Justia Health Law Opinion Summaries

Plaintiff sought insurance coverage under an all-risks commercial insurance policy for business income losses during the COVID-19 pandemic. Finding no “direct physical loss of or damage to property” caused by COVID-19, the Louisiana Supreme Court reversed the appeal court and reinstated the trial court judgment denying coverage. View "Cajun County, LLC et al. v. Certain Underwriter at Llloyd's, London, et al." on Justia Law

This consolidated matter arose from a class action for damages filed by Louisiana health care providers for alleged violations of the Preferred Provider Organizations (“PPO”) statute. La. R.S. 40:2201, et seq. The Louisiana Supreme Court granted writs to interpret the statute and to determine whether defendant, Stratacare, Inc. (“Stratacare”), was a “group purchaser” subject to penalties for violating the mandatory notice provision of the statute. After a review of the record and the law, the Supreme Court concluded that Stratacare was not a group purchaser as contemplated by the statute. Therefore, the Court reversed the court of appeal, vacated the lower court judgments, and dismissed the case. View "Williams, et al. v. Bestcomp, Inc. et al." on Justia Law

On November 21, 2017, Richard Bush presented to Saint Bernard Parish Hospital for depression and suicidal ideations. At the hospital, Dr. Miguel Aguilera treated and discharged him. Bush attempted re-admittance with the same complaints, but was refused re-admittance. Thereafter, Bush attempted suicide in the hospital bathroom. He was found alive and transported to University Hospital in New Orleans for treatment; however, he succumbed to his injuries from the suicide attempt and died on November 30, 2017. In November 2018, his wife, Patricia Bush, on behalf of herself, her daughters, Madalyn and Ashley Bush, and on behalf of the decedent, Richard Bush, filed a formal pro se complaint with the Patient Compensation Fund (“PCF”) to convene a medical review panel (“MRP”), naming Saint Bernard Parish Hospital and Dr. Aguilera for malpractice relating to Richard Bush's death. The Louisiana Supreme Court granted this writ application in order to determine: (1) whether contra non valentem interrupted prescription; and (2) whether the court of appeal erred in relying on documents that were not entered as evidence and were not part of the record. The Court found that, while contra non valentem may interrupt prescription in a wrongful death claim in certain instances, it did not interrupt prescription in this case due to the fact that the court of appeal incorrectly considered documents that were not in evidence. The Court reversed the court of appeal’s ruling in part, affirmed in part, and remanded for further proceedings. View "Medical Review Panel for the Claim of Richard Bush" on Justia Law

In the latter part of August 2021, University Health Shreveport, LLC d/b/a Ochsner LSU Health Shreveport and LSU Health-St. Mary Medical Center, LLC (Employer) notified all employees that they were required to be fully vaccinated against COVID-19 by October 29, 2021. Employees not vaccinated within the specified time were subject to disciplinary action, including mandatory use of leave time and, ultimately, termination. Employer’s policy permitted exemptions to the vaccine requirement for valid religious and medical reasons. Thereafter, 39 plaintiffs (Employees) filed suit against Employer, challenging the employee vaccine mandate and requesting injunctive and declaratory relief, including a temporary restraining order (TRO). The Louisiana Supreme Court found the issue of a vaccine mandate implemented by a healthcare-employer was resolved by the application of Louisiana Civil Code article 2747, the employment-at-will doctrine. "an employer is at liberty to dismiss an at-will employee and, reciprocally, the employee is at liberty to leave the employment to seek other opportunities. However, these rights are tempered by federal and state provisions, both statutory and constitutional, but no such exceptions apply here. Employees have no statutory claim under La. R.S. 40:1159.7 because there is no healthcare provider-patient relationship alleged here. Employees likewise have no constitutional claim under La. Const. art. I, sec. 5 because the employer is a private actor, and this constitutional provision only limits governmental actors. Accordingly, the decision of the court of appeal is reversed, and the judgment of the trial court is reinstated." View "Hayes, et al. v. Univ. Health Shreveport, LLC" on Justia Law

This matter arose from alleged violations of the Health Care Consumer Billing and Disclosure Protection Act (“Balance Billing Act” or “Act”). The Louisiana Supreme Court granted certiorari review to resolve the question of whether a patient’s claims against a contracted healthcare provider for an alleged violation of La. R.S. 22:1874(A)(1) were delictual in nature. The consolidated lawsuits in this matter were filed by Matthew DePhillips and Earnest Williams, individually and on behalf of putative classes, against Hospital District No. 1 of Tangipahoa Parish d/b/a North Oaks Medical Center/North Oaks Health System (“North Oaks”). In February, 2011, Williams was injured in a motor vehicle accident. He sought emergency medical treatment from North Oaks. At the time of the accident, Williams was insured under an insurance policy administered by Louisiana Health Service & Indemnity Company d/b/a Blue Cross and Blue Shield of Louisiana (“BCBS”). North Oaks is a contracted healthcare provider with BCBS pursuant to a certain Member Provider Agreement (the “MPA”) between North Oaks and BCBS. After Williams’ treatment, North Oaks filed a claim with BCBS, and BCBS paid a discounted rate on the claims as provided by the MPA. Thereafter, North Oaks sought to collect from Williams by filing a medical lien against his liability insurance claim for the full and undiscounted charges. Williams alleged that North Oaks filed this lien despite being a contracted healthcare provider with BCBS and despite its legal and contractual requirements to accept the insurance as payment in full. The trial court denied the exceptions of no right of action for breach of contract and prescription, but granted the North Oaks’ exception of no cause of action for claims arising before the effective date of the Balance Billing Act. The court of appeal granted writs in part, finding DePhillips did not have a right of action to assert a claim for breach of the MPA, as he was neither a party nor a third-party beneficiary to that agreement. The appellate court denied North Oaks’ writ application insofar as it related to the trial court’s denial of its exception of prescription. After review, the Supreme Court determined plaintiff's claims were delictual in nature, subject a one-year prescriptive period. View "DePhillips v. Hospital Service Dist. No. 1 of Tangipahoa Parish d/b/a North Oaks Medical Center et al." on Justia Law

Mariah Charles was born prematurely in October 2014 at Lafayette General Medical Center (LGMC) and hospitalized there until transferred to Women’s and Children’s Hospital of Lafayette (W&C). She was released in April 2015 release. Dr. Geeta Dalal, a pediatric cardiologist with clinical privileges at both hospitals, contributed to Mariah’s care during and after Mariah’s hospitalization. While Mariah remained at LGMC, Dr. Dalal ordered and interpreted eight echocardiograms that, according to the petition, revealed abnormal findings that could cause pulmonary artery hypertension. The petition alleged Dr. Dalal took no action other than ordering additional echocardiograms. After Mariah’s transfer to W&C, Dr. Dalal interpreted three more echocardiograms, again noted abnormalities, and allegedly failed to properly diagnose or treat Mariah. On May 8, Mariah was admitted to the pediatric intensive care unit at W&C and examined by another pediatric cardiologist who diagnosed pulmonary artery hypertension. Mariah was transferred by helicopter to Children’s Hospital of New Orleans where medical staff confirmed the diagnosis and performed a heart catheterization procedure. Mariah’s mother, Megan Thomas (Thomas), initiated Medical Review Panel proceedings with the Patient’s Compensation Fund against Dr. Dalal and the hospital defendants, alleging medical malpractice and seeking damages for their alleged failure to properly diagnose and treat Mariah. In addition to the Medical Review Panel proceedings, Thomas filed suit against the hospitals: The Regional Health System of Acadiana, LLC, Women’s & Children’s Hospital, Inc., HCA Holdings, Inc. W&C, and LGMC. The issue presented for the Louisiana Supreme Court's review centered on allegations of negligent credentialing against Dr. Dalal, and whether those allegations fell within the scope of the Louisiana Medical Malpractice Act, or alternatively, sounded in general negligence. The Supreme Court reversed the appellate court, and reinstated the trial court's judgment sustaining the hospital defendants' exceptions of prematurity. View "Thomas v. Regional Health System of Acadiana, LLC." on Justia Law

Elaine Kirt died in 2010, due to complications that developed shortly after undergoing eye surgery. On September 23, 2011, her son, Neville Kirt, appearing in person and on behalf of his deceased mother and his two brothers, filed a request with the Division of Administration asking for a medical review panel to review the care provided to his mother by three defendants: Dr. Rebecca Metzinger, the attending surgeon; Dr. Theodore Strickland III, the anesthesiologist for the procedure; and Tulane Medical Center. In a reply letter to Neville, the Patient’s Compensation Fund Oversight Board (PCF) acknowledged receipt of the request; confirmed Dr. Metzinger, Dr. Strickland, and Tulane University Hospital & Clinic were qualified under the Louisiana Medical Malpractice Act (Act); informed Kirt a filing fee of $100 per qualified defendant was due; and requested payment of $300. The notice stated the failure to pay would render the request invalid, without effect, and would not suspend the time to file suit. Days later, then appearing through counsel, the Kirts sent a second letter asking to amend its previous request, adding two additional nurses. The Kirts included a $500 check to cover filing fees. A medical review panel convened, reviewed the care provided by all named healthcare providers, and found no breach of the standard of care. The Kirts thereafter filed against the doctors and nurses. Claims against the doctors were dismissed by summary judgments because there was no proof they breached the standard of care while treating Elaine Kirt. Those judgments expressly barred allocating fault to the dismissed parties and prohibited introducing evidence at trial to establish their fault. The nurses then filed peremptory exceptions of prescription, claiming the request for a medical review panel was invalid because the Kirts failed to pay the final $100 filing fee, and prescription was not suspended for any claims. The trial court concurred with the nurses and granted an exception of prescription. The Supreme Court determined that because the Kirts paid filing fees for five of six named defendants, dismissal of one of the nurses was proper for lack of a filing fee. The Court determined the lower courts did not consider or decide the merits of the Kirts' argument that they could not have reasonable known about the claims against two of the nurse defendants until one was deposed. Because the lower courts did not consider or decide the merits of the Kirts' basis for the exception of prescription, which could have turned on factual findings, the Supreme Court pretermitted consideration of these arguments and remanded the matter to the trial court for further disposition of the exception. View "Kirt v. Metzinger" on Justia Law

The Louisiana Supreme Court granted writs in consolidated matters to consider whether allegations of negligent credentialing against two healthcare providers were claims that fell within the purview of Louisiana’s Medical Malpractice Act or, alternatively, sounded in general negligence. Mariah Charles was born prematurely in October 2014 at Lafayette General Medical Center (LGMC) and hospitalized there until March 2015, when she was transferred to Women’s and Children’s Hospital of Lafayette (W&C) until her release a month later. Dr. Geeta Dalal, a pediatric cardiologist with clinical privileges at both hospitals, contributed to Mariah’s care during and after Mariah’s hospitalization. While Mariah remained at LGMC, Dr. Dalal ordered and interpreted eight echocardiograms that, according to the petition, revealed abnormal findings that could cause pulmonary artery hypertension, yet, the petition alleged Dr. Dalal took no action other than ordering additional echocardiograms. After Mariah’s transfer to W&C, Dr. Dalal interpreted more echocardiograms, again noted abnormalities, and allegedly failed to properly diagnose or treat Mariah. Mariah’s mother initiated Medical Review Panel proceedings with the Patient’s Compensation Fund against Dr. Dalal and the hospital defendants alleging medical malpractice and seeking damages for their alleged failure to properly diagnose and treat Mariah. In addition to the Medical Review Panel proceedings, Mariah's mother filed suit against the hospitals, The Regional Health System of Acadiana, LLC, Women’s & Children’s Hospital, Inc., HCA Holdings, Inc., and Health Care Indemnity, Inc. (W&C), as well as Lafayette General Medical Center, Inc. and/or Lafayette General Health System, Inc. (LGMC), for damages related to Mariah’s care. The petition for damages asserted a single cause of action that LGMC and W&C were liable under general tort law because they “negligently credentialed Dr. Dalal and negligently provided her with privileges to practice” in their facilities “even though [they] knew or should have known she was not board certified in the field of pediatric cardiology.” LGMC and W&C filed dilatory exceptions of prematurity to this suit, asserting that they were qualified healthcare providers under the MMA and were entitled to have Thomas’s negligent credentialing claims presented first to a medical review panel pursuant to R.S. 40:1231.8(B)(1)(a)(i). Based on the allegations presented by the petition, the provisions of the LMMA, and application of the "Coleman" factors, the Supreme Court found the trial court correctly sustained the exceptions of prematurity raised by LGMC and W&C, therefore reversing the court of appeal's judgment and reinstated the trial court’s judgment. View "Thomas v. Regional Health System of Acadiana, LLC" on Justia Law

In a workers’ compensation case, the claimant, Darvel Burgess, filed a Disputed Claim for Compensation after his employer, Sewerage & Water Board of New Orleans (“S&WB”), refused to pay a $13,110.02 outstanding bill for prescription medications from Injured Workers Pharmacy (“IWP”). The underlying legal issue was whether the injured employee was entitled to his choice of pharmacy, or whether that right belonged to the employer under the Louisiana Workers Compensation Act (“LWCA”). The Louisiana Supreme Court granted review of this matter to resolve a split in the circuit courts of appeal on this issue. After review, the Supreme Court held the choice of pharmacy in a workers’ compensation case belongs to the employer. View "Burgess v. Sewerage & Water Bd. of New Orleans" on Justia Law

In 2003, plaintiff Kimberly Thibodeaux became pregnant with her fourth child. Dr. James Donnell was her obstetrician-gynecologist throughout her pregnancy. During the course of the pregnancy, plaintiff was diagnosed with complete placenta previa and, in mid-November, at approximately 29 weeks pregnant, she was hospitalized for four days. Upon Dr. Donnell’s referral, she consulted a maternal/fetal medicine specialist who handled high risk pregnancies; the specialist recommended rest, limited activity, and delivery of plaintiff’s child at 36-37 weeks gestation. Plaintiff returned to the hospital with renewed vaginal bleeding and contractions. Dr. Donnell delivered plaintiff’s child via cesarean section. Shortly after the baby’s delivery, Dr. Donnell performed an emergency cesarean hysterectomy, which entailed removal of plaintiff’s uterus and cervix. After completing the hysterectomy, and while preparing to close plaintiff’s abdomen, Dr. Donnell discovered a large laceration to her bladder, which he repaired himself. After completing the surgery, Dr. Donnell ordered a test to determine if the bladder repair was successful. The test revealed that the bladder sutures were obstructing plaintiff’s ureters, the tubes that drain urine from the kidney into the bladder. This obstruction was then confirmed by a cystoscopy performed by a urologist, Dr. Robert Alexander, consulted by Dr. Donnell. The same day as the birth and cesarean hysterectomy, Dr. Alexander reopened plaintiff’s abdomen, removed the bladder sutures to free the ureters, and re-repaired the bladder laceration. Plaintiff followed up again with Dr. Alexander in late April 2004. Although her bladder healed, plaintiff continued to see Dr. Alexander for three years with irritative bladder symptoms, including urinary frequency every 30-60 minutes, urgency, urine leakage, painful urination, painful sexual intercourse, urination during sexual intercourse, excessive nighttime urination, and abdominal pain. Dr. Alexander diagnosed her with interstitial cystitis, also known as painful bladder syndrome, and prescribed medications, none of which relieved plaintiff’s symptoms. According to Dr. Alexander, plaintiff’s diminished bladder capacity was permanent. The Supreme Court granted review of this case to determine whether the court of appeal properly assessed damages under the principles set forth in “Coco v. Winston Industries Inc.,” (341 So. 2d 332 (La. 1976)). The Court found that, because the court of appeal found manifest error in the jury’s factual findings, the appellate court should have instead performed a de novo review of damages under the principles outlined in “Mart v. Hill,” (505 So. 2d 1120 (La. 1987)). Accordingly, the Court reversed the court of appeal and remanded back to that court for reconsideration under the proper caselaw precedent. View "Thibodeaux v. Donnell" on Justia Law