Justia Health Law Opinion Summaries

John Dee and Brenda Peterson appealed the grant of summary judgment in favor of Triad of Alabama, LLC, d/b/a Flowers Hospital ("Triad") on the Petersons' claims asserted in their medical-malpractice action. John was admitted to Flowers Hospital ("the hospital") in August 2014 for treatment of abdominal pain and fever that was caused by colitis. John was suffering from chronic lymphocytic leukemia, end-stage renal disease, and diabetes. While he was admitted to the hospital in August 2014, John had a peripherally inserted central catheter ("PICC line") in his left shoulder. According to the Petersons, after John had suffered "constant pain and aggravation" around the area where the PICC line was inserted, a doctor agreed to have the PICC line removed the following morning. The Petersons asserted that, a nurse, Matthew Starr, was busy with other patients to immediately remove the line. The Petersons contended that another doctor was then called, that the doctor advised the nurses treating John to take out the PICC line, and that the nurses refused. The Petersons asserted that Starr "abandoned" John. Thereafter, John experienced a deep vein thrombosis ("DVT") in his upper left arm, which caused swelling and tissue necrosis. The Alabama Supreme Court affirmed, finding that the Petersons did not make an argument supported by sufficient authority to demonstrate the trial court erred. "They failed to present expert medical testimony from a similarly situated health-care provider to establish the applicable standard of care, a deviation from that standard, and proximate causation linking the actions of hospital staff to John's injury." View "Peterson v. Triad of Alabama, LLC, d/b/a Flowers Hospital" on Justia Law

Yshekia Fletcher appealed the grant of summary judgment entered in favor of the Health Care Authority of the City of Huntsville d/b/a Huntsville Hospital ("the Authority") on Fletcher's claims asserted in her medical-malpractice action. In 2016, Fletcher was admitted to Huntsville Hospital to undergo a laparoscopic tubal-ligation surgery. Before the surgery, Fletcher's doctor, Dr. Leon Lewis, explained to Fletcher that he might have issues performing the surgery because of her obesity. During the procedure, Fletcher was placed in a Trendelenburg position - a position that lowers the head of the patient by manipulating the angle of the operating table. While in Trendelenburg, Fletcher began to slip downward off the operating table. Nursing staff caught Fletcher’s body and gently placed her on the operating room floor, where the surgeon removed the trocars and closed the incisions. After the procedure, Fletcher underwent a CT scan of her head, neck, and hip, which were normal. She was admitted overnight and discharged the following day. Fletcher later complained of hip pain after the incident. She was evaluated by an orthopedic surgeon, who noted that she had a contusion and that she had had right-hip surgery as a child. Fletcher was admitted to the hospital overnight and discharged the following day with a walker. The Alabama Supreme Court concluded the trial court correctly entered summary judgment in favor of the Authority based on Fletcher's failure to present expert medical testimony. View "Fletcher v. Health Care Authority of the City of Huntsville d/b/a Huntsville Hospital" on Justia Law

Petitioner Jose Medina was placed in custody in November 2016 on charges of second degree robbery and misdemeanor sexual battery. In June 2017, the respondent court found that Medina was mentally incompetent to stand trial and had a developmental disability under Penal Code section 1370.1. Since the time Medina was adjudicated to be mentally incompetent, he has received neither treatment nor a trial. The regional center and the California Department of Developmental Services (DDS), which have the responsibility for providing services for people with developmental disabilities, disagreed with the court’s adjudication and concluded that Medina did not have a developmental disability. Although the incompetency order was legal and binding on the regional center and the DDS, they declined to offer Medina services or recommend placement. At issue was that the version of Penal Code 1369 and 1370.1 in effect in 2017 did not require the regional center’s determination that a defendant have a developmental disability. In 2017, a trial court’s findings of mental incompetence and developmental disability were sufficient, without concurrence by the regional center, to cause the suspension of criminal proceedings. In July 2020, the respondent court attempted to end the standoff by vacating the 2017 order adjudicating Medina to be incompetent. The court ordered new examinations and another competency hearing to be held. Medina challenged the respondent court’s actions by this petition for writ of mandate/prohibition. The Court of Appeal granted the petition in part and ordered the issuance of a writ directing the respondent court to vacate its order, reinstate the orders adjudicating Medina to be incompetent to stand trial and to have a developmental disability, and determine whether the maximum period of confinement has elapsed. View "Medina v. Superior Court" on Justia Law

Rite Aid’s “Rx Savings Program” provides generic prescription drugs at reduced prices. The program is free and widely available but excludes customers whose prescriptions are paid by publicly funded healthcare programs like Medicare or Medicaid. Federal regulations require pharmacies to dispense prescriptions for beneficiaries of those programs at their “usual and customary charge to the general public” (U&C rate). Rahimi alleged that Rite Aid overbilled the government programs because the amounts it charged did not take into account the lower Rx Savings Program prices. Rahimi claimed Rite Aid's submission of bills for those covered by publicly funded health insurance, representing the price to be the U&C rate, violated the False Claims Act, 31 U.S.C. 3729(a).The Sixth Circuit affirmed the dismissal of Rahimi’s claim. The Act’s public disclosure bar precludes qui tam actions that merely feed off prior public disclosures of fraud. From the beginning, communications about the Rx Savings Program have stated that publicly funded health care programs were ineligible for the discounted prices. Before Rahimi’s disclosures, Connecticut investigated membership discount prices; the Department of Health and Human Services announced that it would review Medicaid claims for generic drugs to determine the extent to which large chain pharmacies are billing Medicaid the usual and customary charges for drugs provided under their retail discount generic programs; and a qui tam action was unsealed in California, describing an identical scheme. View "Rahimi v. Rite Aid Corp." on Justia Law

Paramedics rushed Millicent to Franciscan, a designated acute‐stroke‐ready hospital. Franciscan transferred her to its intensive care unit. Three days later, Millicent suffered a stroke. Her condition deteriorated and she was put on life support. The family expressed concern about the adequacy of care and sought to transfer Millicent to another facility. Franciscan assisted in submitting transfer paperwork to two other hospitals. Both declined the requests for insurance reasons. While a third transfer request was pending, Franciscan advised the family that Millicent was brain dead and that it had decided to stop treatment. Nearly two years later, Nartey reviewed Millicent’s medical records, which she claimed lacked the transfer paperwork and test results.Nartey, acting pro se, sued. The court grouped Nartey’s complaint into claims that Franciscan violated the federal Emergency Medical Treatment and Active Labor Act (EMTALA) by failing to provide adequate care or to transfer Millicent, 42 U.S.C. 1395dd; that Franciscan violated Title VI, which prohibits federally funded programs from discriminating on the basis of race, color, or national origin, 42 U.S.C. 2000d, and that Franciscan fraudulently concealed test results, preventing Nartey from timely bringing a medical malpractice claim.The Seventh Circuit affirmed the dismissal of the suit. Although Nartey missed filing deadlines, the court addressed the merits. EMTALA is not a malpractice statute covering treatment after an emergency patient is screened and admitted. While Nartey presented some statistical evidence that hospital transfers are less common among racial minorities, Franciscan was not responsible for Millicent remaining there. A reasonable inquiry would have discovered the alleged concealment. View "Nartey v. Franciscan Health Hospital" on Justia Law

The Supreme Court held that capacity or willingness to accept treatment is a relevant factor to be considered on the issue of grave disability but is not a separate element that must be proven to establish a conservatorship.Under the Lanterman-Petris-Short Act, Cal. Welf. & Inst. Code 5000 et seq., those subject to a conservatorship petition are entitled to a court or jury trial to decide if they are "gravely disabled." At issue was whether the trier of fact must additionally find that the individual is unwilling or unable to accept treatment voluntarily. The jury in this case found that K.P. was gravely disabled and granted a petition to renew K.P.'s conservatorship. The court of appeal affirmed. On appeal, K.P. claimed that a finding of unwillingness or inability to accept voluntary treatment was required for a conservatorship to be established. The Supreme Court affirmed, holding that inability or unwillingness to accept voluntary treatment need not be separately proven at trial. View "Conservatorship of K.P." on Justia Law

Prosser, a 37-year-old Medicare recipient, suffers from glioblastoma, which causes brain tumors. The five-year survival rate hovers around 5%. Though not curative, Prosser benefits from tumor treating fields therapy (TTF), approved by the FDA in 2011. For most of the day, patients use a device that attaches to the head via adhesive patches that connect to a mobile power supply. The device emits electrical fields to the tumor, which disrupt the division of cancer cells. Early studies show that the device holds promise in prolonging life. TTF therapy is available through a single supplier, Novocure, which rents the device on a monthly basis. The therapy is expensive. Prosser must file a Medicare benefits claim for each period she uses the device. Medicare denied coverage for the treatment period January-April 2018. Though Prosser received the therapy and owed nothing, the denial left Novocure with the bill. Prosser challenged this denial through Medicare’s appeals process before filing suit.The Seventh Circuit affirmed the dismissal of Prosser’s claim for Medicare Part B coverage, holding that she has suffered no injury-in-fact sufficient to satisfy Article III’s standing requirement. Prosser received—and continues to receive—the TTF therapy. She faces no financial liability for the treatment period Medicare denied coverage. Any future financial risk is too attenuated from the denial of the past coverage and far too speculative to establish standing. View "Prosser v. Becerra" on Justia Law

The Supreme Court affirmed the order of the district court committing Respondent to a residential living facility for adults with developmental disabilities, holding that there was no error or abuse of discretion.The Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals filed a petition for civil court certification to retain Respondent, a person with developmental disabilities, in a residential facility. The hearing justice found that Respondent was developmentally disabled and ordered that he reside at a group home. The Supreme Court affirmed, holding (1) Respondent's appeal was timely; and (2) Respondent waived his argument that the district court erred in allowing the admission of testimony regarding Respondent's juvenile conviction, his requirement to register as a sex offender, and other uncharged bad acts committed by Respondent. View "In re J.T." on Justia Law

The Supreme Court reversed the order of the circuit court denying mother's motion to prohibit the Arkansas Department of Human Services (ADHS) from immunizing her one-year-old daughter, M.S., over her objection after the circuit court adjudicated M.S. dependent-neglected, holding that Mother properly availed herself of the vaccination exemption provided for by Ark. Code. Ann. 6-18-702.On appeal, Mother argued that ADHS, as the temporary custodian of M.S., did not have the authority to immunize the child over her philosophical and religious objections. The Supreme Court reversed, holding (1) under the circumstances, the legal issues were sufficiently developed to allow an intelligent and useful decision, and therefore, the case was ripe for appellate review; and (2) Mother exercised her right to exempt M.S. from immunization, as was her right as a parent. View "Macklin v. Arkansas Department of Human Services" on Justia Law

The hospital, located in Philadelphia, received a reclassification into the New York City area, which would sizably increase the hospital’s Medicare reimbursements due to that area’s higher wage index, 42 U.S.C. 1395ww(d). Although a statute makes such reclassifications effective for three fiscal years, the agency updated the geographical boundaries for the New York City area before the close of that period and reassigned the hospital to an area in New Jersey with an appreciably lower wage index. The hospital successfully sued three agency officials in the Eastern District of Pennsylvania.The Third Circuit vacated and remanded for dismissal. The Medicare Act, 42 U.S.C. 1395oo(f)(1), channels reimbursement disputes through administrative adjudication as a near-absolute prerequisite to judicial review. The hospital did not pursue its claim through administrative adjudication before suing in federal court. By not following the statutory channeling requirement, the hospital has no valid basis for subject-matter jurisdiction. View "Temple University Hospital, Inc. v. Secretary United States Department of Health & Human Services" on Justia Law