Justia Health Law Opinion Summaries

"The facts as alleged in the complaint and in plaintiff’s declaration in opposition to the motion to strike are not at all clear." Plaintiff Un Hui Nam, a new medical resident in the anesthesiology department at UC Davis Medical Center, "got off to a rocky start" in July of 2009. The Court of Appeal surmised that there appeared to have been some tension and misunderstandings right from the beginning of plaintiff's residency. What occurred thereafter and why was the subject of the underlying lawsuit and appeal. Plaintiff labeled the hospital's actions as "retaliation" when she questioned whether residents were allowed to intubate patients. She expressed her disagreement with any policy that would compel the residents in an emergency to wait for the on-call team rather than independently intubating a patient. The week prior to this email, she had received excellent performance evaluations. Plaintiff copied all of the residents in her email. Some of these residents thereafter informed her that she should expect retaliation for sending it. Defendant, however, insisted the e-mail excited no such reaction. Defendant’s version of plaintiff's residency file consisted of a series of complaints, warnings, investigations, and leaves of absence necessitated by plaintiff’s "shortcomings" over a three-year period and culminating in her ultimate termination. The record contained both complaints and testimonials about plaintiff’s performance. Apparently she had a particularly good rapport with nurses. Defendant built a paper trail of warnings for unprofessional conduct and an inability to get along with other doctors. But many of defendant’s allegations were not substantiated during the internal investigations that ensued, and the anesthesiology department was criticized repeatedly for what it did, and did not do, to teach plaintiff the clinical and interpersonal skills needed to succeed in the program. Plaintiff requested, without success, a formal hearing to contest the termination. In January 2013 she filed her complaint for retaliation, discrimination, sexual harassment, wrongful termination, violations of the Business and Professions Code, and breach of contract. Defendant filed a motion to strike pursuant to section 425.16 of the Code of Civil Procedure, alleging that plaintiff’s complaint constituted a SLAPP (strategic lawsuit against public participation) and arose from written complaints made in connection with an official proceeding. Defendant argued that the investigations and corrective action were protected conduct. The trial court disagreed and denied the motion. The trial court's denial of defendant's motion to strike was affirmed: "It is hard to imagine that a resident’s complaint alleging retaliatory conduct was designed to, or could, stifle the University from investigating and disciplining doctors who endanger public health and safety. The underlying lawsuit may or may not have merit that can be tested by summary judgment, but it is quite a stretch to consider it a SLAPP merely because a public university commences an investigation." View "Nam v. Regents of UC" on Justia Law

After Siasmorn Gopal was admitted to the emergency room at Kaiser Foundation Hospitals and died after she was transferred to another hospital, Gopal's husband and the trustee of her estate filed suit alleging that defendants violated California law. Plaintiffs alleged that Kaiser Hospitals, SCPMG, and Health Plan treated Gopal differently than they would have treated a member and that the different treatment caused her death. The court affirmed the trial court's rejection of plaintiffs' enterprise theory of liability. The court concluded that there is nothing inequitable in requiring plaintiffs to look to Kaiser Hospitals and SCPMG - the providers at issue - for compensation for their claims. Thus, plaintiffs are not without recourse or remedy. The court noted that the fact that health care providers, and not health plans, are subject to the Medical Injury Compensation Reform Act of 1975 (MICRA), Civ. Code, 3333.2, is not an inequitable result, but a public policy determination made by the Legislature. Accordingly, the court affirmed the judgment. View "Gopal v. Kaiser Found. Health Plan" on Justia Law

Jesse G. appealed the trial court’s orders appointing the Mendocino County Public Guardian conservator of his person and estate pursuant to section 5350 of the Lanterman-Petris-Short Act (LPS Act), Welf. & Inst. Code, 5000, et seq., and imposing certain special disabilities. The totality of the evidence presented in this case did not support the trial court’s finding that Jesse G. was gravely disabled under the LPS Act. The court concluded that substantial evidence did not support the trial court's finding that the public guardian satisfied its burden of proving beyond a reasonable doubt that Jesse G. would remain gravely disabled where the evidence at trial did not support an objective finding that he, as a result of his mental disorder, is incapacitated or rendered unable to carry out the transactions necessary for survival. Accordingly, the court reversed the order appointing a conservator. View "Conservatorship of Jesse G." on Justia Law

The People filed a complaint charging defendants with causing, aiding, and abetting the illegal delivery of marijuana. The trial court granted an injunction barring defendants from further developing or marketing their marijuana delivery app. At issue on appeal is whether Proposition D, L.A. Mun. Code, 45.19.6, which City voters enacted in 2013 to regulate medical marijuana businesses, generally prohibits the delivery of marijuana by vehicles. The court concluded that the City established a likelihood of proving defendants’ app caused, aided, or abetted the violation of Proposition D because, outside of the narrow exception for designated primary caregivers, it prohibits the vehicular delivery of medical marijuana to qualified participants, identification card holders, or primary caregivers in the City. Further, defendants’ opposition to the City’s unfair competition allegations necessarily fails because the City has demonstrated a likelihood of success on its claim that defendants facilitated a violation of Proposition D. In this case, defendants made no showing at all concerning the balance of hardships, much less that the balance tipped sharply in their favor. Accordingly, the court affirmed the trial court's judgment. View "People v. Nestdrop, LLC" on Justia Law

Heather W. appealed an order reappointing the Public Guardian as her conservator under the Lanterman-Petris-Short Act (LPS Act), Welf. & Inst. Code, 5000 et seq. The court concluded that the trial court erred by not advising Heather W. of her right to a jury trial and not obtaining her on-the-record personal waiver of that right without a finding that she lacked the capacity to make a jury waiver. The court further concluded that a remand is required for the trial court to determine whether Heather W. "lacked the capacity to make a knowing and voluntary waiver at the time of counsel's waiver." The court rejected Heather W.'s claims that the trial court's comments show it shifted the burden of proof, relied on statements by the Public Guardian's counsel instead of evidence, and did not apply the gravely disabled standard. The court reviewed the parties' remaining contentions and concluded that they will not change the result the court has reached. Accordingly, the court reversed the order and remanded for further proceedings. View "San Luis Obispo Cnty. Public Guardian v. Heather W." on Justia Law

The Board issued an administrative investigative subpoena seeking complete, certified records of three of plaintiff's patients on the grounds that there was good cause to believe that plaintiff departed from the standard of care in connection with the treatment of those patients. Plaintiff's petitions to quash the subpoena were denied, and the Board’s petition to compel compliance was granted in part, with the limitation that the records to be provided should be limited by time period. The court concluded that the Board had pointed out specific instances of prescribing irregularities, which were sufficient for a finding of good cause; substantial evidence supports the trial court’s finding of good cause; and there is no abuse of discretion in the trial court’s determination that Dr. Pollak was qualified to render an expert opinion in this matter. The court also concluded that plaintiff failed to convince the court that, if the evidence of medical records at issue was obtained in violation of Civil Code section 56.26, the Board was not permitted to use it in the investigation. While the trial court may not have specifically stated it was engaging in a balancing test, the long discussion of good cause shows careful consideration of the patients’ right to privacy versus the state’s interest in safeguarding its citizens from negligent medical care. Finally, the court rejected plaintiff's claim that the subpoena was overbroad where the trial court did not err in failing to modify the subpoena in more ways than it already did in applying time restrictions. Accordingly, the court affirmed the judgment. View "Fett v Medical Bd. of CA" on Justia Law

Legislation, effective in 2004 requires that injured workers’ requests for medical treatment be evaluated through a process called utilization review (UR). Under the UR process, a request for treatment cannot be denied by a claims adjustor and must be approved unless a clinician determines that the treatment is medically unnecessary. Workers can challenge decisions denying requested treatment, but employers cannot challenge decisions approving it. The 2004 legislation called for administrative adoption of uniform standards for physicians to use in evaluating treatment. In 2013, additional reforms went into effect, establishing a new procedure, independent medical review (IMR), to resolve workers’ challenges to UR decisions. Stevens challenged the constitutionality of the IMR process, arguing that it violated the state Constitution’s separation of powers clause, its requirements that workers’ compensation decisions be subject to review and the system “accomplish substantial justice,” and principles of due process. The court of appeal rejected those claims, but remanded Stevens’s request for a home health aid. The Legislature has plenary powers over the workers’ compensation system under article XIV, section 4 of the state Constitution. California’s scheme for evaluating workers’ treatment requests is fundamentally fair and affords workers sufficient opportunities to present evidence and be heard. View "Stevens v. Workers' Comp. Appeals Bd," on Justia Law

UEBT is a healthcare employee benefits trust governed by the Employee Retirement Income Security Act (ERISA), 29 U.S.C. 1001, and pays healthcare providers directly from its own funds for the services provided to enrollees in its health plans. UEBT contracted with a “network vendor,” Blue Shield, to obtain access to Blue Shield’s provider network at the rates Blue Shield had separately negotiated, and certain administrative services. One of Blue Shield’s preexisting provider contracts was with Sutter, a group of health care providers in Northern California. UEBT sued Sutter, on behalf of a putative class of all California self-funded payors, alleging that Sutter’s contracts with network vendors, such as Blue Shield, contain anticompetitive terms that insulate Sutter from competition and drive up the cost of healthcare. UEBT sought damages, restitution, and injunctive relief under the Cartwright Act (Bus. & Prof. Code 16720) and California’s unfair competition law (section 17200). Sutter moved to compel arbitration, relying on an arbitration clause in the provider contract signed by Sutter and Blue Shield. The trial court denied Sutter’s motion, concluding that UEBT was not bound to arbitrate its claims pursuant to an agreement it had not signed or even seen. The court of appeal affirmed. View "UFCW & Employers Benefit Trust v. Sutter Health" on Justia Law