Justia Health Law Opinion Summaries

A man with severe mental illness stabbed his parents during a psychotic episode and was subsequently committed to a psychiatric hospital. He appealed that commitment order. Before the commitment hearing, he stopped taking prescribed medications, leading hospital staff to petition for permission to administer medication involuntarily. The court granted the medication petition as well as a revised petition requesting a higher dose. He also appealed the order authorizing involuntary administration of medication. Finding the superior court did not err in its finding there was no less restrictive alternative to confinement, or that the court did not err petitioner lacked capacity to give or withhold consent to psychotropic medication, the Alaska Supreme Court affirmed both orders. View "In the Matter of the Necessity for the Hospitalization of: Mark V." on Justia Law

The estate of a severely disabled woman sued her in-home care providers for negligence in causing her death. The superior court granted summary judgment in favor of the providers, ruling that the estate was required to support its negligence claim with expert testimony, and failed to do so. After review, the Alaska Supreme Court held that the estate was not required to present expert testimony to establish a breach of the duty of care because the estate’s theory of fault was one of ordinary negligence that did not turn on the exercise of professional skill or judgment. “The estate’s theory of causation, by contrast, is complex and must be supported by the opinion of a medical expert. But the treating physician’s deposition testimony is sufficient evidence of causation to survive summary judgment.” The Court therefore reversed the superior court’s decision and remanded for further proceedings. View "Culliton v. Hope Community Resources, Inc." on Justia Law

The primary issue in consolidated appeals was the scope of an automobile insurance policy’s arbitration provision. Two insureds with identical Allstate Insurance Company medical payments and uninsured/underinsured motorist (UIM) insurance coverage settled with their respective at-fault drivers for applicable liability insurance policy limits and then made medical payments and UIM benefits claims to Allstate. Allstate and the insureds were unable to resolve the UIM claims and went to arbitration as the policy required. The arbitration panels initially answered specific questions submitted about the insureds’ accident-related damages. At the insureds’ requests but over Allstate’s objections, the panels later calculated what the panels believed Allstate ultimately owed the insureds under their medical payments and UIM coverages and issued final awards. Allstate filed superior court suits to confirm the initial damages calculations, reject the final awards as outside the arbitration panels’ authority, and have the court determine the total amounts payable to the insureds under their policies. The judge assigned to both suits affirmed the final arbitration awards; Allstate appealed both decisions. The Alaska Supreme Court determined the arbitration panels had no authority to determine anything beyond the insureds’ damages arising from their accidents and because Allstate withheld its consent for the panels to determine anything else, the Court reversed the superior court’s decisions and judgments. The Supreme Court also reversed some aspects of the superior court’s separate analysis and rulings on legal issues that the panels improperly decided. Given (1) the arbitration panels’ damages calculations and (2) the Supreme Court's clarification of legal issues presented, the cases were remanded for the superior court to determine the amount, if any, Allstate had to pay each insured under their medical payments and UIM coverages. View "Allstate Insurance Company v. Harbour" on Justia Law

Two women were hospitalized following psychiatric emergencies. In each instance hospital staff petitioned the superior court for an order authorizing hospitalization for evaluation, and the superior court granted the order. But the women were not immediately transported for evaluation because no beds were available at Alaska Psychiatric Institute (API). Each woman eventually moved for a review hearing to determine whether continued detention in a hospital was proper; in each case the superior court allowed continued detention. The women were finally transported to API more than 14 calendar days after their initial detentions. On appeal they argued their continued detention before being moved to API for evaluation violated their due process rights. The Alaska Supreme Court agreed, vacating the superior court order in each case: “We conclude there was no reasonable relation between the limited purpose of the evaluation orders and the extended duration of the respondents’ confinements. The State’s unreasonably lengthy detentions of Mabel and Sarah violated their substantive due process rights.” View "In the Matter of the Necessity for the Hospitalization of: Sarah D. & Mabel B." on Justia Law

A patient sued a hospital, arguing the hospital violated the Alaska Health Care Decisions Act (HCDA) when it temporarily assumed decision-making authority over his medical care while he was incapacitated and treated him without his consent or that of his parents, whom he had previously authorized to make medical decisions on his behalf if he were rendered incompetent or incapacitated. The hospital argued it was entitled to immunity under the HCDA because it held a good faith belief that the patient’s parents lacked authority to make medical decisions for him, based on conduct that convinced health care providers at the hospital that the parents were not acting in the patient’s best interest. The superior court agreed with the hospital and granted its summary judgment motion, concluding that the immunity provisions applied. The superior court concluded the hospital was entitled to immunity because its doctors had acted in good faith and in accordance with generally accepted medical standards. In a matter of first impression for the Alaska Supreme Court, it determined the superior court overlooked the requirement for specific good faith as to the authority or lack thereof of the patient’s surrogate or agent. The grant of summary judgment was reversed and the matter remanded for further proceedings. View "Bohn v. Providence Health & Srvs - Washington" on Justia Law

A man appealed superior court orders authorizing his hospitalization for evaluation, his 30-day commitment, and the involuntary administration of psychotropic medication. He argued the superior court’s failure to conduct a screening investigation was an error that required vacation of the evaluation order and the commitment and medication orders that followed it. He also specifically challenged the commitment order, claiming that the court erred by relying on facts not in evidence and by finding clear and convincing evidence that he was gravely disabled and that commitment was the least restrictive alternative. The Alaska Supreme Court concluded: (1) that failing to perform a screening investigation was error, but the error was harmless because the court made findings supported by clear and convincing evidence when ordering a 30-day commitment; (2) it was also harmless error to rely to any extent on facts not in evidence because there was sufficient evidence in the record to support a finding that the respondent was gravely disabled; (3) the superior court did not err when it found by clear and convincing evidence that the respondent was gravely disabled and that commitment was the least restrictive alternative, or when it granted the petition for involuntary hospitalization; and (4) the superior court did not err by finding that medication was in the respondent’s best interests and that there was no less intrusive alternative, or by granting the petition for its involuntary administration. View "In the Matter of the Necessity for the Hospitalization of Rabi R." on Justia Law

Tiffany O., a woman in her 60s, developed epilepsy early in childhood and suffered from regular seizures. She was also diagnosed with intellectual disability, and was described as "unable to engage in a meaningful conversation." In 2007, Tiffany's daughter Rachel petitioned for the appointment of a guardian for Tiffany. In March 2008, the superior court appointed the Office of Public Advocacy to serve as Tiffany’s public guardian. After a period of working well together, the relationship between Rachel and the public guardian soured. Rachel twice petitioned for review of the guardianship. In June 2011 Rachel was appointed as Tiffany’s guardian. The daughter relied on faith-based medicine to care for her mother, electing to, in one instance, pray over her mother after she became nonresponsive instead of calling emergency services. The superior court ultimately removed the daughter as guardian, finding that her behavior and “intractable belief system” caused her to deprive her mother of appropriate services and care. The Alaska Supreme Court found the superior court did not abuse its discretion when it removed the daughter as her mother’s guardian. The Court also concluded that removing the daughter as guardian did not violate the Alaska Constitution’s free exercise clause because the State possessed a compelling interest in preventing harm to the mother. View "In the Matter of the Protective Proceedings of Tiffany O." on Justia Law

The respondent in an involuntary commitment proceeding, "Meredith B.," appealed the ex parte order authorizing her hospitalization for evaluation and the subsequent 30-day commitment order. Respondent argued that the screening investigation was inadequate because she was not interviewed. She asserted that, as a result, both the order hospitalizing her for evaluation and the 30-day commitment order should have been reversed and vacated. Further, she challenged the 30-day commitment order finding she was (1) "gravely disabled" and there (2) was a reasonable expectation she could improve with treatment. After review of the order at issue, the Alaska Supreme Court found the superior court's decision was supported by clear and convincing evidence. "If there was an error during the screening investigation, the error was harmless, because the respondent had the opportunity to testify at the 30-day commitment hearing." View "In the Matter of the Necessity for the Hospitalization of M.B." on Justia Law

Danielle B., a 73-year-old woman who suffers from schizoaffective disorder, was involuntarily committed for 30 days. Her illness led to repeated hospitalizations and temporary improvements with the help of medication. But upon release she has deteriorated after stopping the medication. As a result she has had housing problems and incidents involving police due to her behavior, leading to more hospitalization. Since the 1980s she had been admitted to Alaska Psychiatric Institute (API) 30 times. The last such admission she appealed, arguing the State failed to prove that there were no less restrictive alternatives than commitment. Because the court did not err by finding clear and convincing evidence that there was no less restrictive alternative, the Alaska Supreme Court affirmed the court’s order committing her for involuntary treatment. View "D.B. v. Alaska" on Justia Law

In a case of first impression for the Alaska Supreme Court, at issue was the use of electroconvulsive therapy (ECT) to a catatonic, non-consenting patient. In March 2017, police officers found Lucy G. in an Anchorage parking lot, wet and shivering. She was taken to a local hospital, where she initially exhibited “agitated, self-harming, and disoriented” behaviors requiring sedation for her and the staff’s safety. Lucy, who was calm but unresponsive by the end of the day, was diagnosed as catatonic. Hospital staff also noted her prior schizophrenia diagnosis and psychotropic medication prescriptions, as well as hospitalization the prior month. After a petition by hospital staff, the superior court authorized Lucy’s hospitalization for an involuntary commitment evaluation. She would ultimately be diagnosed with catatonia, involuntarily committed for 30 days, and given psychotropic medication and involuntary ECT. At the superior court hearing, the parties agreed that constitutional standards established in Myers v. Alaska Psychiatric Institute, 138 P.3d 238 (Alaska 2006) for ordering involuntary, non-emergency administration of psychotropic medication also applied to involuntary ECT. The patient argued there should have been heightened standards for ordering involuntary ECT and that, in any event, the superior court’s Myers analysis was legally deficient. The Alaska Supreme Court held that the superior court did not plainly err by applying the existing Myers constitutional standards to authorize involuntary ECT to the non-consenting patient. The Court also held the superior court made sufficient findings related to each relevant, contested mandatory Myers factor. Therefore, the Court surmised these findings supported the court’s involuntary ECT order. View "In the Matter of the Necessity of the Hospitalization of Lucy G." on Justia Law