Justia Health Law Opinion Summaries

On April 7, 2020, the Fifth Circuit issued a writ of mandamus vacating the district court's temporary restraining order (TRO) that exempted abortions from GA-09, an emergency measure temporarily postponing non-essential medical procedures during the COVID-19 pandemic. On April 9, 2020, the district court entered a second TRO exempting various categories of abortion from GA-09. At issue in this mandamus petition is the April 9 TRO.The court held that the district court disregarded the court's mandate in Abbott II and failed to apply the framework governing emergency exercises of state authority during a public health crisis, established over 100 years ago in Jacobson v. Commonwealth of Massachusetts, 197 U.S. 11 (1905). Furthermore, the district court second-guessed the basic mitigation strategy underlying GA-09 (the concept of "flattening the curve"), and also acted without knowing critical facts such as whether, during this pandemic, abortion providers do (or should) wear masks or other protective equipment when meeting with patients. The court concluded that these errors resulted in an overbroad TRO that exceeds the district court's jurisdiction, reaches patently erroneous results, and usurps the state's authority to craft emergency public health measures "during the escalating COVID-19 pandemic." Therefore, the court granted the writ in part and directed the district court to vacate parts of the April 9 TRO. View "In re: Greg Abbott" on Justia Law

The Supreme Court held a doctor who was permitted to practice medicine in Tennessee under a statutory licensure exemption but was not licensed to practice in Tennessee or a contiguous state during the year before the date of the alleged injury or wrongful conduct does not meet the requirements of Tenn. Code Ann. 29-26-115(b) to testify as an expert witness in a health care liability action.Plaintiff brought this action against Thomas Killian, M.D. and Frist Cardiology, PLLC (collectively, Defendants) alleging that Defendants' negligent conduct caused her husband's death. Plaintiff named Dr. Jason A. Rytlewski as the expert witness who would testify that Dr. Killian deviated from the applicable standard of care in his treatment of the decedent. Defendants moved for summary judgment, asserting that Dr. Rytlewski did not have a medical license in Tennessee or a contiguous state the year before the decedent's heart procedure, as required by section 29-26-115(b). In response, Plaintiff explained that Dr. Rytlewski had been granted an exemption allowing him to practice medicine without a medical license. The trial court allowed Dr. Rytlewski's testimony. The Supreme Court reversed, holding that Dr. Rytlewski was not qualified to testify as an expert as an expert witness in this health care liability case. View "Young v. Frist Cardiology, PLLC" on Justia Law

In this case, the parties dispute the proper method for calculating the hospital specific limit for annual DSH payments. The Hospitals filed suit challenging the 2017 final rule clarifying that hospitals' "costs incurred" are net of payments from third parties, liked Medicare and private insurers. The Hospitals contend that the Secretary's definition of "costs incurred" conflicted with the Medicaid Act, 5 U.S.C. 706(2)(C).The Fifth Circuit reversed the district court's grant of summary judgment for the Hospitals, and joined three other circuits in holding that the 2017 rule was consistent with the Medicare Act. The court could not agree with the Hospitals that the ordinary meaning and dictionary definitions of "costs" and "payments" rendered the disputed language unambiguous; the court was unpersuaded by the Hospitals' argument that the statute draws a "clear line" between costs and payments; the court rejected the Hospitals' contention that Congress, by expressly excluding payments from Medicaid and the uninsured, meant to exclude only those payments and no others; the court rejected the Hospitals' argument that the express exclusion of third-party payments in a related Medicaid provision indicates that Congress chose not to deduct third-party payments in 42 U.S.C. 1396r-4(g)(1)(A); and the court saw no basis for the Hospitals' argument that the 2017 Rule conflicts with the statutory purpose of the hospital-specific limit. Accordingly, the court remanded for further proceedings. View "Baptist Memorial Hospital - Golden Triangle, Inc. v. Azar" on Justia Law

The Supreme Judicial Court reversed the decision of the Appellate Division dismissing as untimely Massachusetts General Hospital's (MGH) petition seeking to have C.R. committed, holding that the activity governed by Mass. Gen. Laws ch. 123, 12(a) is separate from the three-day involuntary hospitalization period established under Mass. Gen. Laws ch. 123, 12(b).The day after C.R. was admitted to a psychiatric facility but six days after she was initially brought to the emergency department of MGH by police pursuant to section 12(a), MGH filed its petition for commitment pursuant to Mass. Gen. Laws ch. 123, 7 and 8. The Appellate Division of the Boston Municipal Court concluded that MGH's petition was untimely because the three-day window under section 12(b) begins running when the patient is initially restrained under section 12(a). The Supreme Judicial Court reversed, holding (1) the three-day period under section 12(b) is necessary to fully evaluate the patient and was not intended by the Legislature to be shortened by the section 12(a) time period; and (2) as applied to C.R., the statute did not violate due process, as the section 12(a) period of confinement was no longer than necessary under the circumstances of this case. View "Massachusetts General Hospital v. C.R." on Justia Law

Plaintiffs, health care providers and their patients, filed suit against Iowa's Department of Public Health and its Health Facilities Council, alleging that Iowa's Certificate of Need laws violate the Fourteenth Amendment's Due Process, Equal Protection, and Privileges and Immunities Clauses.The Eighth Circuit held that plaintiffs' Privileges and Immunities Clause claim was foreclosed by the Slaughter-Houses cases. Applying rational basis review to the Certificate of Need (CON) regime and capital expenditures exemption, the court held that Iowa's CON requirement is rationally related to a legitimate state interest in full-service hospital viability. Furthermore, Iowa's decision to exempt competitors who are non-hospital CON-holders is rationally related to its interest in protecting the viability of full-service hospitals. Therefore, the court affirmed the district court's orders dismissing plaintiffs' Privileges and Immunities claim and granting summary judgment in favor of the state defendants on the remaining claims. View "Birchansky v. Clabaugh" on Justia Law

The Supreme Court held that Wis. Stat. 51.61(1)(g), which permits the involuntary medication of an incompetent but non-dangerous inmate, is facially unconstitutional for any inmate who is involuntarily committed based on determinations that he was mentally ill and in need of treatment when the inmate is involuntarily medicated based merely on a determination that the inmate is incompetent to refuse medication.At issue before the Supreme Court was the circuit court's order of extension of commitment, order for involuntary medication and treatment, and order denying C.S.'s postcommitment motion. C.S., who suffered from schizophrenia, was committed while he was an inmate. Because he was determined incompetent to refuse medication pursuant to section 51.61(1)(g) he was the subject of multiple involuntary medication court orders. C.S. was committed not based upon a determination of dangerousness but, rather, on determinations that he was mentally ill and in need of treatment. C.S. argued that section 51.61(1)(g)(3 is unconstitutional when it permits the involuntary medication of any inmate committed under Wis. Stat. 51.20(1)(ar) without a determination that the inmate is dangerous. The Supreme Court agreed, holding that incompetence to refuse medication alone is not an essential or overriding State interest and cannot justify involuntary medication. View "Winnebago County v. C.S." on Justia Law

The Fifth Circuit granted a writ of mandamus directing vacatur of the district court's issuance of a temporary restraining order (TRO) against executive order GA-09 as applied to abortion procedures. In order to preserve critical medical resources during the escalating COVID-19 pandemic, the Governor of Texas issued GA-09, which postpones non-essential surgeries and procedures until 11:59 p.m. on April 21, 2020.The court held that the drastic and extraordinary remedy of mandamus was warranted in this case because the district court ignored the framework governing emergency public health measures, like GA-09, in Jacobson v. Commonwealth of Massachusetts, 197 U.S. 11 (1905); the district court wrongly declared GA-09 an "outright ban" on previability abortions and exempted all abortion procedures from its scope, rather than apply the Jacobson framework to decide whether GA-09 lacks a "real or substantial relation" to the public health crisis or whether it is "beyond all question, a plain, palpable invasion" of the right to abortion; the district court failed to apply the undue-burden analysis in Planned Parenthood v. Casey, 505 U.S. 833, 857 (1992), and thus failed to balance GA-09's temporary burdens on abortion against its benefits in thwarting a public health crisis; and the district court usurped the state's authority to craft emergency health measures, substituting instead its own view of the efficacy of applying GA-09 to abortion. Therefore, the court found that the requirements for a writ of mandamus are satisfied in light of the extraordinary nature of these errors, the escalating spread of COVID-19, and the state's critical interest in protecting the public health. View "In re: Gregg Abbott" on Justia Law

The Supreme Judicial Court held that, due to the crisis caused by the COVID-19 pandemic, pretrial detainees who have not been charged with an excluded offense are entitled to a rebuttable presumption of release on personal recognizance and a hearing within two business days of filing a motion for reconsideration of bail and release.To decrease exposure to COVID-19 within correctional institutions, Petitioners sought the release to the community of as many pretrial detainees and individuals who have been convicted and are serving a sentence of incarceration as possible. The Supreme Judicial Court held (1) the risks inherent in the COVID-19 pandemic constitute a changed circumstance within the meaning of Mass. Gen. Laws ch. 276, 58, tenth paragraph, and the provisions of Mass. Gen. Laws ch. 276, 57; (2) any individual who is not being held without bail under Mass. Gen. Laws ch. 276, 58A and who has not been charged with an excluded offense as set forth in Appendix A to this opinion is entitled to a rebuttable presumption of release; and (3) to afford relief to as many incarcerated individuals as possible, the parole board and Department of Corrections are urged to work with the special master to expedite parole hearings and the issuance of parole permits. View "Committee for Public Counsel Services v. Chief Justice of Trial Court" 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

Brian Ehrhart died within days of contracting hantavirus near his Issaquah, Washington home in early 2017. His widow, Sandra Ehrhart, sued King County’s public health department, Swedish Medical Center, and an emergency room physician, arguing all three had negligently caused Brian's death. King County asserted public duty as an affirmative defense, arguing it was not liable for Brian’s death because it did not owe him any duty as an individual. Ehrhart moved for partial summary judgment asking the court to dismiss this defense and others. The trial court granted Ehrhart’s motion but conditioned its ruling on the jury finding particular facts. King County appealed, and the Washington Supreme Court accepted direct discretionary review. The issues presented were: (1) whether the trial court could properly grant summary judgment conditioned on the jury finding particular facts; and (2) whether the regulations governing King COunty's responsibility to issue health advisories created a duty owed to Brian individually as opposed to a non actionable duty owed to the public as a whole. The Supreme Court determined the trial court could not properly grant summary judgment conditioned on the jury finding particular facts; summary judgment was appropriate only when there were no genuine issues of material fact. The Court concluded King County did not owe an individualized duty to Brian, and no exception to the public duty doctrine applied in this case. The Supreme Court therefore reversed the trial court, and remanded for entry of judgment in favor of King County on its public duty doctrine defense. View "Ehrhart v. King County" on Justia Law