Justia Health Law Opinion Summaries

The Secretary of Labor, through OSHA, enacted a vaccine mandate, to be enforced by employers. The mandate preempted contrary state laws and covered virtually all employers with at least 100 employees, with exemptions for employees who exclusively work remotely or outdoors. It required that covered workers receive a COVID–19 vaccine or obtain a medical test each week at their own expense, on their own time, and also wear a mask at work. Challenges were consolidated before the Sixth Circuit, which allowed OSHA’s rule to take effect.The Supreme Court stayed the rule. Applicants are likely to succeed on the merits of their claim that the Secretary lacked the authority to impose the mandate. The rule is “a significant encroachment into the lives—and health—of a vast number of employees,” not plainly authorized by statute; 29 U.S.C. 655(b) empowers the Secretary to set workplace safety standards, not broad public health measures. Although COVID–19 is a risk in many workplaces, it is not an occupational hazard in most. COVID–19 spreads everywhere that people gather. Permitting OSHA to regulate the hazards of daily life would significantly expand OSHA’s regulatory authority without clear congressional authorization. The vaccine mandate is unlike typical OSHA workplace regulations. A vaccination “cannot be undone.” Where the virus poses a special danger because of the particular features of an employee’s job or workplace, targeted regulations are permissible but OSHA’s indiscriminate approach fails to distinguish between occupational risk and general risk. The equities do not justify withholding interim relief. States and employers allege that OSHA’s mandate will force them to incur billions of dollars in unrecoverable compliance costs and will cause hundreds of thousands of employees to leave their jobs. View "National Federation of Independent Business v. Department of Labor, Occupational Safety & Health Administration" on Justia Law

In November 2021, the Secretary of HHS announced that, in order to receive Medicare and Medicaid funding, participating facilities must ensure that their staff—unless exempt for medical or religious reasons or teleworking full-time—are vaccinated against COVID–19. Two district courts enjoined enforcement of the rule. The Supreme Court stayed the injunctions pending appeals in the Fifth and Eighth Circuits. The rule falls within the Secretary’s statutory authority to promulgate regulations “necessary to the efficient administration of the functions with which [he] is charged,” 42 U.S.C. 1302(a), including ensuring that the healthcare providers who care for Medicare and Medicaid patients protect their patients’ health and safety. Conditions with which facilities must comply to be eligible to receive Medicare and Medicaid funds have long included a requirement that certain providers maintain and enforce an “infection prevention and control program.” Vaccination requirements are a common feature of the provision of healthcare in America. The rule is not arbitrary. The Court noted the Secretary’s findings that in addition to the threat posed by in- facility transmission itself, “fear of exposure” to the virus “from unvaccinated health care staff can lead patients to themselves forgo seeking medically necessary care.” Nor did the Secretary fail to consider that the rule might cause staffing shortages. The Secretary’s finding of good cause to delay notice and comment was based on a finding that accelerated promulgation of the rule in advance of the winter flu season would significantly reduce COVID–19 infections, hospitalizations, and deaths. View "Biden v. Missouri" on Justia Law

In a suit challenging the emergency temporary standards (ETS) promulgated by the California Occupational Safety and Health Standards Board in response to the COVID-19 pandemic, the trial court denied a request for a preliminary injunction suspending enforcement of the ETS. The trial court concluded that the plaintiffs had not shown a likelihood of prevailing on the merits and found the public interest in curbing the spread of COVID-19 weighed “heavily” in favor of ongoing enforcement of the ETS.The court of appeal affirmed, rejecting arguments that the trial court erroneously applied a deferential standard of review, the findings of emergency lacked necessary findings, and the ETS exceeded the Board’s statutory authority. The administrative record demonstrated the Board did not abuse its discretion in adopting prescriptive standards in the ETS; the Board considered performance standards during the rulemaking process, including existing regulations, and concluded certain prescriptive standards were necessary to assure “to the extent feasible, that no employee will suffer material impairment of health or functional capacity.” The Board did not abuse its discretion in establishing regulations excluding workers exposed to COVID-19 cases from the workplace and mandating a continuation of pay, benefits, and seniority during such periods of exclusion. View "Western Growers Association v. Occupational Safety & Health Standards Board" on Justia Law

The First Circuit affirmed the judgment of the district court denying Defendant's motion for compassionate release under 18 U.S.C. 3582(c)(1)(A), as amended by the First Step Act (FSA), holding that the district court did not abuse its discretion.Defendant, an inmate, moved for compassionate release pursuant to the compassionate-release statute, arguing that, given his pre-existing medical conditions, his heightened risk of complications stemming from COVID-19 constituted an "extraordinary and compelling" reason warranting a sentence reduction. The district court denied the motion on the papers. The First Circuit affirmed, holding that Defendant's arguments on appeal were unavailing. View "United States v. Texeira-Nieves" on Justia Law

The Acting Warden of the California Institute for Men petitioned a Superior Court for authorization to perform electroconvulsive therapy (ECT) on inmate Rudy Terraza. Convicted of first-degree murder at age 17, Terraza was a 44-year-old with a history of mental illness. According to a prison psychiatrist, Terraza has a “schizoaffective disorder, bipolar type . . . characterized by auditory hallucinations, delusions, and impairment in thought processing, volition and motivation, and social functioning, as well as significant mood swings, depression, and mania.” Despite medication and psychiatric treatment, his mental health had grown worse over time, and he had resided in a psychiatric hospital since September 2019. He had been “consumed” by voices, with no desire to socialize or “practice self-care.” He occupied a single hospital room and was unable to function in standard prison housing. A psychiatrist averred that ECT was the “gold standard” treatment for patients like Terraza; seizures produced by the treatment would "help the brain return to normal functioning." The trial court authorized ECT after making several findings required by the Penal Code, including that ECT would be beneficial and that there was a compelling justification for it. In this habeas proceeding, the inmate argued the state constitutional right to privacy required the appointment of a surrogate to make a consent determination for him, beyond trial court findings of ECT’s suitability. Upon consideration of precedent, the Court of Appeal concluded the state constitutional right to refuse medical treatment did not require appointment of a surrogate decisionmaker. Nevertheless, the Court concluded that a court’s authorization of ECT therapy had to include a consideration of whether the inmate, when he or she was competent, expressed any preferences, views, or beliefs that would operate to preclude consent to the procedure. "By statute, such consideration is required for most medical procedures performed on incarcerated persons lacking capacity to consent." Because the statutory balancing test for ECT did not do so, the Court granted the writ to allow further consideration. View "In re Terraza" on Justia Law

Appellees, Rite Aid Corporation, Rite Aid Hdqtrs. Corp., and Rite Aid of Maryland, Inc. (collectively, “Rite Aid”), held a general liability insurance policy underwritten by defendany Chubb, Limited ("Chubb"). Rite Aid and others were defendants in multi-district litigation before the United States District Court for the Northern District of Ohio (the “MDL Opioid Lawsuits”). Plaintiffs in that suit filed over a thousand suits in the MDL Opioid Lawsuits against companies in the pharmaceutical supply chain for their roles in the national opioid crisis. Certain suits were bellwether suits - including the complaints of Summit and Cuyahoga Counties in Ohio (“the Counties”) which were at issue here. The question this case presented for the Delaware Supreme Court was whether insurance policies covering lawsuits “for” or “because of” personal injury required insurers to defend their insureds when the plaintiffs in the underlying suits expressly disavowed claims for personal injury and sought only their own economic damages. The Superior Court decided that Rite Aid’s insurance carriers were required to defend it against lawsuits filed by two Ohio counties to recover opioid-epidemic-related economic damages. As the court held, the lawsuits sought damages “for” or “because of” personal injury because there was arguably a causal connection between the counties’ economic damages and the injuries to their citizens from the opioid epidemic. The Supreme Court reversed, finding the plaintiffs, governmental entities, sought to recover only their own economic damages, specifically disclaiming recovery for personal injury or any specific treatment damages. Thus, the carriers did not have a duty to defend Rite Aid under the governing insurance policy. View "ACE American Insurance Company v. Rite Aid Corporation" 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

The Supreme Court reversed the portion of the district court's judgment declaring 2021 Senate Bill 40 invalid and unenforceable based on certain infirmities the court observed, holding that the district court erred by ignoring the constitutional avoidance doctrine and failing to abide by it.This case arose from a dispute regarding public school policies mandating face masks during the COVID-19 pandemic. After the Legislature passed S.B. 40 imposing substantive limits on COVID-19 mitigation measures adopted by other governmental entities Plaintiffs sued the Shawnee Mission School District challenging the district's mask policy. Plaintiffs asserted S.B. 40 as the only legal authority for their lawsuit. The district court dismissed the claims as moot and then ruled that S.B. 40 was unenforceable because it violated both due process and separation of powers. The Supreme Court reversed, holding that the district court erred in its analytical diversion into S.B. 40's constitutionality. View "Butler v. Shawnee Mission School District Board of Education" on Justia Law

The 1949 Federal Property and Administrative Services Act is intended to facilitate the “economical and efficient” purchase of goods and services on behalf of the federal government, 40 U.S.C. 101. In November 2021, the Safer Federal Workforce Task Force, under the supposed auspices of the Act, issued a “Guidance” mandating that employees of federal contractors in “covered contract[s]” with the federal government become fully vaccinated against COVID-19. Ohio, Kentucky, and Tennessee and Ohio sheriffs’ offices sued, alleging that the Property Act does not authorize the mandate, that the mandate violates other federal statutes, and that its intrusion upon traditional state prerogatives raises federalism and Tenth Amendment concerns.The district court enjoined enforcement of the mandate throughout the three states and denied the federal government’s request to stay the injunction pending appeal. The Sixth Circuit denied relief. The government has established none of the showings required to obtain a stay. The government is unlikely to succeed on claims that the plaintiffs lack standing and the plaintiffs likely have a cause of action under the Administrative Procedure Act. The court noted the plaintiff’s concerns about disruptions to the supply chain if workers leave their jobs rather than receiving vaccinations and also stated: Given that expansive scope of the Guidance, the interpretive trouble is not figuring out who’s “covered”; the difficult issue is understanding who, based on the Guidance’s definition of “covered,” could possibly not be covered. View "Commonwealth of Kentucky v. Biden" on Justia Law

B.W., a two-year-old in good health, experienced immune thrombocytopenic purpura after receiving his measles, mumps, and rubella vaccine. Later blood tests showed his condition had resolved. More than six months after he was first diagnosed, B.W. presented with bruising, a possible symptom of immune thrombocytopenic purpura, but blood tests showed the condition had not recurred. In a suit under the National Childhood Vaccine Injury Act of 1986, the Claims Court ruled in favor of B.W., holding that those blood tests, occurring more than six months after his initial diagnosis, were “residual effects” of B.W.’s vaccine injury that satisfied the severity requirement of 42 U.S.C. 300aa-11(c)(1)(D).The Federal Circuit reversed. A residual effect must be a change within the patient that is caused by the vaccine injury. B.W.’s later bruising was not caused by his vaccine injury, and his tests did not reveal, constitute, or cause any somatic change. Tests revealed B.W. had no lingering symptoms or recurrence of thrombocytopenic purpura. There was no argument that the testing itself was detrimental to B.W.’s health such that it might qualify under section 300aa-11(c)(1)(D)(i) as a “residual effect” or a “complication” of thrombocytopenic purpura. View "Wright v. Secretary of Health and Human Services" on Justia Law