Justia Health Law Opinion Summaries

Dr. Ryan Kime, an emergency medicine physician, applied for privileges in the emergency department of two hospitals owned by Dignity Health, Inc. (Dignity) while he was under disciplinary proceedings by the Medical Board of California. The proceedings resulted in a public reprimand. Dignity stopped processing Kime’s application a few days after the reprimand took effect. Kime sued Dignity for injunctive relief and damages, alleging that Dignity violated his common law and statutory rights by denying his application without offering him a hearing. Dignity moved for summary judgment, arguing that it had a policy not to consider applicants with disciplinary histories for emergency department privileges, and that no hearing is required when privileges are denied due to such a policy. The trial court granted Dignity’s motion for summary judgment and denied Kime’s motion for summary adjudication.The Court of Appeal of the State of California First Appellate District affirmed the trial court's decision. The court found that Dignity's policy of not considering applicants with disciplinary histories for emergency department privileges was a quasi-legislative decision, which did not require a hearing under the common law right to fair procedure. The court also found that Dignity's decision to deny Kime's application did not require a hearing under the statutory right set forth in the Business and Professions Code, as the decision was not made by a peer review body and did not require the filing of a report under section 805 of the Code. The court concluded that Kime had no right to a hearing under either the common law or statutory law. View "Kime v. Dignity Health, Inc." on Justia Law

The case involves Christine Matlock Dougherty, who sued U.S. Behavioral Health Plan, California (USB) for claims related to her son's healthcare. Dougherty's son, Ryan, was enrolled in a UnitedHealthcare HMO health plan, which Dougherty had access to through her employer. Ryan admitted himself into a residential treatment facility for severe drug addiction, but USB denied coverage for his stay after three days, arguing that he could be treated at home. Ryan fatally overdosed shortly after his discharge from the facility. Dougherty then sued USB, claiming that its wrongful denial of coverage for Ryan's treatment caused his death. USB petitioned to compel arbitration of her claims, but the trial court denied the petition, stating that USB's arbitration agreement was not enforceable because it did not comply with the disclosure requirements imposed by Health & Safety Code section 1363.1.The trial court denied USB's petition to compel arbitration on the grounds that the arbitration agreement did not comply with the disclosure requirements of Health & Safety Code section 1363.1. The court found that there were two separate contracts, one between Dougherty and UnitedHealthcare, and another between Dougherty and USB. The court ruled that the arbitration agreement in the supplement, which governed Dougherty's claims against USB, did not comply with section 1363.1's disclosure requirements.The Court of Appeal of the State of California Fourth Appellate District Division Two reversed the trial court's decision. The appellate court concluded that USB forfeited its argument that the issue of whether the arbitration agreement was valid under the disclosure requirements of section 1363.1 was delegated to the arbitrator. However, the court agreed with USB that the trial court erroneously denied USB’s petition because USB complied with section 1363.1. The court found that the only "health care service plan" at issue that "includes terms that require binding arbitration" is Dougherty’s plan with UnitedHealthcare, which includes both the EOC and the supplement as components of the plan. Therefore, the court concluded that there was no section 1363.1 violation and reversed the trial court's order denying the petition to compel arbitration. View "Dougherty v. U.S. Behavioral Health Plan" on Justia Law

Tyshawn Michael Lewis, a prisoner diagnosed with rapidly progressing amyotrophic lateral sclerosis (ALS), appealed the denial of a petition for his compassionate release under Penal Code section 1172.2. Lewis was serving a 75-year sentence for first-degree murder committed in 2020. In 2023, the Department of Corrections and Rehabilitation recommended his release due to his deteriorating health condition. The trial court denied the petition, concluding that despite his physical condition, Lewis posed an unreasonable risk of danger to public safety, based on his criminal history, the nature of his crime, and his alleged gang affiliations.The trial court's decision was based on a diagnostic study and evaluation report that suggested Lewis retained the capacity to commit or influence others to commit criminal acts endangering public safety. The court also considered Lewis's criminal history, including his conviction for first-degree murder, his lack of remorse, and his alleged ongoing association with a violent criminal street gang.The Court of Appeal of the State of California Fourth Appellate District Division Two reviewed the case. The court found that the trial court had abused its discretion in denying Lewis's petition for compassionate release. The court concluded that the evidence did not support the trial court's finding that Lewis posed an unreasonable risk of committing a violent felony. The court noted that Lewis's mere capacity to commit a crime did not prove that he posed an unreasonable risk of doing so. The court also found that the evidence of Lewis's gang involvement was ambiguous and did not support the trial court's finding. The court reversed the trial court's order and directed it to grant the petition for compassionate release. View "People v. Lewis" on Justia Law

In this case, the court dealt with the suspension and subsequent resignation of a licensed obstetrician and gynecologist, Plaintiff Dr. Vardui Asiryan, from the defendant Glendale Adventist Medical Center and its Medical Staff. The Medical Staff suspended Asiryan’s privileges at the hospital without holding a hearing or giving her prior notice. Asiryan sued both entities, alleging they failed to comply with statutory and common law procedural requirements in connection with suspending her privileges at the hospital. She further claimed that the Medical Staff lied to her regarding their obligations to report her suspension and resignation to the state licensing board.The Court of Appeal of the State of California, Second Appellate District, Division One, held that the trial court correctly concluded that the Business and Professions Code is the sole source of procedural protections in connection with hospital peer review, and that the common law doctrine of fair procedure does not supplement those protections with additional guarantees. Therefore, the court correctly granted the nonsuit on Asiryan’s common law peer review claims and correctly rejected her proposed jury instructions regarding peer review.As for the court's order awarding attorney fees, the Court of Appeal held that given the court’s rulings denying certain portions of defendants’ summary judgment and nonsuit motions, a hypothetical reasonable attorney could have deemed Asiryan’s peer review claims against the Medical Staff tenable and reasonably decided to take them to trial. This same logic does not apply to the fees awarded to GAMC, because the court disposed of the claims against GAMC on summary judgment. The Court of Appeal therefore reversed the court’s fee order to the extent it awards fees to the Medical Staff, but affirmed the order as it applies to GAMC. View "Asiryan v. Medical Staff of Glendale Adventist Medical Center" on Justia Law

The case involved Rhonda Persiani, a defendant charged with multiple counts of driving under the influence (DUI) in California. Due to doubts about Persiani's mental competence, the criminal proceedings were suspended, and she was found mentally incompetent to stand trial. Persiani was evaluated and found suitable for outpatient treatment through mental health diversion. However, the court and parties believed Persiani was ineligible for such treatment due to a California Vehicle Code section that prohibits diversion in cases where a defendant is charged with DUI. Persiani sought dismissal of her cases, asserting that dismissal was required under the Penal Code because she was ineligible for any of the treatment options. The court denied Persiani’s motion to dismiss and imposed mental health treatment provisions as conditions of her release. In an appeal, the Court of Appeal of the State of California Fourth Appellate District held that a trial court has the authority under the Penal Code to order treatment through mental health diversion for a mentally incompetent misdemeanor defendant charged with DUI. The court concluded that the Vehicle Code section that prohibits diversion for DUI does not prevent a court from ordering a mentally incompetent misdemeanor defendant to receive treatment through mental health diversion after criminal proceedings have been suspended. The matter was remanded back to the lower court to determine whether to order Persiani to receive mental health diversion treatment. View "Persiani v. Superior Court" on Justia Law

In the State of California, a criminal defendant diagnosed with a mental disorder can be placed on mental health diversion under Penal Code section 1001.36. The provision allows such defendants to receive treatment for their mental illness and potentially avoid prosecution. However, the court may reinstate charges if the defendant's behavior while on diversion renders them unsuitable for the program. This case involved a defendant, Jasmen Lavar Hall, who was charged with carjacking and related offenses. After being placed on mental health diversion, Hall was expelled from his residential treatment program for threatening and assaulting other patients and destroying property. Following this behavior, Hall went missing for approximately six months before being apprehended. The trial court subsequently terminated Hall's diversion and reinstated the criminal proceedings. After a jury trial, Hall was convicted of the carjacking-related offenses and sentenced to an aggregate sentence of seven years eight months in prison. Hall argued that the court erred in reinstating the criminal proceedings because his actions did not meet the statutory criteria for having his diversion terminated. The Court of Appeal of the State of California Second Appellate District Division One disagreed, ruling that Hall's violent conduct and failure to comply with his treatment obligations rendered him unsuitable for diversion under Penal Code section 1001.36, subdivision (g)(3). The court therefore held that the trial court did not err in terminating Hall's diversion and reinstating the criminal proceedings, and it affirmed the judgment of conviction. View "People v. Hall" on Justia Law

The case involves Jennifer Garcia, who was charged with multiple counts, including making threats to a public officer, disobeying a court order, possessing a weapon in a courthouse, attempted murder, and assault with a deadly weapon. After her counsel declared doubt as to Garcia's mental competence, the trial court suspended the criminal proceedings for a determination of Garcia's mental competence. Based on the evaluations of a licensed psychiatrist and a licensed psychologist, the court found Garcia mentally incompetent to stand trial and lacking capacity to make decisions regarding the administration of antipsychotic medication. Garcia appealed the court's order authorizing the state hospital to involuntarily administer antipsychotic medication to her, alleging errors with the order and ineffective assistance of her trial counsel. The Court of Appeal, Fourth Appellate District, Division One, State of California, affirmed the trial court's order. The appellate court found that substantial evidence supported the trial court's order, the psychologist did not exceed the scope of her license in her evaluation, and the psychiatrist's opinion did not lack statutorily required information. The appellate court also found that the error in the trial court's form order was harmless and Garcia was not prejudiced by any ineffectiveness of her counsel. View "People v. Garcia" on Justia Law

In this case, Gardena Hospital in California appealed a decision regarding its reporting of patient days for the purpose of calculating Medi-Cal reimbursement. The controversy centered around whether "bed hold" days — days when a patient is not physically in the hospital's subacute section but is expected to return — should be included in the reported patient days. If these days were included, it would result in a smaller per diem reimbursement to the hospital by the state. The hospital argued that bed hold days should be excluded, pointing to the Accounting and Reporting Manual for California Hospitals (the "Hospital Manual"), which does not specifically mention bed holds. The state, on the other hand, referred to the Accounting and Reporting Manual for California Long-Term Care Facilities (the "Long-Term Manual"), which specifically states that bed hold days should be included in total patient days.The Court of Appeal of the State of California, Second Appellate District, Division Eight ruled in favor of the state, affirming the lower court's decision. The court held that where two state manuals guide health care facility accounting, the one that specifically addresses the issue at hand — in this case, the Long-Term Manual's explicit reference to bed holds — governs. The court reasoned that the specific provision controls the general one and can be regarded as a correction to it. Thus, according to this holding, Gardena Hospital must include bed hold days in its reported patient days for the calculation of Medi-Cal reimbursement. View "Gardena Hospital, L.P. v. Baass" on Justia Law

In the case before the Court of Appeal of the State of California First Appellate District Division Four, the plaintiffs, thousands of individuals who suffered adverse effects from the use of a prescription drug, TDF, made by Gilead Life Sciences, Inc., brought a claim of negligence and fraudulent concealment against Gilead. The plaintiffs alleged that while Gilead was developing TDF, it discovered a similar, but chemically distinct and safer potential drug, TAF. However, Gilead allegedly decided to defer development of TAF because it was concerned that the immediate development of TAF would reduce its financial return from TDF. Gilead sought summary judgment on the ground that in order to recover for harm caused by a manufactured product, the plaintiff must prove that the product was defective. The trial court denied Gilead's motion for summary judgment in its entirety.In reviewing this case, the appellate court held that the trial court was correct to deny Gilead's motion for summary judgment on the negligence claim. The court reasoned that a manufacturer's duty of reasonable care can extend beyond the duty not to market a defective product. The court found that the factual basis of the plaintiffs' claim was that Gilead knew TAF was safer than TDF, but decided to defer development of TAF to maximize its profits. The court held that if Gilead's decision to postpone development of TAF indeed breached its duty of reasonable care to users of TDF, then Gilead could potentially be held liable.However, the appellate court reversed the trial court's decision regarding plaintiffs' claim for fraudulent concealment. The court concluded that Gilead's duty to plaintiffs did not extend to the disclosure of information about TAF, as it was not available as an alternative treatment for HIV/AIDS at the time the alleged concealment occurred. Consequently, the court granted in part and denied in part Gilead's petition for a writ of mandate, directing the superior court to vacate its order denying Gilead's motion for summary judgment and to enter a new order denying summary adjudication of the negligence claim but granting summary adjudication of the fraudulent concealment claim. View "Gilead Tenofovir Cases" on Justia Law

In the case before the Court of Appeal of the State of California, Second Appellate District, Division Two, the plaintiff, Ali Shalghoun, appealed a judgment from the Superior Court of Los Angeles County in favor of the defendant, North Los Angeles County Regional Center, Inc. Shalghoun, an administrator of a residential facility for developmentally disabled persons, sued the regional center after he was attacked by a resident at the facility. The resident, known as J.C., was a client of the regional center, which had arranged for his placement at the facility.The central issue in the case was whether the regional center had a legal duty to protect the employees of a residential facility from a developmentally disabled person who had been placed there. The plaintiff argued that the regional center was negligent in failing to immediately move J.C. to another facility after being informed that the facility could no longer provide the level of care he required.However, the appellate court affirmed the lower court's decision, finding that the regional center did not owe a duty of care to the facility's employees. The court reasoned that the regional center's duty, as mandated by the Lanterman Developmental Disabilities Services Act, was to provide services and support to the developmentally disabled person (the "consumer"), not to protect third-party employees at a residential facility. The court also noted that the regional center did not have the unilateral power to relocate a consumer; it depended on the acceptance of the consumer by another residential facility.According to the court, the imposition of liability on regional centers for injuries inflicted by consumers could potentially drive the centers out of business, disrupt the entire system of services and support for developmentally disabled individuals, and contradict the Act's mandate to place consumers in the least restrictive environment. The court therefore concluded that public policy factors weighed against recognizing a duty of care running from the regional center to the employees of the residential facility. View "Shalghoun v. North Los Angeles County Regional Center, Inc." on Justia Law