Appellant received treatment at Hospital for injuries she sustained in an automobile accident. Appellant granted two statutory liens to Hospital on settlement proceeds she obtained from the tortfeasor for hospital services rendered. Appellant subsequently settled her case against the tortfeasor, and the tortfeasor's insurer (Insurer) agreed to pay Appellant $1.3 million in exchange for Appellant's agreement to indemnify Insurer from all healthcare provider liens. Hospital subsequently sued Insurer, and Appellant tendered to Hospital all money it asserted was due. Appellant then filed a complaint against Hospital, alleging that Hospital overcharged her pursuant to Nev. Rev. Stat. 439B.260(1), which provides that hospitals must reduce charges by thirty percent to inpatients who lack insurance "or other contractual provision for the payment of the charge by a third party." The district court entered judgment in favor of Hospital, finding that Appellant's settlement agreement with the tortfeasor rendered Appellant ineligible for the thirty percent statutory discount. The Supreme Court reversed in part, holding that a patient's eligibility is determined at the commencement of hospital services, and therefore, a later settlement agreement with a third party for the payment of such services does not disqualify the patient for the statutory discount. View " Bielar v. Washoe Health Sys., Inc." on Justia Law
The issue before the Supreme Court centered on the duty of care owed by a medical facility when performing nonmedical functions. The Court took the opportunity of this case to recognize that when a medical facility performs a nonmedical function, general negligence standards apply, such that the medical facility has a duty to exercise reasonable care to avoid foreseeable harm as a result of its actions. Here, the complaint alleged that appellant, a cognitively impaired patient who required a guardian to make medical and financial decisions for her, was exploited by a third party after a social worker employed by the respondent medical facility provided the third party with a preprinted general power-of-attorney form, which the patient subsequently executed in furtherance of her discharge from the facility. The manner in which the medical facility allegedly discharged the patient could lead a reasonable jury to find that the patient's financial injuries were a foreseeable result of the facility's conduct. Thus, the Supreme Court found that district court erred when it found that the medical facility owed the patient no duty beyond the duty to provide competent medical care and dismissed the complaint for failure to state a claim. Accordingly, the Supreme Court reversed the order dismissing this action and remanded this case to the district court for further proceedings. View "DeBoer v. Sr. Bridges of Sparks Fam. Hosp." on Justia Law
On December 14, 2006, Robert Winn's daughter, Sedona, suffered an extensive brain injury during a heart surgery. On February 3, 2009, Winn filed a medical malpractice suit against the hospital, doctors, and perfusionists who were involved in the surgery. The district court dismissed the action as untimely, concluding that more than one year had elapsed between the time when Winn discovered Sedona's injury and the time when he filed suit. At issue on appeal was Nev. Rev. Stat. 41A.097(2), which provides that medical malpractice actions must be filed within three years of the injury date and within one year of the injury's discovery, and section 41A.097(3), which tolls both deadlines when the health care provider has concealed information upon which the action is based. The Supreme Court vacated in part and affirmed in part the judgment of the district court, holding (1) questions of fact remained as to whether subsection 2's one-year discovery period was tolled for concealment against the hospital; and (2) subsection 3's tolling-for-concealment provision did not apply against the doctors and perfusionists. View "Winn v. Sunrise Hosp. & Med. Ctr." on Justia Law
Real parties in interest Laura and Edward Rehfeldt filed a complaint for medical malpractice against Defendants, a hospital and health care practitioners. Accompanying the Rehfeldts' complaint was an opinion letter from a medical expert supporting their claim and a notary acknowledgment form attached to the letter. Neither the opinion letter nor the acknowledgment contained a declaration that the statements contained in the opinion letter were made under penalty of perjury, and the opinion letter did not contain a jurat. Defendants filed a motion to dismiss, arguing that the Rehfeldts failed to comply with the affidavit requirement of Nev. Rev. Stat. 41A.071. Defendants then filed the instant petition for a writ of mandamus or prohibition. The Supreme Court granted a writ of mandamus for the purpose of instructing the district court to conduct an evidentiary hearing for the limited purpose of determining whether the Rehfeldts could sufficiently prove that the medical expert appeared before the notary public and swore under oath that the statements contained in his opinion letter were true and correct in accordance with section 41A.071's affidavit requirement. View "MountainView Hosp. v. Nev. Dist. Court " on Justia Law
Plaintiffs filed a complaint against Defendants, health care practitioners and health care facilities, alleging claims for medical negligence, wrongful death, and statutory abuse and neglect arising from the care of Patient. The district court denied Defendants' motion for summary judgment, and the Supreme Court granted Defendant's petition for writ of mandamus, finding that the court abused its discretion in not granting summary judgment in Defendants' favor because the claims failed to comply with the affidavit requirements of Nev. Rev. Stat. 41A.071. Plaintiffs subsequently filed a new complaint, reasserting the dismissed medical malpractice claims, but the statute of limitations for Plaintiffs' claims had passed. The district court applied Nev. Rev. Stat. 11.500, Nevada's savings statute, to save the time-barred medical malpractice claims. The Supreme Court subsequently granted Defendants' writ for mandamus relief, holding that section 11.500 does not save medical malpractice claims dismissed for failure to comply with section 41A.071 because these claims are void, and section 11.500 applies only to actions that have been "commenced." View "Wheble v. Eighth Judicial Dist. Court" on Justia Law
Respondent, an insurer/managed care organization, contracted with an endoscopy center and gastroenterology center (collectively, the Clinic) to provide health care services to its insureds. After the Nevada Health District found that the Clinic engaged in a number of unsafe medical practices, Respondent terminated its contract with the Clinic. Janice Munda was insured by Respondent through her employer's health plan, which was governed by ERISA. Munda was diagnosed with hepatitis C, which the Health District determined she contracted as a result of being treated at the Clinic. Janise and her husband (collectively, Appellants) sued Respondent for negligence, negligence per se, breach of implied covenant of good faith and fair dealing, and loss of consortium. The district court granted Respondent's motion to dismiss, finding that Appellants' claims were preempted by ERISA. The Supreme Court reversed, holding that under the facts, there was no preemption because Respondent's alleged actions were independent of the administration of the ERISA plan.
From 2007 to 2008, Dorothy Rogers received Medicare benefits through Pacificare's federally-approved Medicare Advantage Plan, Secure Horizons. Rogers and Pacificare entered into separate contracts each year providing the terms and conditions of coverage. After receiving treatment from the Endoscopy Center of Southern Nevada (ECSN), a facility approved by Pacificare for use by its Secure Horizons plan members, Rogers tested positive for hepatitis C. Rogers sued Pacificare, alleging that Pacificare should be held responsible for her injuries because it failed to adopt and implement an appropriate quality assurance program. Pacificare moved to dismiss her claims and compel arbitration based on a provision in the parties' 2007 contract. The district court determined that the 2007 contract governed, but held that the arbitration provision was unconscionable and, thus, unenforceable. The Supreme Court reversed, holding (1) because the parties in this case did not expressly rescind the arbitration provision at issue, the provision survived the 2007 contract's expiration and was properly invoked; and (2) as the Medicare Act expressly preempts any state laws or regulations with respect to the Medicare plan at issue in this case, Nevada's unconscionability doctrine was preempted to the extent that it would regulate federally-approved Medicare plans.
Posted in: Arbitration & Mediation, Contracts, Health Law, Injury Law, Nevada Supreme Court, Public Benefits
Appellant Margerita Cervantes allegedly contracted hepatitis C as a result of treatment she received at the Endoscopy Center of Southern Nevada (ECSN). Appellant obtained treatment at ECSN as part of the health care benefits she received through her culinary union. The union operated a self-funded ERISA health care plan and retained Respondents, Health Plan of Nevada and other health and life insurance entities, as its agents to assist in establishing a network of the plan's chosen medical provider. Appellant filed a lawsuit alleging that Respondents were responsible for her injuries because they failed to ensure the quality of care provided by ECSN and referred her to a blatantly unsafe medical provider. The district court concluded that Cervantes' claims were preempted by ERISA section 514(a). The Supreme Court affirmed, holding that state law claims of negligence and negligence per se against a managed care organization contracted by an ERISA plan to facilitate the development of the ERISA plan's network of health care providers were precluded by ERISA section 514.
This case involved consolidated petitions for writs of mandamus challenging district court rulings regarding the admissibility of expert testimony. The petitions arose out of two separate actions resulting from an outbreak of heptitis C at an endoscopy clinic. Plaintiffs sued defendants, pharmaceutical companies, for strict products liability. The Supreme Court held that (1) a nurse can testify regarding matters within his or her specialized area of practice but not as to medical causation unless he or she has obtained the requisite knowledge, skill, experience, or training to identify cause; and (2) the standard for defense expert testimony regarding medical causation differs depending on how the defendant utilizes the expert's testimony. When a defense expert traverses the causation theory offered by the plaintiff and purports an independent causation theory, the testimony must be stated to a reasonable degree of medical probability pursuant to Morsicato v. Sav-On Drug Stores. However, when a defense expert's testimony of alternative causation theories controverts an element of the plaintiff's prima facie case where the plaintiff bears the burden of proof, the testimony must only be relevant and supported by competent medical research.