Licensing & Regulatory

• Represented a physician before the state licensing board and successfully negotiated a reduction in proposed penalties.
• Represented a nurse before the state licensing board and successfully petitioned for reinstatement of her license.
• Represented a hospital system before the Provider Reimbursement Review Board (PRRB) and successfully negotiated a reduction in imposed penalties pursuant to National Healthcare Safety Network (NHSN) reporting requirements.

Medical Malpractice – Physicians

• Obtained a defense verdict in a wrongful-death action in which a woman underwent an emergency Caesarean section during which she experienced significant blood loss when the surgeon transected her uterine vessels. After the bleeding was controlled, clients – the anesthesia team – managed the resuscitation, replacing the lost blood with transfusions, fluids and medications. Plaintiffs’ allegations included failure to insert an arterial line or a central venous pressure line and failure to administer appropriate volumes of blood products. Plaintiffs sought $25 million, primarily for future needs of woman’s children. Defendants contended death was due to an amniotic fluid embolism. After two-week trial, jury found in favor of client.
• Defended a physician in a wrongful-death action in Boone County, Mo., resulting in a voluntary dismissal of the physician by the plaintiffs at the close of evidence during the trial. Plaintiff’s claimed the physician did not properly monitor the patient post-operatively.
• Secured a favorable decision for an anesthesiologist who provided medical care to the plaintiff, a 72-year-old woman who underwent a nerve block procedure. The plaintiff alleged that as a result of improper technique in performing the procedure, she suffered residual left-sided weakness and was permanently paralyzed. The defense argued that the procedure was necessary and was performed properly and that the plaintiff's current problems were caused by her pre-existing medical conditions.
• Received a defense verdict in which the plaintiff underwent elective surgery. During the surgery, the plaintiff suffered a perforated esophagus, most likely the result of the intubation efforts by our client, the anesthesiology team for the surgery. Although perforation is a known complication, it is extremely rare. The trial went forward against our clients and another doctor, and the jury returned a complete defense verdict. The plaintiff initially appealed the judgment, but then dismissed the appeal.
• Defended two gastric-bypass surgeons in a suit brought by one of their former patients who developed a neurological condition caused by a vitamin deficiency following her obesity surgery. The plaintiff alleged that for 10 weeks following surgery, she suffered from intractable nausea and vomiting and was unable to keep down any food, liquid or medications, including the daily multivitamins that she was directed by the doctors to take every day for the rest of her life. Throughout the trial, plaintiff’s assertion that she was unable to keep her oral multivitamins down was refuted. The jury returned a complete defense verdict.
• Won complete defense verdict for physicians group in malpractice lawsuit that claimed plaintiff was injured during surgery as a result of improper anesthesia practice.
• Represented an anesthesiologist in a matter in which the plaintiff underwent a neurosurgical procedure and suffered a significant brain injury with hemiparesis. The neurosurgeon was sued and settled before trial for his policy limits. The plaintiff also sued our client for the surgery and sought $15 million in damages, primarily for future medical needs. The jury returned a defense verdict, which was confirmed on appeal.

Medical Malpractice – Skilled-Nursing Facilities

• Secured a significant verdict when the plaintiff, the daughter of a former nursing home resident, sued on behalf of the resident who died during a heat wave in St. Louis at a time when the air conditioning system was not activated. Four other residents died at the nursing home during a 48-hour period. The medical examiner concluded that four of the residents died of hyperthermia. The plaintiff’s counsel argued that the resident died as a result of exposure to hot temperature, a fall from her wheelchair, and lack of adequate nutrition and hydration. The plaintiff sued the nursing home, its owner, the owner’s and nursing home’s management companies, and four employees. Directed verdicts were obtained on behalf of the owner, the nursing home management company and the four employees. Plaintiff sought $50 million in damages. After a five week trial, the jury returned a verdict in favor of plaintiff for $275,000, against the nursing home and owner’s management company defendants only.
• Obtained a complete defense verdict for a skilled-nursing facility in a wrongful-death action. While being transferred from her bed to a wheelchair, the female plaintiff suffered a left knee injury. Two weeks later, she complained of pain in her left lower leg and was sent to the hospital. While at the hospital, she was initially diagnosed with a deep vein thrombosis. She was then diagnosed with a fractured femur in her left leg. Because of the severity of the fracture and her underlying medical conditions, the woman’s left lower leg was amputated. The resident returned to the skilled-nursing facility. Two weeks later she suffered a stroke and subsequently died. After a two-week trial, the jury found the facility was not responsible in the woman's death.

Pro Bono

• Reunited a mother with her 3-year-old son, who had been wrongfully withheld from her for more than a year. The client was a Canadian woman who lived in northern Saskatchewan on a reserve, similar to a Native American reservation in the United States. She had allowed her son’s paternal grandparents to take the boy to the grandparents’ home in the United States for a visit. However, the grandparents soon refused to return the boy and then cut off all contact. Thereafter, the grandparents filed state court proceedings to be appointed the boy’s legal guardian, claiming that the mother had “abandoned” the boy and that the whereabouts of the mother were unknown. The mother’s attempts to obtain assistance through local Canadian attorneys were unsuccessful. The grandparents then ignored a request from the Canadian government that the boy be returned. The client was referred through the U.S. State Department. A petition for return of the child was filed under the International Child Abduction provision of The Hague Convention. After expedited discovery and a two-day trial in U.S. District Court, Eastern District of Missouri, the court granted the mother’s petition and ordered that the grandparents return the boy. Mother and son were reunited a few days later.
• Greg has several reported decisions, including the following:
  • Johnson v. Delmar Gardens West Inc., 335 S.W.3d 83 (Mo.App. E.D. 2011)
  • Powderly v. South County Anesthesia Associates Ltd., 245 S.W.3d 267 (Mo.App. E.D. 2008)
  • State ex rel. Delmar Gardens North Operating LLC v. Gaertner, 239 S.W.3d 608 (Mo. 2007)
  • Heartland Payment Systems LLC v. Utica Mut. Ins. Co., 185 S.W.3d 225 (Mo.App. E.D. 2006)
  • City of St. Louis v. Cernicek, 145 S.W.3d 37 (Mo.App. E.D. 2004)
  • Information Technologies Inc. v. Cybertel Corp., 66 S.W.3d 126 (Mo.App. E.D. 2001)
  • Aliff v. Cody, 26 S.W.3d 309 (Mo.App. W.D. 2000)
  • Aliff v. Cody, 987 S.W.2d 439 (Mo.App. W.D. 1999)
  • Brandt v. Csaki, 937 S.W.2d 268 (Mo.App. W.D. 1996)
• Successfully defended senior care facility against claims of failing to properly accommodate patient’s deafness. Judge dismissed four of the plaintiff’s claims on a successful motion for summary judgment; federal jury returned a unanimous defense verdict on the remaining six claims.