Justia Health Law Opinion Summaries

The case revolves around John Doyle, who was charged with crimes stemming from a domestic dispute. In August 2019, the trial court ordered Doyle to undergo a competency evaluation, and his mental health and medical records were provided to the Office of the Forensic Examiner (OFE). The court specified that these records could only be used to determine competency and not for any other proceeding without a court order. The OFE concluded that Doyle was not competent to stand trial but could be restored to competence with appropriate treatment. However, an independent examiner concluded that Doyle was unlikely to be restored to competency. In August 2021, the OFE re-evaluated Doyle and concluded that he had not been restored to competency and was dangerous to himself or others.The trial court had previously ruled that Doyle's medical and mental health records were exempt from the physician-patient and psychotherapist-patient privileges, allowing the State to release these records to a physician designated by the State for assessing the appropriateness of involuntary commitment. Doyle appealed this decision, arguing that the court erred in ruling that his records were exempt from these privileges.The Supreme Court of New Hampshire vacated the trial court's decision and remanded the case. The Supreme Court found that the trial court erred in determining that Doyle's medical and mental health records were exempt from statutory privileges under RSA 135:17-a, V. The court concluded that these records were privileged under RSA 329:26 and RSA 330-A:32, and the trial court erred in determining that they were exempt from these privileges. The case was remanded for further proceedings to determine whether there were grounds for disclosing the privileged information. View "State v. Doyle" on Justia Law

In an interlocutory appeal, multiple hotel operators challenged a superior court’s orders in a suit against defendants, multiple insurance underwriters, all relating to the denial of coverage during the COVID-19 world health pandemic. Plaintiffs owned and operated twenty-three hotels: four in New Hampshire, eighteen in Massachusetts, and one in New Jersey. Plaintiffs purchased $600 million of insurance coverage from defendants for the policy period from November 1, 2019 to November 1, 2020. With the exception of certain addenda, the relevant language of the policies was identical, stating in part that it “insures against risks of direct physical loss of or damage to property described herein . . . except as hereinafter excluded.” For periods of time, pursuant to governors’ orders, hotels in each of the three states were permitted to provide lodging only to vulnerable populations and to essential workers. These essential workers included healthcare workers, the COVID-19 essential workforce, and other workers responding to the COVID-19 public health emergency. Beginning in June 2020, plaintiffs’ hotels were permitted to reopen with a number of restrictions on their business operations. Plaintiffs, through their insurance broker, provided notice to defendants they were submitting claims in connection with losses stemming from COVID-19. Plaintiffs sued when these claims denied, arguing that the potential presence of the virus triggered business loss provisions in their respective policies. To this, the New Hampshire Supreme Court disagreed, finding that “[w]hile the presence of the virus might affect how people interact with one another, and interact with the property, it does not render the property useless or uninhabitable, nor distinctly and demonstrably altered.” View "Schleicher & Stebbins Hotels, LLC, et al. v. Starr Surplus Lines Insurance Co., et al." on Justia Law

Plaintiffs Clearview Realty Ventures, LLC, JHM HIX Keene, LLC, VIDHI Hospitality, LLC, NAKSH Hospitality, LLC, 298 Queen City Hotel, LLC, ANSHI Hospitality, LLC, 700 Elm, LLC, Bedford-Carnevale, LLC, and Carnevale Holdings, LLC, owned commercial real estate on which they operated hotels, some of which offered restaurant services along with banquet or function facilities. They contended that the COVID-19 pandemic was a “natural disaster” and that their buildings were “damaged” within the meaning of RSA 76:21, I. Plaintiffs sought relief from the New Hampshire municipalities involved: the Cities of Laconia, Keene, and Manchester, and the Town of Bedford. After denial of their applications, they appealed to the superior court in the applicable county. Observing that there were thirteen separate lawsuits pending in six counties, they then filed an assented-to motion for interlocutory transfer without ruling and motion to consolidate to allow the coordinated transfer of the common questions of law to the New Hampshire Supreme Court. In this interlocutory transfer without ruling, the Supreme Court was asked to determine: (1) whether, for purposes of RSA 76:21, the COVID-19 pandemic constituted a “natural disaster”; and (2) if so, whether the buildings owned by the plaintiffs were “damaged” by COVID-19 such that they were “not able to be used for [their] intended use” within the meaning of RSA 76:21, I. The Court answered the second question in the negative. View "Clearview Realty Ventures, LLC v. City of Laconia; et al." on Justia Law

The United States District Court for the District of New Hampshire certified two questions of law for the New Hampshire Supreme Court's consideration. Plaintiffs, individuals who presently or formerly lived in the Merrimack area, brought tort claims, including negligence, nuisance, trespass, and negligent failure to warn, alleging that defendants’ manufacturing process at its facility in the Town of Merrimack used chemicals that included perfluorooctanoic acid (PFOA). They alleged PFOA was a toxic chemical that was released into the air from the Merrimack facility and has contaminated the air, ground, and water in Merrimack and nearby towns. As a result, plaintiffs alleged the wells and other drinking water sources in those places were contaminated, exposing them to PFOA, placing them at risk of developing health problems, including testicular cancer, kidney cancer, immunotoxicity, thyroid disease, high cholesterol, ulcerative colitis, and pregnancy induced hypertension. The first question from the federal circuit court asked whether New Hampshire recognized “a claim for the costs of medical monitoring as a remedy or as a cause of action” in plaintiffs' context. Depending on the answer to the first question, the second question asked, “what are the requirements and elements of a remedy or cause of action for medical monitoring” under New Hampshire law. Because the Supreme Court answered the first question in the negative, it did not address the second question. View "Brown, et al. v. Saint-Gobain Performance Plastics Corporation, et al." on Justia Law

Respondent K.C. appealed a circuit court decision ordering her to involuntary admission to the New Hampshire Hospital (NHH) for a two-year period, to be discharged when clinically appropriate. On appeal, respondent contended NHH presented insufficient evidence at the hearing to support the circuit court’s order. Respondent was diagnosed with bipolar I disorder with manic, psychotic features. She had contacted police in the previous year 300-400 times, believing someone was hacking her phone and “rerouting her to people in black ops.” She had two active protective orders preventing her from contacting her ex-husband and another man, and there was outstanding criminal complaints from her violating those orders. Respondent was admitted to NHH, whereupon she was evaluated by psychiatrists, and the decision was ultimately made to have her committed. Finding no reversible error in the circuit court’s order, the New Hampshire Supreme Court affirmed, finding the evidence presented at respondent’s hearing was sufficient on which to have her involuntarily committed. View "In re K.C." on Justia Law

Respondent, C.R. (ward) appealed a circuit court order appointing a guardian over her person, arguing that petitioner New Hampshire Hospital (NHH) failed to prove beyond a reasonable doubt that she was incapacitated. She also argued the trial court’s findings of incapacity exceeded the scope of the pleadings and evidence at trial, thereby depriving her of notice and an opportunity to be heard. The ward suffered from schizoaffective disorder, and, in November 2020, was involuntarily admitted to NHH for a two-year period. NHH obtained emergency treatment authorization to provide the ward with psychiatric medication without her consent, and although her condition improved, the medication caused side effects that required a reduction in dosage. The ward declined to take any medication to treat the side effects or any alternative medication that would not cause the side effects. The emergency treatment authorization expired on January 4, 2021. In the two weeks before the February 2021 guardianship proceeding, the ward started exhibiting worsening thoughts that people were trying to target her, and her mood fluctuated more, spurring concerns that the current medication was insufficient. NHH filed the guardianship petition at issue here, alleging that, the guardianship was necessary. The New Hampshire Supreme Court concluded the evidence presented at trial was sufficient for the trial court to have found the ward “is likely to suffer substantial harm due to an inability to provide for [her] personal needs for food, clothing, shelter, health care or safety or an inability to manage . . . her property or financial affairs.” Further, the Court found there was support in the record for the trial court's finding that guardianship was the least restrictive intervention for the ward. The Court found that the guardianship petition informed the ward the trial court could “impose additional orders as a result of the hearing,” but it did not inform her that NHH was asking the court to find her incapable of exercising her rights to marry or divorce, make a will or waive a will’s provisions, hold or obtain a motor vehicle operator’s license, initiate/defend/settle lawsuits, or make decisions concerning educational matters or training. Under these circumstances, the Supreme Court held that the ward did not receive the notice contemplated by RSA 464-A:5, I, as to those rights. Therefore, the Court vacated the guardianship order to the extent that it deprived her of those rights. The Court otherwise affirmed the order appointing a guardian over the person of the ward and remanded. View "In re Guardianship of C.R." on Justia Law

Petitioner Andrew Panaggio appealed a New Hampshire Compensation Appeals Board (Board) determination that respondent, CNA Insurance Company (the insurer), could not be ordered to reimburse him for his purchase of medical marijuana because such reimbursement would have constituted aiding and abetting his commission of a federal crime under the federal Controlled Substances Act (CSA). When Panaggio appealed the insurer’s denial to the New Hampshire Department of Labor, a hearing officer agreed with the insurer. Panaggio appealed the hearing officer’s decision to the Board, which unanimously found that his use of medical marijuana was reasonable and medically necessary. Nonetheless, the Board upheld the insurer’s refusal to reimburse Panaggio, concluding that “the carrier is not able to provide medical marijuana because such reimbursement is not legal under state or federal law.” The New Hampshire Supreme Court surmised the issue on appeal raised a question of federal preemption, "which is essentially a matter of statutory interpretation and construction." Although it was an issue of first impression for the New Hampshire Court, other courts considered whether the CSA preempted a state order requiring reimbursement of an employee’s purchase of medical marijuana. Panaggio reasoned that “[b]ecause New Hampshire law unambiguously requires the insurer to pay for the claimant’s medically related treatment,” an insurer that reimburses a claimant for the purchase of medical marijuana acts without the volition required by the federal aiding and abetting statute. The insurer asserted Panaggio’s argument leads to an absurd result, observing that “[c]onflict preemption applies because state law requires what federal law forbids.” The New Hampshire Supreme Court ultimately concluded the CSA did not make it illegal for an insurer to reimburse an employee for his or her purchase of medical marijuana. "[A] Board order to reimburse Panaggio does not interfere with the federal government’s ability to enforce the CSA. Regardless of whether the insurer is ordered to reimburse Panaggio for his medical marijuana purchase, the federal government is free to prosecute him for simple possession of marijuana under the CSA." Under these circumstances, the Court concluded the “high threshold” for preemption “is not met here.” The Board's decision was reversed and the matter remanded for further proceedings. View "Appeal of Andrew Panaggio" on Justia Law

In February 2020, the 79-year-old ward was a patient at a hospital in Lebanon, New Hampshire. At that time, the hospital filed a petition to appoint a guardian over the ward’s person and estate. The hospital alleged a guardianship was necessary because the ward “has persistent cognitive impairment due to an anoxic brain injury and a major [neurocognitive] disorder,” which “renders him unable to provide for his personal needs for health care, food, clothing, shelter and safety” or to “manage his finances or estate.” The court held a hearing in March at which only the ward’s adult children were present. The ward’s children testified that, in October 2019, when their father was in the intensive care unit, they executed a “Do Not Resuscitate” (DNR) order for him. The ward had no DNR order previously. When the ward’s condition improved and he was transferred to a medical ward, he specifically told his children that he wanted the DNR order removed. Based upon the evidence at the March hearing, the court found that the ward was incapacitated and that a guardianship was necessary as a means of providing for his “continuing care ... and for the prudent management of [his] property and financial affairs.” The court limited the guardian’s authority to execute either a DNR order or an order limiting life-sustaining treatment. In August 2020, the guardian moved for a hearing to ask the court to remove the limitations on her authority regarding the ward’s medical care. The guardian averred that the ward, who now resided in a nursing home, was in need of dialysis but had refused dialysis on three occasions, and refused future treatment. The guardian asserted that, by declining to resume dialysis, “the ward himself has decided to stop his own life sustaining treatment,” and that “without having a DNR order in place and without anyone else having the ability to sign [one],” it will be “quite problematic and painful for the ward.” The ward’s attorney informed the court that the ward was “very clear that he did not want a DNR Order.” Upon interlocuroty transfer without a ruling from the circuit court, the New Hampshire Supreme Court accepted review of issues arising from the ward's guardianship. The Court determined that although the ward had a guardian to make health care decisions on his behalf, the trial court had limited the guardian’s authority to withhold life-sustaining treatment, including whether to execute a DNR order on his behalf. "Under these circumstances, given the ward’s lack of capacity to make health care decisions generally, and assuming that he does not have a valid and unrevoked living will or an authorized agent under a durable power of attorney for health care, the process for appointing a surrogate, as described in RSA 137-J:34-:37, applies. ... Accordingly, it does not appear that at this time, a DNR order may be executed on his behalf by his health care providers." View "In re Guardianship of D.E." on Justia Law

Respondent L.N. appealed a circuit court order denying a motion to authorize removal of life support filed by her guardian. In 2018, tests indicated that L.N. had suffered a stroke. L.N. was 69 years old at the time of the orders on appeal, and had “enjoyed a full, active, independent life” prior to her stroke on September 12. Thereafter, L.N. remained in the hospital on a ventilator to assist with breathing and a nasal-gastric tube for nutrition and hydration. L.N.’s attorney informed the court in a motion for expedited hearing that “[a]fter consulting with personnel, it has been indicated that [L.N.] will probably not survive the massive stroke which precipitated this hospitalization, but there is no one with authority to act.” There was no evidence that L.N. had previously executed either a living will or a durable power of attorney for healthcare. M.C., a former co-worker, was ultimately appointed as guardian. Based upon conversations, the guardian’s sense was that L.N. “would want to be allowed to have a natural death.” Notwithstanding testimony by L.N.’s caregivers and guardian, the trial court concluded that, “in cases of doubt, the Court must assume that the patient would choose to defend life” and did “not find that [L.N.] - under the facts in this case - would choose to have life support removed and a natural death process to occur.” On appeal, L.N. argues that the probate court erred in determining that “it had jurisdiction to make a determination as to the appropriateness, or lack thereof, of the removal of life support in the case of a patient who was in a persistent vegetative state” where “no party challeng[ed] the proposed removal.” She further argued that, even if the court had the authority to exercise its discretion in this matter, its findings were unsupported by the testimony. The New Hampshire Supreme Court reversed the order denying authority to remove life support and vacated, in part, the order appointing the guardian: “Because any limitation on the guardian’s RSA 464-A:25, I(d) authority after the October 17 hearing was not supported by the statutorily-required finding that it was “desirable for the best interests of [L.N.],” RSA 464-A:25, II, we vacate that limitation. Without that limitation, the guardianship order’s grant of the ‘right and authority to determine if refusal should be made or consent should be given to any medical or other professional care, counseling, treatment, or service’ constitutes a general grant of authority that includes the authority to withdraw life-sustaining treatment in appropriate circumstances.” View "In re Guardianship of L.N." on Justia Law

Respondent R.M. appealed a circuit court order that renewed his involuntary admission to New Hampshire Hospital for the purpose of allowing him to remain on a conditional discharge for a period of five years. Respondent was a 30-year-old man who had been hospitalized on multiple occasions as a result of schizophrenia. When respondent doesn't take his prescribed anti-psychotic medication, he becomes paranoid, violent, and suicidal. In addition, he experienced hallucinations, paranoid delusions, and difficulties with impulse control and exhibited “a serious level of aggression.” Respondent was first hospitalized in 2010 after voicing suicidal ideation, stating that he would be “better off dead.” Pertinent here, was admitted on an emergency basis again in February 2015 due to concerns of suicidal threats, incapacity, and his paranoid belief that people were conspiring against him. In early March 2019, a few weeks before the respondent’s three-year conditional discharge was set to expire, the local community mental health center filed a petition to renew his conditional discharge. On appeal, respondent challenged the sufficiency of the evidence and argued the five-year renewal was not the least restrictive treatment option. Finding no reversible error, the New Hampshire Supreme Court affirmed. View "In re R.M." on Justia Law