Justia Health Law Opinion Summaries

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The People of the State of California, by and through the Santa Clara County Counsel, the Orange County District Attorney, the Los Angeles County Counsel, and the Oakland City Attorney, filed suit against various pharmaceutical companies involved in the manufacture, marketing, distribution, and sale of prescription opioid medications. The People alleged the defendants made false and misleading statements as part of a deceptive marketing scheme designed to minimize the risks of opioid medications and inflate their benefits. The People alleged this scheme caused a public health crisis in California by dramatically increasing opioid prescriptions, opioid use, opioid abuse, and opioid-related deaths. In their suit, the People allege causes of action for violations of the False Advertising Law, and the public nuisance statutes. After several years of litigation, the defendants served business record subpoenas on four nonparty state agencies: the California State Board of Registered Nursing (Nursing Board), the California State Board of Pharmacy (Pharmacy Board), the Medical Board of California (Medical Board), and the California Department of Justice (DOJ). The Pharmacy Board, the Medical Board, and the DOJ served objections to the subpoenas. The Nursing Board filed a motion for a protective order seeking relief from the production obligations of its subpoena. After further litigation, which is recounted below, the trial court ordered the state agencies to produce documents in response to the subpoenas. In consolidated proceedings, the state agencies challenged the trial court's orders compelling production of documents. After review, the Court of Appeal concluded the motions to compel against the Pharmacy Board and Medical Board were untimely, and the defendants were required to serve consumer notices on at least the doctors, nurses, pharmacists, and other health care professionals whose identities would be disclosed in the administrative records, investigatory files, and coroner’s reports. Furthermore, the Court concluded the requests for complete administrative records and investigatory files, were overbroad and not reasonably calculated to lead to the discovery of admissible evidence. "The requests for complete administrative records and investigatory files also ran afoul of the constitutional right to privacy and the statutory official information and deliberative process privileges." The trial court was directed to vacate its orders compelling production of documents, and to enter new orders denying the motions to compel and, for the Nursing Board, granting its motion for a protective order. View "Board of Registered Nursing v. Super. Ct." on Justia Law

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Alice Borman filed this action against defendants Tara Brown, M.D. and North County Eye Center, Inc. (NCEC). Borman alleged that she sought treatment from defendants for a “droopy eyelid and brow.” According to Borman, Dr. Brown told Borman that Brown could perform a “brow lift” to correct the problem, but that a brow lift would not be covered by Borman’s insurance. Borman further alleged that Dr. Brown told Borman that she could instead perform a blepharoplasty, which would be covered by Borman’s insurance. Borman further claimed that Dr. Brown’s statement that a brow lift would not be covered by Borman’s insurance was false, and that Dr. Brown had no reasonable basis for making the statement. Borman alleged that she relied on Dr. Brown’s representations and agreed to undergo a blepharoplasty. After undergoing the blepharoplasty, Borman claimed that she continued to have physical difficulties with her eyelid and her brow. Borman consulted another doctor who advised Borman that Dr. Brown had “performed the wrong procedure and that a brow[ ]lift should have been performed instead.” The trial court denied Borman's motion for summary judgment, denied the motion for summary adjudication of the professional negligence and lack of informed consent causes action, but granted the motion for summary adjudication as to Borman’s fraud and deceit and battery causes of action. The trial court entered judgment in favor of defendants, and awarded costs to defendants as prevailing parties. Borman appealed, arguing the trial court erred in granting defendants' motion for summary adjudication with respect to her fraud and deceit cause of action, because the trial court should have permitted her to “proceed at trial on a claim for ‘[n]egligent [m]isrepresentation.’ ” The Court of Appeal concluded the record contained evidence from which a reasonable jury could find that Dr. Brown intended for Borman to rely on her statement that a brow lift would not be covered by Borman’s insurance. Since that was the sole element of a negligent misrepresentation theory of liability that the trial court found Borman would be unable to prove, the Court further concluded the trial court erred in granting summary adjudication of Borman’s fraud and deceit cause of action. The trial court's postjudgment cost order, and the order granting summary adjudication of Brown’s fraud and deceit cause of action were both reversed, and the matter remanded for further proceedings. View "Borman v. Brown" on Justia Law

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The Health Care Authority for Baptist Health, an affiliate of UAB Health System ("HCA"), and The Health Care Authority for Baptist Health, an affiliate of UAB Health System d/b/a Prattville Baptist Hospital (collectively, "the HCA entities"), appealed a circuit court order denying their motion to compel arbitration in an action brought by Leonidas Dickson, II. In 2015, Dickson sustained injuries as a result of an automobile accident. Following the accident, Dickson was taken to Prattville Baptist Hospital ("PBH"), where he was treated and discharged. Dickson was partially covered by a health-insurance policy issued by Blue Cross and Blue Shield of Alabama, Inc. ("BCBS"). PBH was a party to a "Preferred Outpatient Facility Contract" ("the provider agreement") with BCBS, under which the medical care rendered to Dickson in the emergency department at PBH was reimbursable. In 2017, Dickson filed a complaint to challenge a reimbursement that PBH had received in exchange for Dickson's medical treatment. Dickson's complaint also sought to certify a class of people who were insured by BCBS and who had received care at any hospital operated by HCA's predecessor, Baptist Health, Inc. ("BHI"). After the HCA entities' motion to dismiss was denied, the HCA entities filed an answer to the lawsuit, but the answer did not raise arbitration as a defense. After a year of extensive discovery (including class certification and class-related discovery), the HCA entities moved to compel arbitration on grounds that Dickson's health-insurance policy with BCBS required all claims related to the policy to be arbitrated and that the provider agreement also provided for arbitration, contingent upon the arbitration requirements of the BCBS policy. The trial court denied the motion to compel without providing a reason for the denial. After a request for reconsideration was also denied, the HCA entities appealed. The Alabama Supreme Court concluded the HCA entities waived their right to arbitration, thus affirming the trial court order. View "The Health Care Authority for Baptist Health v. Dickson" on Justia Law

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Shah, a board-certified pediatric anesthesiology specialist, joined STAR, which became the exclusive provider of anesthesia services at several San Antonio-area acute-care hospitals, including NCB. BHS guaranteed STAR $500,000 in collections for pediatric anesthesia services provided at NCB. In 2012, STAR became the exclusive provider of anesthesia services at four BHS hospitals. Shah was not a party to the 2012 agreement, nor was he named in the pediatric income guarantee but he continued to practice as a STAR pediatric anesthesiologist, becoming the primary beneficiary of STAR’s guaranteed collections. In 2016, STAR and BHS amended the 2012 agreement, eliminating the pediatric income guarantee. The exclusivity provision remained. STAR terminated its relationship with Shah. Shah could no longer provide pediatric anesthesia services at NCB or any other BHS facility included in the exclusivity agreement. Shah requested authorization to provide pediatric anesthesia care at NCB; BHS responded that Shah’s reappointment to the Medical Staff of BHS and his privileges were approved but the exclusivity provision precluded Shah from providing pediatric anesthesia services at six BHS facilities (including NCB). After unsuccessfully suing STAR in Texas state court, Shah sued under the Sherman Act.The Fifth Circuit affirmed summary judgment in favor of the BHS parties. Shah’s definition of the relevant market is insufficient as a matter of law; it does not encompass all interchangeable substitute products because it does not include the two non-BHS facilities that the BHS parties contend serve as viable alternatives to BHS facilities. View "Shah v. VHS San Antonio Partners, LLC" on Justia Law

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Johnson & Johnson and other pharmaceutical defendants sought mandamus relief from an Alabama circuit court order that refused to transfer venue of the underlying lawsuit to the Jefferson County, Alabama circuit court, on grounds that venue in Conecuh County was not proper as to all plaintiffs, or alternatively, on the basis that convenience of the parties and/or the interest of justice required it. In 2019, the plaintiffs filed a complaint at the Conecuh Circuit Court against numerous defendants that, they averred, manufactured, marketed, distributed, and/or dispensed opioid medications throughout Alabama in a manner that was misleading, unsafe, and resulted in drug addiction, injury, and/or death to Alabama citizens. The complaint asserted claims of negligence, nuisance, unjust enrichment, fraud and deceit, wantonness, and civil conspiracy. The manufacturer defendants moved to transfer the case to Jefferson County, reasoning that because 8 of the 17 plaintiffs either had a place of business in Jefferson County or operated hospitals in Jefferson County or adjacent counties, logic dictated that a large percentage of the witnesses for those plaintiffs (i.e., prescribing doctors, hospital administrators, etc.) and their evidence were located in or around Jefferson County. After a review of the circuit court record, the Alabama Supreme Court determined defendants did not demonstrate a clear, legal right to transfer the underlying case from Conecuh to Jefferson County. Therefore, the petition was denied. View "Ex parte Johnson & Johnson et al." on Justia Law

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Martin Crowson was an inmate at the Washington County Purgatory Correctional Facility (the “Jail”) when he began suffering from symptoms of toxic metabolic encephalopathy. Nurse Michael Johnson and Dr. Judd LaRowe, two of the medical staff members responsible for Crowson’s care, wrongly concluded Crowson was experiencing drug or alcohol withdrawal. On the seventh day of medical observation, Crowson’s condition deteriorated and he was transported to the hospital, where he was accurately diagnosed. After Crowson recovered, he sued Johnson, LaRowe, and Washington County under 42 U.S.C. 1983, alleging violations of the Eighth and Fourteenth Amendments. The district court denied motions for summary judgment on the issue of qualified immunity by Johnson and LaRowe, concluding a reasonable jury could find both were deliberately indifferent to Crowson’s serious medical needs, and that it was clearly established their conduct amounted to a constitutional violation. The district court also denied the County’s motion for summary judgment, concluding a reasonable jury could find the treatment failures were an obvious consequence of the County’s reliance on LaRowe’s infrequent visits to the Jail and the County’s lack of written protocols for monitoring, diagnosing, and treating inmates. Johnson, LaRowe, and the County filed consolidated interlocutory appeals, raising threshold questions of jurisdiction. Johnson and LaRowe challenged the denial of qualified immunity, while the County contended the Tenth Circuit should exercise pendent appellate jurisdiction to review the district court’s denial of its summary judgment motion. The Tenth Circuit exercised limited jurisdiction over Johnson’s and LaRowe’s appeals pursuant to the exception to 28 U.S.C. 1291, carved out for purely legal issues of qualified immunity through the collateral order doctrine. The Court held Johnson’s conduct did not violate Crowson’s rights and, assuming without deciding LaRowe’s conduct did, the Court concluded LaRowe’s conduct did not violate any clearly established rights. The Court's holding was "inextricably intertwined with the County’s liability on a failure-to-train theory," so the Court exercised pendent appellate jurisdiction to the extent Crowson’s claims against the County rested on that theory. However, under Tenth Circuit binding precedent, the Court's holdings on the individual defendants’ appeals were not inextricably intertwined with Crowson’s claims against the County to the extent he advanced a systemic failure theory. The district court's denial of summary judgment to Johnson, LaRowe, and the County on the failure-to-train theory was reversed, and the remainder of the County’s appeal was dismissed for lack of jurisdiction. View "Crowson v. Washington County State, Utah" on Justia Law

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Pursuant to the Affordable Care Act, Congress required hospitals to make public "a list" of "standard charges" in accordance with guidelines developed by the Secretary of Health and Human Services. The Hospital and others challenged the Secretary's rule defining "standard charges" as including prices that hospitals charge insurers.The DC Circuit affirmed the district court's grant of summary judgment in favor of the Secretary, holding that the rule does not violate the Affordable Care Act of 2010, the Administrative Procedure Act, or the First Amendment. The court concluded that, viewed in its entirety, 42 U.S.C. 2718(e) is best interpreted as requiring disclosure of more than list prices. The court explained that section 2718(e) permits the Secretary to require disclosure of negotiated rates, and requiring hospitals to display certain datapoints separately falls squarely within the Secretary's authority to develop guidelines for making the list public. Furthermore, contrary to the Association's argument, the best reading of section 2718(e), in its entirety, permits the Secretary to require hospitals to display the information in multiple ways.In regard to the APA claims, the court concluded that the Secretary adequately addressed the feasibility and administrative burdens, as well as the benefits, of complying with the rule. Furthermore, the court rejected the Association's claim that the agency changed its position. Finally, the court concluded that the Association's argument that the rule violates the First Amendment is squarely barred by the Supreme Court's decision in Zauderer v. Office of Disciplinary Counsel of the Supreme Court of Ohio, 471 U.S. 626 (1985), and the court's case law applying that decision. View "American Hospital Ass'n v. Azar" on Justia Law

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Due to the rate of positive COVID-19 cases and hospitalizations on O'ahu, the Supreme Court ordered that the August 27, 2020 order regarding temporary extension of the time requirements under Haw. R. Pen. P. 5(c)(3) for first circuit criminal matters is further extended until February 14, 2021.On August 27, because of a surge of COVID-19 cases in community correctional centers and facilities, especially at the O‘ahu Community Correctional Center, the Supreme Court entered its order providing that the first circuit may temporarily extend the time requirements for preliminary hearings to protect public health and safety. Because the rate of positive COVID-19 cases continues to fluctuate and the grand jury was scheduled to be in recess in January, the Supreme Court held that a further extension of the August 27 order was necessary. Thus, the Court ordered that the August 27 order be extended until February 14, 2021 unless otherwise further modified or extended. View "In re Judiciary's Response to the COVID-19 Outbreak" on Justia Law

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The Supreme Court reversed the judgment of the court of appeals denying Henderson County Health Care Corporation's (hereinafter, Redbanks) petition for a writ of prohibition prohibiting the enforcement of an order issued by Judge Karen Wilson of the Henderson Circuit Court compelling Redbanks to produce certain consultant reports to the real party of interest, Roland McGuire, holding that the court of appeals erred.Specifically, the Supreme Court held Redbanks was entitled to the issuance of the writ because the consultant reports at issue in this case were protected by the Federal Quality Assurance Privilege, 42 U.S.C. 1396r(b)(1)(B) and 42 U.S.C. 1395i-3(b)(1)(B), because they were used for quality assurance purposes. View "Henderson County Health Care Corp. v. Honorable Karen Lynn Wilson" on Justia Law

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Defendants appealed the district court's judgment certifying a plaintiff class and enjoining state defendants from conducting Medicaid fair hearings in a manner that does not result in final determinations of Medicaid eligibility within 90 days of hearing requests. At issue is the phrase "final administrative action" in the context of a federal Medicaid regulation that requires a state agency to take such action within a specified time limit following a Medicaid applicant's request for a fair hearing. 42 C.F.R. 431.244(f).The Second Circuit held that the federal regulatory requirement of "final administrative action" within 90 days requires the state to determine Medicaid eligibility within that time. However, the court explained that such determinations may be made in hearing decisions or on remand to local agencies. Therefore, the regulation mandates that states meet the applicable deadline, but it does not limit states as to the administrative level at which that deadline is met. The court affirmed in part and remanded for further proceedings. View "Lisnitzer v. Zucker" on Justia Law