Justia Health Law Opinion Summaries

The Supreme Court affirmed the order of the trial court directing that while Plaintiff may pursue his claims against Ball State University based on its response to the COVID-19 pandemic on his on behalf, he may not pursue a class action on behalf of other students, holding that there was no error.Plaintiff, a university student, sued the University for breach of contract and unjust enrichment after the university switched to providing only online instruction for the 2020 spring semester, seeking to recover tuition and fees for in-person instruction and services allegedly promised by the university. Plaintiff sought to litigate his claims as a class action, but after he filed his action, Public Law No. 166-2021 was signed into law, prohibiting class action lawsuits against postsecondary educational institutions for contract and unjust enrichment claims arising from COVID-19. The trial court denied class certification based on this new law. The Supreme Court affirmed, holding that the trial court correctly concluded that the law was constitutional and precluded a class action in this case. View "Mellowitz v. Ball State University" on Justia Law

Plaintiff-Appellant E.W. was a participant in an employer-sponsored health insurance plan governed by the Employee Retirement Income Security Act of 1974 (“ERISA”). E.W.’s daughter, Plaintiff-Appellant I.W., was a beneficiary of E.W.’s plan. From September 2016 through December 2017, I.W. received treatment in connection with mental health challenges and an eating disorder at Uinta Academy (“Uinta”), an adolescent residential treatment center in Utah. In January 2017, Defendants-Appellees Health Net Insurance Company and Health Net of Arizona, Inc. began covering I.W.’s treatment under E.W.’s ERISA plan (the “Plan”). Effective February 23, 2017, Health Net determined I.W.’s care at Uinta was no longer medically necessary, and it denied coverage from that day forward. In assessing whether to discontinue coverage, Health Net applied the McKesson InterQual Behavioral Health 2016.3 Child and Adolescent Psychiatry Criteria. Health Net determined I.W. did not satisfy the InterQual Criteria within the relevant period and notified Plaintiffs in a letter dated March 1, 2017. Plaintiffs allegedly did not receive Health Net’s March 2017 denial letter, and I.W. remained at Uinta until December 2017, when she was formally discharged. After receiving notice in May 2018 that Health Net had denied coverage effective February 23, 2017, Plaintiffs appealed the decision. Health Net again determined I.W. did not satisfy the InterQual Criteria during the relevant period and upheld its initial denial. Plaintiffs then appealed to an external reviewer, which upheld the decision to deny coverage. Health Net moved to dismiss plaintiffs' legal claims under ERISA and the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (“MHPAEA”). The district court denied Plaintiffs’ motion and granted summary judgment to Health Net. After review, the Tenth Circuit affirmed the district court’s decision granting summary judgment to Health Net on Plaintiffs’ ERISA claim; the Court reversed the finding Plaintiffs failed to state a claim under MHPAEA; and the case was remanded for further proceedings. View "W., et al. v. Health Net Life Insurance Company, et al." on Justia Law

The Supreme Court dismissed this interlocutory appeal of a vacated class certification order and directed the circuit court to remand the case to address motions to compel arbitration, holding that this appeal was moot.Plaintiffs, who represented the estates of former residents of fourteen different nursing homes, alleged breach of contract and unjust enrichment claims against the nursing homes, in violation of the Arkansas Civil Rights act and the Arkansas Deceptive Trade Practices Act. The nursing homes moved to compel arbitration for all but two of the named plaintiffs, after which the plaintiffs moved for class certification. The circuit court granted Plaintiffs' motion for class certification without ruling on the motions to compel arbitration. The nursing homes brought an interlocutory appeal of the class-certification order and petitioned for writ of prohibition, mandamus, and certiorari. The Supreme Court granted the writ petition, vacating the order granting class certification, and ordered the circuit court to rule on the motions to compel before ruling on class certification, holding that the interlocutory appeal of the vacated class-certification order was moot. View "Reliance Health Care, Inc. v. Mitchell" on Justia Law

The appellants in this case filed an action to permanently enjoin enforcement of five Acts of the Oklahoma Legislature. Each Act concerned the termination of a pregnancy. The appellants' challenges were based upon Oklahoma law and not federal law. They argued there was a constitutional right to terminate a pregnancy under the Oklahoma Constitution. The trial court denied a temporary injunction on three of the Acts, which was the basis of this appeal. The Oklahoma Supreme Court granted a temporary injunction pending appeal, vacated the trial court's order denying temporary injunction, directed it to grant a temporary injunction and remanded the matter for further proceedings on the merits. View "Oklahoma Call for Reproductive Justice v. Drummond" on Justia Law

Facing a tight deadline from the Ninth Circuit, the Environmental Protection Agency banned the use of chlorpyrifos on food crops. Two environmental groups petitioned the EPA in 2007 to have all tolerances revoked. In denying the petition, the EPA concluded that their objections were “not supported by valid, complete, and reliable evidence.”   The Eighth Circuit granted the petitions, finding that the EPA’s decision was arbitrary and capricious. The court explained that in this case, the EPA believed it lacked discretion or at least acted that way. The Ninth Circuit’s opinion had already narrowed its options down to two: revoke the tolerances or modify them. With little time to act, the agency ruled out the second option, leaving only revocation by default. In doing so, however, it misread the statute and misunderstood the “scope of its discretion”. Therefore, the court set aside the decision as arbitrary and capricious. Further, the court explained that a partial ban was a real alternative for the EPA. It could have canceled some registrations and retained others that satisfied the statutory safety margin. View "RRVSG Assoc. v. Michael Regan" on Justia Law

Alicia Sampson ("Alicia"), as administratrix of the estate of her deceased husband, Joshua Sampson ("Josh"), appealed the grant of summary judgment in favor of HeartWise Health Systems Corporation; HeartWise Clinic, LLC (collectively referred to as "HeartWise"); Isaac Health & Prevention Partners, LLC ("Isaac Health"); William Nixon, M.D.; and Jeffrey Saylor, M.D., in a wrongful-death action. At its HeartWise clinic, Isaac Health administered a battery of up to 31 physical tests that were intended "to assist in the detection of early evidence of vascular and cardiac abnormalities." In 2015, 29-year-old Josh visited the Isaac Health clinic. Months earlier, Josh's father died at age of 56 from "right ventricular dysplasia," which was a "congenital heart defect." Lowell's death led the Sampson family to seek heart evaluations to determine whether they had inherited the heart defect. Josh underwent the full battery of testing provided at the Isaac Health clinic; Josh's data from the left ventricular echocardiogram was within the "normal" range. Josh's mother, who also received the testing, stated that the nurse practitioner did not tell Josh in any way that he "needed to have any further diagnostic work-up or testing relative to his heart." On October 5, 2015, Josh collapsed at home while working on a construction project. He was taken to the Emergency Room, but died that day. The Sampson family procured a private autopsy; the report concluded that Josh died due to an arrhythmia secondary to hypertrophic cardiomyopathy, a congenital heart condition. Alicia thereafter filed suit against the clinic, HearWise and the doctors, alleging fraud and negligence. The Alabama Supreme Court reversed summary judgment entered in favor of Isaac Health and Drs. Nixon and Saylor with respect to Alicia's negligence allegations against them because those allegations were never properly presented to the circuit court for adjudication. The Court also reversed summary judgment in favor of HeartWise with respect to Alicia's fraud allegations against HeartWise because Alicia presented substantial evidence of Josh's reasonable reliance upon HeartWise's representations about its program. The Court affirmed summary judgment in favor of Isaac Health with respect to Alicia's fraud allegations against Isaac Health because Alicia failed to present substantial evidence that Josh's course of conduct would have changed if he had not seen HeartWise materials in the Isaac Health clinic's waiting room. The Court also affirmed summary judgment in favor of HeartWise with respect to Alicia's negligence allegations against HeartWise for multiple reasons. View "Sampson v. HeartWise Health Systems Corporation, et al." on Justia Law

This appeal stemmed from a medical-malpractice wrongful-death action filed by Patricia West ("Mrs. West"), the personal representative of the estate of her husband, John West, Jr. ("Mr. West"), against Springhill Hospitals, Inc., d/b/a Springhill Memorial Hospital ("SMH"). In 2014, then 59-year-old Mr. West accidentally sliced most of the tip of his left thumb off when he was using a table saw in his shop. He went to the emergency room, at which he had surgery to suture the wound from the saw cut. Mr. West was given two pain medications for postsurgical care: Dilaudid, the brand name for hydromorphone, and Percocet, the brand name for the opioid oxycodone. Mr. West was admitted to the hospital following surgery for observation. He was given the prescribed pain medications while in the hospital. The hospital admitted prescribed doses of Dilaudid were administered to Mr. West, but Percoset was not. Mr. West was found unresponsive after the doses of Dilaudid, and no drugs to counteract opioid overdoses were given. Mrs. West's lawsuit alleged negligence against the hospital for failing to assess monitor her husband while in the hospital. A jury returned a verdict against SMH and awarded $35 million in punitive damages. The trial court thereafter entered judgment on the jury's verdict finding SMH liable. After a hearing concerning a remittitur of the punitive-damages award, the trial court reduced the amount of the award to $10 million. After review, the Alabama Supreme Court affirmed both the judgment entered on the jury's verdict finding SMH liable and the trial court's order reducing the punitive-damages award. View "Springhill Hospitals, Inc. v. West" on Justia Law

The First Circuit affirmed the judgment of the district court determining that Anonymous Appellant (AA) should be civilly committed upon the expiation of his prison sentence, holding that AA was not entitled to relief on his allegations of error.Seventy-three-year-old AA had a history of incarceration spanning more than five decades. During his incarceration AA began to exhibit psychotic symptoms and was diagnosed with having schizoaffective disorder, bipolar type, and antisocial personality disorder. Based on the concerns of a risk-assessment panel the government filed a petition for the civil commitment of AA pursuant to 18 U.S.C. 4246. The district court granted the petition. The First Circuit affirmed, holding that there was no error in the proceedings below. View "United States v. Anonymous Appellant" on Justia Law

Adams, born in 1960, smoked about a pack a day starting at age 18 and worked in coal mines at times between 1979-1995, mostly underground using a “cutting machine” in the “dustiest” areas. Adams struggled to breathe after his retirement. Adams’s 1998 application under the Black Lung Benefits Act, 30 U.S.C. 901(b), was denied because he failed to prove that he had pneumoconiosis. In 2008, Adams sought benefits from Wilgar. His treating physician, Dr. Alam, identified the causes of his 2013 death as cardiopulmonary arrest, emphysema, coal worker’s pneumoconiosis, throat cancer, and aspiration pneumonia.A 2019 notice in the case stated “the Court may look to the preamble to the revised” regulations in weighing conflicting medical opinions. Wilgar unsuccessfully requested discovery concerning the preamble and the scientific studies that supported its conclusions. The ALJ awarded benefits, finding that Adams had “legal pneumoconiosis” and giving Dr. Alam’s opinion that Adam’s coal mine work had substantially aggravated his disease “controlling weight.” All things being equal, a treating physician’s opinion is “entitled to more weight,” 30 C.F.R. 718.104(d)(1). Wilgar's three experts had opined that Adams’s smoking exclusively caused his disease The ALJ gave “little weight” to these opinions, believing that they conflicted with the preamble to the 2001 regulation.The Benefits Review Board and Sixth Circuit affirmed. The preamble interpreted the then-existing scientific studies to establish that coal mine work can cause obstructive diseases, either alone or in combination with smoking. The ALJ simply found the preamble more persuasive than the experts. View "Wilgar Land Co. v. Director, Office of Workers’ Compensation Programs" on Justia Law

Plaintiffs are individual physicians based in Arizona, joined by several Arizona medical and advocacy groups. The named Defendants are Arizona Attorney General Kristin Mayes, all Arizona County Attorneys, and various state enforcement agencies. The Attorney General declined to defend this lawsuit, and the district court allowed Warren Petersen, President of the Arizona Senate, and Ben Toma, Speaker of the Arizona House of Representatives, to intervene. This suit by Arizona physicians, medical associations, and advocacy groups claims that an Arizona law criminalizing the performance of certain abortions is unconstitutionally vague. The district court denied a preliminary injunction, finding that Plaintiffs lacked standing.   The Ninth Circuit reversed and remanded. The panel held that the physician plaintiffs had demonstrated both actual and imminent injuries sufficient for standing. Plaintiffs suffered an actual injury—economic losses— because they lost money by complying with the laws, which forbade them from providing medical services they would otherwise provide, and these economic losses were fairly traceable to the statute. A favorable decision would relieve plaintiffs of compliance with the laws and restore the revenue generated by the prohibited procedures. Plaintiffs sufficiently alleged two imminent future injuries that affected interests protected by the Fifth and Fourteenth Amendments: (1) a liberty interest that was imperiled because violating the statute could result in imprisonment; and (2) a property interest that was threatened because a statutory violation could result in revocation of plaintiffs’ licenses, loss of revenue, and monetary damages. Finally, plaintiffs satisfied the causation and redressability requirements with respect to their imminent future injury. View "PAUL ISAACSON, ET AL V. KRISTIN MAYES, ET AL" on Justia Law