Justia Health Law Opinion Summaries

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Shawna Tanner, the plaintiff below, appealed an adverse ruling on summary judgment. Tanner was approximately 35 weeks pregnant and in custody at the Metropolitan Detention Center in Bernalillo County, New Mexico when she went into the final stages of her pregnancy. Over the ensuing thirty hours, commencing with the point at which her water broke, Appellees—employees of a nationwide private medical contractor—ignored and minimized her symptoms, refused to transport her to a hospital, and failed to conduct even a cursory pelvic examination. Only minimal attention was given to her: water, Tylenol, and sanitary pads. After thirty hours of pain and trauma, Tanner gave birth to her son. The child was born with his umbilical cord wrapped around his neck. He was not breathing. He had no pulse. This appeal considered whether full-time employees of a for-profit, multi-state corporation organized to provide contract medical care in detention facilities may assert a qualified immunity defense to shield themselves from 42 U.S.C. 1983 liability. The Tenth Circuit found neither historical justifications of special government immunity nor modern policy considerations supported the extension of a qualified immunity defense to Appellees. Judgment was reversed and the matter remanded for further proceedings. View "Tanner v. McMurray" on Justia Law

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This case arose from the tragic death of 21-year-old Madison Jensen while in custody of the Duchesne County Jail. Jensen was arrested after her father alerted law enforcement to her drug use and possession of drug paraphernalia. Her estate brought this action for deprivation of civil rights under color of state law. The district court granted summary judgment in favor of the county and qualified immunity to jail supervisors and staff, but denied qualified immunity to jail medical personnel, Defendants-Appellants (Nurse) Jana Clyde and Dr. Kennon Tubbs. The district court held that genuine issues of material fact precluded qualified immunity on the Estate’s claims of: (1) deliberate indifference to serious medical needs against Nurse Clyde; and (2) supervisory liability against Dr. Tubbs. The Tenth Circuit ultimately concluded that when an individual’s sole purpose was “to serve as a gatekeeper for other medical personnel,” and that person delays or refuses to fulfill the gatekeeper role, he may be liable for deliberate indifference. Clyde was the gatekeeper in this case, and she failed to fulfill that role when she chose to give Jensen Gatorade instead of calling Dr. Tubbs or PA Clark. Accordingly, Clyde was given sufficient notice that what she was doing violated Jensen’s rights to medical care. The Court affirmed as to Clyde and reversed as to Dr. Tubbs. View "Estate of Madison Jody Jensen v. Clyde" on Justia Law

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Petitioner Andrew Panaggio appealed a New Hampshire Compensation Appeals Board (Board) determination that respondent, CNA Insurance Company (the insurer), could not be ordered to reimburse him for his purchase of medical marijuana because such reimbursement would have constituted aiding and abetting his commission of a federal crime under the federal Controlled Substances Act (CSA). When Panaggio appealed the insurer’s denial to the New Hampshire Department of Labor, a hearing officer agreed with the insurer. Panaggio appealed the hearing officer’s decision to the Board, which unanimously found that his use of medical marijuana was reasonable and medically necessary. Nonetheless, the Board upheld the insurer’s refusal to reimburse Panaggio, concluding that “the carrier is not able to provide medical marijuana because such reimbursement is not legal under state or federal law.” The New Hampshire Supreme Court surmised the issue on appeal raised a question of federal preemption, "which is essentially a matter of statutory interpretation and construction." Although it was an issue of first impression for the New Hampshire Court, other courts considered whether the CSA preempted a state order requiring reimbursement of an employee’s purchase of medical marijuana. Panaggio reasoned that “[b]ecause New Hampshire law unambiguously requires the insurer to pay for the claimant’s medically related treatment,” an insurer that reimburses a claimant for the purchase of medical marijuana acts without the volition required by the federal aiding and abetting statute. The insurer asserted Panaggio’s argument leads to an absurd result, observing that “[c]onflict preemption applies because state law requires what federal law forbids.” The New Hampshire Supreme Court ultimately concluded the CSA did not make it illegal for an insurer to reimburse an employee for his or her purchase of medical marijuana. "[A] Board order to reimburse Panaggio does not interfere with the federal government’s ability to enforce the CSA. Regardless of whether the insurer is ordered to reimburse Panaggio for his medical marijuana purchase, the federal government is free to prosecute him for simple possession of marijuana under the CSA." Under these circumstances, the Court concluded the “high threshold” for preemption “is not met here.” The Board's decision was reversed and the matter remanded for further proceedings. View "Appeal of Andrew Panaggio" on Justia Law

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The Court of Appeal issued a peremptory writ of mandate directing the trial court to set aside its order enjoining the County from enforcing its orders to the extent they prohibit outdoor dining due to the COVID-19 pandemic until after conducting an appropriate risk-benefit analysis. During the pendency of the petition, the County lifted its prohibition based on infection rates declining and ICU availability increasing. However, the court concluded that these cases are not moot because conditions may change and the County may re-impose its outdoor restaurant dining ban.The court held that courts should be extremely deferential to public health authorities, particularly during a pandemic, and particularly where, as here, the public health authorities have demonstrated a rational basis for their actions. In this case, the County's order banning outdoor dining is not a plain, palpable invasion of rights secured by the fundamental law and is rationally related to limiting the spread of COVID-19.Even assuming that Mark's, a restaurant, has a First Amendment right to freedom of assembly, or that Mark's has standing to bring a First Amendment challenge on behalf of its patrons or employees, the court held that the order does not violate Mark's purported First Amendment right to freedom of assembly or that of its patrons. The court explained that the County's order does not regulate assembly based on the expressive conduct of the assembly; it is undisputed that limiting the spread of COVID-19 is a legitimate and substantial government interest; and the order leaves open alternative channels for assembling. Accordingly, the court entered a new order denying the Restauranteurs' request for a preliminary injunction. View "County of Los Angeles Department of Health v. Superior Court of Los Angeles County" on Justia Law

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Smith suffered an injury from a car accident, retained an attorney for a personal injury lawsuit, and authorized her attorney to obtain her healthcare information. The attorney requested Smith’s medical records from MHS, on three occasions. RecordQuest, not MHS, answered those requests and charged Smith’s attorney (who paid on her behalf) a $20.96 handling fee and an $8.26 certification fee each time.Smith brought a class action, alleging these charged fees contravened the permissible fee schedule set out in Wis. Stat. 146.83(3f)(b) for healthcare records requests and resulted in the unjust enrichment of RecordQuest. The district court dismissed both claims, reasoning that the statute imposes a duty upon only healthcare providers.” RecordQuest is not a healthcare provider but is the agent of MHS; “no principle of agency law holds that a principal’s liability is imputed to the agent when the agent performs the act that results in the principal’s liability.” Smith’s unjust enrichment claim failed because any unjust benefit that Smith allegedly conferred to RecordQuest belonged to MHS.The Wisconsin Court of Appeals subsequently expressly disagreed with the district court’s analysis of Smith’s statutory claim. The Seventh Circuit reversed the dismissal of the statutory claim but affirmed as to Smith’s unjust enrichment claim. Under section 146.83(3f)(b), Smith has a remedy at law for any “injustice” that allegedly resulted from excessive payments; the equitable remedy of unjust enrichment is derivative of and predicated upon the statutory claim. View "Smith v. RecordQuest LLC" on Justia Law

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The Fifth Circuit withdrew its prior opinion and substituted the following opinion.The States filed suit against the United States, raising constitutional challenges to Section 9010 of the Affordable Care Act (ACA), as well as statutory and constitutional challenges to an HHS administrative rule (Certification Rule).As a preliminary matter, the Fifth Circuit affirmed the district court's ruling that the States had standing. The court reversed the district court's ruling that the States' Administrative Procedure Act (APA) claims were not time-barred and dismissed those claims for lack of jurisdiction. On the merits, the court held that the Certification Rule and Section 9010 are constitutional and lawful. As a result, the court explained that there can be no equitable disgorgement, regardless of whether such a remedy would be otherwise appropriate. Accordingly, the court affirmed the district court's judgment on the Section 9010 claims and reversed the district court's judgment that the Certification Rule violated the nondelegation doctrine. Therefore, the court rendered judgment in favor of the United States. Because the court held that neither the Certification Rule nor Section 9010 are unlawful, the court vacated the district court's grant of equitable disgorgement to the States. View "Texas v. United States" on Justia Law

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Plaintiff-appellee Christina Smith was the mother of Joshua England. Her claims arose from the death of England from a ruptured appendix in May 2018, while England was housed at the Joseph Harp Correctional Center (JHCC), an Oklahoma Department of Corrections (ODOC) facility in Lexington, Oklahoma. England was a 21-year-old prisoner at JHCC who was a few months away from release when he submitted multiple sick call requests. At the fifth such request, England complained his stomach hurt and he was short of breath. Unable to bear the pain while waiting at the clinic, England died in his cell from a ruptured appendix with acute peritonitis. Defendants-Appellants Joe Allbaugh, the Director of the Department of Corrections at the time this claim arose, and Carl Bear, the Warden of Joseph Harp Correctional Center (collectively, Defendants) appealed the district court’s order denying their motion to dismiss Smith's subsequent lawsuit relating to England's death on grounds of qualified immunity. The Tenth Circuit reversed, finding Smith alleged only that JHCC medical staff failed to follow procedure, not that Defendants failed to enforce those policies. Furthermore, the Court determined Smith failed to plead sufficient factual allegations to support deliberate indifference on the part of these defendants. Likewise, Smith failed to sufficiently plead Defendants improperly hired, supervised, and retained certain medical staff employees. View "Smith v. Allbaugh" on Justia Law

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When Medicare overpays hospitals, it offsets that mistake by reducing future payments. By 2013, Medicare was out $11 billion because of new diagnostic codes and bookkeeping that did not keep up. Congress required that the Secretary of Health and Human Services recoup that amount by the end of fiscal year 2017 by reducing the base rate (standardized amount) paid for inpatient care and directed the Secretary to adjust the base rate by 0.5% each year through 2023, 129 Stat. 87, 163 (2015). Subsequently, while reviewing the 2017 budget, the Secretary realized that a -3.2% adjustment would leave the agency short of its $11 billion goal and announced a -3.9% adjustment. Congress then told the Secretary to increase the base rate by 0.4588% (not 0.5%) in 2018, 130 Stat. 1033, 1320 (2016). In 2017, the Secretary adjusted the base rate -3.9%. The agency met its goal. In 2018, the Secretary adjusted the base rate -3.4412%.Medicare providers sued, arguing that the Secretary should have reversed that expedient at the end of 2017 rather than carry it over into 2018, costing the hospitals $840 million in lost payments. The D.C. Circuit affirmed the dismissal of the suit. While the hospitals felt a “significant financial impact” from the -0.7% adjustment, Section 7(b)(5) bars judicial review of adjustments made under the Act. View "Fresno Community Hospital and Medical Center v. Cochran" on Justia Law

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The Supreme Court affirmed the circuit court's order extending K.E.K.'s involuntary commitment pursuant to Wis. Stat. 51.20(13)(g)3., holding that Wis. Stat. 51.20(1)(am), the statute upon which Waupaca County relied on to prove K.E.K.'s dangerous, is facially constitutional and that K.E.K.'s as-applied constitutional challenges failed.K.E.K. challenged the commitment extension on appeal, arguing that section 51.20(1)(am) was both facially unconstitutional and unconstitutional as applied because it does not require a sufficient showing of current dangerousness, as exhibited by recent acts of dangerousness. The court of appeals denied relief. The Supreme Court affirmed, holding that the statute is facially constitutional and that K.E.K.'s as-applied constitutional challenges, which the Court noted were disguised sufficiency of the evidence challenges, also failed. View "Waupaca County v. K.E.K." on Justia Law

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Cutchin’s wife and daughter were killed in an automobile accident that occurred when another driver, Watson, age 72, struck their vehicle. Cutchin alleges that Watson’s driving ability was impaired by medications she had been prescribed, including an opioid. Cutchin filed a malpractice suit against Watson’s healthcare providers, charging them with negligence for an alleged failure to warn Watson that she should not be driving given the known motor and cognitive effects of those medications. After the providers and their malpractice insurer agreed to a settlement of $250,000, the maximum amount for which they can be held individually liable under the Indiana Medical Malpractice Act (MMA), Cutchin sought further relief from the Patient’s Compensation Fund, which acts as an excess insurer. The Fund argued that the MMA does not apply to Cutchin’s claim and that he is barred from seeking excess damages from the Fund. The district court agreed.The Seventh Circuit certified to the Indiana Supreme Court the questions: Whether Ithe MMA prohibits the Fund from contesting the Act’s applicability to a claim after the claimant concludes a court‐approved settlement with a qualified healthcare provider, and whether the MMA applies to claims brought against individuals (survivors) who did not receive medical care from the provider, but who are injured as a result of the provider’s negligence in providing medical treatment to someone else. View "Cutchin v. Robertson" on Justia Law