Health Law - Justia Case Law Summarieshttps://law.justia.com/summaryfeed/health-law/2024-03-28T15:17:28-08:00Justia Inchttps://www.justia.com/Justia Lawhttps://justatic.com/v/20240328145339/shared/images/social-media/law.pngCopyright 2024 Justia Inchttps://law.justia.com/cases/federal/appellate-courts/cafc/22-1877/22-1877-2024-03-25.htmlEDWARDS LIFESCIENCES CORPORATION v. MERIL LIFE SCIENCES PVT. LTD. 2024-03-25T05:31:37-08:002024-03-25T05:31:37-08:00
This case deals with the importation of two transcatheter heart valve systems by Meril Life Sciences Pvt. Ltd. and Meril, Inc. (collectively, "Meril") into the United States for a medical conference in San Francisco. The plaintiff, Edwards Lifesciences Corporation and Edwards Lifesciences LLC (collectively, "Edwards"), a competitor medical device company, alleged that this act constituted patent infringement. Meril argued that the importation was covered by the "safe harbor" provision of 35 U.S.C. § 271(e)(1), which exempts certain activities from being considered patent infringement if they are reasonably related to the development and submission of information under a Federal law which regulates the manufacture, use, or sale of drugs.
The district court granted summary judgment in favor of Meril, and Edwards appealed to the United States Court of Appeals for the Federal Circuit. The Court of Appeals affirmed the decision of the district court, noting that the undisputed evidence showed that the importation of the valve systems was reasonably related to submitting information to the United States Food and Drug Administration. The court rejected Edwards' arguments that the district court had disregarded contemporaneous evidence, applied the safe harbor with an objective standard, and relied improperly on declarations from Meril employees. The court affirmed the district court's conclusion that there was no genuine dispute of material fact and that Meril was entitled to judgment as a matter of law. <a href="https://law.justia.com/cases/federal/appellate-courts/cafc/22-1877/22-1877-2024-03-25.html" target="_blank">View "EDWARDS LIFESCIENCES CORPORATION v. MERIL LIFE SCIENCES PVT. LTD. " on Justia Law</a>
This case deals with the importation of two transcatheter heart valve systems by Meril Life Sciences Pvt. Ltd. and Meril, Inc. (collectively, "Meril") into the United States for a medical conference in San Francisco. The plaintiff, Edwards Lifesciences Corporation and Edwards Lifesciences LLC (collectively, "Edwards"), a competitor medical device company, alleged that this act constituted patent infringement. Meril argued that the importation was covered by the "safe harbor" provision of 35 U.S.C. § 271(e)(1), which exempts certain activities from being considered patent infringement if they are reasonably related to the development and submission of information under a Federal law which regulates the manufacture, use, or sale of drugs.
The district court granted summary judgment in favor of Meril, and Edwards appealed to the United States Court of Appeals for the Federal Circuit. The Court of Appeals affirmed the decision of the district court, noting that the undisputed evidence showed that the importation of the valve systems was reasonably related to submitting information to the United States Food and Drug Administration. The court rejected Edwards' arguments that the district court had disregarded contemporaneous evidence, applied the safe harbor with an objective standard, and relied improperly on declarations from Meril employees. The court affirmed the district court's conclusion that there was no genuine dispute of material fact and that Meril was entitled to judgment as a matter of law.
2024-03-25federalUS Court of Appeals for the Federal CircuitStollhttps://law.justia.com/cases/north-carolina/supreme-court/2024/59a23.htmlHalikierra Cmty. Servs. LLC v. N.C. Dep't of Health & Hum. Servs2024-03-22T07:31:18-08:002024-03-22T07:31:18-08:00
The Supreme Court of North Carolina ruled on a case involving Halikierra Community Services LLC (Halikierra), a provider of home personal care services to Medicaid beneficiaries and the North Carolina Department of Health and Human Services (DHHS). DHHS had placed Halikierra on Medicaid reimbursement prepayment review following several overbilling complaints, leading to several post-payment audits. The audits revealed that Halikierra had erroneously received excess Medicaid reimbursement funds on multiple occasions and found suspicious reimbursement claims.
Halikierra filed a lawsuit against DHHS, alleging that the decision to place them on prepayment review violated their substantive due process and equal protection rights under the North Carolina Constitution. The trial court granted summary judgment in favor of DHHS, leading to an appeal from Halikierra.
The Supreme Court of North Carolina affirmed the trial court's decision, holding that summary judgment was properly entered against Halikierra. The Court found that Halikierra’s evidentiary forecast failed to disclose any genuine issues of material fact in support of its claims. The Court concluded that DHHS's actions were not arbitrary or capricious, as the prepayment review was rationally related to a legitimate government interest, namely combating Medicaid fraud and ensuring that claims meet the requirements of federal and state laws and regulations. The Court also found no evidence of unequal treatment of Halikierra compared to other Medicaid providers. <a href="https://law.justia.com/cases/north-carolina/supreme-court/2024/59a23.html" target="_blank">View "Halikierra Cmty. Servs. LLC v. N.C. Dep't of Health & Hum. Servs" on Justia Law</a>
The Supreme Court of North Carolina ruled on a case involving Halikierra Community Services LLC (Halikierra), a provider of home personal care services to Medicaid beneficiaries and the North Carolina Department of Health and Human Services (DHHS). DHHS had placed Halikierra on Medicaid reimbursement prepayment review following several overbilling complaints, leading to several post-payment audits. The audits revealed that Halikierra had erroneously received excess Medicaid reimbursement funds on multiple occasions and found suspicious reimbursement claims.
Halikierra filed a lawsuit against DHHS, alleging that the decision to place them on prepayment review violated their substantive due process and equal protection rights under the North Carolina Constitution. The trial court granted summary judgment in favor of DHHS, leading to an appeal from Halikierra.
The Supreme Court of North Carolina affirmed the trial court's decision, holding that summary judgment was properly entered against Halikierra. The Court found that Halikierra’s evidentiary forecast failed to disclose any genuine issues of material fact in support of its claims. The Court concluded that DHHS's actions were not arbitrary or capricious, as the prepayment review was rationally related to a legitimate government interest, namely combating Medicaid fraud and ensuring that claims meet the requirements of federal and state laws and regulations. The Court also found no evidence of unequal treatment of Halikierra compared to other Medicaid providers.
2024-03-22stateNorth CarolinaNorth Carolina Supreme CourtRiggshttps://law.justia.com/cases/illinois/supreme-court/2024/129289.htmlPeople v. Torres2024-03-21T06:33:55-08:002024-03-21T06:33:55-08:00
The Supreme Court of the State of Illinois reviewed a case where a defendant, Ramon Torres, was convicted of predatory criminal sexual assault of his four-year-old daughter. The State’s evidence included testimony that Torres tested positive for chlamydia in 2013 and again in 2016. On appeal, Torres argued that his trial counsel was constitutionally ineffective for failing to object to the admission of evidence of these two test results. He maintained that the test results fell under the purview of the physician-patient privilege statute and that none of the statutory exceptions to the physician-patient privilege applied.
This case required the court to interpret the physician-patient privilege statute and whether the test results would have been excluded from evidence at his jury trial had his attorney objected. The appellate court disagreed with Torres and affirmed his conviction and sentence. The Supreme Court of the State of Illinois affirmed the lower courts’ judgments.
The court held that the physician-patient privilege statute did not apply to the 2016 test results as Torres submitted to testing in 2016 not for the purpose of seeking medical treatment, but because he was ordered to do so by the Department of Children and Family Services. Therefore, the privilege and the exceptions to the privilege were irrelevant to the admissibility of the 2016 test results.
Regarding the 2013 test results, the court found that the physician-patient privilege statute does apply. The court, however, determined that the exception set out in subsection (7) authorizes physicians to disclose information subject to the physician-patient privilege “in actions, civil or criminal, arising from the filing of a report in compliance with the Abused and Neglected Child Reporting Act.” Therefore, the 2013 chlamydia test results were admissible even though the physician-patient privilege attached to those test results. The court concluded that the defendant has not satisfied the first prong of the Strickland standard, and his claim of ineffective assistance of counsel fails. <a href="https://law.justia.com/cases/illinois/supreme-court/2024/129289.html" target="_blank">View "People v. Torres" on Justia Law</a>
The Supreme Court of the State of Illinois reviewed a case where a defendant, Ramon Torres, was convicted of predatory criminal sexual assault of his four-year-old daughter. The State’s evidence included testimony that Torres tested positive for chlamydia in 2013 and again in 2016. On appeal, Torres argued that his trial counsel was constitutionally ineffective for failing to object to the admission of evidence of these two test results. He maintained that the test results fell under the purview of the physician-patient privilege statute and that none of the statutory exceptions to the physician-patient privilege applied.
This case required the court to interpret the physician-patient privilege statute and whether the test results would have been excluded from evidence at his jury trial had his attorney objected. The appellate court disagreed with Torres and affirmed his conviction and sentence. The Supreme Court of the State of Illinois affirmed the lower courts’ judgments.
The court held that the physician-patient privilege statute did not apply to the 2016 test results as Torres submitted to testing in 2016 not for the purpose of seeking medical treatment, but because he was ordered to do so by the Department of Children and Family Services. Therefore, the privilege and the exceptions to the privilege were irrelevant to the admissibility of the 2016 test results.
Regarding the 2013 test results, the court found that the physician-patient privilege statute does apply. The court, however, determined that the exception set out in subsection (7) authorizes physicians to disclose information subject to the physician-patient privilege “in actions, civil or criminal, arising from the filing of a report in compliance with the Abused and Neglected Child Reporting Act.” Therefore, the 2013 chlamydia test results were admissible even though the physician-patient privilege attached to those test results. The court concluded that the defendant has not satisfied the first prong of the Strickland standard, and his claim of ineffective assistance of counsel fails.
2024-03-21stateIllinoisSupreme Court of IllinoisOVERSTREEThttps://law.justia.com/cases/federal/appellate-courts/ca5/22-40617/22-40617-2024-03-20.htmlUSA v. Marchetti2024-03-20T15:32:23-08:002024-03-20T15:32:23-08:00
The United States Court of Appeals for the Fifth Circuit affirmed the conviction and sentence of defendant Vincent Marchetti, Jr., who was found guilty of one count of conspiracy to commit illegal remunerations in violation of 18 U.S.C. § 371. Marchetti was involved in a scheme wherein Vantari Genetics LLC, a medical laboratory, paid distributors to attract Medicare referrals to Vantari. Marchetti, who operated Advanced Life Sciences LLC, was one of the distributors and had a network of sub-distributors. The court found sufficient evidence that Marchetti was knowingly and actively participating in a scheme involving CodonDx, another entity, that violated the Anti-Kickback Statute. The court rejected Marchetti's challenges regarding the sufficiency of the evidence, the district court's failure to submit his theory of defense instruction, the court's alleged constructive amendment of the indictment, and the court's application of the sentencing guidelines. The court also dismissed his claim for a new trial based on cumulative error. <a href="https://law.justia.com/cases/federal/appellate-courts/ca5/22-40617/22-40617-2024-03-20.html" target="_blank">View "USA v. Marchetti" on Justia Law</a>
The United States Court of Appeals for the Fifth Circuit affirmed the conviction and sentence of defendant Vincent Marchetti, Jr., who was found guilty of one count of conspiracy to commit illegal remunerations in violation of 18 U.S.C. § 371. Marchetti was involved in a scheme wherein Vantari Genetics LLC, a medical laboratory, paid distributors to attract Medicare referrals to Vantari. Marchetti, who operated Advanced Life Sciences LLC, was one of the distributors and had a network of sub-distributors. The court found sufficient evidence that Marchetti was knowingly and actively participating in a scheme involving CodonDx, another entity, that violated the Anti-Kickback Statute. The court rejected Marchetti's challenges regarding the sufficiency of the evidence, the district court's failure to submit his theory of defense instruction, the court's alleged constructive amendment of the indictment, and the court's application of the sentencing guidelines. The court also dismissed his claim for a new trial based on cumulative error.
2024-03-20federalUS Court of Appeals for the Fifth CircuitSmithhttps://law.justia.com/cases/federal/appellate-courts/ca4/22-1678/22-1678-2024-03-20.htmlIn re Estate of Alvarez v. Rockefeller Foundation2024-03-20T11:00:47-08:002024-03-20T11:00:47-08:00
This case was heard in the United States Court of Appeals for the Fourth Circuit and involved the Estate of Arturo Giron Alvarez and 773 other plaintiffs, who brought claims against The Rockefeller Foundation (TRF), alleging the foundation's involvement in nonconsensual human medical experiments in Guatemala from 1946 to 1948. The experiments involved exposing people to sexually transmitted diseases (STDs) to study the diseases and potential treatments. The defendants had previously filed a motion for summary judgment, which was granted by the district court. The plaintiffs appealed this decision, specifically challenging the decision relating to TRF.
The appeal hinged on the question of whether Dr. Soper, an Associate Director of TRF who was assigned to the Pan-American Sanitary Bureau (PASB) in Guatemala during the time of the experiments, was acting as an agent of TRF, thus making TRF liable for his actions. The court found that despite TRF paying Dr. Soper's salary during his time at the PASB, there was no indication that TRF was directing or controlling Dr. Soper’s work. Furthermore, the evidence showed that Dr. Soper considered himself no longer with TRF, and the PASB's constitution prohibited him from taking outside direction.
The court concluded that TRF's connection to the experiments was too tenuous to be held liable for them. It affirmed the district court's grant of summary judgment in favor of TRF, stating that Dr. Soper was not an agent of TRF during the time of the experiments. <a href="https://law.justia.com/cases/federal/appellate-courts/ca4/22-1678/22-1678-2024-03-20.html" target="_blank">View "In re Estate of Alvarez v. Rockefeller Foundation" on Justia Law</a>
This case was heard in the United States Court of Appeals for the Fourth Circuit and involved the Estate of Arturo Giron Alvarez and 773 other plaintiffs, who brought claims against The Rockefeller Foundation (TRF), alleging the foundation's involvement in nonconsensual human medical experiments in Guatemala from 1946 to 1948. The experiments involved exposing people to sexually transmitted diseases (STDs) to study the diseases and potential treatments. The defendants had previously filed a motion for summary judgment, which was granted by the district court. The plaintiffs appealed this decision, specifically challenging the decision relating to TRF.
The appeal hinged on the question of whether Dr. Soper, an Associate Director of TRF who was assigned to the Pan-American Sanitary Bureau (PASB) in Guatemala during the time of the experiments, was acting as an agent of TRF, thus making TRF liable for his actions. The court found that despite TRF paying Dr. Soper's salary during his time at the PASB, there was no indication that TRF was directing or controlling Dr. Soper’s work. Furthermore, the evidence showed that Dr. Soper considered himself no longer with TRF, and the PASB's constitution prohibited him from taking outside direction.
The court concluded that TRF's connection to the experiments was too tenuous to be held liable for them. It affirmed the district court's grant of summary judgment in favor of TRF, stating that Dr. Soper was not an agent of TRF during the time of the experiments.
2024-03-20federalUS Court of Appeals for the Fourth CircuitHUDSONhttps://law.justia.com/cases/california/court-of-appeal/2024/b316313.htmlAsiryan v. Medical Staff of Glendale Adventist Medical Center2024-03-19T13:01:19-08:002024-03-19T13:01:19-08:00
In this case, the court dealt with the suspension and subsequent resignation of a licensed obstetrician and gynecologist, Plaintiff Dr. Vardui Asiryan, from the defendant Glendale Adventist Medical Center and its Medical Staff. The Medical Staff suspended Asiryan’s privileges at the hospital without holding a hearing or giving her prior notice. Asiryan sued both entities, alleging they failed to comply with statutory and common law procedural requirements in connection with suspending her privileges at the hospital. She further claimed that the Medical Staff lied to her regarding their obligations to report her suspension and resignation to the state licensing board.
The Court of Appeal of the State of California, Second Appellate District, Division One, held that the trial court correctly concluded that the Business and Professions Code is the sole source of procedural protections in connection with hospital peer review, and that the common law doctrine of fair procedure does not supplement those protections with additional guarantees. Therefore, the court correctly granted the nonsuit on Asiryan’s common law peer review claims and correctly rejected her proposed jury instructions regarding peer review.
As for the court's order awarding attorney fees, the Court of Appeal held that given the court’s rulings denying certain portions of defendants’ summary judgment and nonsuit motions, a hypothetical reasonable attorney could have deemed Asiryan’s peer review claims against the Medical Staff tenable and reasonably decided to take them to trial. This same logic does not apply to the fees awarded to GAMC, because the court disposed of the claims against GAMC on summary judgment. The Court of Appeal therefore reversed the court’s fee order to the extent it awards fees to the Medical Staff, but affirmed the order as it applies to GAMC. <a href="https://law.justia.com/cases/california/court-of-appeal/2024/b316313.html" target="_blank">View "Asiryan v. Medical Staff of Glendale Adventist Medical Center" on Justia Law</a>
In this case, the court dealt with the suspension and subsequent resignation of a licensed obstetrician and gynecologist, Plaintiff Dr. Vardui Asiryan, from the defendant Glendale Adventist Medical Center and its Medical Staff. The Medical Staff suspended Asiryan’s privileges at the hospital without holding a hearing or giving her prior notice. Asiryan sued both entities, alleging they failed to comply with statutory and common law procedural requirements in connection with suspending her privileges at the hospital. She further claimed that the Medical Staff lied to her regarding their obligations to report her suspension and resignation to the state licensing board.
The Court of Appeal of the State of California, Second Appellate District, Division One, held that the trial court correctly concluded that the Business and Professions Code is the sole source of procedural protections in connection with hospital peer review, and that the common law doctrine of fair procedure does not supplement those protections with additional guarantees. Therefore, the court correctly granted the nonsuit on Asiryan’s common law peer review claims and correctly rejected her proposed jury instructions regarding peer review.
As for the court's order awarding attorney fees, the Court of Appeal held that given the court’s rulings denying certain portions of defendants’ summary judgment and nonsuit motions, a hypothetical reasonable attorney could have deemed Asiryan’s peer review claims against the Medical Staff tenable and reasonably decided to take them to trial. This same logic does not apply to the fees awarded to GAMC, because the court disposed of the claims against GAMC on summary judgment. The Court of Appeal therefore reversed the court’s fee order to the extent it awards fees to the Medical Staff, but affirmed the order as it applies to GAMC.
2024-03-19stateCaliforniaCalifornia Courts of AppealROTHSCHILDhttps://law.justia.com/cases/federal/appellate-courts/ca4/22-6313/22-6313-2024-03-18.htmlPhoenix v. Amonette2024-03-18T11:00:38-08:002024-03-18T11:00:38-08:00
The United States Court of Appeals for the Fourth Circuit addressed a case where an inmate with celiac disease sued a doctor for depriving him of a gluten-free diet. The district court had granted summary judgment to the doctor because the plaintiff did not have an expert witness to testify about the standard treatment for celiac disease or the causal link between the doctor’s conduct and the plaintiff’s alleged harm. The appeals court held that no expert testimony was needed to avoid summary judgment in this case. The court found that the plaintiff had presented sufficient evidence to create a genuine dispute of material fact about the doctor's knowledge of his celiac disease and the excessive risk it posed by failing to respond reasonably, even without an expert.
The court also clarified that expert testimony is not necessary to establish an Eighth Amendment claim of deliberate indifference. The court held that while determining whether medical professionals responded reasonably to a particular risk can involve an examination of the relevant standard of care, the fact that expert testimony may be necessary in some cases does not mean it was in this one. The court vacated the district court’s judgment and remanded the case for further proceedings. <a href="https://law.justia.com/cases/federal/appellate-courts/ca4/22-6313/22-6313-2024-03-18.html" target="_blank">View "Phoenix v. Amonette" on Justia Law</a>
The United States Court of Appeals for the Fourth Circuit addressed a case where an inmate with celiac disease sued a doctor for depriving him of a gluten-free diet. The district court had granted summary judgment to the doctor because the plaintiff did not have an expert witness to testify about the standard treatment for celiac disease or the causal link between the doctor’s conduct and the plaintiff’s alleged harm. The appeals court held that no expert testimony was needed to avoid summary judgment in this case. The court found that the plaintiff had presented sufficient evidence to create a genuine dispute of material fact about the doctor's knowledge of his celiac disease and the excessive risk it posed by failing to respond reasonably, even without an expert.
The court also clarified that expert testimony is not necessary to establish an Eighth Amendment claim of deliberate indifference. The court held that while determining whether medical professionals responded reasonably to a particular risk can involve an examination of the relevant standard of care, the fact that expert testimony may be necessary in some cases does not mean it was in this one. The court vacated the district court’s judgment and remanded the case for further proceedings.
2024-03-18federalUS Court of Appeals for the Fourth CircuitHEYTENShttps://law.justia.com/cases/federal/appellate-courts/ca4/22-1819/22-1819-2024-03-18.htmlCity of Huntington v. Amerisourcebergen Drug Corporation2024-03-18T11:00:37-08:002024-03-18T11:00:37-08:00
This case was before the United States Court of Appeals for the Fourth Circuit where the City of Huntington and Cabell County Commission (plaintiffs) brought a suit against AmerisourceBergen Drug Corporation, Cardinal Health, Inc., and McKesson Corporation (defendants), three distributors of opioids. The plaintiffs alleged that these companies perpetuated the opioid epidemic by repeatedly shipping excessive quantities of opioids to pharmacies, thus creating a public nuisance under West Virginia common law. The district court ruled in favor of the distributors, holding that West Virginia’s common law of public nuisance did not cover the plaintiffs’ claims.
After a bench trial in 2021, the district court held that the common law of public nuisance in West Virginia did not extend to the sale, distribution, and manufacture of opioids. The court found that the application of public nuisance law to the sale, marketing, and distribution of products would invite litigation against any product with a known risk of harm, regardless of the benefits conferred on the public from proper use of the product. The court also rejected the plaintiffs’ proposed remedy, a 15-year “Abatement Plan” developed by an expert in opioid abatement intervention. The court held that this relief did not qualify as an abatement as it did not restrict the defendants' conduct or their distribution of opioids but generally proposed programs and services to address the harms caused by opioid abuse and addiction.
The plaintiffs appealed the decision to the United States Court of Appeals for the Fourth Circuit, which certified the following question to the Supreme Court of Appeals of West Virginia: Under West Virginia’s common law, can conditions caused by the distribution of a controlled substance constitute a public nuisance and, if so, what are the elements of such a public nuisance claim? <a href="https://law.justia.com/cases/federal/appellate-courts/ca4/22-1819/22-1819-2024-03-18.html" target="_blank">View "City of Huntington v. Amerisourcebergen Drug Corporation" on Justia Law</a>
This case was before the United States Court of Appeals for the Fourth Circuit where the City of Huntington and Cabell County Commission (plaintiffs) brought a suit against AmerisourceBergen Drug Corporation, Cardinal Health, Inc., and McKesson Corporation (defendants), three distributors of opioids. The plaintiffs alleged that these companies perpetuated the opioid epidemic by repeatedly shipping excessive quantities of opioids to pharmacies, thus creating a public nuisance under West Virginia common law. The district court ruled in favor of the distributors, holding that West Virginia’s common law of public nuisance did not cover the plaintiffs’ claims.
After a bench trial in 2021, the district court held that the common law of public nuisance in West Virginia did not extend to the sale, distribution, and manufacture of opioids. The court found that the application of public nuisance law to the sale, marketing, and distribution of products would invite litigation against any product with a known risk of harm, regardless of the benefits conferred on the public from proper use of the product. The court also rejected the plaintiffs’ proposed remedy, a 15-year “Abatement Plan” developed by an expert in opioid abatement intervention. The court held that this relief did not qualify as an abatement as it did not restrict the defendants' conduct or their distribution of opioids but generally proposed programs and services to address the harms caused by opioid abuse and addiction.
The plaintiffs appealed the decision to the United States Court of Appeals for the Fourth Circuit, which certified the following question to the Supreme Court of Appeals of West Virginia: Under West Virginia’s common law, can conditions caused by the distribution of a controlled substance constitute a public nuisance and, if so, what are the elements of such a public nuisance claim?
2024-03-18federalUS Court of Appeals for the Fourth CircuitKeenanhttps://law.justia.com/cases/federal/appellate-courts/ca9/21-35412/21-35412-2024-03-14.htmlFerguson v. O'Malley2024-03-14T10:31:57-08:002024-03-14T10:31:57-08:00
The United States Court of Appeals for the Ninth Circuit ruled in a case involving a claimant who was denied Social Security benefits. The claimant, who had undergone surgery to treat a brain condition known as Arnold-Chiari malformation, testified to experiencing severe and frequent headaches. However, the Administrative Law Judge (ALJ) rejected his testimony regarding the severity of his headaches, asserting that his headache symptoms were inconsistent with the medical evidence and his daily activities.
The court of appeals found that the ALJ failed to provide clear and convincing reasons for rejecting the claimant's symptom testimony regarding his headaches. It noted that the ALJ did not specify which of the claimant's symptoms were inconsistent with the record evidence. The court also rejected the argument that a claimant must provide independent medical evidence to establish the severity of headaches.
Furthermore, the court found that the claimant's daily activities were not inconsistent with his testimony about the severity and frequency of his headaches. The district court's affirmation of the ALJ's decision based on the claimant's conservative treatment was also found erroneous since the ALJ did not consider this factor. Consequently, the court reversed the judgment of the district court, remanding it back to the ALJ to reconsider the credibility of the claimant's headache symptom testimony. <a href="https://law.justia.com/cases/federal/appellate-courts/ca9/21-35412/21-35412-2024-03-14.html" target="_blank">View "Ferguson v. O'Malley" on Justia Law</a>
The United States Court of Appeals for the Ninth Circuit ruled in a case involving a claimant who was denied Social Security benefits. The claimant, who had undergone surgery to treat a brain condition known as Arnold-Chiari malformation, testified to experiencing severe and frequent headaches. However, the Administrative Law Judge (ALJ) rejected his testimony regarding the severity of his headaches, asserting that his headache symptoms were inconsistent with the medical evidence and his daily activities.
The court of appeals found that the ALJ failed to provide clear and convincing reasons for rejecting the claimant's symptom testimony regarding his headaches. It noted that the ALJ did not specify which of the claimant's symptoms were inconsistent with the record evidence. The court also rejected the argument that a claimant must provide independent medical evidence to establish the severity of headaches.
Furthermore, the court found that the claimant's daily activities were not inconsistent with his testimony about the severity and frequency of his headaches. The district court's affirmation of the ALJ's decision based on the claimant's conservative treatment was also found erroneous since the ALJ did not consider this factor. Consequently, the court reversed the judgment of the district court, remanding it back to the ALJ to reconsider the credibility of the claimant's headache symptom testimony.
2024-03-14federalUS Court of Appeals for the Ninth CircuitSunghttps://law.justia.com/cases/federal/appellate-courts/ca11/22-10978/22-10978-2024-03-14.htmlUnited States v. Markovich2024-03-14T08:34:16-08:002024-03-14T08:34:16-08:00
The case involved an appeal by two brothers, Jonathan and Daniel Markovich, who were convicted for operating fraudulent drug rehabilitation clinics in Florida. They were found guilty of various charges, including health-care fraud, wire fraud, kickbacks, money laundering, and bank fraud, resulting in fraudulent claims of over $100 million.
The brothers appealed their convictions on several grounds. They argued that the district court violated their constitutional rights by denying their motion to compel the prosecution to obtain and disclose confidential medical records possessed by third parties. They also claimed that the court violated Federal Rules of Evidence by admitting unreliable and confusing expert testimony about the clinics' medical and billing practices. Additionally, they argued that the court abused its discretion by admitting lay summary testimony about medical and billing records.
The United States Court of Appeals for the Eleventh Circuit affirmed the convictions. The court ruled that the prosecution had no duty to seek out potentially exculpatory evidence not in its possession. It also determined that the expert testimony was clear and reliable, and the summary testimony was proper. The court found that any challenge to bank-fraud counts was forfeited due to a lack of explanation or supporting legal authority. Finally, the court ruled that the district court did not abuse its discretion by denying the brothers' motion for a new trial based on newly discovered evidence. <a href="https://law.justia.com/cases/federal/appellate-courts/ca11/22-10978/22-10978-2024-03-14.html" target="_blank">View "United States v. Markovich" on Justia Law</a>
The case involved an appeal by two brothers, Jonathan and Daniel Markovich, who were convicted for operating fraudulent drug rehabilitation clinics in Florida. They were found guilty of various charges, including health-care fraud, wire fraud, kickbacks, money laundering, and bank fraud, resulting in fraudulent claims of over $100 million.
The brothers appealed their convictions on several grounds. They argued that the district court violated their constitutional rights by denying their motion to compel the prosecution to obtain and disclose confidential medical records possessed by third parties. They also claimed that the court violated Federal Rules of Evidence by admitting unreliable and confusing expert testimony about the clinics' medical and billing practices. Additionally, they argued that the court abused its discretion by admitting lay summary testimony about medical and billing records.
The United States Court of Appeals for the Eleventh Circuit affirmed the convictions. The court ruled that the prosecution had no duty to seek out potentially exculpatory evidence not in its possession. It also determined that the expert testimony was clear and reliable, and the summary testimony was proper. The court found that any challenge to bank-fraud counts was forfeited due to a lack of explanation or supporting legal authority. Finally, the court ruled that the district court did not abuse its discretion by denying the brothers' motion for a new trial based on newly discovered evidence.
2024-03-14federalUS Court of Appeals for the Eleventh CircuitPryorhttps://law.justia.com/cases/montana/supreme-court/2024/da-21-0476.htmlIn re Matter of G.M.2024-03-12T14:35:23-08:002024-03-12T14:35:23-08:00
This case involves an appeal against a judgment from the Montana Eighteenth Judicial District Court, Gallatin County, which committed the appellant, G.M., into the custody and care of the Montana State Hospital (MSH) for involuntary mental health treatment. The key issue at hand is whether the District Court erroneously found that G.M. was unable to adequately care for her own basic needs and safety based on hearsay statements made by her husband through the testimony of a court-appointed professional.
G.M., aged 66 at the time of the petition for involuntary mental health commitment in 2021, was alleged to be suffering from a diagnosed psychotic mental disorder. G.M.'s husband's statements, along with her own behavior and assessments from mental health professionals, were the basis for the court's decision. G.M.'s counsel repeatedly objected to the court-appointed professional's testimony regarding her husband's out-of-court statements, but these objections were overruled.
G.M. testified on her own behalf, denying having a mental disorder or requiring treatment. Despite this, the District Court found that due to her diagnosed schizophrenic and delusional mental disorder, G.M. was “substantially unable to provide for her own basic needs of food, clothing, shelter, health, or safety."
On appeal, the Supreme Court of the State of Montana affirmed the judgment of the lower court. The court found that the lower court's decision was not clearly erroneous and was supported by substantial admissible evidence. The court stated that the hearsay statements of G.M.'s husband were admissible under the rules of evidence to explain the underlying rationale for the court-appointed professional person's expert opinion. The court also noted that the judgment was independently supported by the professional person's personal observations and opinions on G.M.'s condition and ability to care for her own needs and safety. <a href="https://law.justia.com/cases/montana/supreme-court/2024/da-21-0476.html" target="_blank">View "In re Matter of G.M." on Justia Law</a>
This case involves an appeal against a judgment from the Montana Eighteenth Judicial District Court, Gallatin County, which committed the appellant, G.M., into the custody and care of the Montana State Hospital (MSH) for involuntary mental health treatment. The key issue at hand is whether the District Court erroneously found that G.M. was unable to adequately care for her own basic needs and safety based on hearsay statements made by her husband through the testimony of a court-appointed professional.
G.M., aged 66 at the time of the petition for involuntary mental health commitment in 2021, was alleged to be suffering from a diagnosed psychotic mental disorder. G.M.'s husband's statements, along with her own behavior and assessments from mental health professionals, were the basis for the court's decision. G.M.'s counsel repeatedly objected to the court-appointed professional's testimony regarding her husband's out-of-court statements, but these objections were overruled.
G.M. testified on her own behalf, denying having a mental disorder or requiring treatment. Despite this, the District Court found that due to her diagnosed schizophrenic and delusional mental disorder, G.M. was “substantially unable to provide for her own basic needs of food, clothing, shelter, health, or safety."
On appeal, the Supreme Court of the State of Montana affirmed the judgment of the lower court. The court found that the lower court's decision was not clearly erroneous and was supported by substantial admissible evidence. The court stated that the hearsay statements of G.M.'s husband were admissible under the rules of evidence to explain the underlying rationale for the court-appointed professional person's expert opinion. The court also noted that the judgment was independently supported by the professional person's personal observations and opinions on G.M.'s condition and ability to care for her own needs and safety.
2024-03-12stateMontanaMontana Supreme CourtSandefurhttps://law.justia.com/cases/federal/appellate-courts/ca1/21-1734/21-1734-2024-03-12.htmlUnited States v. Ayala-Vazquez2024-03-12T13:00:03-08:002024-03-12T13:00:03-08:00
In 2010, Ángel M. Ayala-Vázquez was indicted and convicted on multiple drug-related charges, including conspiring to possess with intent to distribute and aiding and abetting the possession of with intent to distribute over 280 grams of cocaine base. He was sentenced in 2011 to life imprisonment. In 2021, Ayala filed a motion to reduce his sentence under the First Step Act and for compassionate release due to his hypertension and obesity making him vulnerable to COVID-19.
The District Court denied Ayala's motion, concluding that he was ineligible for a sentence reduction under the First Step Act because his sentences were imposed "in accordance with" the amendments made by the Fair Sentencing Act. The court also rejected his request for compassionate release, finding that Ayala failed to demonstrate extraordinary and compelling reasons to warrant such relief. Moreover, the court determined that Ayala posed a danger to other persons and the community.
On appeal to the United States Court of Appeals for the First Circuit, the court affirmed the District Court's decision. It concluded that Ayala was indeed convicted of offenses involving 280 grams or more of cocaine base, and his life sentences were in accordance with the Fair Sentencing Act. Therefore, he was not eligible for a sentence reduction under the First Step Act. As for the compassionate release, the court found no abuse of discretion in the District Court's evaluation of Ayala's health conditions and perceived danger to the community. <a href="https://law.justia.com/cases/federal/appellate-courts/ca1/21-1734/21-1734-2024-03-12.html" target="_blank">View "United States v. Ayala-Vazquez" on Justia Law</a>
In 2010, Ángel M. Ayala-Vázquez was indicted and convicted on multiple drug-related charges, including conspiring to possess with intent to distribute and aiding and abetting the possession of with intent to distribute over 280 grams of cocaine base. He was sentenced in 2011 to life imprisonment. In 2021, Ayala filed a motion to reduce his sentence under the First Step Act and for compassionate release due to his hypertension and obesity making him vulnerable to COVID-19.
The District Court denied Ayala's motion, concluding that he was ineligible for a sentence reduction under the First Step Act because his sentences were imposed "in accordance with" the amendments made by the Fair Sentencing Act. The court also rejected his request for compassionate release, finding that Ayala failed to demonstrate extraordinary and compelling reasons to warrant such relief. Moreover, the court determined that Ayala posed a danger to other persons and the community.
On appeal to the United States Court of Appeals for the First Circuit, the court affirmed the District Court's decision. It concluded that Ayala was indeed convicted of offenses involving 280 grams or more of cocaine base, and his life sentences were in accordance with the Fair Sentencing Act. Therefore, he was not eligible for a sentence reduction under the First Step Act. As for the compassionate release, the court found no abuse of discretion in the District Court's evaluation of Ayala's health conditions and perceived danger to the community.
2024-03-12federalUS Court of Appeals for the First CircuitBARRONhttps://law.justia.com/cases/federal/appellate-courts/ca5/23-10159/23-10159-2024-03-12.htmlDeanda v. Becerra2024-03-12T09:30:33-08:002024-03-12T09:30:33-08:00
The United States Court of Appeals for the Fifth Circuit reviewed a case involving the question of whether the federal Title X program preempts a Texas law that gives parents the right to consent to their teenagers’ obtaining contraceptives. Alexander Deanda, a father raising his children according to Christian beliefs, challenged the Secretary of Health and Human Services' administration of Title X, which funds clinics providing contraceptives to minors without parental notification or consent. Deanda contested this on the grounds that it nullifies his right to consent to his children's medical care, infringing on his state-created right. The court held that Title X does not preempt Texas's law. The statute does not preempt Deanda's parental right to consent to his children's obtaining contraceptives because Title X's goal (encouraging family participation in teens’ receiving family planning services) is not undermined by Texas's goal (empowering parents to consent to their teen’s receiving contraceptives). Instead, the two laws reinforce each other. The court affirmed the district court’s judgment to the extent it declared that Title X does not preempt Texas's parental consent law. However, the court reversed the partial vacatur of a regulation which forbids Title X grantees from notifying parents or obtaining their consent, as the regulation was not challenged by Deanda under the Administrative Procedure Act or otherwise.
<a href="https://law.justia.com/cases/federal/appellate-courts/ca5/23-10159/23-10159-2024-03-12.html" target="_blank">View "Deanda v. Becerra" on Justia Law</a>
The United States Court of Appeals for the Fifth Circuit reviewed a case involving the question of whether the federal Title X program preempts a Texas law that gives parents the right to consent to their teenagers’ obtaining contraceptives. Alexander Deanda, a father raising his children according to Christian beliefs, challenged the Secretary of Health and Human Services' administration of Title X, which funds clinics providing contraceptives to minors without parental notification or consent. Deanda contested this on the grounds that it nullifies his right to consent to his children's medical care, infringing on his state-created right. The court held that Title X does not preempt Texas's law. The statute does not preempt Deanda's parental right to consent to his children's obtaining contraceptives because Title X's goal (encouraging family participation in teens’ receiving family planning services) is not undermined by Texas's goal (empowering parents to consent to their teen’s receiving contraceptives). Instead, the two laws reinforce each other. The court affirmed the district court’s judgment to the extent it declared that Title X does not preempt Texas's parental consent law. However, the court reversed the partial vacatur of a regulation which forbids Title X grantees from notifying parents or obtaining their consent, as the regulation was not challenged by Deanda under the Administrative Procedure Act or otherwise.
2024-03-12federalUS Court of Appeals for the Fifth CircuitDuncanhttps://law.justia.com/cases/federal/appellate-courts/ca8/22-3675/22-3675-2024-03-12.htmlPharmaceutical Research and Mfrs of America v. McClain2024-03-12T07:30:22-08:002024-03-12T07:30:22-08:00
In this case, the United States Court of Appeals for the Eighth Circuit was asked to determine whether Arkansas Code § 23-92-604(c), also known as Act 1103, was preempted by federal law. Act 1103 prohibits pharmaceutical manufacturers from limiting the ability of healthcare providers, who are eligible for drug pricing discounts under the Section 340B Program, to contract with outside pharmacies for drug distribution.
The Pharmaceutical Research and Manufacturers of America (PhRMA) sued the Commissioner of the Arkansas Insurance Department, arguing that Act 1103 was unconstitutional because it was preempted by the Section 340B Program and the Federal Food, Drug, and Cosmetic Act, under theories of field, obstacle, and impossibility preemption.
The court, however, disagreed with PhRMA's arguments. The court found that Act 1103 did not create an obstacle for pharmaceutical manufacturers to comply with 340B, rather it assisted in fulfilling the purpose of 340B. The court also found that Act 1103 did not make it impossible for drug manufacturers and wholesale distributors to comply with the Risk Evaluation and Mitigation Strategies (REMS) Program under the Federal Food, Drug, and Cosmetic Act.
Therefore, the court held that Act 1103 was not preempted by either the Section 340B Program or the Federal Food, Drug, and Cosmetic Act. As such, the court affirmed the district court’s decision in favor of the Intervenors and against PhRMA. <a href="https://law.justia.com/cases/federal/appellate-courts/ca8/22-3675/22-3675-2024-03-12.html" target="_blank">View "Pharmaceutical Research and Mfrs of America v. McClain" on Justia Law</a>
In this case, the United States Court of Appeals for the Eighth Circuit was asked to determine whether Arkansas Code § 23-92-604(c), also known as Act 1103, was preempted by federal law. Act 1103 prohibits pharmaceutical manufacturers from limiting the ability of healthcare providers, who are eligible for drug pricing discounts under the Section 340B Program, to contract with outside pharmacies for drug distribution.
The Pharmaceutical Research and Manufacturers of America (PhRMA) sued the Commissioner of the Arkansas Insurance Department, arguing that Act 1103 was unconstitutional because it was preempted by the Section 340B Program and the Federal Food, Drug, and Cosmetic Act, under theories of field, obstacle, and impossibility preemption.
The court, however, disagreed with PhRMA's arguments. The court found that Act 1103 did not create an obstacle for pharmaceutical manufacturers to comply with 340B, rather it assisted in fulfilling the purpose of 340B. The court also found that Act 1103 did not make it impossible for drug manufacturers and wholesale distributors to comply with the Risk Evaluation and Mitigation Strategies (REMS) Program under the Federal Food, Drug, and Cosmetic Act.
Therefore, the court held that Act 1103 was not preempted by either the Section 340B Program or the Federal Food, Drug, and Cosmetic Act. As such, the court affirmed the district court’s decision in favor of the Intervenors and against PhRMA.
2024-03-12federalUS Court of Appeals for the Eighth CircuitMelloyhttps://law.justia.com/cases/federal/appellate-courts/ca10/22-1034/22-1034-2024-03-12.htmlUnited States v. Zhong2024-03-12T07:01:00-08:002024-03-12T07:01:00-08:00
In this case, the United States Court of Appeals for the Tenth Circuit dealt with the appeal of Youlian Zhong, who contested her mandatory minimum sentences for crimes related to her participation in a conspiracy to manufacture and distribute large quantities of marijuana. Zhong argued that the district court erred in finding that she did not qualify for the statutory safety valve for mandatory minimum sentences.
Zhong and her husband, Housheng Xian, were found guilty of conspiring to grow more than 1,500 marijuana plants in their residence, intending to process and sell the marijuana. They were convicted on three counts: conspiring to manufacture and possess with the intent to distribute 1,000 and more marijuana plants, manufacturing and possessing with intent to distribute 1,000 or more marijuana plants, and using and maintaining their house for the purpose of manufacturing and distributing marijuana.
Before sentencing, Zhong and Xian requested a non-guideline sentence of time served plus five years of supervised release, arguing that they met the requirements of the safety valve provisions. However, the court found that they did not provide all necessary information to the government, particularly regarding their mens rea, or intent, for the crimes for which they were convicted.
On appeal, the Tenth Circuit affirmed the lower court's decision. The appeals court held that a defendant must provide the government with information sufficient to prove the mens rea required for the crimes of conviction to meet the requirement of providing “all information and evidence” concerning the offense for the safety valve provision to apply. The court concluded that Zhong did not provide sufficient information about her intent to commit the crimes for which she was convicted, and thus, did not meet her burden to prove that she qualified for safety-valve relief.
<a href="https://law.justia.com/cases/federal/appellate-courts/ca10/22-1034/22-1034-2024-03-12.html" target="_blank">View "United States v. Zhong" on Justia Law</a>
In this case, the United States Court of Appeals for the Tenth Circuit dealt with the appeal of Youlian Zhong, who contested her mandatory minimum sentences for crimes related to her participation in a conspiracy to manufacture and distribute large quantities of marijuana. Zhong argued that the district court erred in finding that she did not qualify for the statutory safety valve for mandatory minimum sentences.
Zhong and her husband, Housheng Xian, were found guilty of conspiring to grow more than 1,500 marijuana plants in their residence, intending to process and sell the marijuana. They were convicted on three counts: conspiring to manufacture and possess with the intent to distribute 1,000 and more marijuana plants, manufacturing and possessing with intent to distribute 1,000 or more marijuana plants, and using and maintaining their house for the purpose of manufacturing and distributing marijuana.
Before sentencing, Zhong and Xian requested a non-guideline sentence of time served plus five years of supervised release, arguing that they met the requirements of the safety valve provisions. However, the court found that they did not provide all necessary information to the government, particularly regarding their mens rea, or intent, for the crimes for which they were convicted.
On appeal, the Tenth Circuit affirmed the lower court's decision. The appeals court held that a defendant must provide the government with information sufficient to prove the mens rea required for the crimes of conviction to meet the requirement of providing “all information and evidence” concerning the offense for the safety valve provision to apply. The court concluded that Zhong did not provide sufficient information about her intent to commit the crimes for which she was convicted, and thus, did not meet her burden to prove that she qualified for safety-valve relief.
2024-03-12federalUS Court of Appeals for the Tenth CircuitEidhttps://law.justia.com/cases/federal/appellate-courts/ca2/23-726/23-726-2024-03-12.htmlUnited States, ex rel. Hart v. McKesson Corp.2024-03-12T06:00:42-08:002024-03-12T06:00:42-08:00
The United States Court of Appeals for the Second Circuit heard a case initiated by Adam Hart, who filed a qui tam action under the False Claims Act (FCA) against pharmaceutical distributor McKesson. Hart alleged that McKesson provided business management tools to its customers for free in exchange for commitments to purchase drugs, which he claimed violated the federal anti-kickback statute (AKS) and several analogous state laws. The district court dismissed Hart's FCA claim, determining he failed to allege McKesson acted "willfully" as required by the AKS.
On appeal, the Second Circuit held that to act "willfully" under the AKS, a defendant must knowingly act in a way that is unlawful. The court found that Hart failed to provide sufficient facts to meet this standard. However, the court disagreed with the district court's assertion that Hart's state claims were premised solely on a violation of the federal AKS. Consequently, the Second Circuit affirmed the dismissal of Hart’s federal FCA claim, vacated the dismissal of the remaining state claims, and remanded for further proceedings. <a href="https://law.justia.com/cases/federal/appellate-courts/ca2/23-726/23-726-2024-03-12.html" target="_blank">View "United States, ex rel. Hart v. McKesson Corp." on Justia Law</a>
The United States Court of Appeals for the Second Circuit heard a case initiated by Adam Hart, who filed a qui tam action under the False Claims Act (FCA) against pharmaceutical distributor McKesson. Hart alleged that McKesson provided business management tools to its customers for free in exchange for commitments to purchase drugs, which he claimed violated the federal anti-kickback statute (AKS) and several analogous state laws. The district court dismissed Hart's FCA claim, determining he failed to allege McKesson acted "willfully" as required by the AKS.
On appeal, the Second Circuit held that to act "willfully" under the AKS, a defendant must knowingly act in a way that is unlawful. The court found that Hart failed to provide sufficient facts to meet this standard. However, the court disagreed with the district court's assertion that Hart's state claims were premised solely on a violation of the federal AKS. Consequently, the Second Circuit affirmed the dismissal of Hart’s federal FCA claim, vacated the dismissal of the remaining state claims, and remanded for further proceedings.
2024-03-12federalUS Court of Appeals for the Second CircuitLynchhttps://law.justia.com/cases/nevada/supreme-court/2024/84492.htmlTaylor v. Brill2024-03-08T15:30:00-08:002024-03-08T15:30:00-08:00
In a medical malpractice case before the Supreme Court of the State of Nevada, the plaintiff, Kimberly D. Taylor, sued Dr. Keith Brill and Women’s Health Associates of Southern Nevada-Martin PLLC for professional negligence. Taylor alleged that Dr. Brill breached the standard of care by perforating her uterus and bowel during a surgical procedure and failed to inform her of these complications. The jury ruled in favor of Dr. Brill and denied all of Taylor’s claims.
The Supreme Court of Nevada held that in a professional negligence action, evidence of informed consent and assumption of the risk are irrelevant and inadmissible when the plaintiff does not challenge consent. The court stated that even if a plaintiff gave informed consent, it would not vitiate the medical provider’s duty to provide treatment according to the ordinary standard of care. Furthermore, evidence of a procedure’s risks must still fall within Nevada's professional negligence statute, and a case-by-case analysis is required to determine whether the evidence should be excluded due to its potential to confuse the jury.
The court also held that expert or physician testimony is not required to demonstrate the reasonableness of the billing amount of special damages. The court found that the district court had abused its discretion by prohibiting non-expert evidence demonstrating the reasonableness of the charges for medical treatment received by Taylor.
Finally, the court ruled that evidence of insurance write-downs is not admissible under NRS 42.021(1), as it only contemplates evidence of actual benefits paid to the plaintiff by collateral sources.
Based on these errors, the Supreme Court of Nevada reversed the judgment and remanded the case for further proceedings, including a new trial. <a href="https://law.justia.com/cases/nevada/supreme-court/2024/84492.html" target="_blank">View "Taylor v. Brill" on Justia Law</a>
In a medical malpractice case before the Supreme Court of the State of Nevada, the plaintiff, Kimberly D. Taylor, sued Dr. Keith Brill and Women’s Health Associates of Southern Nevada-Martin PLLC for professional negligence. Taylor alleged that Dr. Brill breached the standard of care by perforating her uterus and bowel during a surgical procedure and failed to inform her of these complications. The jury ruled in favor of Dr. Brill and denied all of Taylor’s claims.
The Supreme Court of Nevada held that in a professional negligence action, evidence of informed consent and assumption of the risk are irrelevant and inadmissible when the plaintiff does not challenge consent. The court stated that even if a plaintiff gave informed consent, it would not vitiate the medical provider’s duty to provide treatment according to the ordinary standard of care. Furthermore, evidence of a procedure’s risks must still fall within Nevada's professional negligence statute, and a case-by-case analysis is required to determine whether the evidence should be excluded due to its potential to confuse the jury.
The court also held that expert or physician testimony is not required to demonstrate the reasonableness of the billing amount of special damages. The court found that the district court had abused its discretion by prohibiting non-expert evidence demonstrating the reasonableness of the charges for medical treatment received by Taylor.
Finally, the court ruled that evidence of insurance write-downs is not admissible under NRS 42.021(1), as it only contemplates evidence of actual benefits paid to the plaintiff by collateral sources.
Based on these errors, the Supreme Court of Nevada reversed the judgment and remanded the case for further proceedings, including a new trial.
2024-03-07stateNevadaSupreme Court of NevadaHerndonhttps://law.justia.com/cases/mississippi/supreme-court/2024/2023-sa-00098-sct.htmlMississippi Division of Medicaid v. Women's Pavilion of South Mississippi, PLLC2024-03-08T02:16:19-08:002024-03-08T02:16:19-08:00
The case involves the Mississippi Division of Medicaid and the Women’s Pavilion of South Mississippi, PLLC. Women's Pavilion, a physician-owned OBGYN clinic, challenged Mississippi Division of Medicaid's calculation of the "encounter rate," a set amount of money per visit by a Medicaid patient. Medicaid set the clinic’s encounter rate at $157.94, which was partially based on the compensation of the five physician owners of the clinic.
Women’s Pavilion appealed this decision and requested an administrative hearing. The hearing officer evaluated whether Medicaid’s initial decision was supported by substantial evidence, affirming the reimbursement rate. However, Women’s Pavilion appealed again, arguing that the hearing officer applied the wrong standard of review.
The Hinds County Chancery Court agreed with Women’s Pavilion, holding that the hearing officer should have made his own findings of fact and determinations of the issues presented, rather than merely evaluating whether Medicaid’s initial decision was supported by substantial evidence. The court vacated Medicaid’s final decision and remanded the matter back to Medicaid.
The Mississippi Division of Medicaid appealed to the Supreme Court of Mississippi. The Supreme Court affirmed the decision of the Hinds County Chancery Court, stating that the hearing officer had erred by applying the standard of review for courts reviewing a final administrative decision, rather than following Medicaid’s own administrative rules governing provider appeals. The case was remanded back to Medicaid for further proceedings under the proper standard of review. <a href="https://law.justia.com/cases/mississippi/supreme-court/2024/2023-sa-00098-sct.html" target="_blank">View "Mississippi Division of Medicaid v. Women's Pavilion of South Mississippi, PLLC" on Justia Law</a>
The case involves the Mississippi Division of Medicaid and the Women’s Pavilion of South Mississippi, PLLC. Women's Pavilion, a physician-owned OBGYN clinic, challenged Mississippi Division of Medicaid's calculation of the "encounter rate," a set amount of money per visit by a Medicaid patient. Medicaid set the clinic’s encounter rate at $157.94, which was partially based on the compensation of the five physician owners of the clinic.
Women’s Pavilion appealed this decision and requested an administrative hearing. The hearing officer evaluated whether Medicaid’s initial decision was supported by substantial evidence, affirming the reimbursement rate. However, Women’s Pavilion appealed again, arguing that the hearing officer applied the wrong standard of review.
The Hinds County Chancery Court agreed with Women’s Pavilion, holding that the hearing officer should have made his own findings of fact and determinations of the issues presented, rather than merely evaluating whether Medicaid’s initial decision was supported by substantial evidence. The court vacated Medicaid’s final decision and remanded the matter back to Medicaid.
The Mississippi Division of Medicaid appealed to the Supreme Court of Mississippi. The Supreme Court affirmed the decision of the Hinds County Chancery Court, stating that the hearing officer had erred by applying the standard of review for courts reviewing a final administrative decision, rather than following Medicaid’s own administrative rules governing provider appeals. The case was remanded back to Medicaid for further proceedings under the proper standard of review.
2024-03-07stateMississippiSupreme Court of MississippiMaxwellhttps://law.justia.com/cases/nevada/supreme-court/2024/85844.htmlSunrise Hospital v. Eighth Judicial District Court2024-03-07T09:32:55-08:002024-03-07T09:32:55-08:00
This case revolves around a lawsuit filed by Tiffiny Grace, legal guardian of E.G., against Sunrise Hospital and Nurse Cord Olsen for professional negligence. E.G. was born prematurely at Sunrise Hospital and suffered permanent developmental damage following a cardiac arrest in the Neonatal Intensive Care Unit. The hospital's Patient Safety Committee investigated the incident, which Grace sought to examine during discovery. However, Sunrise Hospital objected, asserting that the information was privileged under the Patient Safety and Quality Improvement Act of 2005 (PSQIA) and Nevada law. The district court compelled the testimony, ruling that Sunrise Hospital had waived any privilege by allowing testimony on certain privileged topics.
The Supreme Court of the State of Nevada, however, disagreed with the lower court's interpretation. It ruled that the PSQIA provides an absolute privilege for patient safety work products that is not subject to waiver. The court explained that this privilege aims to encourage healthcare providers to identify and learn from errors without fear of legal repercussions. The court concluded that the district court erred by interpreting the PSQIA to allow for waiver of privilege and by failing to determine whether the testimony sought constituted identifiable or non-identifiable patient safety work product. Therefore, the court granted a writ of prohibition, vacated the district court's order, and directed the lower court to reconsider Grace's motion to compel in light of its interpretation of the PSQIA. <a href="https://law.justia.com/cases/nevada/supreme-court/2024/85844.html" target="_blank">View "Sunrise Hospital v. Eighth Judicial District Court" on Justia Law</a>
This case revolves around a lawsuit filed by Tiffiny Grace, legal guardian of E.G., against Sunrise Hospital and Nurse Cord Olsen for professional negligence. E.G. was born prematurely at Sunrise Hospital and suffered permanent developmental damage following a cardiac arrest in the Neonatal Intensive Care Unit. The hospital's Patient Safety Committee investigated the incident, which Grace sought to examine during discovery. However, Sunrise Hospital objected, asserting that the information was privileged under the Patient Safety and Quality Improvement Act of 2005 (PSQIA) and Nevada law. The district court compelled the testimony, ruling that Sunrise Hospital had waived any privilege by allowing testimony on certain privileged topics.
The Supreme Court of the State of Nevada, however, disagreed with the lower court's interpretation. It ruled that the PSQIA provides an absolute privilege for patient safety work products that is not subject to waiver. The court explained that this privilege aims to encourage healthcare providers to identify and learn from errors without fear of legal repercussions. The court concluded that the district court erred by interpreting the PSQIA to allow for waiver of privilege and by failing to determine whether the testimony sought constituted identifiable or non-identifiable patient safety work product. Therefore, the court granted a writ of prohibition, vacated the district court's order, and directed the lower court to reconsider Grace's motion to compel in light of its interpretation of the PSQIA.
2024-03-07stateNevadaSupreme Court of NevadaHerndonhttps://law.justia.com/cases/missouri/supreme-court/2024/sc100099.htmlState ex rel. Clinton No. 1 vs. Baker2024-03-06T08:30:17-08:002024-03-06T08:30:17-08:00
The plaintiff, Yarnell, filed a wrongful death action against Clinton No. 1, Inc., a healthcare and rehabilitation center, alleging that Clinton's negligence led to her mother's death from COVID-19. The Missouri Supreme Court addressed whether Clinton's proposed theories of immunity barred Yarnell's claims, which were based on the Public Readiness and Emergency Preparedness (PREP) Act and two Missouri acts.
Yarnell's mother had contracted with Clinton for a private room, but Clinton placed her with a roommate, which Yarnell claimed exposed her mother to COVID-19, violated their agreement, and ultimately led to her mother's death. Clinton argued that Yarnell's claims were barred by the PREP Act, which provides immunity for healthcare providers administering or using covered countermeasures during a public health emergency, and Missouri laws granting immunity to healthcare providers during an emergency declared by the governor and in COVID-19 exposure actions.
The court found that Yarnell's petition did not implicate a covered countermeasure under the PREP Act, as it made no reference to the administration or use of a diagnostic test or any other covered countermeasure. The court also found that Clinton failed to demonstrate it agreed to be deployed during the emergency or that the governor or any state agency acted on such agreement and deployed Clinton, which would have entitled it to immunity under Missouri law. Lastly, the court noted that Yarnell had adequately alleged her harm was caused by Clinton's recklessness, and the two COVID-19 statutes would not foreclose relief if Yarnell were able to prove such recklessness. Therefore, the court quashed its preliminary writ of mandamus, allowing Yarnell's case to proceed. <a href="https://law.justia.com/cases/missouri/supreme-court/2024/sc100099.html" target="_blank">View "State ex rel. Clinton No. 1 vs. Baker" on Justia Law</a>
The plaintiff, Yarnell, filed a wrongful death action against Clinton No. 1, Inc., a healthcare and rehabilitation center, alleging that Clinton's negligence led to her mother's death from COVID-19. The Missouri Supreme Court addressed whether Clinton's proposed theories of immunity barred Yarnell's claims, which were based on the Public Readiness and Emergency Preparedness (PREP) Act and two Missouri acts.
Yarnell's mother had contracted with Clinton for a private room, but Clinton placed her with a roommate, which Yarnell claimed exposed her mother to COVID-19, violated their agreement, and ultimately led to her mother's death. Clinton argued that Yarnell's claims were barred by the PREP Act, which provides immunity for healthcare providers administering or using covered countermeasures during a public health emergency, and Missouri laws granting immunity to healthcare providers during an emergency declared by the governor and in COVID-19 exposure actions.
The court found that Yarnell's petition did not implicate a covered countermeasure under the PREP Act, as it made no reference to the administration or use of a diagnostic test or any other covered countermeasure. The court also found that Clinton failed to demonstrate it agreed to be deployed during the emergency or that the governor or any state agency acted on such agreement and deployed Clinton, which would have entitled it to immunity under Missouri law. Lastly, the court noted that Yarnell had adequately alleged her harm was caused by Clinton's recklessness, and the two COVID-19 statutes would not foreclose relief if Yarnell were able to prove such recklessness. Therefore, the court quashed its preliminary writ of mandamus, allowing Yarnell's case to proceed.
2024-03-05stateMissouriSupreme Court of MissouriRansomhttps://law.justia.com/cases/federal/appellate-courts/ca11/22-12044/22-12044-2024-03-06.htmlUSA v. Gbenedio2024-03-06T08:02:13-08:002024-03-06T08:02:13-08:00
The case pertains to Thomas Ukoshovbera A. Gbenedio, a licensed pharmacist, who was charged with 72 counts of unlawful drug dispensing and one count of refusing an inspection of his pharmacy, essentially operating a "pill mill." The district court sentenced Gbenedio to 188 months of imprisonment and imposed a $200,000 fine.
Gbenedio appealed, arguing that the lower court erred in denying his motion to dismiss the indictment due to insufficient notice of the charges against him, and in making certain evidentiary rulings. He also contested the fine imposed, stating he was unable to pay.
The United States Court of Appeals for the Eleventh Circuit affirmed the district court's decision. The court found that the indictment provided enough facts for Gbenedio to understand the charges against him. It also deemed the district court's evidentiary rulings as non-abusive and found that Gbenedio failed to prove his inability to pay the fine. <a href="https://law.justia.com/cases/federal/appellate-courts/ca11/22-12044/22-12044-2024-03-06.html" target="_blank">View "USA v. Gbenedio" on Justia Law</a>
The case pertains to Thomas Ukoshovbera A. Gbenedio, a licensed pharmacist, who was charged with 72 counts of unlawful drug dispensing and one count of refusing an inspection of his pharmacy, essentially operating a "pill mill." The district court sentenced Gbenedio to 188 months of imprisonment and imposed a $200,000 fine.
Gbenedio appealed, arguing that the lower court erred in denying his motion to dismiss the indictment due to insufficient notice of the charges against him, and in making certain evidentiary rulings. He also contested the fine imposed, stating he was unable to pay.
The United States Court of Appeals for the Eleventh Circuit affirmed the district court's decision. The court found that the indictment provided enough facts for Gbenedio to understand the charges against him. It also deemed the district court's evidentiary rulings as non-abusive and found that Gbenedio failed to prove his inability to pay the fine.
2024-03-06federalUS Court of Appeals for the Eleventh CircuitPryorhttps://law.justia.com/cases/federal/appellate-courts/ca11/22-10829/22-10829-2024-03-05.htmlUSA v. Dubois2024-03-05T09:02:57-08:002024-03-05T09:02:57-08:00
The case involves Andre Dubois, who was convicted on several federal firearm offenses. These offenses arose when Dubois attempted to ship a box containing firearms from Georgia to Dominica. The United States Court of Appeals for the Eleventh Circuit was asked to address five issues on appeal.
Firstly, the court dismissed Dubois's argument that a recent Supreme Court case overturned the precedent upholding a ban on felons possessing firearms. The court held that the Supreme Court case did not abrogate the precedent, and therefore Dubois's argument failed.
Secondly, the court affirmed that there was sufficient evidence for a reasonable jury to find that Dubois knew he was in possession of a firearm.
Thirdly, the court found that Dubois's prior conviction for possession with intent to distribute marijuana under Georgia law qualified as a "controlled substance offense" under the federal Sentencing Guidelines, triggering a higher base offense level.
Fourthly, the court rejected Dubois's argument that the application of a sentencing enhancement for possession of a stolen gun violated his due process rights.
Finally, the court held that the district court had not erred in imposing a $25,000 fine on Dubois, as there was sufficient evidence to suggest that he could afford to pay the fine.
Therefore, Dubois's convictions and sentence were affirmed. <a href="https://law.justia.com/cases/federal/appellate-courts/ca11/22-10829/22-10829-2024-03-05.html" target="_blank">View "USA v. Dubois" on Justia Law</a>
The case involves Andre Dubois, who was convicted on several federal firearm offenses. These offenses arose when Dubois attempted to ship a box containing firearms from Georgia to Dominica. The United States Court of Appeals for the Eleventh Circuit was asked to address five issues on appeal.
Firstly, the court dismissed Dubois's argument that a recent Supreme Court case overturned the precedent upholding a ban on felons possessing firearms. The court held that the Supreme Court case did not abrogate the precedent, and therefore Dubois's argument failed.
Secondly, the court affirmed that there was sufficient evidence for a reasonable jury to find that Dubois knew he was in possession of a firearm.
Thirdly, the court found that Dubois's prior conviction for possession with intent to distribute marijuana under Georgia law qualified as a "controlled substance offense" under the federal Sentencing Guidelines, triggering a higher base offense level.
Fourthly, the court rejected Dubois's argument that the application of a sentencing enhancement for possession of a stolen gun violated his due process rights.
Finally, the court held that the district court had not erred in imposing a $25,000 fine on Dubois, as there was sufficient evidence to suggest that he could afford to pay the fine.
Therefore, Dubois's convictions and sentence were affirmed.
2024-03-05federalUS Court of Appeals for the Eleventh CircuitPryorhttps://law.justia.com/cases/massachusetts/supreme-court/2024/sjc-13440.htmlFallon Community Health Plan, Inc. v. Acting Director of the Department of Unemployment Assistance2024-03-05T05:04:13-08:002024-03-05T05:04:13-08:00
In this case, the plaintiff, Fallon Community Health Plan, Inc., adopted a policy requiring its employees to be vaccinated against COVID-19. The defendant, Shanika Jefferson, a home health aide employed by Fallon, sought a religious exemption from the vaccination requirement. Her request was denied, and her employment was terminated. Jefferson then applied for and was approved for unemployment benefits from the Department of Unemployment Assistance. However, Fallon contended that Jefferson was ineligible for the benefits and sought review of the decision. The board of review of the department, as well as a District Court judge, affirmed the decision.
Fallon argued that Jefferson was disqualified from receiving unemployment benefits as per § 25 (e) (2) of General Laws c. 151A because she refused the COVID-19 vaccine in knowing violation of Fallon's reasonable policy and in wilful disregard of Fallon's interest in keeping its vulnerable patient population healthy. However, the Supreme Judicial Court disagreed with Fallon's contention. The court held that Jefferson did not engage in "deliberate misconduct", but rather made a good faith effort to comply with Fallon's policy by applying for a religious exemption. The court also found that Fallon failed to demonstrate that Jefferson should be disqualified on the basis of a "knowing violation" of that policy. The court considered the unique circumstances of the case, including Jefferson's sincere religious beliefs, which did not present her with a meaningful choice regarding vaccination. Therefore, the Supreme Judicial Court affirmed the decision of the lower courts, allowing Jefferson to receive unemployment benefits.
<a href="https://law.justia.com/cases/massachusetts/supreme-court/2024/sjc-13440.html" target="_blank">View "Fallon Community Health Plan, Inc. v. Acting Director of the Department of Unemployment Assistance" on Justia Law</a>
In this case, the plaintiff, Fallon Community Health Plan, Inc., adopted a policy requiring its employees to be vaccinated against COVID-19. The defendant, Shanika Jefferson, a home health aide employed by Fallon, sought a religious exemption from the vaccination requirement. Her request was denied, and her employment was terminated. Jefferson then applied for and was approved for unemployment benefits from the Department of Unemployment Assistance. However, Fallon contended that Jefferson was ineligible for the benefits and sought review of the decision. The board of review of the department, as well as a District Court judge, affirmed the decision.
Fallon argued that Jefferson was disqualified from receiving unemployment benefits as per § 25 (e) (2) of General Laws c. 151A because she refused the COVID-19 vaccine in knowing violation of Fallon's reasonable policy and in wilful disregard of Fallon's interest in keeping its vulnerable patient population healthy. However, the Supreme Judicial Court disagreed with Fallon's contention. The court held that Jefferson did not engage in "deliberate misconduct", but rather made a good faith effort to comply with Fallon's policy by applying for a religious exemption. The court also found that Fallon failed to demonstrate that Jefferson should be disqualified on the basis of a "knowing violation" of that policy. The court considered the unique circumstances of the case, including Jefferson's sincere religious beliefs, which did not present her with a meaningful choice regarding vaccination. Therefore, the Supreme Judicial Court affirmed the decision of the lower courts, allowing Jefferson to receive unemployment benefits.
2024-03-04stateMassachusettsMassachusetts Supreme Judicial CourtBuddhttps://law.justia.com/cases/federal/appellate-courts/ca9/22-56220/22-56220-2024-02-29.htmlMCDONALD V. LAWSON2024-02-29T09:00:41-08:002024-02-29T09:00:41-08:00
The United States Court of Appeals for the Ninth Circuit, in a case involving physicians who challenged California's Assembly Bill 2098 (AB 2098), which declared it unprofessional conduct for a doctor to provide COVID-19-related disinformation or misinformation to patients, ruled that the case is moot following the repeal of AB 2098. The court found no reasonable expectation that California would reenact AB 2098 or similar legislation. Additionally, evidence from the Executive Director of the Medical Board of California indicated that the board's employees and agents had been instructed not to enforce AB 2098, and that the board would have no legal authority to enforce the law once it was no longer in effect. Therefore, the court vacated the lower court's judgement and instructed it to dismiss the case due to mootness. <a href="https://law.justia.com/cases/federal/appellate-courts/ca9/22-56220/22-56220-2024-02-29.html" target="_blank">View "MCDONALD V. LAWSON" on Justia Law</a>
The United States Court of Appeals for the Ninth Circuit, in a case involving physicians who challenged California's Assembly Bill 2098 (AB 2098), which declared it unprofessional conduct for a doctor to provide COVID-19-related disinformation or misinformation to patients, ruled that the case is moot following the repeal of AB 2098. The court found no reasonable expectation that California would reenact AB 2098 or similar legislation. Additionally, evidence from the Executive Director of the Medical Board of California indicated that the board's employees and agents had been instructed not to enforce AB 2098, and that the board would have no legal authority to enforce the law once it was no longer in effect. Therefore, the court vacated the lower court's judgement and instructed it to dismiss the case due to mootness.
2024-02-29federalUS Court of Appeals for the Ninth CircuitForresthttps://law.justia.com/cases/california/court-of-appeal/2024/g062648.htmlPersiani v. Superior Court2024-02-28T14:01:12-08:002024-02-28T14:01:12-08:00
The case involved Rhonda Persiani, a defendant charged with multiple counts of driving under the influence (DUI) in California. Due to doubts about Persiani's mental competence, the criminal proceedings were suspended, and she was found mentally incompetent to stand trial. Persiani was evaluated and found suitable for outpatient treatment through mental health diversion. However, the court and parties believed Persiani was ineligible for such treatment due to a California Vehicle Code section that prohibits diversion in cases where a defendant is charged with DUI. Persiani sought dismissal of her cases, asserting that dismissal was required under the Penal Code because she was ineligible for any of the treatment options. The court denied Persiani’s motion to dismiss and imposed mental health treatment provisions as conditions of her release. In an appeal, the Court of Appeal of the State of California Fourth Appellate District held that a trial court has the authority under the Penal Code to order treatment through mental health diversion for a mentally incompetent misdemeanor defendant charged with DUI. The court concluded that the Vehicle Code section that prohibits diversion for DUI does not prevent a court from ordering a mentally incompetent misdemeanor defendant to receive treatment through mental health diversion after criminal proceedings have been suspended. The matter was remanded back to the lower court to determine whether to order Persiani to receive mental health diversion treatment. <a href="https://law.justia.com/cases/california/court-of-appeal/2024/g062648.html" target="_blank">View "Persiani v. Superior Court" on Justia Law</a>
The case involved Rhonda Persiani, a defendant charged with multiple counts of driving under the influence (DUI) in California. Due to doubts about Persiani's mental competence, the criminal proceedings were suspended, and she was found mentally incompetent to stand trial. Persiani was evaluated and found suitable for outpatient treatment through mental health diversion. However, the court and parties believed Persiani was ineligible for such treatment due to a California Vehicle Code section that prohibits diversion in cases where a defendant is charged with DUI. Persiani sought dismissal of her cases, asserting that dismissal was required under the Penal Code because she was ineligible for any of the treatment options. The court denied Persiani’s motion to dismiss and imposed mental health treatment provisions as conditions of her release. In an appeal, the Court of Appeal of the State of California Fourth Appellate District held that a trial court has the authority under the Penal Code to order treatment through mental health diversion for a mentally incompetent misdemeanor defendant charged with DUI. The court concluded that the Vehicle Code section that prohibits diversion for DUI does not prevent a court from ordering a mentally incompetent misdemeanor defendant to receive treatment through mental health diversion after criminal proceedings have been suspended. The matter was remanded back to the lower court to determine whether to order Persiani to receive mental health diversion treatment.
2024-02-28stateCaliforniaCalifornia Courts of AppealMOTOIKEhttps://law.justia.com/cases/federal/appellate-courts/ca1/22-1782/22-1782-2024-02-15.htmlWilkins v. Genzyme Corporation2024-02-27T10:07:13-08:002024-02-27T10:07:13-08:00
A group of individuals filed a lawsuit against Genzyme Corporation, a drug manufacturer, for injuries allegedly caused by the company's mishandling of a prescription drug shortage between 2009 and 2012. The lawsuit was filed several years after the events in question occurred and would typically have been considered too late under the applicable statutory limitations periods. However, the plaintiffs argued that previous class actions, a savings statute, and a tolling agreement between the parties allowed the lawsuit to proceed. The district court partially agreed and rejected Genzyme's argument that the delay in filing required dismissal of the lawsuit. However, it dismissed the claims of all but four plaintiffs for lack of standing, and dismissed the remaining claims on the merits.
On appeal, the United States Court of Appeals for the First Circuit found that all plaintiffs have standing and the court has jurisdiction to proceed with the case, at least with respect to the plaintiffs' individual claims. However, it concluded that four plaintiffs waited too long before filing this lawsuit, and their claims are time-barred. For the remaining plaintiffs, the court vacated the judgment dismissing their claims and remanded the case to the district court for further proceedings. <a href="https://law.justia.com/cases/federal/appellate-courts/ca1/22-1782/22-1782-2024-02-15.html" target="_blank">View "Wilkins v. Genzyme Corporation" on Justia Law</a>
A group of individuals filed a lawsuit against Genzyme Corporation, a drug manufacturer, for injuries allegedly caused by the company's mishandling of a prescription drug shortage between 2009 and 2012. The lawsuit was filed several years after the events in question occurred and would typically have been considered too late under the applicable statutory limitations periods. However, the plaintiffs argued that previous class actions, a savings statute, and a tolling agreement between the parties allowed the lawsuit to proceed. The district court partially agreed and rejected Genzyme's argument that the delay in filing required dismissal of the lawsuit. However, it dismissed the claims of all but four plaintiffs for lack of standing, and dismissed the remaining claims on the merits.
On appeal, the United States Court of Appeals for the First Circuit found that all plaintiffs have standing and the court has jurisdiction to proceed with the case, at least with respect to the plaintiffs' individual claims. However, it concluded that four plaintiffs waited too long before filing this lawsuit, and their claims are time-barred. For the remaining plaintiffs, the court vacated the judgment dismissing their claims and remanded the case to the district court for further proceedings.
2024-02-15federalUS Court of Appeals for the First CircuitKayattahttps://law.justia.com/cases/federal/appellate-courts/ca5/22-11007/22-11007-2024-02-26.htmlUnited States v. Garza2024-02-26T16:30:14-08:002024-02-26T16:30:14-08:00
The case concerns an appeal by Andrew Ocanas Garza against his conviction and a 235-month sentence for drug trafficking and firearm possession. Garza argued that the court incorrectly used his 2016 felony drug offenses for sentencing enhancement, contending that the 2018 amendment to the Agricultural Improvement Act altered marijuana’s definition, potentially excluding the substance he was previously convicted for trafficking. He also claimed that the court erred by not suppressing an unMirandized statement he made about having a gun in his bedroom during the execution of a search warrant.
The United States Court of Appeals for the Fifth Circuit affirmed the District Court's ruling. The Appeals Court held that Garza waived his right to challenge the admission of the Bedroom Gun statement by bringing it up during the trial. The Court also rejected Garza's argument concerning the sentencing enhancement based on his 2016 drug convictions. The Court applied the "backward-looking" test, which determines whether the prior convictions were felonies at the time of conviction and were final at the time of sentencing for the current crimes. The Court found that Garza's 2016 convictions met these criteria, making them applicable for sentencing enhancement. The Court also noted that even if the District Court had erred in applying the sentencing enhancement, the error was harmless, as the same sentence would have been imposed. <a href="https://law.justia.com/cases/federal/appellate-courts/ca5/22-11007/22-11007-2024-02-26.html" target="_blank">View "United States v. Garza" on Justia Law</a>
The case concerns an appeal by Andrew Ocanas Garza against his conviction and a 235-month sentence for drug trafficking and firearm possession. Garza argued that the court incorrectly used his 2016 felony drug offenses for sentencing enhancement, contending that the 2018 amendment to the Agricultural Improvement Act altered marijuana’s definition, potentially excluding the substance he was previously convicted for trafficking. He also claimed that the court erred by not suppressing an unMirandized statement he made about having a gun in his bedroom during the execution of a search warrant.
The United States Court of Appeals for the Fifth Circuit affirmed the District Court's ruling. The Appeals Court held that Garza waived his right to challenge the admission of the Bedroom Gun statement by bringing it up during the trial. The Court also rejected Garza's argument concerning the sentencing enhancement based on his 2016 drug convictions. The Court applied the "backward-looking" test, which determines whether the prior convictions were felonies at the time of conviction and were final at the time of sentencing for the current crimes. The Court found that Garza's 2016 convictions met these criteria, making them applicable for sentencing enhancement. The Court also noted that even if the District Court had erred in applying the sentencing enhancement, the error was harmless, as the same sentence would have been imposed.
2024-02-26federalUS Court of Appeals for the Fifth Circuithttps://law.justia.com/cases/federal/appellate-courts/ca8/23-1209/23-1209-2024-02-26.htmlBrennan v. Cass County Health2024-02-26T08:31:12-08:002024-02-26T08:31:12-08:00
Catherine Brennan, after being prescribed psychotropic medications due to a stressful job transition, began to experience symptoms of akathisia, a neuropsychiatric syndrome associated with psychomotor restlessness often seen in individuals using antipsychotic medications. Despite having no prior history of mental illness, Brennan was treated by multiple providers and was diagnosed with bipolar disorder, depression, and generalized anxiety disorder between 2015 and 2018. In 2019, Brennan was committed due to displaying signs of mental health decompensation. She was diagnosed with bipolar disorder involving current manic episodes with psychotic features, suicidal ideations, and medication noncompliance. Brennan was committed for a period of six months. After this commitment, she commenced a federal action alleging wrongful commitment and unlawful forced medication, arguing that her symptoms were side effects of the prescribed medications and were mistaken for psychosis and mania.
The United States Court of Appeals for the Eighth Circuit, however, upheld the district court's dismissal of Brennan's claims. The court held that Brennan could not proceed with her wrongful commitment claim because her commitment order was still valid, as per the precedent set in Heck v. Humphrey and Thomas v. Eschen. Regarding Brennan's claim of forcible administration of neuroleptic medications, the court found that Brennan failed to show deliberate indifference on the part of the defendants. The court noted that deliberate indifference is more than negligence and requires a plaintiff to show that an objectively serious medical need was knowingly disregarded by the defendants. The court ruled that Brennan did not adequately plead deliberate indifference as she failed to identify how her care exceeded gross negligence or demonstrate when the defendants knew or should have known that her psychiatric problems were the result of akathisia and not mental illness. The court thus affirmed the district court's judgment dismissing Brennan's claims. <a href="https://law.justia.com/cases/federal/appellate-courts/ca8/23-1209/23-1209-2024-02-26.html" target="_blank">View "Brennan v. Cass County Health" on Justia Law</a>
Catherine Brennan, after being prescribed psychotropic medications due to a stressful job transition, began to experience symptoms of akathisia, a neuropsychiatric syndrome associated with psychomotor restlessness often seen in individuals using antipsychotic medications. Despite having no prior history of mental illness, Brennan was treated by multiple providers and was diagnosed with bipolar disorder, depression, and generalized anxiety disorder between 2015 and 2018. In 2019, Brennan was committed due to displaying signs of mental health decompensation. She was diagnosed with bipolar disorder involving current manic episodes with psychotic features, suicidal ideations, and medication noncompliance. Brennan was committed for a period of six months. After this commitment, she commenced a federal action alleging wrongful commitment and unlawful forced medication, arguing that her symptoms were side effects of the prescribed medications and were mistaken for psychosis and mania.
The United States Court of Appeals for the Eighth Circuit, however, upheld the district court's dismissal of Brennan's claims. The court held that Brennan could not proceed with her wrongful commitment claim because her commitment order was still valid, as per the precedent set in Heck v. Humphrey and Thomas v. Eschen. Regarding Brennan's claim of forcible administration of neuroleptic medications, the court found that Brennan failed to show deliberate indifference on the part of the defendants. The court noted that deliberate indifference is more than negligence and requires a plaintiff to show that an objectively serious medical need was knowingly disregarded by the defendants. The court ruled that Brennan did not adequately plead deliberate indifference as she failed to identify how her care exceeded gross negligence or demonstrate when the defendants knew or should have known that her psychiatric problems were the result of akathisia and not mental illness. The court thus affirmed the district court's judgment dismissing Brennan's claims.
2024-02-26federalUS Court of Appeals for the Eighth CircuitEricksonhttps://law.justia.com/cases/minnesota/supreme-court/2024/a22-1340.htmlState v. Ulrich2024-02-23T14:05:29-08:002024-02-23T14:05:29-08:00
The Minnesota Supreme Court affirmed the convictions of Gregory Paul Ulrich for first-degree premeditated murder, attempted first-degree premeditated murder, and discharge of an explosive or incendiary device. Ulrich had targeted the Allina Health clinic in Wright County, where he had been treated, because he was dissatisfied with his medical care and blamed the clinic for his chronic pain. He had recorded videos threatening the clinic, purchased a gun and supplies for making pipe bombs, and then carried out an attack at the clinic, shooting several people and detonating three pipe bombs. On appeal, Ulrich argued that the lower court had abused its discretion by denying his motions to strike a juror for cause and to change the venue, and that the evidence was insufficient to support his convictions. The Supreme Court ruled that the lower court had not abused its discretion because the juror had not expressed actual bias requiring either rehabilitation or removal, and because Ulrich had not renewed his motion to change the venue after voir dire, thereby forfeiting his right to contest the denial of his motion. The Supreme Court also ruled that the evidence was sufficient to support the convictions because it supported a reasonable inference that Ulrich had planned the attack and believed that it would cause the victims' deaths. <a href="https://law.justia.com/cases/minnesota/supreme-court/2024/a22-1340.html" target="_blank">View "State v. Ulrich" on Justia Law</a>
The Minnesota Supreme Court affirmed the convictions of Gregory Paul Ulrich for first-degree premeditated murder, attempted first-degree premeditated murder, and discharge of an explosive or incendiary device. Ulrich had targeted the Allina Health clinic in Wright County, where he had been treated, because he was dissatisfied with his medical care and blamed the clinic for his chronic pain. He had recorded videos threatening the clinic, purchased a gun and supplies for making pipe bombs, and then carried out an attack at the clinic, shooting several people and detonating three pipe bombs. On appeal, Ulrich argued that the lower court had abused its discretion by denying his motions to strike a juror for cause and to change the venue, and that the evidence was insufficient to support his convictions. The Supreme Court ruled that the lower court had not abused its discretion because the juror had not expressed actual bias requiring either rehabilitation or removal, and because Ulrich had not renewed his motion to change the venue after voir dire, thereby forfeiting his right to contest the denial of his motion. The Supreme Court also ruled that the evidence was sufficient to support the convictions because it supported a reasonable inference that Ulrich had planned the attack and believed that it would cause the victims' deaths.
2024-02-21stateMinnesotaMinnesota Supreme CourtANDERSONhttps://law.justia.com/cases/california/court-of-appeal/2024/b326944.htmlPeople v. Hall2024-02-22T11:31:11-08:002024-02-22T11:31:11-08:00
In the State of California, a criminal defendant diagnosed with a mental disorder can be placed on mental health diversion under Penal Code section 1001.36. The provision allows such defendants to receive treatment for their mental illness and potentially avoid prosecution. However, the court may reinstate charges if the defendant's behavior while on diversion renders them unsuitable for the program. This case involved a defendant, Jasmen Lavar Hall, who was charged with carjacking and related offenses. After being placed on mental health diversion, Hall was expelled from his residential treatment program for threatening and assaulting other patients and destroying property. Following this behavior, Hall went missing for approximately six months before being apprehended. The trial court subsequently terminated Hall's diversion and reinstated the criminal proceedings. After a jury trial, Hall was convicted of the carjacking-related offenses and sentenced to an aggregate sentence of seven years eight months in prison. Hall argued that the court erred in reinstating the criminal proceedings because his actions did not meet the statutory criteria for having his diversion terminated. The Court of Appeal of the State of California Second Appellate District Division One disagreed, ruling that Hall's violent conduct and failure to comply with his treatment obligations rendered him unsuitable for diversion under Penal Code section 1001.36, subdivision (g)(3). The court therefore held that the trial court did not err in terminating Hall's diversion and reinstating the criminal proceedings, and it affirmed the judgment of conviction. <a href="https://law.justia.com/cases/california/court-of-appeal/2024/b326944.html" target="_blank">View "People v. Hall" on Justia Law</a>
In the State of California, a criminal defendant diagnosed with a mental disorder can be placed on mental health diversion under Penal Code section 1001.36. The provision allows such defendants to receive treatment for their mental illness and potentially avoid prosecution. However, the court may reinstate charges if the defendant's behavior while on diversion renders them unsuitable for the program. This case involved a defendant, Jasmen Lavar Hall, who was charged with carjacking and related offenses. After being placed on mental health diversion, Hall was expelled from his residential treatment program for threatening and assaulting other patients and destroying property. Following this behavior, Hall went missing for approximately six months before being apprehended. The trial court subsequently terminated Hall's diversion and reinstated the criminal proceedings. After a jury trial, Hall was convicted of the carjacking-related offenses and sentenced to an aggregate sentence of seven years eight months in prison. Hall argued that the court erred in reinstating the criminal proceedings because his actions did not meet the statutory criteria for having his diversion terminated. The Court of Appeal of the State of California Second Appellate District Division One disagreed, ruling that Hall's violent conduct and failure to comply with his treatment obligations rendered him unsuitable for diversion under Penal Code section 1001.36, subdivision (g)(3). The court therefore held that the trial court did not err in terminating Hall's diversion and reinstating the criminal proceedings, and it affirmed the judgment of conviction.
2024-02-22stateCaliforniaCalifornia Courts of AppealWEINGARThttps://law.justia.com/cases/federal/appellate-courts/ca5/22-20620/22-20620-2024-02-21.htmlUSA v. King2024-02-21T16:30:49-08:002024-02-21T16:30:49-08:00
In a healthcare fraud case involving Medicare kickbacks, defendants Lindell King and Ynedra Diggs appealed their convictions and sentences. They challenged the United States District Court for the Southern District of Texas's decision to admit recordings involving them and other co-conspirators, and disputed the court's calculation of the improper benefit received for the purpose of their sentence, as well as the restitution award. The United States Court of Appeals for the Fifth Circuit examined these arguments and ruled in favor of the lower court.
The defendants were accused of receiving bribes from a Medicare provider, Dr. Paulo Bettega, for referring Medicare beneficiaries to him for unnecessary treatment or non-provided treatment. The Court of Appeals rejected the defendants' Confrontation Clause arguments, stating the recordings were not testimonial and did not violate the Confrontation Clause. It further dismissed the defendants' assertion that the recordings were impermissible hearsay.
Regarding the calculation of the improper benefit, the court concluded that the government had proved by a preponderance of the evidence that the entire operation was fraudulent. The defendants failed to provide rebuttal evidence of any legitimate medical expenses that should offset the amount paid to Bettega for treatment provided to residents of their group homes.
The Court of Appeals also upheld the restitution award. It rejected the defendants' argument that their maximum restitution was limited to the $70,000 they received in kickbacks. The court held the defendants jointly and severally liable for all foreseeable losses within the scope of their conspiracy.
In conclusion, the Court of Appeals affirmed the judgment and sentence of the district court, finding no error in its proceedings or decisions. <a href="https://law.justia.com/cases/federal/appellate-courts/ca5/22-20620/22-20620-2024-02-21.html" target="_blank">View "USA v. King" on Justia Law</a>
In a healthcare fraud case involving Medicare kickbacks, defendants Lindell King and Ynedra Diggs appealed their convictions and sentences. They challenged the United States District Court for the Southern District of Texas's decision to admit recordings involving them and other co-conspirators, and disputed the court's calculation of the improper benefit received for the purpose of their sentence, as well as the restitution award. The United States Court of Appeals for the Fifth Circuit examined these arguments and ruled in favor of the lower court.
The defendants were accused of receiving bribes from a Medicare provider, Dr. Paulo Bettega, for referring Medicare beneficiaries to him for unnecessary treatment or non-provided treatment. The Court of Appeals rejected the defendants' Confrontation Clause arguments, stating the recordings were not testimonial and did not violate the Confrontation Clause. It further dismissed the defendants' assertion that the recordings were impermissible hearsay.
Regarding the calculation of the improper benefit, the court concluded that the government had proved by a preponderance of the evidence that the entire operation was fraudulent. The defendants failed to provide rebuttal evidence of any legitimate medical expenses that should offset the amount paid to Bettega for treatment provided to residents of their group homes.
The Court of Appeals also upheld the restitution award. It rejected the defendants' argument that their maximum restitution was limited to the $70,000 they received in kickbacks. The court held the defendants jointly and severally liable for all foreseeable losses within the scope of their conspiracy.
In conclusion, the Court of Appeals affirmed the judgment and sentence of the district court, finding no error in its proceedings or decisions.
2024-02-21federalUS Court of Appeals for the Fifth CircuitJoneshttps://law.justia.com/cases/california/court-of-appeal/2024/d081713.htmlPeople v. Garcia2024-02-21T12:01:22-08:002024-02-21T12:01:22-08:00
The case involves Jennifer Garcia, who was charged with multiple counts, including making threats to a public officer, disobeying a court order, possessing a weapon in a courthouse, attempted murder, and assault with a deadly weapon. After her counsel declared doubt as to Garcia's mental competence, the trial court suspended the criminal proceedings for a determination of Garcia's mental competence. Based on the evaluations of a licensed psychiatrist and a licensed psychologist, the court found Garcia mentally incompetent to stand trial and lacking capacity to make decisions regarding the administration of antipsychotic medication. Garcia appealed the court's order authorizing the state hospital to involuntarily administer antipsychotic medication to her, alleging errors with the order and ineffective assistance of her trial counsel. The Court of Appeal, Fourth Appellate District, Division One, State of California, affirmed the trial court's order. The appellate court found that substantial evidence supported the trial court's order, the psychologist did not exceed the scope of her license in her evaluation, and the psychiatrist's opinion did not lack statutorily required information. The appellate court also found that the error in the trial court's form order was harmless and Garcia was not prejudiced by any ineffectiveness of her counsel. <a href="https://law.justia.com/cases/california/court-of-appeal/2024/d081713.html" target="_blank">View "People v. Garcia" on Justia Law</a>
The case involves Jennifer Garcia, who was charged with multiple counts, including making threats to a public officer, disobeying a court order, possessing a weapon in a courthouse, attempted murder, and assault with a deadly weapon. After her counsel declared doubt as to Garcia's mental competence, the trial court suspended the criminal proceedings for a determination of Garcia's mental competence. Based on the evaluations of a licensed psychiatrist and a licensed psychologist, the court found Garcia mentally incompetent to stand trial and lacking capacity to make decisions regarding the administration of antipsychotic medication. Garcia appealed the court's order authorizing the state hospital to involuntarily administer antipsychotic medication to her, alleging errors with the order and ineffective assistance of her trial counsel. The Court of Appeal, Fourth Appellate District, Division One, State of California, affirmed the trial court's order. The appellate court found that substantial evidence supported the trial court's order, the psychologist did not exceed the scope of her license in her evaluation, and the psychiatrist's opinion did not lack statutorily required information. The appellate court also found that the error in the trial court's form order was harmless and Garcia was not prejudiced by any ineffectiveness of her counsel.
2024-02-21stateCaliforniaCalifornia Courts of AppealMcCONNELLhttps://law.justia.com/cases/federal/appellate-courts/ca3/23-1924/23-1924-2024-02-21.htmlMohr v. Trustees of the University of Pennsylvania2024-02-21T10:01:17-08:002024-02-21T10:01:17-08:00
In a class action suit, the plaintiffs, a group of patients, alleged that the Trustees of the University of Pennsylvania (Penn), who operate the Hospital of the University of Pennsylvania Health System (Penn Medicine), were in violation of Pennsylvania privacy law. The plaintiffs claimed that Penn Medicine shared sensitive health information and online activity of its patients with Facebook through its patient portal. Penn removed the case to federal court, asserting that it was "acting under" the federal government, referencing the federal-officer removal statute. However, the District Court rejected this argument and returned the case to state court.
This case was primarily focused on whether Penn was "acting under" the federal government in its operation of Penn Medicine's patient portal. The United States Court of Appeals for the Third Circuit affirmed the District Court's decision to remand the case back to state court. The Court of Appeals determined that Penn was not "acting under" the federal government, as it did not demonstrate that it was performing a delegated governmental task. The court declared that Penn was merely complying with federal laws and regulations, which does not qualify as "acting under" the federal government. The court noted that just because a private party has a contractual relationship with the federal government does not mean that it is "acting under" the federal authority. In conclusion, the court determined that the relationship between Penn and the federal government did not meet the requirements for Penn to be considered as "acting under" the federal government, thus the case was correctly returned to state court. <a href="https://law.justia.com/cases/federal/appellate-courts/ca3/23-1924/23-1924-2024-02-21.html" target="_blank">View "Mohr v. Trustees of the University of Pennsylvania" on Justia Law</a>
In a class action suit, the plaintiffs, a group of patients, alleged that the Trustees of the University of Pennsylvania (Penn), who operate the Hospital of the University of Pennsylvania Health System (Penn Medicine), were in violation of Pennsylvania privacy law. The plaintiffs claimed that Penn Medicine shared sensitive health information and online activity of its patients with Facebook through its patient portal. Penn removed the case to federal court, asserting that it was "acting under" the federal government, referencing the federal-officer removal statute. However, the District Court rejected this argument and returned the case to state court.
This case was primarily focused on whether Penn was "acting under" the federal government in its operation of Penn Medicine's patient portal. The United States Court of Appeals for the Third Circuit affirmed the District Court's decision to remand the case back to state court. The Court of Appeals determined that Penn was not "acting under" the federal government, as it did not demonstrate that it was performing a delegated governmental task. The court declared that Penn was merely complying with federal laws and regulations, which does not qualify as "acting under" the federal government. The court noted that just because a private party has a contractual relationship with the federal government does not mean that it is "acting under" the federal authority. In conclusion, the court determined that the relationship between Penn and the federal government did not meet the requirements for Penn to be considered as "acting under" the federal government, thus the case was correctly returned to state court.
2024-02-21federalUS Court of Appeals for the Third CircuitPORTERhttps://law.justia.com/cases/federal/appellate-courts/cafc/22-2119/22-2119-2024-02-21.htmlW. J. v. Health and Human Services2024-02-21T07:05:38-08:002024-02-21T07:05:38-08:00
In this case, the parents of W.J., a young man with a chromosomal abnormality and autism, brought a case under the National Childhood Vaccine Injury Act of 1986 against the Secretary of Health and Human Services, claiming that the Measles, Mumps, and Rubella vaccine administered to their son had caused or significantly aggravated his health issues. They filed their petition more than 15 years after the vaccine was administered, well beyond the Act's three-year statute of limitations. The parents argued that the statute of limitations should be equitably tolled due to their son's mental incapacitation, his minority status, and the government's alleged fraudulent concealment of a connection between the vaccine and autism.
The United States Court of Appeals for the Federal Circuit affirmed the decision of the United States Court of Federal Claims, which had denied the parents' petition for review and confirmed a special master’s decision to dismiss the case as untimely. The court concluded that the mental incapacitation of the son did not qualify as an "extraordinary circumstance" warranting equitable tolling because the parents, as his legal guardians, had failed to demonstrate that they were unable to file a claim on his behalf. The court also rejected the arguments for minority tolling and fraudulent concealment, finding no basis for these in the Vaccine Act or its legislative history. The court further held that the special master had not erred in raising the issue of the statute of limitations, nor in dismissing the claim for failure to state a claim upon which relief could be granted. <a href="https://law.justia.com/cases/federal/appellate-courts/cafc/22-2119/22-2119-2024-02-21.html" target="_blank">View "W. J. v. Health and Human Services" on Justia Law</a>
In this case, the parents of W.J., a young man with a chromosomal abnormality and autism, brought a case under the National Childhood Vaccine Injury Act of 1986 against the Secretary of Health and Human Services, claiming that the Measles, Mumps, and Rubella vaccine administered to their son had caused or significantly aggravated his health issues. They filed their petition more than 15 years after the vaccine was administered, well beyond the Act's three-year statute of limitations. The parents argued that the statute of limitations should be equitably tolled due to their son's mental incapacitation, his minority status, and the government's alleged fraudulent concealment of a connection between the vaccine and autism.
The United States Court of Appeals for the Federal Circuit affirmed the decision of the United States Court of Federal Claims, which had denied the parents' petition for review and confirmed a special master’s decision to dismiss the case as untimely. The court concluded that the mental incapacitation of the son did not qualify as an "extraordinary circumstance" warranting equitable tolling because the parents, as his legal guardians, had failed to demonstrate that they were unable to file a claim on his behalf. The court also rejected the arguments for minority tolling and fraudulent concealment, finding no basis for these in the Vaccine Act or its legislative history. The court further held that the special master had not erred in raising the issue of the statute of limitations, nor in dismissing the claim for failure to state a claim upon which relief could be granted.
2024-02-21federalUS Court of Appeals for the Federal Circuithttps://law.justia.com/cases/georgia/supreme-court/2024/s23g0405.htmlVANTAGE CANCER CENTERS OF GEORGIA, LLC v. GEORGIA DEPARTMENT OF COMMUNITY HEALTH2024-02-20T05:32:09-08:002024-02-20T05:32:09-08:00
This case concerns the standard of review that the Commissioner of the Georgia Department of Community Health must apply when reviewing the decision of a hearing officer on an application for a certificate of need to establish a new health service. The Supreme Court of Georgia vacated the Court of Appeals’ judgment, set forth the standard applicable to the Commissioner’s review, and remanded the case to the Court of Appeals. The Supreme Court clarified that "competent substantial evidence" in the context of the Commissioner's review means evidence that is "relevant" such that "a reasonable mind might accept it as adequate to support" a finding of fact, and that is admissible. The court also determined that the Commissioner must provide sufficient detail in his order from which a reviewing court can determine whether the Commissioner has or has not improperly substituted his judgment for the findings of fact of the hearing officer. <a href="https://law.justia.com/cases/georgia/supreme-court/2024/s23g0405.html" target="_blank">View "VANTAGE CANCER CENTERS OF GEORGIA, LLC v. GEORGIA DEPARTMENT OF COMMUNITY HEALTH" on Justia Law</a>
This case concerns the standard of review that the Commissioner of the Georgia Department of Community Health must apply when reviewing the decision of a hearing officer on an application for a certificate of need to establish a new health service. The Supreme Court of Georgia vacated the Court of Appeals’ judgment, set forth the standard applicable to the Commissioner’s review, and remanded the case to the Court of Appeals. The Supreme Court clarified that "competent substantial evidence" in the context of the Commissioner's review means evidence that is "relevant" such that "a reasonable mind might accept it as adequate to support" a finding of fact, and that is admissible. The court also determined that the Commissioner must provide sufficient detail in his order from which a reviewing court can determine whether the Commissioner has or has not improperly substituted his judgment for the findings of fact of the hearing officer.
2024-02-20stateGeorgiaSupreme Court of GeorgiaBoggshttps://law.justia.com/cases/alabama/supreme-court/2024/sc-2022-0579.htmlLePage v. Center for Reproductive Medicine, P.C.2024-02-16T12:30:05-08:002024-02-16T12:30:05-08:00
In this case, the Supreme Court of Alabama ruled that under Alabama's Wrongful Death of a Minor Act, the definition of a "child" includes those who are unborn, regardless of their location (either inside or outside a biological uterus). The case involves multiple sets of parents who had embryos created through in vitro fertilization (IVF) and stored at the Center for Reproductive Medicine, P.C. An incident occurred in which a patient at the hospital where the center was located wandered into the cryogenic nursery and removed several embryos, causing their deaths. The parents sued the center and the hospital for wrongful death under Alabama's Wrongful Death of a Minor Act and also asserted common-law claims of negligence. The trial court dismissed the wrongful-death and negligence/wantonness claims, concluding that the embryos did not fit the definition of a "person" or "child" and thus their loss could not give rise to a wrongful-death claim. On appeal, the Supreme Court of Alabama reversed the lower court's dismissal of the wrongful-death claims, holding that the Act applies to all unborn children, regardless of their location. The court affirmed the dismissal of the negligence and wantonness claims as moot, given the court's ruling on the wrongful-death claims. <a href="https://law.justia.com/cases/alabama/supreme-court/2024/sc-2022-0579.html" target="_blank">View "LePage v. Center for Reproductive Medicine, P.C." on Justia Law</a>
In this case, the Supreme Court of Alabama ruled that under Alabama's Wrongful Death of a Minor Act, the definition of a "child" includes those who are unborn, regardless of their location (either inside or outside a biological uterus). The case involves multiple sets of parents who had embryos created through in vitro fertilization (IVF) and stored at the Center for Reproductive Medicine, P.C. An incident occurred in which a patient at the hospital where the center was located wandered into the cryogenic nursery and removed several embryos, causing their deaths. The parents sued the center and the hospital for wrongful death under Alabama's Wrongful Death of a Minor Act and also asserted common-law claims of negligence. The trial court dismissed the wrongful-death and negligence/wantonness claims, concluding that the embryos did not fit the definition of a "person" or "child" and thus their loss could not give rise to a wrongful-death claim. On appeal, the Supreme Court of Alabama reversed the lower court's dismissal of the wrongful-death claims, holding that the Act applies to all unborn children, regardless of their location. The court affirmed the dismissal of the negligence and wantonness claims as moot, given the court's ruling on the wrongful-death claims.
2024-02-16stateAlabamaSupreme Court of AlabamaMitchellhttps://law.justia.com/cases/federal/appellate-courts/cadc/23-5020/23-5020-2024-02-16.htmlRow 1 Inc. v. Becerra2024-02-16T07:35:12-08:002024-02-16T07:35:12-08:00
The United States Court of Appeals for the District of Columbia Circuit ruled in a case involving Regenative Labs ("Regenative"), a manufacturer of medical products containing human cells, tissues, or cellular or tissue-based products ("HCT/Ps"), and the Secretary of Health and Human Services. Following the Centers for Medicare and Medicaid Services ("CMS") issuing two technical direction letters instructing Medicare contractors to deny reimbursement for claims for products manufactured by Regenative, the company filed suit challenging these letters without first exhausting administrative remedies. The District Court dismissed the case due to lack of subject matter jurisdiction as Regenative had failed to exhaust its administrative remedies. On appeal, the Court of Appeals affirmed the District Court’s dismissal, in part for lack of subject matter jurisdiction and in part on grounds of mootness. The Court concluded that the claims raised by Regenative arose under the Medicare Act and had to be pursued through the statutorily-prescribed administrative process. The Court also found that the company’s request for the court to vacate the contested policy was moot because the policy had already been rescinded by CMS. Finally, the court rejected Regenative's argument for mandamus jurisdiction, finding that it did not satisfy the jurisdictional requirements for this relief. <a href="https://law.justia.com/cases/federal/appellate-courts/cadc/23-5020/23-5020-2024-02-16.html" target="_blank">View "Row 1 Inc. v. Becerra" on Justia Law</a>
The United States Court of Appeals for the District of Columbia Circuit ruled in a case involving Regenative Labs ("Regenative"), a manufacturer of medical products containing human cells, tissues, or cellular or tissue-based products ("HCT/Ps"), and the Secretary of Health and Human Services. Following the Centers for Medicare and Medicaid Services ("CMS") issuing two technical direction letters instructing Medicare contractors to deny reimbursement for claims for products manufactured by Regenative, the company filed suit challenging these letters without first exhausting administrative remedies. The District Court dismissed the case due to lack of subject matter jurisdiction as Regenative had failed to exhaust its administrative remedies. On appeal, the Court of Appeals affirmed the District Court’s dismissal, in part for lack of subject matter jurisdiction and in part on grounds of mootness. The Court concluded that the claims raised by Regenative arose under the Medicare Act and had to be pursued through the statutorily-prescribed administrative process. The Court also found that the company’s request for the court to vacate the contested policy was moot because the policy had already been rescinded by CMS. Finally, the court rejected Regenative's argument for mandamus jurisdiction, finding that it did not satisfy the jurisdictional requirements for this relief.
2024-02-16federalUS Court of Appeals for the District of Columbia CircuitEdwardshttps://law.justia.com/cases/texas/supreme-court/2024/22-0987.htmlIN RE A.R.C.2024-02-16T07:32:02-08:002024-02-16T07:32:02-08:00
The case in question was heard by the Supreme Court of Texas and revolved around the interpretation of the term "psychiatrist" as it applies to the involuntary civil commitment of individuals exhibiting signs of mental illness. The case involved a 34-year-old man, A.R.C., who had exhibited psychotic symptoms and delusional behavior. Two second-year psychiatry residents completed the required "certificates of medical examination for mental illness," as outlined in Tex. Health & Safety Code § 574.009(a). However, a question arose as to whether these residents could be considered psychiatrists under the statute.
The Supreme Court of Texas ruled that these residents were indeed psychiatrists, reversing the lower court's judgment. The court determined that the residents, who were licensed under a physician-in-training program and were engaged in specialized psychiatric training, fell within the definition of a physician specializing in psychiatry. The court rejected the argument that only board-certified psychiatrists qualify under the statute, stating that physicians who specialize in psychiatry qualify as psychiatrists under § 574.009(a).
The court emphasized that it is the judge, not the physician, who ultimately decides whether involuntary commitment is necessary or lawful. The court also noted that the legislature has the power to amend the qualifications for psychiatrists and other physicians as it sees fit, provided it adheres to the constitutional requirement of competent medical or psychiatric testimony.
The Supreme Court of Texas remanded the case to the court of appeals for consideration of A.R.C.'s remaining challenges. <a href="https://law.justia.com/cases/texas/supreme-court/2024/22-0987.html" target="_blank">View "IN RE A.R.C." on Justia Law</a>
The case in question was heard by the Supreme Court of Texas and revolved around the interpretation of the term "psychiatrist" as it applies to the involuntary civil commitment of individuals exhibiting signs of mental illness. The case involved a 34-year-old man, A.R.C., who had exhibited psychotic symptoms and delusional behavior. Two second-year psychiatry residents completed the required "certificates of medical examination for mental illness," as outlined in Tex. Health & Safety Code § 574.009(a). However, a question arose as to whether these residents could be considered psychiatrists under the statute.
The Supreme Court of Texas ruled that these residents were indeed psychiatrists, reversing the lower court's judgment. The court determined that the residents, who were licensed under a physician-in-training program and were engaged in specialized psychiatric training, fell within the definition of a physician specializing in psychiatry. The court rejected the argument that only board-certified psychiatrists qualify under the statute, stating that physicians who specialize in psychiatry qualify as psychiatrists under § 574.009(a).
The court emphasized that it is the judge, not the physician, who ultimately decides whether involuntary commitment is necessary or lawful. The court also noted that the legislature has the power to amend the qualifications for psychiatrists and other physicians as it sees fit, provided it adheres to the constitutional requirement of competent medical or psychiatric testimony.
The Supreme Court of Texas remanded the case to the court of appeals for consideration of A.R.C.'s remaining challenges.
2024-02-16stateTexasSupreme Court of TexasYounghttps://law.justia.com/cases/kentucky/supreme-court/2024/2023-sc-0178-dg.htmlCOMMONWEALTH OF KENTUCKY V. DAVIS2024-02-15T07:04:31-08:002024-02-15T07:04:31-08:00
In November 2013, Ahmad Rashad Davis was indicted for Medicaid fraud and theft by deception for defrauding Medicaid of $14,505.36 by falsifying timesheets over two years. In May 2014, the Commonwealth of Kentucky and Davis entered into a plea agreement in which Davis agreed to plead guilty to Medicaid fraud, and in exchange, the Commonwealth recommended to the trial court that Davis's theft by deception charge be dismissed. The trial court accepted Davis's guilty plea and sentenced him to one year of imprisonment, probated for three years or until restitution was paid in full, and dismissed the theft by deception charge. In December 2021, Davis filed a petition to expunge the theft by deception charge. The Commonwealth objected, arguing that the charge was dismissed in exchange for Davis's guilty plea to Medicaid fraud, making it ineligible for expungement under Kentucky Revised Statute (KRS) 431.076(1)(b). The circuit court granted Davis's petition without holding a hearing, and the Court of Appeals affirmed the decision. The Supreme Court of Kentucky granted discretionary review and reversed the decisions of the lower courts.
The Supreme Court of Kentucky held that a circuit court can look beyond the sentencing court's final judgment to determine whether a dismissal was granted in exchange for a guilty plea to another charge. The court ruled that the circuit court erred in failing to do so in Davis's case. As a result, the Supreme Court reversed the Court of Appeals and vacated the circuit court's order granting expungement. <a href="https://law.justia.com/cases/kentucky/supreme-court/2024/2023-sc-0178-dg.html" target="_blank">View "COMMONWEALTH OF KENTUCKY V. DAVIS" on Justia Law</a>
In November 2013, Ahmad Rashad Davis was indicted for Medicaid fraud and theft by deception for defrauding Medicaid of $14,505.36 by falsifying timesheets over two years. In May 2014, the Commonwealth of Kentucky and Davis entered into a plea agreement in which Davis agreed to plead guilty to Medicaid fraud, and in exchange, the Commonwealth recommended to the trial court that Davis's theft by deception charge be dismissed. The trial court accepted Davis's guilty plea and sentenced him to one year of imprisonment, probated for three years or until restitution was paid in full, and dismissed the theft by deception charge. In December 2021, Davis filed a petition to expunge the theft by deception charge. The Commonwealth objected, arguing that the charge was dismissed in exchange for Davis's guilty plea to Medicaid fraud, making it ineligible for expungement under Kentucky Revised Statute (KRS) 431.076(1)(b). The circuit court granted Davis's petition without holding a hearing, and the Court of Appeals affirmed the decision. The Supreme Court of Kentucky granted discretionary review and reversed the decisions of the lower courts.
The Supreme Court of Kentucky held that a circuit court can look beyond the sentencing court's final judgment to determine whether a dismissal was granted in exchange for a guilty plea to another charge. The court ruled that the circuit court erred in failing to do so in Davis's case. As a result, the Supreme Court reversed the Court of Appeals and vacated the circuit court's order granting expungement.
2024-02-15stateKentuckyKentucky Supreme CourtKellerhttps://law.justia.com/cases/missouri/supreme-court/2024/sc99966.htmlPlanned Parenthood of the St. Louis Region vs. Knodell2024-02-14T13:30:04-08:002024-02-14T13:30:04-08:00
In Missouri, Planned Parenthood and other affiliated health organizations sought a declaratory judgment declaring House Bill No. 3014 (HB 3014) unconstitutional and requested injunctive relief to prevent its implementation and enforcement. HB 3014 was a bill passed by the Missouri General Assembly that would cut Medicaid funding for abortion providers and their affiliates, including Planned Parenthood. The plaintiffs alleged that the bill violated the single subject requirement and the equal protection clause of the Missouri Constitution. The Supreme Court of Missouri affirmed the decision of the lower court, which had ruled in favor of Planned Parenthood on both constitutional claims. The state appealed on procedural grounds, alleging that Planned Parenthood failed to exhaust administrative remedies, lacked standing, and waived its right to bring these claims. The state also argued the bill did not violate the single subject or equal protection provisions of the Missouri Constitution. However, the Supreme Court dismissed these arguments, affirming the lower court's ruling.
<a href="https://law.justia.com/cases/missouri/supreme-court/2024/sc99966.html" target="_blank">View "Planned Parenthood of the St. Louis Region vs. Knodell" on Justia Law</a>
In Missouri, Planned Parenthood and other affiliated health organizations sought a declaratory judgment declaring House Bill No. 3014 (HB 3014) unconstitutional and requested injunctive relief to prevent its implementation and enforcement. HB 3014 was a bill passed by the Missouri General Assembly that would cut Medicaid funding for abortion providers and their affiliates, including Planned Parenthood. The plaintiffs alleged that the bill violated the single subject requirement and the equal protection clause of the Missouri Constitution. The Supreme Court of Missouri affirmed the decision of the lower court, which had ruled in favor of Planned Parenthood on both constitutional claims. The state appealed on procedural grounds, alleging that Planned Parenthood failed to exhaust administrative remedies, lacked standing, and waived its right to bring these claims. The state also argued the bill did not violate the single subject or equal protection provisions of the Missouri Constitution. However, the Supreme Court dismissed these arguments, affirming the lower court's ruling.
2024-02-14stateMissouriSupreme Court of MissouriPowellhttps://law.justia.com/cases/federal/appellate-courts/ca5/22-30249/22-30249-2024-02-14.htmlUSA v. Dinkins2024-02-14T10:30:51-08:002024-02-14T10:30:51-08:00
The United States Court of Appeals for the Fifth Circuit affirmed the district court’s decision to order Marty Johnson, the owner of a mental health rehabilitation clinic, and Keesha Dinkins, an employee of the clinic, to pay $3.5 million in restitution. Johnson and Dinkins had pleaded guilty to charges related to a fraudulent billing scheme targeting Medicaid that lasted from 2014 to 2018. On the day before their jury trial was set to begin, both defendants pled guilty to their respective charges and agreed in their plea deals to recommend $3.5 million in restitution. However, after their pleas were accepted, both defendants objected to the restitution order, arguing that it was erroneous. Johnson challenged the loss and restitution calculation while Dinkins argued that the entire loss should not have been attributed to her. The court held that the defendants were bound by the plea agreements they had made and affirmed the district court’s order for each defendant to pay $3.5 million in restitution. The court found that there was sufficient evidence to support the pleas, the restitution amount did not exceed the actual loss, and the district court appropriately used the total loss amount when calculating Dinkins’s sentence. <a href="https://law.justia.com/cases/federal/appellate-courts/ca5/22-30249/22-30249-2024-02-14.html" target="_blank">View "USA v. Dinkins" on Justia Law</a>
The United States Court of Appeals for the Fifth Circuit affirmed the district court’s decision to order Marty Johnson, the owner of a mental health rehabilitation clinic, and Keesha Dinkins, an employee of the clinic, to pay $3.5 million in restitution. Johnson and Dinkins had pleaded guilty to charges related to a fraudulent billing scheme targeting Medicaid that lasted from 2014 to 2018. On the day before their jury trial was set to begin, both defendants pled guilty to their respective charges and agreed in their plea deals to recommend $3.5 million in restitution. However, after their pleas were accepted, both defendants objected to the restitution order, arguing that it was erroneous. Johnson challenged the loss and restitution calculation while Dinkins argued that the entire loss should not have been attributed to her. The court held that the defendants were bound by the plea agreements they had made and affirmed the district court’s order for each defendant to pay $3.5 million in restitution. The court found that there was sufficient evidence to support the pleas, the restitution amount did not exceed the actual loss, and the district court appropriately used the total loss amount when calculating Dinkins’s sentence.
2024-02-14federalUS Court of Appeals for the Fifth CircuitHigginbothamhttps://law.justia.com/cases/federal/appellate-courts/ca5/22-30242/22-30242-2024-02-14.htmlUSA v. Johnson2024-02-14T10:30:50-08:002024-02-14T10:30:50-08:00
In the United States Court of Appeals for the Fifth Circuit, the case involved Marty Johnson, the owner of a mental health rehabilitation clinic, and Keesha Dinkins, an employee of the same clinic. Both defendants fraudulently billed Medicaid for illegitimate services between 2014 and January 2018. On the day their jury trial was scheduled to begin, Johnson pled guilty to conspiracy to commit healthcare and wire fraud, and Dinkins pled guilty to misprision of a felony. Each of their plea agreements stipulated a loss of $3.5 million and recommended that the judge order $3.5 million in restitution to the government. The district court accepted the defendants' recommendations and ordered each to pay $3.5 million in restitution. After receiving the benefit of their plea bargain, both defendants argued that the $3.5 million order was erroneous. Dinkins also contended that under the sentencing guidelines, the entire loss should not have been attributed to her. The court held the defendants to the plea bargain they had made and affirmed the district court's decision. The Court of Appeals determined that the district court's restitution order was valid under the Mandatory Victims Restitution Act (MVRA). <a href="https://law.justia.com/cases/federal/appellate-courts/ca5/22-30242/22-30242-2024-02-14.html" target="_blank">View "USA v. Johnson" on Justia Law</a>
In the United States Court of Appeals for the Fifth Circuit, the case involved Marty Johnson, the owner of a mental health rehabilitation clinic, and Keesha Dinkins, an employee of the same clinic. Both defendants fraudulently billed Medicaid for illegitimate services between 2014 and January 2018. On the day their jury trial was scheduled to begin, Johnson pled guilty to conspiracy to commit healthcare and wire fraud, and Dinkins pled guilty to misprision of a felony. Each of their plea agreements stipulated a loss of $3.5 million and recommended that the judge order $3.5 million in restitution to the government. The district court accepted the defendants' recommendations and ordered each to pay $3.5 million in restitution. After receiving the benefit of their plea bargain, both defendants argued that the $3.5 million order was erroneous. Dinkins also contended that under the sentencing guidelines, the entire loss should not have been attributed to her. The court held the defendants to the plea bargain they had made and affirmed the district court's decision. The Court of Appeals determined that the district court's restitution order was valid under the Mandatory Victims Restitution Act (MVRA).
2024-02-14federalUS Court of Appeals for the Fifth CircuitHigginbothamhttps://law.justia.com/cases/montana/supreme-court/2024/da-22-0014.htmlIn re M.T.H.2024-02-13T14:18:00-08:002024-02-13T14:18:00-08:00
The case involves an appellant, M.T.H., who was arrested for criminal endangerment after he pulled the steering wheel in his mother's vehicle while she was driving. M.T.H. was diagnosed with major depressive disorder and paranoid schizophrenia. Following his arrest, the State filed a petition for M.T.H.'s involuntary commitment to the Montana State Hospital (MSH) for up to three months. The District Court of the Twenty-First Judicial District, Ravalli County, ordered his commitment and authorized MSH to involuntarily administer medications to M.T.H. This led to an appeal to the Supreme Court of the State of Montana.
The Supreme Court of Montana had two main issues to consider. The first issue was whether the District Court erroneously determined that a signed waiver constituted a sufficient record to commit M.T.H. The Supreme Court found that M.T.H.'s waiver and the District Court’s order committing him were sufficient to constitute an intentional and knowing waiver under the relevant statute. The court emphasized that the record reflected that M.T.H. understood his procedural rights and had a clear presence of mind to consider his position logically.
The second issue was whether the District Court erroneously authorized MSH to administer involuntary medications to M.T.H. The Supreme Court held that the District Court erred in this aspect. It emphasized the importance of due process protections and noted that the State must demonstrate a need for involuntary medication before a court may authorize it. In this case, the State did not make this necessary showing. Therefore, the Supreme Court affirmed the District Court’s decision in part but reversed its decision to authorize involuntary medication for M.T.H. <a href="https://law.justia.com/cases/montana/supreme-court/2024/da-22-0014.html" target="_blank">View "In re M.T.H." on Justia Law</a>
The case involves an appellant, M.T.H., who was arrested for criminal endangerment after he pulled the steering wheel in his mother's vehicle while she was driving. M.T.H. was diagnosed with major depressive disorder and paranoid schizophrenia. Following his arrest, the State filed a petition for M.T.H.'s involuntary commitment to the Montana State Hospital (MSH) for up to three months. The District Court of the Twenty-First Judicial District, Ravalli County, ordered his commitment and authorized MSH to involuntarily administer medications to M.T.H. This led to an appeal to the Supreme Court of the State of Montana.
The Supreme Court of Montana had two main issues to consider. The first issue was whether the District Court erroneously determined that a signed waiver constituted a sufficient record to commit M.T.H. The Supreme Court found that M.T.H.'s waiver and the District Court’s order committing him were sufficient to constitute an intentional and knowing waiver under the relevant statute. The court emphasized that the record reflected that M.T.H. understood his procedural rights and had a clear presence of mind to consider his position logically.
The second issue was whether the District Court erroneously authorized MSH to administer involuntary medications to M.T.H. The Supreme Court held that the District Court erred in this aspect. It emphasized the importance of due process protections and noted that the State must demonstrate a need for involuntary medication before a court may authorize it. In this case, the State did not make this necessary showing. Therefore, the Supreme Court affirmed the District Court’s decision in part but reversed its decision to authorize involuntary medication for M.T.H.
2024-02-13stateMontanaMontana Supreme CourtMcGrathhttps://law.justia.com/cases/federal/appellate-courts/ca6/22-6078/22-6078-2024-02-13.htmlIn re Onglyza (Saxagliptin) and Kombiglyze (Saxagliptin and Metformin) Products Liability Litigation2024-02-13T12:00:17-08:002024-02-13T12:00:17-08:00
In a multi-district litigation involving diabetes drug saxagliptin, the plaintiffs claimed that the drug caused their heart failure. They presented a single expert to show the drug could cause heart failure. After a Daubert hearing and expert motions, the United States Court of Appeals for the Sixth Circuit found that the expert's testimony was unreliable due to methodological flaws and therefore excluded it. Subsequently, the district court granted summary judgment for the defendants, rejecting the plaintiffs' claim that other evidence created a genuine issue of material fact. The court also refused the plaintiffs' request for ninety days to find a replacement expert. On appeal, the plaintiffs challenged the district court's exclusion of their expert, its grant of summary judgment, and its refusal to give them more time to find another expert witness. The Court of Appeals affirmed the district court's decisions, stating that the plaintiffs' claims lacked merit. The court found that the expert's reliance on one study to the exclusion of all others was unreliable, that his use of animal data was unreliable due to his admitted lack of qualifications to analyze such studies, and that he did not reliably apply the Bradford Hill criteria - a scientific framework used to analyze whether an association between two variables is causal. The court also found that all jurisdictions require expert testimony to show general causation in complex medical cases such as this one. As the plaintiffs failed to identify a reliable general causation expert, the court granted summary judgment for the defendants. The court also found no good cause to grant the plaintiffs more time to find a replacement expert. <a href="https://law.justia.com/cases/federal/appellate-courts/ca6/22-6078/22-6078-2024-02-13.html" target="_blank">View "In re Onglyza (Saxagliptin) and Kombiglyze (Saxagliptin and Metformin) Products Liability Litigation" on Justia Law</a>
In a multi-district litigation involving diabetes drug saxagliptin, the plaintiffs claimed that the drug caused their heart failure. They presented a single expert to show the drug could cause heart failure. After a Daubert hearing and expert motions, the United States Court of Appeals for the Sixth Circuit found that the expert's testimony was unreliable due to methodological flaws and therefore excluded it. Subsequently, the district court granted summary judgment for the defendants, rejecting the plaintiffs' claim that other evidence created a genuine issue of material fact. The court also refused the plaintiffs' request for ninety days to find a replacement expert. On appeal, the plaintiffs challenged the district court's exclusion of their expert, its grant of summary judgment, and its refusal to give them more time to find another expert witness. The Court of Appeals affirmed the district court's decisions, stating that the plaintiffs' claims lacked merit. The court found that the expert's reliance on one study to the exclusion of all others was unreliable, that his use of animal data was unreliable due to his admitted lack of qualifications to analyze such studies, and that he did not reliably apply the Bradford Hill criteria - a scientific framework used to analyze whether an association between two variables is causal. The court also found that all jurisdictions require expert testimony to show general causation in complex medical cases such as this one. As the plaintiffs failed to identify a reliable general causation expert, the court granted summary judgment for the defendants. The court also found no good cause to grant the plaintiffs more time to find a replacement expert.
2024-02-13federalUS Court of Appeals for the Sixth CircuitNALBANDIANhttps://law.justia.com/cases/california/court-of-appeal/2024/b316529.htmlGardena Hospital, L.P. v. Baass2024-02-09T14:01:04-08:002024-02-09T14:01:04-08:00
In this case, Gardena Hospital in California appealed a decision regarding its reporting of patient days for the purpose of calculating Medi-Cal reimbursement. The controversy centered around whether "bed hold" days — days when a patient is not physically in the hospital's subacute section but is expected to return — should be included in the reported patient days. If these days were included, it would result in a smaller per diem reimbursement to the hospital by the state. The hospital argued that bed hold days should be excluded, pointing to the Accounting and Reporting Manual for California Hospitals (the "Hospital Manual"), which does not specifically mention bed holds. The state, on the other hand, referred to the Accounting and Reporting Manual for California Long-Term Care Facilities (the "Long-Term Manual"), which specifically states that bed hold days should be included in total patient days.
The Court of Appeal of the State of California, Second Appellate District, Division Eight ruled in favor of the state, affirming the lower court's decision. The court held that where two state manuals guide health care facility accounting, the one that specifically addresses the issue at hand — in this case, the Long-Term Manual's explicit reference to bed holds — governs. The court reasoned that the specific provision controls the general one and can be regarded as a correction to it. Thus, according to this holding, Gardena Hospital must include bed hold days in its reported patient days for the calculation of Medi-Cal reimbursement. <a href="https://law.justia.com/cases/california/court-of-appeal/2024/b316529.html" target="_blank">View "Gardena Hospital, L.P. v. Baass" on Justia Law</a>
In this case, Gardena Hospital in California appealed a decision regarding its reporting of patient days for the purpose of calculating Medi-Cal reimbursement. The controversy centered around whether "bed hold" days — days when a patient is not physically in the hospital's subacute section but is expected to return — should be included in the reported patient days. If these days were included, it would result in a smaller per diem reimbursement to the hospital by the state. The hospital argued that bed hold days should be excluded, pointing to the Accounting and Reporting Manual for California Hospitals (the "Hospital Manual"), which does not specifically mention bed holds. The state, on the other hand, referred to the Accounting and Reporting Manual for California Long-Term Care Facilities (the "Long-Term Manual"), which specifically states that bed hold days should be included in total patient days.
The Court of Appeal of the State of California, Second Appellate District, Division Eight ruled in favor of the state, affirming the lower court's decision. The court held that where two state manuals guide health care facility accounting, the one that specifically addresses the issue at hand — in this case, the Long-Term Manual's explicit reference to bed holds — governs. The court reasoned that the specific provision controls the general one and can be regarded as a correction to it. Thus, according to this holding, Gardena Hospital must include bed hold days in its reported patient days for the calculation of Medi-Cal reimbursement.
2024-02-09stateCaliforniaCalifornia Courts of AppealWILEYhttps://law.justia.com/cases/federal/appellate-courts/ca10/22-5107/22-5107-2024-02-09.htmlCline v. Clinical Perfusion Systems2024-02-09T08:02:43-08:002024-02-09T08:02:43-08:00
The United States Court of Appeals for the Tenth Circuit reviewed the dismissal of a case involving Charles Cline, who was terminated by Clinical Perfusion Systems, Inc. after a medical emergency led to an extended hospital stay. Cline brought forward disability discrimination claims under the Rehabilitation Act, the Affordable Care Act (ACA), and the Oklahoma AntiDiscrimination Act (OADA); and age discrimination claims under the OADA. The court concluded that Cline was unable to establish a disability discrimination claim as he failed to plausibly allege that he could perform his job functions with a reasonable accommodation by his employer. The court also disagreed with the district court's dismissal of Cline's age discrimination claim, arguing that Cline had sufficiently alleged that age was a but-for cause of his termination. Therefore, the court affirmed the dismissal of Cline's disability discrimination claims, reversed the dismissal of his age discrimination claim, and remanded the case for further proceedings. <a href="https://law.justia.com/cases/federal/appellate-courts/ca10/22-5107/22-5107-2024-02-09.html" target="_blank">View "Cline v. Clinical Perfusion Systems" on Justia Law</a>
The United States Court of Appeals for the Tenth Circuit reviewed the dismissal of a case involving Charles Cline, who was terminated by Clinical Perfusion Systems, Inc. after a medical emergency led to an extended hospital stay. Cline brought forward disability discrimination claims under the Rehabilitation Act, the Affordable Care Act (ACA), and the Oklahoma AntiDiscrimination Act (OADA); and age discrimination claims under the OADA. The court concluded that Cline was unable to establish a disability discrimination claim as he failed to plausibly allege that he could perform his job functions with a reasonable accommodation by his employer. The court also disagreed with the district court's dismissal of Cline's age discrimination claim, arguing that Cline had sufficiently alleged that age was a but-for cause of his termination. Therefore, the court affirmed the dismissal of Cline's disability discrimination claims, reversed the dismissal of his age discrimination claim, and remanded the case for further proceedings.
2024-02-09federalUS Court of Appeals for the Tenth CircuitEBELhttps://law.justia.com/cases/iowa/supreme-court/2024/22-0576.htmlJorgensen v. Smith2024-02-09T07:03:23-08:002024-02-09T07:03:23-08:00
In this case, Charlene and Michael Jorgensen sued Dr. Adam Smith, his professional corporation (Adam Smith, M.D., P.C.), and Tri-State Specialists, L.L.P., a clinic that employed Dr. Smith, after Charlene underwent surgeries in 2016 and 2018 that they allege were botched by Dr. Smith. They specifically claim that Tri-State was negligent in retaining Dr. Smith despite knowledge of his unfitness to practice surgery. The Supreme Court of Iowa considered whether the Jorgensens were required to produce a "certificate of merit affidavit" containing an expert’s opinion that the clinic had breached the applicable standard of care by retaining Dr. Smith, under Iowa Code section 147.140 (2018). The court found that this requirement did not apply to the Jorgensens' claim of negligent retention. While Tri-State is considered a "health care provider" as per the definition in the Iowa Code, the language of the statute requiring a certificate of merit refers to negligence in the practice of a profession, occupation, or in patient care. The court concluded that in the context of section 147.140, the term "occupation" does not encompass the activities of entities such as Tri-State. Therefore, the court affirmed the lower court's decision denying Tri-State's motion for summary judgment. <a href="https://law.justia.com/cases/iowa/supreme-court/2024/22-0576.html" target="_blank">View "Jorgensen v. Smith" on Justia Law</a>
In this case, Charlene and Michael Jorgensen sued Dr. Adam Smith, his professional corporation (Adam Smith, M.D., P.C.), and Tri-State Specialists, L.L.P., a clinic that employed Dr. Smith, after Charlene underwent surgeries in 2016 and 2018 that they allege were botched by Dr. Smith. They specifically claim that Tri-State was negligent in retaining Dr. Smith despite knowledge of his unfitness to practice surgery. The Supreme Court of Iowa considered whether the Jorgensens were required to produce a "certificate of merit affidavit" containing an expert’s opinion that the clinic had breached the applicable standard of care by retaining Dr. Smith, under Iowa Code section 147.140 (2018). The court found that this requirement did not apply to the Jorgensens' claim of negligent retention. While Tri-State is considered a "health care provider" as per the definition in the Iowa Code, the language of the statute requiring a certificate of merit refers to negligence in the practice of a profession, occupation, or in patient care. The court concluded that in the context of section 147.140, the term "occupation" does not encompass the activities of entities such as Tri-State. Therefore, the court affirmed the lower court's decision denying Tri-State's motion for summary judgment.
2024-02-09stateIowaIowa Supreme CourtMayhttps://law.justia.com/cases/federal/appellate-courts/ca11/22-10614/22-10614-2024-02-08.htmlJumlist v. Prime Insurance Co.2024-02-08T10:32:39-08:002024-02-08T10:32:39-08:00
In the United States Court of Appeals for the Eleventh Circuit, the Court reviewed a case involving the estates of two patients who passed away after undergoing liposuction procedures at CJL Healthcare, LLC in Georgia. After the patients' deaths, their estates filed lawsuits against the clinic and its doctor. The clinic's insurer, Prime Insurance Co., defended the clinic under a reservation of rights but ultimately withdrew its defense after the costs of defending the lawsuits exhausted the insurance coverage.
The estates of the patients and the clinic then filed a lawsuit against the insurers, Prime Insurance Co., Prime Holdings Insurance Services, and Evolution Insurance Brokers, claiming they had breached their duties, contract, and acted negligently. They also claimed the insurers had unlawfully sold surplus lines insurance. The district court dismissed the case, and the plaintiffs appealed.
The Court of Appeals affirmed the district court's decision. The Court held that the policy unambiguously provided a $50,000 limit for a single professional liability claim and a $100,000 aggregate limit for all claims. The Court further held that the insurers' duty to defend the clinic ended when the policy limits were exhausted by payment of damages and claim expenses. The Court also affirmed the district court's finding that the Georgia Surplus Lines Insurance Act did not provide a private cause of action for the unauthorized sale of surplus lines insurance. <a href="https://law.justia.com/cases/federal/appellate-courts/ca11/22-10614/22-10614-2024-02-08.html" target="_blank">View "Jumlist v. Prime Insurance Co." on Justia Law</a>
In the United States Court of Appeals for the Eleventh Circuit, the Court reviewed a case involving the estates of two patients who passed away after undergoing liposuction procedures at CJL Healthcare, LLC in Georgia. After the patients' deaths, their estates filed lawsuits against the clinic and its doctor. The clinic's insurer, Prime Insurance Co., defended the clinic under a reservation of rights but ultimately withdrew its defense after the costs of defending the lawsuits exhausted the insurance coverage.
The estates of the patients and the clinic then filed a lawsuit against the insurers, Prime Insurance Co., Prime Holdings Insurance Services, and Evolution Insurance Brokers, claiming they had breached their duties, contract, and acted negligently. They also claimed the insurers had unlawfully sold surplus lines insurance. The district court dismissed the case, and the plaintiffs appealed.
The Court of Appeals affirmed the district court's decision. The Court held that the policy unambiguously provided a $50,000 limit for a single professional liability claim and a $100,000 aggregate limit for all claims. The Court further held that the insurers' duty to defend the clinic ended when the policy limits were exhausted by payment of damages and claim expenses. The Court also affirmed the district court's finding that the Georgia Surplus Lines Insurance Act did not provide a private cause of action for the unauthorized sale of surplus lines insurance.
2024-02-08federalUS Court of Appeals for the Eleventh CircuitCARNEShttps://law.justia.com/cases/south-dakota/supreme-court/2024/30207.htmlOrthopedic Institute v. Sanford Health Plan, Inc.2024-02-08T08:10:17-08:002024-02-08T08:10:17-08:00
In this case, a group of healthcare providers (Providers) sued the insurer Sanford Health Plan, Inc. (SHP) for excluding them from participating in some of its health benefit plans. The Providers argued that according to South Dakota’s “Any Willing Provider” law (SDCL 58-17J-2), they had the right to participate as panel providers in all of SHP's plans. The law stipulates that a health insurer cannot block patient choice by excluding a willing and qualified healthcare provider from its panel of providers if the provider is within the geographic coverage area of the health benefit plan. The circuit court determined that the law did not permit SHP to exclude a qualified and willing healthcare provider from participating in every health benefit plan it offered, granting summary judgment in favor of the Providers.
The Supreme Court of the State of South Dakota affirmed the circuit court's decision. It interpreted the law as plan-specific, meaning an insurer may not exclude any willing and fully qualified provider from any of its plans or from any tier within a plan. It also clarified that an insurer may still exclude providers from plans if they do not meet the statutory requirements for participation as a panel provider. The court concluded that, according to the law, SHP could not exclude the Providers from participating in its TRUE Plan or Tier 1 of the PLUS Plan, thus affirming the circuit court's granting of summary judgment in favor of the Providers. <a href="https://law.justia.com/cases/south-dakota/supreme-court/2024/30207.html" target="_blank">View "Orthopedic Institute v. Sanford Health Plan, Inc." on Justia Law</a>
In this case, a group of healthcare providers (Providers) sued the insurer Sanford Health Plan, Inc. (SHP) for excluding them from participating in some of its health benefit plans. The Providers argued that according to South Dakota’s “Any Willing Provider” law (SDCL 58-17J-2), they had the right to participate as panel providers in all of SHP's plans. The law stipulates that a health insurer cannot block patient choice by excluding a willing and qualified healthcare provider from its panel of providers if the provider is within the geographic coverage area of the health benefit plan. The circuit court determined that the law did not permit SHP to exclude a qualified and willing healthcare provider from participating in every health benefit plan it offered, granting summary judgment in favor of the Providers.
The Supreme Court of the State of South Dakota affirmed the circuit court's decision. It interpreted the law as plan-specific, meaning an insurer may not exclude any willing and fully qualified provider from any of its plans or from any tier within a plan. It also clarified that an insurer may still exclude providers from plans if they do not meet the statutory requirements for participation as a panel provider. The court concluded that, according to the law, SHP could not exclude the Providers from participating in its TRUE Plan or Tier 1 of the PLUS Plan, thus affirming the circuit court's granting of summary judgment in favor of the Providers.
2024-02-07stateSouth DakotaSouth Dakota Supreme CourtJensenhttps://law.justia.com/cases/oklahoma/supreme-court/2024/120500.htmlIN RE GUARDIANSHIP OF L.A.C.2024-02-06T09:37:09-08:002024-02-06T09:37:09-08:00
In Oklahoma, a woman suffering from various progressive, degenerative diseases executed an advance directive instructing that her life not be extended by life-sustaining treatment, including artificially administered nutrition and hydration. Later, she was hospitalized and a PEG tube was inserted to provide artificially administered nutrition and hydration, contrary to the terms of her advance directive. The woman's sister and children disagreed on whether to keep the PEG tube in place or follow the instructions in the advance directive. The Supreme Court of the State of Oklahoma held that an incapacitated or incompetent person retains the legal right to revoke their advance directive and that revocation of an advance directive must be proven by clear and convincing evidence. The court affirmed the decision of the lower court, which had found that the woman had not revoked her advance directive and that the insertion of the PEG tube violated the terms of her advance directive. <a href="https://law.justia.com/cases/oklahoma/supreme-court/2024/120500.html" target="_blank">View "IN RE GUARDIANSHIP OF L.A.C." on Justia Law</a>
In Oklahoma, a woman suffering from various progressive, degenerative diseases executed an advance directive instructing that her life not be extended by life-sustaining treatment, including artificially administered nutrition and hydration. Later, she was hospitalized and a PEG tube was inserted to provide artificially administered nutrition and hydration, contrary to the terms of her advance directive. The woman's sister and children disagreed on whether to keep the PEG tube in place or follow the instructions in the advance directive. The Supreme Court of the State of Oklahoma held that an incapacitated or incompetent person retains the legal right to revoke their advance directive and that revocation of an advance directive must be proven by clear and convincing evidence. The court affirmed the decision of the lower court, which had found that the woman had not revoked her advance directive and that the insertion of the PEG tube violated the terms of her advance directive.
2024-02-06stateOklahomaOklahoma Supreme CourtKEELEYhttps://law.justia.com/cases/federal/appellate-courts/ca8/23-1522/23-1522-2024-02-06.htmlUnited States v. Heard2024-02-06T08:31:11-08:002024-02-06T08:31:11-08:00
In the case before the United States Court of Appeals For the Eighth Circuit, the defendant, Kaycee Heard, appealed his 180-month sentence for involvement in a drug-trafficking conspiracy that transported oxycodone and fentanyl pills from Michigan to North Dakota for distribution. Heard pleaded guilty to conspiring to distribute and possess with intent to distribute controlled substances, and his sentence exceeded his Guidelines range of 135 to 168 months. Heard's appeal centered around three key claims: the district court miscalculated his criminal history score, wrongly applied a Guidelines enhancement for his role in the conspiracy, and issued an unreasonable sentence.
The Court of Appeals rejected all three of Heard's claims. First, the court found that the district court was correct to assess a criminal history point for a two-year probation term Heard served under Michigan’s Holmes Youthful Trainee Act. Despite Heard's argument that this sentence should not have counted towards his criminal history score as no conviction was entered and the underlying charges were dismissed, the Appeals Court ruled that Heard's admission of guilt by pleading guilty meant the probation term was correctly counted as a "prior sentence".
Second, the Appeals Court upheld the district court's application of a three-level enhancement for Heard's role in the conspiracy, finding that Heard had exhibited sufficient managerial or supervisory authority to warrant this enhancement. The court pointed to evidence that Heard had recruited co-conspirators, used a co-conspirator’s apartment as a stash house, directed a co-conspirator to travel to get pills for distribution, and received proceeds from the pills’ sale.
Finally, the court found Heard's sentence to be both procedurally and substantively reasonable. The district court had varied up from the Guidelines range based on Heard's conduct in pretrial detention, including his participation in a prison riot and assaults on two inmates. The Appeals Court found no clear error in the district court's determination that Heard had participated in the riot, and concluded that the 180-month sentence was within the realm of reasonableness given Heard's drug trafficking and pretrial detention misconduct. The court also rejected Heard's claim that his sentence created unwarranted disparities with his co-conspirators, stating that the need to avoid unwarranted sentence disparities refers to national disparities, not differences among co-conspirators. The court therefore affirmed the district court’s judgment. <a href="https://law.justia.com/cases/federal/appellate-courts/ca8/23-1522/23-1522-2024-02-06.html" target="_blank">View "United States v. Heard" on Justia Law</a>
In the case before the United States Court of Appeals For the Eighth Circuit, the defendant, Kaycee Heard, appealed his 180-month sentence for involvement in a drug-trafficking conspiracy that transported oxycodone and fentanyl pills from Michigan to North Dakota for distribution. Heard pleaded guilty to conspiring to distribute and possess with intent to distribute controlled substances, and his sentence exceeded his Guidelines range of 135 to 168 months. Heard's appeal centered around three key claims: the district court miscalculated his criminal history score, wrongly applied a Guidelines enhancement for his role in the conspiracy, and issued an unreasonable sentence.
The Court of Appeals rejected all three of Heard's claims. First, the court found that the district court was correct to assess a criminal history point for a two-year probation term Heard served under Michigan’s Holmes Youthful Trainee Act. Despite Heard's argument that this sentence should not have counted towards his criminal history score as no conviction was entered and the underlying charges were dismissed, the Appeals Court ruled that Heard's admission of guilt by pleading guilty meant the probation term was correctly counted as a "prior sentence".
Second, the Appeals Court upheld the district court's application of a three-level enhancement for Heard's role in the conspiracy, finding that Heard had exhibited sufficient managerial or supervisory authority to warrant this enhancement. The court pointed to evidence that Heard had recruited co-conspirators, used a co-conspirator’s apartment as a stash house, directed a co-conspirator to travel to get pills for distribution, and received proceeds from the pills’ sale.
Finally, the court found Heard's sentence to be both procedurally and substantively reasonable. The district court had varied up from the Guidelines range based on Heard's conduct in pretrial detention, including his participation in a prison riot and assaults on two inmates. The Appeals Court found no clear error in the district court's determination that Heard had participated in the riot, and concluded that the 180-month sentence was within the realm of reasonableness given Heard's drug trafficking and pretrial detention misconduct. The court also rejected Heard's claim that his sentence created unwarranted disparities with his co-conspirators, stating that the need to avoid unwarranted sentence disparities refers to national disparities, not differences among co-conspirators. The court therefore affirmed the district court’s judgment.
2024-02-06federalUS Court of Appeals for the Eighth CircuitKobeshttps://law.justia.com/cases/federal/appellate-courts/ca2/20-3894/20-3894-2024-02-06.htmlPorter v. Dartmouth-Hitchcock Medical Center2024-02-06T07:30:14-08:002024-02-06T07:30:14-08:00
The plaintiff, Dr. Misty Blanchette Porter, had been a staff physician at Dartmouth-Hitchcock Medical Center (DHMC) since 1996. She specialized in reproductive medicine and was highly regarded in her field. In November 2015, Dr. Porter developed a medical condition that required her to take a medical leave of absence and subsequently work reduced hours. In 2017, DHMC decided to close the Reproductive Endocrinology and Infertility Division (REI) where Dr. Porter worked and terminate her employment. Dr. Porter claimed that her termination was due to her disability and her whistleblowing activity, in violation of the Americans with Disabilities Act (ADA), the Rehabilitation Act, and the laws of Vermont and New Hampshire.
The United States Court of Appeals for the Second Circuit found that the district court failed to properly apply summary judgment standards when it reviewed the evidence on pretext and causation. Thus, it should not have granted summary judgment on the allegations that the plaintiff was terminated due to her disability or whistleblowing. However, it affirmed the dismissal of the claims involving alleged discrimination related to a reasonable accommodation for the disability. The case was affirmed in part and vacated and remanded in part. <a href="https://law.justia.com/cases/federal/appellate-courts/ca2/20-3894/20-3894-2024-02-06.html" target="_blank">View "Porter v. Dartmouth-Hitchcock Medical Center" on Justia Law</a>
The plaintiff, Dr. Misty Blanchette Porter, had been a staff physician at Dartmouth-Hitchcock Medical Center (DHMC) since 1996. She specialized in reproductive medicine and was highly regarded in her field. In November 2015, Dr. Porter developed a medical condition that required her to take a medical leave of absence and subsequently work reduced hours. In 2017, DHMC decided to close the Reproductive Endocrinology and Infertility Division (REI) where Dr. Porter worked and terminate her employment. Dr. Porter claimed that her termination was due to her disability and her whistleblowing activity, in violation of the Americans with Disabilities Act (ADA), the Rehabilitation Act, and the laws of Vermont and New Hampshire.
The United States Court of Appeals for the Second Circuit found that the district court failed to properly apply summary judgment standards when it reviewed the evidence on pretext and causation. Thus, it should not have granted summary judgment on the allegations that the plaintiff was terminated due to her disability or whistleblowing. However, it affirmed the dismissal of the claims involving alleged discrimination related to a reasonable accommodation for the disability. The case was affirmed in part and vacated and remanded in part.
2024-02-06federalUS Court of Appeals for the Second CircuitKearsehttps://law.justia.com/cases/georgia/supreme-court/2024/s22g1282.htmlKENNESTONE HOSPITAL, INC. v. EMORY UNIVERSITY2024-02-06T06:02:41-08:002024-02-06T06:02:41-08:00
The case revolves around Windy Hill Hospital's request to change from a long-term care hospital to a short-term care hospital in Georgia, without obtaining a new Certificate of Need (CON) from the Department of Community Health. The case addresses two preliminary questions: whether a CON confers a private right or a public right on a hospital, and the proper framework for interpreting the Department's CON regulations.
The Supreme Court of Georgia held that a CON confers a private right as it provides the individual, usually a corporate entity, with the right to operate a particular kind of hospital. This is because the right to use one's property in a particular way is a traditional property right. The Court also clarified the framework for interpreting administrative rules, stating that courts may defer to an agency's interpretation of its own rule only if the rule's meaning is ambiguous. In this case, the Court did not definitively determine if the Court of Appeals had applied this framework correctly in interpreting the Department's regulations relevant to this case.
The case was remanded to the Court of Appeals for further proceedings consistent with this opinion, without deciding several other issues that could be dispositive of this case. The Court did not rule on whether Windy Hill Hospital ever held a CON to operate as a long-term care hospital, whether the hospital's 1996 correspondence with the State Health Planning Agency constituted a "CON process", and whether any rights purportedly conferred by a CON ultimately vested. <a href="https://law.justia.com/cases/georgia/supreme-court/2024/s22g1282.html" target="_blank">View "KENNESTONE HOSPITAL, INC. v. EMORY UNIVERSITY" on Justia Law</a>
The case revolves around Windy Hill Hospital's request to change from a long-term care hospital to a short-term care hospital in Georgia, without obtaining a new Certificate of Need (CON) from the Department of Community Health. The case addresses two preliminary questions: whether a CON confers a private right or a public right on a hospital, and the proper framework for interpreting the Department's CON regulations.
The Supreme Court of Georgia held that a CON confers a private right as it provides the individual, usually a corporate entity, with the right to operate a particular kind of hospital. This is because the right to use one's property in a particular way is a traditional property right. The Court also clarified the framework for interpreting administrative rules, stating that courts may defer to an agency's interpretation of its own rule only if the rule's meaning is ambiguous. In this case, the Court did not definitively determine if the Court of Appeals had applied this framework correctly in interpreting the Department's regulations relevant to this case.
The case was remanded to the Court of Appeals for further proceedings consistent with this opinion, without deciding several other issues that could be dispositive of this case. The Court did not rule on whether Windy Hill Hospital ever held a CON to operate as a long-term care hospital, whether the hospital's 1996 correspondence with the State Health Planning Agency constituted a "CON process", and whether any rights purportedly conferred by a CON ultimately vested.
2024-02-06stateGeorgiaSupreme Court of GeorgiaPetersonhttps://law.justia.com/cases/federal/appellate-courts/ca1/22-1507/22-1507-2024-02-02.htmlLech v. Von Goeler2024-02-02T14:00:25-08:002024-02-02T14:00:25-08:00
A pregnant inmate, Lidia Lech, filed a lawsuit against several healthcare providers and staff at the Western Massachusetts Regional Women's Correctional Center (WCC), alleging that they ignored her serious medical symptoms and denied her requests to go to the hospital, resulting in the stillbirth of her baby. The district court permitted most of Lech's claims to proceed to trial, but granted summary judgment in favor of one of the correctional officers. The jury returned a verdict in favor of the defense. On appeal, the United States Court of Appeals for the First Circuit found that the district court abused its discretion in two evidentiary rulings. The first error was allowing the defense to use Lech's recorded phone calls to impugn her character for truthfulness. The second error was excluding testimony from Lech's friend, which would have corroborated her version of events. The court concluded that at least one of these evidentiary rulings was not harmless, vacated the jury verdict, and remanded for a new trial against most of the defendants. However, the court affirmed the district court's grant of summary judgment to the correctional officer, as well as the jury verdict in favor of one of the medical providers. <a href="https://law.justia.com/cases/federal/appellate-courts/ca1/22-1507/22-1507-2024-02-02.html" target="_blank">View "Lech v. Von Goeler" on Justia Law</a>
A pregnant inmate, Lidia Lech, filed a lawsuit against several healthcare providers and staff at the Western Massachusetts Regional Women's Correctional Center (WCC), alleging that they ignored her serious medical symptoms and denied her requests to go to the hospital, resulting in the stillbirth of her baby. The district court permitted most of Lech's claims to proceed to trial, but granted summary judgment in favor of one of the correctional officers. The jury returned a verdict in favor of the defense. On appeal, the United States Court of Appeals for the First Circuit found that the district court abused its discretion in two evidentiary rulings. The first error was allowing the defense to use Lech's recorded phone calls to impugn her character for truthfulness. The second error was excluding testimony from Lech's friend, which would have corroborated her version of events. The court concluded that at least one of these evidentiary rulings was not harmless, vacated the jury verdict, and remanded for a new trial against most of the defendants. However, the court affirmed the district court's grant of summary judgment to the correctional officer, as well as the jury verdict in favor of one of the medical providers.
2024-02-02federalUS Court of Appeals for the First CircuitRIKELMANhttps://law.justia.com/cases/federal/appellate-courts/ca4/19-4761/19-4761-2024-02-02.htmlUnited States v. Joel Smithers2024-02-02T11:32:18-08:002024-02-02T11:32:18-08:00
The case involves Joel Smithers, who was a doctor of osteopathy and was convicted on 861 counts associated with his opioid prescription practices. He was sentenced to a total of 480 months in prison. Smithers was charged under 21 U.S.C. § 841(a)(1), which makes it unlawful for any person knowingly or intentionally to manufacture, distribute, or dispense a controlled substance without authorization. Authorization is defined by Drug Enforcement Agency regulations as a prescription issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice. Following his conviction, the Supreme Court in Ruan v. United States clarified the mens rea required to convict someone of unauthorized dispensing or distributing of a controlled substance. The United States Court of Appeals for the Fourth Circuit found that, in light of the Ruan decision, Smithers' jury instructions were incorrect, and the errors were not harmless. Therefore, the court vacated the convictions and remanded the case to the district court for a new trial. <a href="https://law.justia.com/cases/federal/appellate-courts/ca4/19-4761/19-4761-2024-02-02.html" target="_blank">View "United States v. Joel Smithers" on Justia Law</a>
The case involves Joel Smithers, who was a doctor of osteopathy and was convicted on 861 counts associated with his opioid prescription practices. He was sentenced to a total of 480 months in prison. Smithers was charged under 21 U.S.C. § 841(a)(1), which makes it unlawful for any person knowingly or intentionally to manufacture, distribute, or dispense a controlled substance without authorization. Authorization is defined by Drug Enforcement Agency regulations as a prescription issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice. Following his conviction, the Supreme Court in Ruan v. United States clarified the mens rea required to convict someone of unauthorized dispensing or distributing of a controlled substance. The United States Court of Appeals for the Fourth Circuit found that, in light of the Ruan decision, Smithers' jury instructions were incorrect, and the errors were not harmless. Therefore, the court vacated the convictions and remanded the case to the district court for a new trial.
2024-02-02federalUS Court of Appeals for the Fourth CircuitGREGORYhttps://law.justia.com/cases/california/court-of-appeal/2024/a165558m.htmlGilead Tenofovir Cases2024-02-01T12:01:20-08:002024-02-01T12:01:20-08:00
In the case before the Court of Appeal of the State of California First Appellate District Division Four, the plaintiffs, thousands of individuals who suffered adverse effects from the use of a prescription drug, TDF, made by Gilead Life Sciences, Inc., brought a claim of negligence and fraudulent concealment against Gilead. The plaintiffs alleged that while Gilead was developing TDF, it discovered a similar, but chemically distinct and safer potential drug, TAF. However, Gilead allegedly decided to defer development of TAF because it was concerned that the immediate development of TAF would reduce its financial return from TDF. Gilead sought summary judgment on the ground that in order to recover for harm caused by a manufactured product, the plaintiff must prove that the product was defective. The trial court denied Gilead's motion for summary judgment in its entirety.
In reviewing this case, the appellate court held that the trial court was correct to deny Gilead's motion for summary judgment on the negligence claim. The court reasoned that a manufacturer's duty of reasonable care can extend beyond the duty not to market a defective product. The court found that the factual basis of the plaintiffs' claim was that Gilead knew TAF was safer than TDF, but decided to defer development of TAF to maximize its profits. The court held that if Gilead's decision to postpone development of TAF indeed breached its duty of reasonable care to users of TDF, then Gilead could potentially be held liable.
However, the appellate court reversed the trial court's decision regarding plaintiffs' claim for fraudulent concealment. The court concluded that Gilead's duty to plaintiffs did not extend to the disclosure of information about TAF, as it was not available as an alternative treatment for HIV/AIDS at the time the alleged concealment occurred. Consequently, the court granted in part and denied in part Gilead's petition for a writ of mandate, directing the superior court to vacate its order denying Gilead's motion for summary judgment and to enter a new order denying summary adjudication of the negligence claim but granting summary adjudication of the fraudulent concealment claim. <a href="https://law.justia.com/cases/california/court-of-appeal/2024/a165558m.html" target="_blank">View "Gilead Tenofovir Cases" on Justia Law</a>
In the case before the Court of Appeal of the State of California First Appellate District Division Four, the plaintiffs, thousands of individuals who suffered adverse effects from the use of a prescription drug, TDF, made by Gilead Life Sciences, Inc., brought a claim of negligence and fraudulent concealment against Gilead. The plaintiffs alleged that while Gilead was developing TDF, it discovered a similar, but chemically distinct and safer potential drug, TAF. However, Gilead allegedly decided to defer development of TAF because it was concerned that the immediate development of TAF would reduce its financial return from TDF. Gilead sought summary judgment on the ground that in order to recover for harm caused by a manufactured product, the plaintiff must prove that the product was defective. The trial court denied Gilead's motion for summary judgment in its entirety.
In reviewing this case, the appellate court held that the trial court was correct to deny Gilead's motion for summary judgment on the negligence claim. The court reasoned that a manufacturer's duty of reasonable care can extend beyond the duty not to market a defective product. The court found that the factual basis of the plaintiffs' claim was that Gilead knew TAF was safer than TDF, but decided to defer development of TAF to maximize its profits. The court held that if Gilead's decision to postpone development of TAF indeed breached its duty of reasonable care to users of TDF, then Gilead could potentially be held liable.
However, the appellate court reversed the trial court's decision regarding plaintiffs' claim for fraudulent concealment. The court concluded that Gilead's duty to plaintiffs did not extend to the disclosure of information about TAF, as it was not available as an alternative treatment for HIV/AIDS at the time the alleged concealment occurred. Consequently, the court granted in part and denied in part Gilead's petition for a writ of mandate, directing the superior court to vacate its order denying Gilead's motion for summary judgment and to enter a new order denying summary adjudication of the negligence claim but granting summary adjudication of the fraudulent concealment claim.
2024-02-01stateCaliforniaCalifornia Courts of AppealGOLDMANhttps://law.justia.com/cases/federal/appellate-courts/ca9/22-35218/22-35218-2024-02-01.htmlMANEY V. BROWN2024-02-01T09:30:59-08:002024-02-01T09:30:59-08:00
A group of current and former inmates, or their representatives, filed a class action lawsuit against Kate Brown, the Governor of Oregon, and Patrick Allen, the Director of the Oregon Health Authority, claiming that the state's COVID-19 vaccine rollout plan, which prioritized corrections officers over inmates, violated their Eighth Amendment rights. The defendants moved to dismiss the claim, asserting immunity under the Public Readiness and Emergency Preparedness (PREP) Act. The district court denied the motion, and the defendants appealed.
The United States Court of Appeals for the Ninth Circuit reversed the district court's decision, finding that the defendants were immune from liability for the vaccine prioritization claim under the PREP Act. The court held that the statutory requirements for PREP Act immunity were met because the "administration" of a covered countermeasure includes prioritization of that countermeasure when its supply is limited. The court further concluded that the PREP Act's provisions extend immunity to persons who make policy-level decisions regarding the administration or use of covered countermeasures. The court also held that the PREP Act provides immunity from suit and liability for constitutional claims brought under 42 U.S.C. § 1983, even if those claims are federal constitutional claims. <a href="https://law.justia.com/cases/federal/appellate-courts/ca9/22-35218/22-35218-2024-02-01.html" target="_blank">View "MANEY V. BROWN" on Justia Law</a>
A group of current and former inmates, or their representatives, filed a class action lawsuit against Kate Brown, the Governor of Oregon, and Patrick Allen, the Director of the Oregon Health Authority, claiming that the state's COVID-19 vaccine rollout plan, which prioritized corrections officers over inmates, violated their Eighth Amendment rights. The defendants moved to dismiss the claim, asserting immunity under the Public Readiness and Emergency Preparedness (PREP) Act. The district court denied the motion, and the defendants appealed.
The United States Court of Appeals for the Ninth Circuit reversed the district court's decision, finding that the defendants were immune from liability for the vaccine prioritization claim under the PREP Act. The court held that the statutory requirements for PREP Act immunity were met because the "administration" of a covered countermeasure includes prioritization of that countermeasure when its supply is limited. The court further concluded that the PREP Act's provisions extend immunity to persons who make policy-level decisions regarding the administration or use of covered countermeasures. The court also held that the PREP Act provides immunity from suit and liability for constitutional claims brought under 42 U.S.C. § 1983, even if those claims are federal constitutional claims.
2024-02-01federalUS Court of Appeals for the Ninth CircuitSunghttps://law.justia.com/cases/maine/supreme-court/2024/2024-me-16.htmlIn re Child of Barni A.2024-01-31T12:34:41-08:002024-01-31T12:34:41-08:00
In this case, the appellant, Barni A., appealed against an order from the District Court in Lewiston, Maine, terminating her parental rights to her older child. The child was born prematurely with a genetic abnormality that led to several medical issues, including tumors on his brain, leading to seizures and affecting his executive functioning, vision, and visual processing. The child qualified for 24/7 private nursing care under Maine's Medicaid program, MaineCare, but never received it. Barni A. argued that the State of Maine's failure to provide the child with the required care resulted in the trial court erroneously finding her unfit because she could not address her child's complicated medical needs.
The Maine Supreme Judicial Court agreed with Barni A., stating that the trial court's findings did not address important issues that needed to be answered before determining whether the record supports a finding by clear and convincing evidence that she is unfit. The court noted that the child's right to full-time private nursing care under federal and state law had not been provided by the Department of Health and Human Services, and this failure affected the mother's ability to care for the child. The court further explained that while the mother had made significant progress in dealing with her personal challenges, her visitation time with the child was substantially limited, and she was never afforded the assistance necessary to care for her child.
The court therefore vacated the judgment and remanded the matter to the trial court, instructing it to consider whether the mother has an intellectual disability, whether the mother is or would be unfit regardless of the Department's failure to meet its MaineCare obligation regarding skilled nursing care, and whether there is an alternative to termination of the mother's parental rights that meets the best interest of the child. <a href="https://law.justia.com/cases/maine/supreme-court/2024/2024-me-16.html" target="_blank">View "In re Child of Barni A." on Justia Law</a>
In this case, the appellant, Barni A., appealed against an order from the District Court in Lewiston, Maine, terminating her parental rights to her older child. The child was born prematurely with a genetic abnormality that led to several medical issues, including tumors on his brain, leading to seizures and affecting his executive functioning, vision, and visual processing. The child qualified for 24/7 private nursing care under Maine's Medicaid program, MaineCare, but never received it. Barni A. argued that the State of Maine's failure to provide the child with the required care resulted in the trial court erroneously finding her unfit because she could not address her child's complicated medical needs.
The Maine Supreme Judicial Court agreed with Barni A., stating that the trial court's findings did not address important issues that needed to be answered before determining whether the record supports a finding by clear and convincing evidence that she is unfit. The court noted that the child's right to full-time private nursing care under federal and state law had not been provided by the Department of Health and Human Services, and this failure affected the mother's ability to care for the child. The court further explained that while the mother had made significant progress in dealing with her personal challenges, her visitation time with the child was substantially limited, and she was never afforded the assistance necessary to care for her child.
The court therefore vacated the judgment and remanded the matter to the trial court, instructing it to consider whether the mother has an intellectual disability, whether the mother is or would be unfit regardless of the Department's failure to meet its MaineCare obligation regarding skilled nursing care, and whether there is an alternative to termination of the mother's parental rights that meets the best interest of the child.
2024-01-31stateMaineMaine Supreme Judicial CourtJABARhttps://law.justia.com/cases/maine/supreme-court/2024/2024-me-12.htmlState v. Tripp2024-01-30T09:34:27-08:002024-01-30T09:34:27-08:00
The Supreme Judicial Court of Maine upheld the conviction of Ralph A. Tripp Jr., who was found guilty of several drug-trafficking offenses, possession of a firearm by a prohibited person, and criminal forfeiture of property. Tripp appealed on the grounds that he should be immune from prosecution for his drug-related offenses, that there were errors in the State's conduct during its opening statement and closing argument, and that the jury was not provided with clear instructions. The court ruled that Maine’s immunity statutes did not apply in this case, that any prosecutorial error did not affect Tripp’s substantial rights, and that the trial court sufficiently corrected any potential confusion stemming from its initial jury instructions. The court therefore affirmed the judgment. The case involved Tripp and his wife, Amanda Tripp, who resided in a rooming house in Bangor. After the Tripps moved in, residents noticed an increase in visitors, found hypodermic needles outside the building, and frequently observed the Tripps letting visitors into the building. On one occasion, Tripp called 9-1-1 to report a person unconscious in one of the shared bathrooms of the rooming house. The person was later pronounced dead, and the cause of death was determined to be acute intoxication from multiple drugs. When the police executed a search warrant for Tripp’s room, they seized a handgun, various drugs, drug paraphernalia, and cash. Tripp was subsequently charged with several offenses. <a href="https://law.justia.com/cases/maine/supreme-court/2024/2024-me-12.html" target="_blank">View "State v. Tripp" on Justia Law</a>
The Supreme Judicial Court of Maine upheld the conviction of Ralph A. Tripp Jr., who was found guilty of several drug-trafficking offenses, possession of a firearm by a prohibited person, and criminal forfeiture of property. Tripp appealed on the grounds that he should be immune from prosecution for his drug-related offenses, that there were errors in the State's conduct during its opening statement and closing argument, and that the jury was not provided with clear instructions. The court ruled that Maine’s immunity statutes did not apply in this case, that any prosecutorial error did not affect Tripp’s substantial rights, and that the trial court sufficiently corrected any potential confusion stemming from its initial jury instructions. The court therefore affirmed the judgment. The case involved Tripp and his wife, Amanda Tripp, who resided in a rooming house in Bangor. After the Tripps moved in, residents noticed an increase in visitors, found hypodermic needles outside the building, and frequently observed the Tripps letting visitors into the building. On one occasion, Tripp called 9-1-1 to report a person unconscious in one of the shared bathrooms of the rooming house. The person was later pronounced dead, and the cause of death was determined to be acute intoxication from multiple drugs. When the police executed a search warrant for Tripp’s room, they seized a handgun, various drugs, drug paraphernalia, and cash. Tripp was subsequently charged with several offenses.
2024-01-30stateMaineMaine Supreme Judicial CourtLAWRENCEhttps://law.justia.com/cases/federal/appellate-courts/ca8/23-1338/23-1338-2024-01-29.htmlUnited States v. Riaski2024-01-29T08:04:05-08:002024-01-29T08:04:05-08:00
In this appeal before the United States Court of Appeals For the Eighth Circuit, the defendant, Linda Riaski, who was convicted of one count of conspiracy to distribute methamphetamine and one count of possession of a firearm in furtherance of a drug trafficking crime, appealed the denial of her request for a hearing under Franks v. Delaware. The case involves a search warrant that was issued based on an affidavit prepared by Deputy Sheriff Jerry Brisky, who relied on information provided by a confidential informant (CI). The CI claimed to have observed Riaski packaging methamphetamine for distribution and to have seen Riaski with a black 9 millimeter handgun. The search of Riaski's residence resulted in the discovery of methamphetamine and firearms.
Riaski's appeal was based on the argument that the district court erred in denying her request for a Franks hearing to challenge the validity of the search warrant. She claimed that the affidavit supporting the search warrant was misleading because it omitted information about the CI’s credibility, her criminal history, her drug use, the financial arrangement between her and Deputy Brisky, and certain facts alleged in Riaski’s own affidavit.
The court affirmed the district court's decision, holding that Riaski failed to make a substantial preliminary showing that Deputy Brisky intentionally or recklessly omitted facts with the intent to mislead the issuing judge, and that the affidavit, even if supplemented by the omitted information, could still support a finding of probable cause. The court reasoned that the omitted information about the CI's criminal history and drug use would not have altered the probable cause determination, as the affidavit had already provided a basis for the CI’s reliability, disclosing that she previously had provided accurate information and had made controlled purchases under Brisky’s supervision. The court also found that the omission of the details and existence of the agreement between Brisky and the CI did not render the affidavit misleading. The judgment was affirmed. <a href="https://law.justia.com/cases/federal/appellate-courts/ca8/23-1338/23-1338-2024-01-29.html" target="_blank">View "United States v. Riaski" on Justia Law</a>
In this appeal before the United States Court of Appeals For the Eighth Circuit, the defendant, Linda Riaski, who was convicted of one count of conspiracy to distribute methamphetamine and one count of possession of a firearm in furtherance of a drug trafficking crime, appealed the denial of her request for a hearing under Franks v. Delaware. The case involves a search warrant that was issued based on an affidavit prepared by Deputy Sheriff Jerry Brisky, who relied on information provided by a confidential informant (CI). The CI claimed to have observed Riaski packaging methamphetamine for distribution and to have seen Riaski with a black 9 millimeter handgun. The search of Riaski's residence resulted in the discovery of methamphetamine and firearms.
Riaski's appeal was based on the argument that the district court erred in denying her request for a Franks hearing to challenge the validity of the search warrant. She claimed that the affidavit supporting the search warrant was misleading because it omitted information about the CI’s credibility, her criminal history, her drug use, the financial arrangement between her and Deputy Brisky, and certain facts alleged in Riaski’s own affidavit.
The court affirmed the district court's decision, holding that Riaski failed to make a substantial preliminary showing that Deputy Brisky intentionally or recklessly omitted facts with the intent to mislead the issuing judge, and that the affidavit, even if supplemented by the omitted information, could still support a finding of probable cause. The court reasoned that the omitted information about the CI's criminal history and drug use would not have altered the probable cause determination, as the affidavit had already provided a basis for the CI’s reliability, disclosing that she previously had provided accurate information and had made controlled purchases under Brisky’s supervision. The court also found that the omission of the details and existence of the agreement between Brisky and the CI did not render the affidavit misleading. The judgment was affirmed.
2024-01-29federalUS Court of Appeals for the Eighth CircuitWOLLMANhttps://law.justia.com/cases/federal/appellate-courts/ca2/22-2928/22-2928-2024-01-29.htmlMcCracken v. Verisma Systems, Inc.2024-01-29T08:00:31-08:002024-01-29T08:00:31-08:00
In this case, a group of patients initiated a class action lawsuit against various hospitals and vendors who provide medical record production services to the hospitals. The plaintiffs alleged that the hospitals and vendors were involved in an illegal kickback scheme, where the vendors charged patients excessive prices for their medical records and used the profits to offer free and discounted pages to the hospitals for other types of medical records. The plaintiffs alleged violations of New York Public Health Law (PHL) § 18(2)(e) (which restricts the price that can be charged for medical records), New York General Business Law (GBL) § 349 (which prohibits deceptive business practices), and unjust enrichment. However, the New York Court of Appeals had previously ruled in Ortiz v. Ciox Health LLC that PHL § 18(2)(e) does not provide a private right of action.
The United States Court of Appeals for the Second Circuit affirmed the district court's dismissal of all the plaintiffs' claims. It found that the patients' GBL § 349 and unjust enrichment claims were essentially repackaging their PHL § 18(2)(e) claims, and therefore not cognizable as they attempted to circumvent the Ortiz ruling. The court also held that the plaintiffs failed to allege any actionable wrongs independent of the requirements of PHL § 18(2)(e). The court concluded that the plaintiffs failed to state a claim, and as such, the district court did not err in granting the defendants' motions for judgment on the pleadings, in denying the plaintiffs' cross-motion for summary judgment as moot, and in denying the plaintiffs' leave to file a second amended complaint.
<a href="https://law.justia.com/cases/federal/appellate-courts/ca2/22-2928/22-2928-2024-01-29.html" target="_blank">View "McCracken v. Verisma Systems, Inc." on Justia Law</a>
In this case, a group of patients initiated a class action lawsuit against various hospitals and vendors who provide medical record production services to the hospitals. The plaintiffs alleged that the hospitals and vendors were involved in an illegal kickback scheme, where the vendors charged patients excessive prices for their medical records and used the profits to offer free and discounted pages to the hospitals for other types of medical records. The plaintiffs alleged violations of New York Public Health Law (PHL) § 18(2)(e) (which restricts the price that can be charged for medical records), New York General Business Law (GBL) § 349 (which prohibits deceptive business practices), and unjust enrichment. However, the New York Court of Appeals had previously ruled in Ortiz v. Ciox Health LLC that PHL § 18(2)(e) does not provide a private right of action.
The United States Court of Appeals for the Second Circuit affirmed the district court's dismissal of all the plaintiffs' claims. It found that the patients' GBL § 349 and unjust enrichment claims were essentially repackaging their PHL § 18(2)(e) claims, and therefore not cognizable as they attempted to circumvent the Ortiz ruling. The court also held that the plaintiffs failed to allege any actionable wrongs independent of the requirements of PHL § 18(2)(e). The court concluded that the plaintiffs failed to state a claim, and as such, the district court did not err in granting the defendants' motions for judgment on the pleadings, in denying the plaintiffs' cross-motion for summary judgment as moot, and in denying the plaintiffs' leave to file a second amended complaint.
2024-01-29federalUS Court of Appeals for the Second CircuitNARDINIhttps://law.justia.com/cases/federal/appellate-courts/ca2/21-2763/21-2763-2024-01-29.htmlUnited States v. Aquart2024-01-29T07:00:50-08:002024-01-29T07:00:50-08:00
The United States Court of Appeals for the Second Circuit upheld the life imprisonment sentence of Azibo Aquart, who was found guilty of multiple federal homicide and drug trafficking crimes. The court had previously affirmed his conviction but vacated his death sentence, remanding the case for a new penalty proceeding. On remand, the government decided not to pursue the death penalty, and Aquart was resentenced to life imprisonment. Aquart appealed, arguing that the district court erred in refusing to address new challenges to his conviction and in sentencing him for both drug-related murder and drug conspiracy, which he argued constituted double jeopardy. The Appeals Court rejected both arguments, ruling that the district court correctly applied the mandate rule and that Aquart's double jeopardy argument was without merit. <a href="https://law.justia.com/cases/federal/appellate-courts/ca2/21-2763/21-2763-2024-01-29.html" target="_blank">View "United States v. Aquart" on Justia Law</a>
The United States Court of Appeals for the Second Circuit upheld the life imprisonment sentence of Azibo Aquart, who was found guilty of multiple federal homicide and drug trafficking crimes. The court had previously affirmed his conviction but vacated his death sentence, remanding the case for a new penalty proceeding. On remand, the government decided not to pursue the death penalty, and Aquart was resentenced to life imprisonment. Aquart appealed, arguing that the district court erred in refusing to address new challenges to his conviction and in sentencing him for both drug-related murder and drug conspiracy, which he argued constituted double jeopardy. The Appeals Court rejected both arguments, ruling that the district court correctly applied the mandate rule and that Aquart's double jeopardy argument was without merit.
2024-01-29federalUS Court of Appeals for the Second CircuitRAGGIhttps://law.justia.com/cases/pennsylvania/supreme-court/2024/26-map-2021.htmlAllegheny Reprod. Health v. PA DHS2024-01-29T06:28:43-08:002024-01-29T06:28:43-08:00
In the case at hand, a group of reproductive health centers and Planned Parenthood affiliates in Pennsylvania challenged the constitutionality of sections of the Pennsylvania Abortion Control Act and corresponding regulations which prohibit the use of state Medicaid funds for abortions except in cases of rape, incest, or to avert the death of the mother. The petitioners argued that the exclusion of abortion from Medicaid coverage violated the Equal Rights Amendment and equal protection provisions of the Pennsylvania Constitution. However, the lower court ultimately dismissed their petition for review.
The petitioners appealed to the Pennsylvania Supreme Court, asking it to address three issues. These were whether the petitioners had standing to bring these claims on behalf of Medicaid patients seeking an abortion, whether the lower court should not have allowed individual members of the Pennsylvania legislature to intervene as respondents, and ultimately whether the coverage exclusion violated the Pennsylvania Constitution.
Regarding the standing question, the Supreme Court determined that the providers successfully showed that they were aggrieved by the coverage exclusion, so they had standing to pursue the claims. On the second question, the Court found that the members of the legislature should not be permitted to intervene in the case, since it was unpersuaded by the argument that striking down the exclusion would affect their authority to appropriate government funds.
Finally, the Court overruled its interpretation of the Equal Rights Amendment and a constitutional non-discrimination provision in a preceding case. It provided certain standards for evaluating claims under these constitutional provisions and remanded to the lower court to apply the appropriate standards. <a href="https://law.justia.com/cases/pennsylvania/supreme-court/2024/26-map-2021.html" target="_blank">View "Allegheny Reprod. Health v. PA DHS" on Justia Law</a>
In the case at hand, a group of reproductive health centers and Planned Parenthood affiliates in Pennsylvania challenged the constitutionality of sections of the Pennsylvania Abortion Control Act and corresponding regulations which prohibit the use of state Medicaid funds for abortions except in cases of rape, incest, or to avert the death of the mother. The petitioners argued that the exclusion of abortion from Medicaid coverage violated the Equal Rights Amendment and equal protection provisions of the Pennsylvania Constitution. However, the lower court ultimately dismissed their petition for review.
The petitioners appealed to the Pennsylvania Supreme Court, asking it to address three issues. These were whether the petitioners had standing to bring these claims on behalf of Medicaid patients seeking an abortion, whether the lower court should not have allowed individual members of the Pennsylvania legislature to intervene as respondents, and ultimately whether the coverage exclusion violated the Pennsylvania Constitution.
Regarding the standing question, the Supreme Court determined that the providers successfully showed that they were aggrieved by the coverage exclusion, so they had standing to pursue the claims. On the second question, the Court found that the members of the legislature should not be permitted to intervene in the case, since it was unpersuaded by the argument that striking down the exclusion would affect their authority to appropriate government funds.
Finally, the Court overruled its interpretation of the Equal Rights Amendment and a constitutional non-discrimination provision in a preceding case. It provided certain standards for evaluating claims under these constitutional provisions and remanded to the lower court to apply the appropriate standards.
2024-01-29statePennsylvaniaSupreme Court of PennsylvaniaDONOHUEhttps://law.justia.com/cases/alabama/supreme-court/2024/sc-2023-0874.htmlEx parte Triad of Alabama, LLC2024-01-26T06:30:11-08:002024-01-26T06:30:11-08:00
The Supreme Court of Alabama granted a writ of mandamus to Triad of Alabama, LLC, doing business as Flowers Hospital, in a personal-injury lawsuit filed by Voncille and Don Askew. The Askews sued Triad after Voncille fell and sustained serious injuries at the hospital while undergoing treatment for COVID-19. In response, Triad asserted an affirmative defense of civil immunity under the Alabama COVID-19 Immunity Act (ACIA). The Askews moved to strike this defense, arguing that their claims were related to the hospital's failure to maintain safe premises and not to any health emergency related to COVID-19. The trial court granted the Askews' motion, prompting Triad to petition the Supreme Court of Alabama for a writ of mandamus.
The Supreme Court found that Triad was entitled to immunity under the ACIA as Voncille's injury occurred in connection with her treatment for COVID-19 at the hospital. The court held that any claim that arises from or is related to COVID-19 falls under the immunity provisions of the ACIA, rejecting the Askews' argument that the Act's immunity provisions only apply to claims expressly related to exposure or contraction of COVID-19 or efforts to prevent its spread. Therefore, the court directed the trial court to vacate its order striking Triad's affirmative defense under the ACIA. <a href="https://law.justia.com/cases/alabama/supreme-court/2024/sc-2023-0874.html" target="_blank">View "Ex parte Triad of Alabama, LLC" on Justia Law</a>
The Supreme Court of Alabama granted a writ of mandamus to Triad of Alabama, LLC, doing business as Flowers Hospital, in a personal-injury lawsuit filed by Voncille and Don Askew. The Askews sued Triad after Voncille fell and sustained serious injuries at the hospital while undergoing treatment for COVID-19. In response, Triad asserted an affirmative defense of civil immunity under the Alabama COVID-19 Immunity Act (ACIA). The Askews moved to strike this defense, arguing that their claims were related to the hospital's failure to maintain safe premises and not to any health emergency related to COVID-19. The trial court granted the Askews' motion, prompting Triad to petition the Supreme Court of Alabama for a writ of mandamus.
The Supreme Court found that Triad was entitled to immunity under the ACIA as Voncille's injury occurred in connection with her treatment for COVID-19 at the hospital. The court held that any claim that arises from or is related to COVID-19 falls under the immunity provisions of the ACIA, rejecting the Askews' argument that the Act's immunity provisions only apply to claims expressly related to exposure or contraction of COVID-19 or efforts to prevent its spread. Therefore, the court directed the trial court to vacate its order striking Triad's affirmative defense under the ACIA.
2024-01-26stateAlabamaSupreme Court of AlabamaSELLERShttps://law.justia.com/cases/california/court-of-appeal/2024/b323186.htmlShalghoun v. North Los Angeles County Regional Center, Inc.2024-01-25T11:31:04-08:002024-01-25T11:31:04-08:00
In the case before the Court of Appeal of the State of California, Second Appellate District, Division Two, the plaintiff, Ali Shalghoun, appealed a judgment from the Superior Court of Los Angeles County in favor of the defendant, North Los Angeles County Regional Center, Inc. Shalghoun, an administrator of a residential facility for developmentally disabled persons, sued the regional center after he was attacked by a resident at the facility. The resident, known as J.C., was a client of the regional center, which had arranged for his placement at the facility.
The central issue in the case was whether the regional center had a legal duty to protect the employees of a residential facility from a developmentally disabled person who had been placed there. The plaintiff argued that the regional center was negligent in failing to immediately move J.C. to another facility after being informed that the facility could no longer provide the level of care he required.
However, the appellate court affirmed the lower court's decision, finding that the regional center did not owe a duty of care to the facility's employees. The court reasoned that the regional center's duty, as mandated by the Lanterman Developmental Disabilities Services Act, was to provide services and support to the developmentally disabled person (the "consumer"), not to protect third-party employees at a residential facility. The court also noted that the regional center did not have the unilateral power to relocate a consumer; it depended on the acceptance of the consumer by another residential facility.
According to the court, the imposition of liability on regional centers for injuries inflicted by consumers could potentially drive the centers out of business, disrupt the entire system of services and support for developmentally disabled individuals, and contradict the Act's mandate to place consumers in the least restrictive environment. The court therefore concluded that public policy factors weighed against recognizing a duty of care running from the regional center to the employees of the residential facility. <a href="https://law.justia.com/cases/california/court-of-appeal/2024/b323186.html" target="_blank">View "Shalghoun v. North Los Angeles County Regional Center, Inc." on Justia Law</a>
In the case before the Court of Appeal of the State of California, Second Appellate District, Division Two, the plaintiff, Ali Shalghoun, appealed a judgment from the Superior Court of Los Angeles County in favor of the defendant, North Los Angeles County Regional Center, Inc. Shalghoun, an administrator of a residential facility for developmentally disabled persons, sued the regional center after he was attacked by a resident at the facility. The resident, known as J.C., was a client of the regional center, which had arranged for his placement at the facility.
The central issue in the case was whether the regional center had a legal duty to protect the employees of a residential facility from a developmentally disabled person who had been placed there. The plaintiff argued that the regional center was negligent in failing to immediately move J.C. to another facility after being informed that the facility could no longer provide the level of care he required.
However, the appellate court affirmed the lower court's decision, finding that the regional center did not owe a duty of care to the facility's employees. The court reasoned that the regional center's duty, as mandated by the Lanterman Developmental Disabilities Services Act, was to provide services and support to the developmentally disabled person (the "consumer"), not to protect third-party employees at a residential facility. The court also noted that the regional center did not have the unilateral power to relocate a consumer; it depended on the acceptance of the consumer by another residential facility.
According to the court, the imposition of liability on regional centers for injuries inflicted by consumers could potentially drive the centers out of business, disrupt the entire system of services and support for developmentally disabled individuals, and contradict the Act's mandate to place consumers in the least restrictive environment. The court therefore concluded that public policy factors weighed against recognizing a duty of care running from the regional center to the employees of the residential facility.
2024-01-25stateCaliforniaCalifornia Courts of AppealHOFFSTADThttps://law.justia.com/cases/ohio/supreme-court-of-ohio/2024/2023-0369.htmlState ex rel. Mobarak v. Brown2024-01-25T06:05:28-08:002024-01-25T06:05:28-08:00
The case involves appellant Soleiman Mobarak, who appealed the judgment of the Tenth District Court of Appeals dismissing his petition for a writ of mandamus against appellee, Franklin County Court of Common Pleas Judge Jeffrey M. Brown. Mobarak had sought to vacate his criminal convictions for lack of subject-matter jurisdiction in the trial court. The court of appeals held that the trial court had jurisdiction over Mobarak’s criminal case and that Mobarak had an adequate remedy in the ordinary course of the law.
In 2012, Mobarak was indicted on charges of engaging in a pattern of corrupt activity, aggravated trafficking in drugs, and aggravated possession of drugs. The charges alleged that Mobarak had possessed and sold a controlled-substance analog commonly known as bath salts. In his petition, Mobarak asserted that the trial court lacked subject-matter jurisdiction over his criminal case on several grounds including that there was no statute prohibiting the possession or sale of bath salts at the time his offenses were alleged to have occurred, and that the controlled-substance-analogs law was unconstitutionally vague.
The Supreme Court of Ohio affirmed the Tenth District Court of Appeals' judgment dismissing Mobarak’s petition. The court held that Mobarak’s petition failed to state a mandamus claim because he had an adequate remedy in the ordinary course of the law and failed to show that the trial court had patently and unambiguously lacked jurisdiction over his criminal case. The court found that by virtue of the Ohio Constitution and R.C. 2931.03, the trial court had jurisdiction over Mobarak’s criminal case. The court also noted that Mobarak’s arguments were similar to those raised and rejected in his prior appeals. The court stated that extraordinary writs may not be used as a substitute for an otherwise barred second appeal or to gain successive appellate reviews of the same issue. <a href="https://law.justia.com/cases/ohio/supreme-court-of-ohio/2024/2023-0369.html" target="_blank">View "State ex rel. Mobarak v. Brown" on Justia Law</a>
The case involves appellant Soleiman Mobarak, who appealed the judgment of the Tenth District Court of Appeals dismissing his petition for a writ of mandamus against appellee, Franklin County Court of Common Pleas Judge Jeffrey M. Brown. Mobarak had sought to vacate his criminal convictions for lack of subject-matter jurisdiction in the trial court. The court of appeals held that the trial court had jurisdiction over Mobarak’s criminal case and that Mobarak had an adequate remedy in the ordinary course of the law.
In 2012, Mobarak was indicted on charges of engaging in a pattern of corrupt activity, aggravated trafficking in drugs, and aggravated possession of drugs. The charges alleged that Mobarak had possessed and sold a controlled-substance analog commonly known as bath salts. In his petition, Mobarak asserted that the trial court lacked subject-matter jurisdiction over his criminal case on several grounds including that there was no statute prohibiting the possession or sale of bath salts at the time his offenses were alleged to have occurred, and that the controlled-substance-analogs law was unconstitutionally vague.
The Supreme Court of Ohio affirmed the Tenth District Court of Appeals' judgment dismissing Mobarak’s petition. The court held that Mobarak’s petition failed to state a mandamus claim because he had an adequate remedy in the ordinary course of the law and failed to show that the trial court had patently and unambiguously lacked jurisdiction over his criminal case. The court found that by virtue of the Ohio Constitution and R.C. 2931.03, the trial court had jurisdiction over Mobarak’s criminal case. The court also noted that Mobarak’s arguments were similar to those raised and rejected in his prior appeals. The court stated that extraordinary writs may not be used as a substitute for an otherwise barred second appeal or to gain successive appellate reviews of the same issue.
2024-01-25stateOhioSupreme Court of OhioMassahttps://law.justia.com/cases/south-carolina/supreme-court/2024/28189.htmlWalterboro Comm Hospital v. SCDHEC2024-01-24T07:07:42-08:002024-01-24T07:07:42-08:00
In South Carolina, two hospitals, Walterboro Community Hospital and Trident Medical Center, appealed an Administrative Law Court (ALC) order which approved the certificate of need (CON) for the Medical University Hospital Authority (MUHA). MUHA had applied for a CON to construct a new general hospital in Berkeley County to address capacity issues at its existing hospital in Charleston. The appellant hospitals raised four issues against ALC's decision: 1) the ALC's dismissal of certain errors in the review by the South Carolina Department of Health and Environmental Control (DHEC), 2) a misinterpretation of the State Health Plan by the ALC, 3) the ALC's approval of MUHA's application conditional on the closure of a freestanding emergency department planned by MUHA, and 4) the appeal bond required by South Carolina law is unconstitutional.
The Supreme Court of South Carolina affirmed the ALC's decision and held that despite errors in DHEC's review process and decision, the ALC's de novo review rendered these errors harmless. The court also agreed with ALC's interpretation of the State Health Plan and found no issue in the ALC's condition of approval. The court further held that the appeal bond requirement was not unconstitutional, as the appellant hospitals were statutory affected persons and there was a rational basis for different treatment for a party opposing an approved CON and a party appealing the denial of its own CON application. However, the court did instruct that the appeal bond be voided and returned to Trident Medical Center. <a href="https://law.justia.com/cases/south-carolina/supreme-court/2024/28189.html" target="_blank">View "Walterboro Comm Hospital v. SCDHEC" on Justia Law</a>
In South Carolina, two hospitals, Walterboro Community Hospital and Trident Medical Center, appealed an Administrative Law Court (ALC) order which approved the certificate of need (CON) for the Medical University Hospital Authority (MUHA). MUHA had applied for a CON to construct a new general hospital in Berkeley County to address capacity issues at its existing hospital in Charleston. The appellant hospitals raised four issues against ALC's decision: 1) the ALC's dismissal of certain errors in the review by the South Carolina Department of Health and Environmental Control (DHEC), 2) a misinterpretation of the State Health Plan by the ALC, 3) the ALC's approval of MUHA's application conditional on the closure of a freestanding emergency department planned by MUHA, and 4) the appeal bond required by South Carolina law is unconstitutional.
The Supreme Court of South Carolina affirmed the ALC's decision and held that despite errors in DHEC's review process and decision, the ALC's de novo review rendered these errors harmless. The court also agreed with ALC's interpretation of the State Health Plan and found no issue in the ALC's condition of approval. The court further held that the appeal bond requirement was not unconstitutional, as the appellant hospitals were statutory affected persons and there was a rational basis for different treatment for a party opposing an approved CON and a party appealing the denial of its own CON application. However, the court did instruct that the appeal bond be voided and returned to Trident Medical Center.
2024-01-24stateSouth CarolinaSouth Carolina Supreme CourtFEWhttps://law.justia.com/cases/washington/supreme-court/2024/101-537-2.htmlM.N. v. MultiCare Health Sys., Inc.2024-01-18T08:25:34-08:002024-01-18T08:25:34-08:00
In this case, the Supreme Court of the State of Washington was asked to consider a class action suit brought by patients against MultiCare Health System, Inc., a Washington corporation that operates Good Samaritan Hospital. The suit arose after a nurse employed by MultiCare, Cora Weberg, improperly diverted injectable narcotics for her own use and infected some emergency department patients with hepatitis C. The patients claimed that MultiCare failed to meet the accepted standard of care in supervising and hiring Nurse Weberg. The trial court divided the class into two groups: those who were assigned to Nurse Weberg and those who were not. It then dismissed the claims of the second group. The trial court ruled that legal causation was not satisfied because Nurse Weberg did not directly treat these patients. The Court of Appeals affirmed this decision.
However, the Supreme Court of the State of Washington reversed both courts and held that legal causation is satisfied. The court held that both classes can proceed with their chapter 7.70 RCW claims, which govern civil actions for damages for injury occurring as a result of health care. The court reasoned that the General Treatment Class's injuries arose as a result of health care, allowing their claim under chapter 7.70 RCW to proceed. The court also found that legal causation is satisfied when a hospital’s negligent supervision and hiring potentially exposes patients to a bloodborne pathogen, inducing fear and requiring blood testing. Thus, the court concluded that the General Treatment Class's claims should not have been dismissed. <a href="https://law.justia.com/cases/washington/supreme-court/2024/101-537-2.html" target="_blank">View "M.N. v. MultiCare Health Sys., Inc." on Justia Law</a>
In this case, the Supreme Court of the State of Washington was asked to consider a class action suit brought by patients against MultiCare Health System, Inc., a Washington corporation that operates Good Samaritan Hospital. The suit arose after a nurse employed by MultiCare, Cora Weberg, improperly diverted injectable narcotics for her own use and infected some emergency department patients with hepatitis C. The patients claimed that MultiCare failed to meet the accepted standard of care in supervising and hiring Nurse Weberg. The trial court divided the class into two groups: those who were assigned to Nurse Weberg and those who were not. It then dismissed the claims of the second group. The trial court ruled that legal causation was not satisfied because Nurse Weberg did not directly treat these patients. The Court of Appeals affirmed this decision.
However, the Supreme Court of the State of Washington reversed both courts and held that legal causation is satisfied. The court held that both classes can proceed with their chapter 7.70 RCW claims, which govern civil actions for damages for injury occurring as a result of health care. The court reasoned that the General Treatment Class's injuries arose as a result of health care, allowing their claim under chapter 7.70 RCW to proceed. The court also found that legal causation is satisfied when a hospital’s negligent supervision and hiring potentially exposes patients to a bloodborne pathogen, inducing fear and requiring blood testing. Thus, the court concluded that the General Treatment Class's claims should not have been dismissed.
2024-01-18stateWashingtonWashington Supreme Courthttps://law.justia.com/cases/federal/appellate-courts/ca4/22-1825/22-1825-2024-01-17.htmlTartaro-McGowan v. Inova Home Health, LLC2024-01-17T11:30:39-08:002024-01-17T11:30:39-08:00
In a case before the United States Court of Appeals for the Fourth Circuit, Laura Tartaro-McGowan, a clinical manager with Inova Home Health, was terminated after failing to perform direct patient care field visits by a specified date. Tartaro-McGowan, who suffers from chronic arthritis in her knees due to bilateral knee replacement surgeries, sued her employer under the Americans with Disabilities Act (ADA) for failure to accommodate, discrimination, and retaliation. The district court granted summary judgment in favor of the defendants, Inova Home Health, LLC and Alternate Solutions Health Network, LLC.
Amidst the COVID-19 pandemic, Inova Home Health experienced a severe shortage of field clinicians and informed all staff members, including clinical managers, that they would be required to perform direct patient care field visits. Tartaro-McGowan requested an accommodation to be excused from performing direct patient care field visits due to her physical limitations caused by her chronic arthritis. In response, the defendants proposed an accommodation that involved allowing Tartaro-McGowan to screen and select appropriate visits that would greatly reduce the possibility of injury. Tartaro-McGowan refused this accommodation and was later terminated for not performing any direct patient care field visits by the specified date.
On appeal, the Fourth Circuit affirmed the district court's decision. The court determined that Tartaro-McGowan failed to prove the defendants denied her a reasonable accommodation, an essential element of her ADA claim. The court noted that the circumstances surrounding the pandemic were exceptional, and given the severe shortage of field nurses, the defendants' proposed accommodation was reasonable. The court also found that Tartaro-McGowan failed to establish a prima facie case for her discrimination and retaliation claims. <a href="https://law.justia.com/cases/federal/appellate-courts/ca4/22-1825/22-1825-2024-01-17.html" target="_blank">View "Tartaro-McGowan v. Inova Home Health, LLC" on Justia Law</a>
In a case before the United States Court of Appeals for the Fourth Circuit, Laura Tartaro-McGowan, a clinical manager with Inova Home Health, was terminated after failing to perform direct patient care field visits by a specified date. Tartaro-McGowan, who suffers from chronic arthritis in her knees due to bilateral knee replacement surgeries, sued her employer under the Americans with Disabilities Act (ADA) for failure to accommodate, discrimination, and retaliation. The district court granted summary judgment in favor of the defendants, Inova Home Health, LLC and Alternate Solutions Health Network, LLC.
Amidst the COVID-19 pandemic, Inova Home Health experienced a severe shortage of field clinicians and informed all staff members, including clinical managers, that they would be required to perform direct patient care field visits. Tartaro-McGowan requested an accommodation to be excused from performing direct patient care field visits due to her physical limitations caused by her chronic arthritis. In response, the defendants proposed an accommodation that involved allowing Tartaro-McGowan to screen and select appropriate visits that would greatly reduce the possibility of injury. Tartaro-McGowan refused this accommodation and was later terminated for not performing any direct patient care field visits by the specified date.
On appeal, the Fourth Circuit affirmed the district court's decision. The court determined that Tartaro-McGowan failed to prove the defendants denied her a reasonable accommodation, an essential element of her ADA claim. The court noted that the circumstances surrounding the pandemic were exceptional, and given the severe shortage of field nurses, the defendants' proposed accommodation was reasonable. The court also found that Tartaro-McGowan failed to establish a prima facie case for her discrimination and retaliation claims.
2024-01-17federalUS Court of Appeals for the Fourth Circuithttps://law.justia.com/cases/minnesota/supreme-court/2024/a21-1477.htmlIn the Matter of SIRS Appeal by Nobility Home Health Care, Inc2024-01-12T14:34:17-08:002024-01-12T14:34:17-08:00
In a dispute with the Department of Human Services (DHS) in Minnesota, Nobility Home Health Care, Inc. (Nobility) was found to have violated Minnesota Statutes section 256B.064 and Minnesota Rule 9505.2165 by failing to maintain health service records as required by law and by submitting claims for services for which underlying health service records were inadequate. The Minnesota Supreme Court held that such conduct constitutes "abuse" under the statute, even if there was no intent to deceive the DHS. However, the court declined to interpret or apply the phrase "improperly paid... as a result of" abuse in the statute, which governs the grounds for monetary recovery. The court reversed the decision of the court of appeals and remanded the case to the DHS for further analysis of this issue. The court's decision means that DHS's demand for an overpayment for Nobility’s first-time paperwork errors may not be reversed unless the DHS also establishes that the provider was improperly paid because of that abuse. <a href="https://law.justia.com/cases/minnesota/supreme-court/2024/a21-1477.html" target="_blank">View "In the Matter of SIRS Appeal by Nobility Home Health Care, Inc" on Justia Law</a>
In a dispute with the Department of Human Services (DHS) in Minnesota, Nobility Home Health Care, Inc. (Nobility) was found to have violated Minnesota Statutes section 256B.064 and Minnesota Rule 9505.2165 by failing to maintain health service records as required by law and by submitting claims for services for which underlying health service records were inadequate. The Minnesota Supreme Court held that such conduct constitutes "abuse" under the statute, even if there was no intent to deceive the DHS. However, the court declined to interpret or apply the phrase "improperly paid... as a result of" abuse in the statute, which governs the grounds for monetary recovery. The court reversed the decision of the court of appeals and remanded the case to the DHS for further analysis of this issue. The court's decision means that DHS's demand for an overpayment for Nobility’s first-time paperwork errors may not be reversed unless the DHS also establishes that the provider was improperly paid because of that abuse.
2024-01-10stateMinnesotaMinnesota Supreme CourtTHISSENhttps://law.justia.com/cases/federal/appellate-courts/ca1/23-1286/23-1286-2024-01-10.htmlLawrence General Hospital v. Continental Casualty Co.2024-01-10T14:00:06-08:002024-01-10T14:00:06-08:00
The United States Court of Appeals for the First Circuit considered a case where Lawrence General Hospital (LGH) sued Continental Casualty Company for denying coverage for losses LGH alleges it suffered during the COVID-19 pandemic. LGH argued that its insurance policy with Continental covered the losses under two types of coverage: coverage for "direct physical loss of or damage to property" and a Health Care Endorsement covering losses and costs incurred due to compliance with government decontamination orders.
Applying Massachusetts state law, the court ruled that LGH failed to state a claim that the SARS-CoV-2 virus caused "direct physical loss of or damage to its property," affirming the lower court's dismissal of this claim. However, the court found that LGH was subject to decontamination orders due to COVID-19 and thus had a valid claim for coverage under the Health Care Endorsement. As such, the court reversed the lower court's dismissal of this claim and remanded the case for further proceedings. <a href="https://law.justia.com/cases/federal/appellate-courts/ca1/23-1286/23-1286-2024-01-10.html" target="_blank">View "Lawrence General Hospital v. Continental Casualty Co." on Justia Law</a>
The United States Court of Appeals for the First Circuit considered a case where Lawrence General Hospital (LGH) sued Continental Casualty Company for denying coverage for losses LGH alleges it suffered during the COVID-19 pandemic. LGH argued that its insurance policy with Continental covered the losses under two types of coverage: coverage for "direct physical loss of or damage to property" and a Health Care Endorsement covering losses and costs incurred due to compliance with government decontamination orders.
Applying Massachusetts state law, the court ruled that LGH failed to state a claim that the SARS-CoV-2 virus caused "direct physical loss of or damage to its property," affirming the lower court's dismissal of this claim. However, the court found that LGH was subject to decontamination orders due to COVID-19 and thus had a valid claim for coverage under the Health Care Endorsement. As such, the court reversed the lower court's dismissal of this claim and remanded the case for further proceedings.
2024-01-10federalUS Court of Appeals for the First Circuithttps://law.justia.com/cases/federal/appellate-courts/ca9/22-55717/22-55717-2024-01-10.htmlSOUTH COAST SPECIALTY SURGERY CENTER, INC. V. BLUE CROSS OF CALIFORNIA2024-01-10T09:01:25-08:002024-01-10T09:01:25-08:00
In this case, the United States Court of Appeals for the Ninth Circuit reversed the district court's dismissal of an ERISA action brought by South Coast Specialty Surgery Center, Inc. against Blue Cross of California, d/b/a Anthem Blue Cross.
South Coast, a healthcare provider, sought reimbursement from Blue Cross for the costs of medical services provided to its patients. South Coast argued that although it was not a plan participant or a beneficiary under ERISA, it had the right to enforce ERISA's protections directly because its patients had assigned it the right to sue for the non-payment of plan benefits via an "Assignment of Benefits" form. The district court disagreed and dismissed South Coast's suit, concluding that the form only conveyed the right to receive direct payment from Anthem, and not the right to sue for non-payment of plan benefits.
The Ninth Circuit held that a healthcare provider can enforce ERISA's protections if it has received a valid assignment of rights. The court determined that South Coast's patients had effectuated a valid assignment through the "Assignment of Benefits" form. Therefore, South Coast had the right to seek payment of benefits and to sue for non-payment. The court reversed the lower court's decision and remanded the case for further proceedings. <a href="https://law.justia.com/cases/federal/appellate-courts/ca9/22-55717/22-55717-2024-01-10.html" target="_blank">View "SOUTH COAST SPECIALTY SURGERY CENTER, INC. V. BLUE CROSS OF CALIFORNIA" on Justia Law</a>
In this case, the United States Court of Appeals for the Ninth Circuit reversed the district court's dismissal of an ERISA action brought by South Coast Specialty Surgery Center, Inc. against Blue Cross of California, d/b/a Anthem Blue Cross.
South Coast, a healthcare provider, sought reimbursement from Blue Cross for the costs of medical services provided to its patients. South Coast argued that although it was not a plan participant or a beneficiary under ERISA, it had the right to enforce ERISA's protections directly because its patients had assigned it the right to sue for the non-payment of plan benefits via an "Assignment of Benefits" form. The district court disagreed and dismissed South Coast's suit, concluding that the form only conveyed the right to receive direct payment from Anthem, and not the right to sue for non-payment of plan benefits.
The Ninth Circuit held that a healthcare provider can enforce ERISA's protections if it has received a valid assignment of rights. The court determined that South Coast's patients had effectuated a valid assignment through the "Assignment of Benefits" form. Therefore, South Coast had the right to seek payment of benefits and to sue for non-payment. The court reversed the lower court's decision and remanded the case for further proceedings.
2024-01-10federalUS Court of Appeals for the Ninth Circuithttps://law.justia.com/cases/california/court-of-appeal/2024/d082443.htmlSarmiento v. Super. Ct.2024-01-09T15:01:03-08:002024-01-09T15:01:03-08:00
This case concerns a defendant, Jeanette Sarmiento, who requested mental health diversion after being charged with attempted robbery. Sarmiento suffers from posttraumatic stress disorder (PTSD), major depressive disorder, and stimulant use disorder, all of which have never been treated. Despite meeting many of the requirements for diversion, her request was denied by the Superior Court of San Diego County due to her history of drug abuse and the court's conclusion that she posed an unreasonable risk of danger to the public.
Sarmiento sought a writ of mandate from the Court of Appeal, Fourth Appellate District Division One, State of California. The court determined that her past failures in drug treatment did not predict her response to mental health treatment, since her underlying mental health conditions, which were the core of her substance abuse issues, were never previously addressed. The court also found that the trial court's concern about Sarmiento's lack of success in past attempts at substance abuse treatment did not support the finding that the recommended treatment would not meet her specialized needs. Further, the court found that the trial court misapplied the statutory criteria in determining that residual concerns for public safety could justify the denial of diversion.
Given these findings, the Court of Appeal granted the writ and directed the Superior Court to approve Sarmiento's request for mental health diversion. The court emphasized that the purpose of mental health diversion is to treat individuals with mental disorders in order to prevent them from entering and reentering the criminal justice system, and to protect public safety. The court concluded that the trial court's decision failed to follow the Legislature's direction to focus less on Sarmiento's past and more on the promise of her future and that of her community. <a href="https://law.justia.com/cases/california/court-of-appeal/2024/d082443.html" target="_blank">View "Sarmiento v. Super. Ct." on Justia Law</a>
This case concerns a defendant, Jeanette Sarmiento, who requested mental health diversion after being charged with attempted robbery. Sarmiento suffers from posttraumatic stress disorder (PTSD), major depressive disorder, and stimulant use disorder, all of which have never been treated. Despite meeting many of the requirements for diversion, her request was denied by the Superior Court of San Diego County due to her history of drug abuse and the court's conclusion that she posed an unreasonable risk of danger to the public.
Sarmiento sought a writ of mandate from the Court of Appeal, Fourth Appellate District Division One, State of California. The court determined that her past failures in drug treatment did not predict her response to mental health treatment, since her underlying mental health conditions, which were the core of her substance abuse issues, were never previously addressed. The court also found that the trial court's concern about Sarmiento's lack of success in past attempts at substance abuse treatment did not support the finding that the recommended treatment would not meet her specialized needs. Further, the court found that the trial court misapplied the statutory criteria in determining that residual concerns for public safety could justify the denial of diversion.
Given these findings, the Court of Appeal granted the writ and directed the Superior Court to approve Sarmiento's request for mental health diversion. The court emphasized that the purpose of mental health diversion is to treat individuals with mental disorders in order to prevent them from entering and reentering the criminal justice system, and to protect public safety. The court concluded that the trial court's decision failed to follow the Legislature's direction to focus less on Sarmiento's past and more on the promise of her future and that of her community.
2024-01-09stateCaliforniaCalifornia Courts of AppealDATOhttps://law.justia.com/cases/california/court-of-appeal/2024/a165558.htmlGilead Tenofovir Cases2024-01-09T15:01:01-08:002024-01-09T15:01:01-08:00
This case involves a pharmaceutical manufacturer, Gilead Life Sciences, Inc., and its development and sale of a drug, tenofovir disoproxil fumarate (TDF), to treat HIV/AIDS. The approximately 24,000 plaintiffs allege that they suffered adverse effects from TDF, including skeletal and kidney damage. Gilead developed a similar but chemically distinct drug, tenofovir alafenamide fumarate (TAF), which could potentially treat HIV/AIDS with fewer side effects. The plaintiffs claim that Gilead delayed the development of TAF to maximize profits from TDF.
The plaintiffs do not claim that TDF is defective. Instead, they assert a claim for ordinary negligence, arguing that Gilead's decision to delay the development of TAF breached its duty of reasonable care to users of TDF. They also assert a claim for fraudulent concealment, arguing that Gilead had a duty to disclose information about TAF to users of TDF.
The Court of Appeal of the State of California, First Appellate District, Division Four, partially granted Gilead's petition for a writ of mandate and held that the plaintiffs could proceed with their negligence claim. The court concluded that a manufacturer's legal duty of reasonable care can extend beyond the duty not to market a defective product. However, the court reversed the trial court's decision denying Gilead's motion for summary adjudication of the plaintiffs' claim for fraudulent concealment. The court held that Gilead had no duty to disclose information about TAF to users of TDF, as TAF was not available as an alternative treatment at the time. <a href="https://law.justia.com/cases/california/court-of-appeal/2024/a165558.html" target="_blank">View "Gilead Tenofovir Cases" on Justia Law</a>
This case involves a pharmaceutical manufacturer, Gilead Life Sciences, Inc., and its development and sale of a drug, tenofovir disoproxil fumarate (TDF), to treat HIV/AIDS. The approximately 24,000 plaintiffs allege that they suffered adverse effects from TDF, including skeletal and kidney damage. Gilead developed a similar but chemically distinct drug, tenofovir alafenamide fumarate (TAF), which could potentially treat HIV/AIDS with fewer side effects. The plaintiffs claim that Gilead delayed the development of TAF to maximize profits from TDF.
The plaintiffs do not claim that TDF is defective. Instead, they assert a claim for ordinary negligence, arguing that Gilead's decision to delay the development of TAF breached its duty of reasonable care to users of TDF. They also assert a claim for fraudulent concealment, arguing that Gilead had a duty to disclose information about TAF to users of TDF.
The Court of Appeal of the State of California, First Appellate District, Division Four, partially granted Gilead's petition for a writ of mandate and held that the plaintiffs could proceed with their negligence claim. The court concluded that a manufacturer's legal duty of reasonable care can extend beyond the duty not to market a defective product. However, the court reversed the trial court's decision denying Gilead's motion for summary adjudication of the plaintiffs' claim for fraudulent concealment. The court held that Gilead had no duty to disclose information about TAF to users of TDF, as TAF was not available as an alternative treatment at the time.
2024-01-09stateCaliforniaCalifornia Courts of AppealGOLDMANhttps://law.justia.com/cases/federal/appellate-courts/ca4/22-2227/22-2227-2024-01-09.htmlNeidig v. Valley Health System2024-01-09T11:30:34-08:002024-01-09T11:30:34-08:00
Elaine Neidig, individually and on behalf of a class, sued Valley Health System, a health care provider, for unfair and deceptive practices, unjust enrichment, and breach of contract. Neidig had received three mammograms at Valley Health's Winchester Medical Center between March 2016 and June 2019. In July 2019, federal inspectors found that the center's staff were not correctly positioning or compressing women's breasts during mammograms, leading to serious image quality deficiencies. Valley Health then had to alert all at-risk patients, including Neidig, of the mammography quality problems. Neidig, who did not allege any physical or emotional harm resulting from the low-quality mammograms, sued Valley Health in August 2022. Valley Health moved to dismiss the case on the basis that it was filed beyond the two-year statute of limitations provided by the West Virginia Medical Professional Liability Act. The United States District Court for the Northern District of West Virginia agreed with Valley Health and dismissed Neidig's claims as untimely. Neidig appealed the decision to the United States Court of Appeals for the Fourth Circuit.
Upon review, the Fourth Circuit concluded that the case presented a novel issue of state law that needed to be addressed by the Supreme Court of Appeals of West Virginia. The issue was whether a plaintiff's claims can fall under the West Virginia Medical Professional Liability Act if the plaintiff does not claim any form of physical or emotional injury. The Fourth Circuit certified this question to the Supreme Court of Appeals of West Virginia for resolution. <a href="https://law.justia.com/cases/federal/appellate-courts/ca4/22-2227/22-2227-2024-01-09.html" target="_blank">View "Neidig v. Valley Health System" on Justia Law</a>
Elaine Neidig, individually and on behalf of a class, sued Valley Health System, a health care provider, for unfair and deceptive practices, unjust enrichment, and breach of contract. Neidig had received three mammograms at Valley Health's Winchester Medical Center between March 2016 and June 2019. In July 2019, federal inspectors found that the center's staff were not correctly positioning or compressing women's breasts during mammograms, leading to serious image quality deficiencies. Valley Health then had to alert all at-risk patients, including Neidig, of the mammography quality problems. Neidig, who did not allege any physical or emotional harm resulting from the low-quality mammograms, sued Valley Health in August 2022. Valley Health moved to dismiss the case on the basis that it was filed beyond the two-year statute of limitations provided by the West Virginia Medical Professional Liability Act. The United States District Court for the Northern District of West Virginia agreed with Valley Health and dismissed Neidig's claims as untimely. Neidig appealed the decision to the United States Court of Appeals for the Fourth Circuit.
Upon review, the Fourth Circuit concluded that the case presented a novel issue of state law that needed to be addressed by the Supreme Court of Appeals of West Virginia. The issue was whether a plaintiff's claims can fall under the West Virginia Medical Professional Liability Act if the plaintiff does not claim any form of physical or emotional injury. The Fourth Circuit certified this question to the Supreme Court of Appeals of West Virginia for resolution.
2024-01-09federalUS Court of Appeals for the Fourth Circuithttps://law.justia.com/cases/federal/appellate-courts/ca6/22-3835/22-3835-2024-01-08.htmlUnited States v. O'Lear2024-01-08T14:01:06-08:002024-01-08T14:01:06-08:00
In the case before the United States Court of Appeals for the Sixth Circuit, the defendant, Thomas O’Lear, was convicted of healthcare fraud, making a false statement in connection with healthcare services, and aggravated identity theft. O’Lear ran a company that provided mobile x-ray services to residents in nursing homes. However, he used the company to defraud Medicare and Medicaid programs by billing for fictitious x-rays using the identities of nursing-home residents. When an audit revealed the fraud, O’Lear attempted to conceal it by forging staff names and duplicating x-rays in the patient files.
On appeal, O’Lear raised several questions. Firstly, he questioned whether his Sixth Amendment right to an impartial jury was violated by excluding individuals who had not been vaccinated against COVID-19 from the jury pool. The court ruled that the unvaccinated do not qualify as a “distinctive group” that can trigger Sixth Amendment concerns. Secondly, O’Lear questioned whether the nursing-home residents were “victims” of his fraud under a “vulnerable victims” sentencing enhancement, even though the monetary losses were suffered by Medicare and Medicaid. The court ruled that the residents were indeed victims, as O’Lear had used their identities and health records without their permission, which constituted taking advantage of them.
O’Lear also challenged his two aggravated-identity-theft convictions and objected to his 180-month sentence on various grounds, but these arguments were also dismissed by the court. Ultimately, the court affirmed O’Lear's conviction and sentence. <a href="https://law.justia.com/cases/federal/appellate-courts/ca6/22-3835/22-3835-2024-01-08.html" target="_blank">View "United States v. O'Lear" on Justia Law</a>
In the case before the United States Court of Appeals for the Sixth Circuit, the defendant, Thomas O’Lear, was convicted of healthcare fraud, making a false statement in connection with healthcare services, and aggravated identity theft. O’Lear ran a company that provided mobile x-ray services to residents in nursing homes. However, he used the company to defraud Medicare and Medicaid programs by billing for fictitious x-rays using the identities of nursing-home residents. When an audit revealed the fraud, O’Lear attempted to conceal it by forging staff names and duplicating x-rays in the patient files.
On appeal, O’Lear raised several questions. Firstly, he questioned whether his Sixth Amendment right to an impartial jury was violated by excluding individuals who had not been vaccinated against COVID-19 from the jury pool. The court ruled that the unvaccinated do not qualify as a “distinctive group” that can trigger Sixth Amendment concerns. Secondly, O’Lear questioned whether the nursing-home residents were “victims” of his fraud under a “vulnerable victims” sentencing enhancement, even though the monetary losses were suffered by Medicare and Medicaid. The court ruled that the residents were indeed victims, as O’Lear had used their identities and health records without their permission, which constituted taking advantage of them.
O’Lear also challenged his two aggravated-identity-theft convictions and objected to his 180-month sentence on various grounds, but these arguments were also dismissed by the court. Ultimately, the court affirmed O’Lear's conviction and sentence.
2024-01-08federalUS Court of Appeals for the Sixth Circuithttps://law.justia.com/cases/new-jersey/supreme-court/2023/a-27-22.htmlMeyers v. State Health Benefits Commission2024-01-08T11:05:12-08:002024-01-08T11:05:12-08:00
The Supreme Court of New Jersey affirmed the judgment of the Appellate Division in a case concerning the New Jersey State Health Benefits Program Act. The case was brought by James Meyers, a retired state police officer, who challenged the State Health Benefits Commission's (SHBC) decision that he was not exempt from health benefits premium-sharing obligations imposed by the Act. The Act requires public employees to contribute towards the cost of their healthcare benefits upon retirement, with an exemption for employees who had 20 or more years of creditable service in a state or locally administered retirement system as of June 28, 2011. Meyers had 17 years and 9 months of creditable service at that time. Upon his retirement in 2015, he was erroneously offered retiree health benefits at no premium cost. This mistake was discovered in 2017, and the state began deducting premium-sharing contributions from his pension payments.
The Court held that Meyers was not eligible for the exemption under the Act, and correcting the erroneous exemption was proper. The court found that neither Meyers' subsequent service nor his purchase of four years of military service credit could change the fact that he did not meet the Act's requirement as of June 28, 2011. The court also agreed with the Appellate Division's determination that it was not necessary to reach the issue of equitable estoppel. The court noted that a governmental entity cannot be estopped from refusing to take an action that it was never authorized to take under the law, even if it had mistakenly agreed to that action. In this case, the SHBC was never authorized to offer Meyers free healthcare benefits, an act beyond the jurisdiction of the SHBC and therefore ultra vires in the primary sense. Thus, the doctrine of equitable estoppel did not apply. <a href="https://law.justia.com/cases/new-jersey/supreme-court/2023/a-27-22.html" target="_blank">View "Meyers v. State Health Benefits Commission" on Justia Law</a>
The Supreme Court of New Jersey affirmed the judgment of the Appellate Division in a case concerning the New Jersey State Health Benefits Program Act. The case was brought by James Meyers, a retired state police officer, who challenged the State Health Benefits Commission's (SHBC) decision that he was not exempt from health benefits premium-sharing obligations imposed by the Act. The Act requires public employees to contribute towards the cost of their healthcare benefits upon retirement, with an exemption for employees who had 20 or more years of creditable service in a state or locally administered retirement system as of June 28, 2011. Meyers had 17 years and 9 months of creditable service at that time. Upon his retirement in 2015, he was erroneously offered retiree health benefits at no premium cost. This mistake was discovered in 2017, and the state began deducting premium-sharing contributions from his pension payments.
The Court held that Meyers was not eligible for the exemption under the Act, and correcting the erroneous exemption was proper. The court found that neither Meyers' subsequent service nor his purchase of four years of military service credit could change the fact that he did not meet the Act's requirement as of June 28, 2011. The court also agreed with the Appellate Division's determination that it was not necessary to reach the issue of equitable estoppel. The court noted that a governmental entity cannot be estopped from refusing to take an action that it was never authorized to take under the law, even if it had mistakenly agreed to that action. In this case, the SHBC was never authorized to offer Meyers free healthcare benefits, an act beyond the jurisdiction of the SHBC and therefore ultra vires in the primary sense. Thus, the doctrine of equitable estoppel did not apply.
2023-12-14stateNew JerseySupreme Court of New Jerseyhttps://law.justia.com/cases/federal/appellate-courts/ca4/21-4181/21-4181-2024-01-05.htmlUS v. Evans2024-01-05T11:30:49-08:002024-01-05T11:30:49-08:00
The defendant, Rodriquies Evans, was convicted of four criminal offenses related to his involvement in a multistate conspiracy to transport and distribute methamphetamine and other controlled substances. The district court sentenced him to the statutory maximum of 80 years in prison. The Fourth Circuit United States Court of Appeals found that the district court had erred in calculating Evans’s Sentencing Guidelines range and vacated his sentence, remanding the case for resentencing. The court determined that the district court had incorrectly attributed nearly three kilograms of crystal methamphetamine seized from a co-conspirator to Evans. The court held that for sentencing purposes under the Sentencing Guidelines, only acts that fall within the scope of the criminal activity the defendant agreed to jointly undertake can be considered relevant conduct. The district court had attributed the drugs based on the broader standard of substantive liability under Pinkerton, which allows a defendant to be held liable for the acts of co-conspirators if they are within the scope of the overall conspiracy and reasonably foreseeable to the defendant. The court also found that the district court had erred in applying a threat enhancement in calculating Evans's Sentencing Guidelines range, as the possession of a firearm enhancement could not by itself be the basis for a threat enhancement. <a href="https://law.justia.com/cases/federal/appellate-courts/ca4/21-4181/21-4181-2024-01-05.html" target="_blank">View "US v. Evans" on Justia Law</a>
The defendant, Rodriquies Evans, was convicted of four criminal offenses related to his involvement in a multistate conspiracy to transport and distribute methamphetamine and other controlled substances. The district court sentenced him to the statutory maximum of 80 years in prison. The Fourth Circuit United States Court of Appeals found that the district court had erred in calculating Evans’s Sentencing Guidelines range and vacated his sentence, remanding the case for resentencing. The court determined that the district court had incorrectly attributed nearly three kilograms of crystal methamphetamine seized from a co-conspirator to Evans. The court held that for sentencing purposes under the Sentencing Guidelines, only acts that fall within the scope of the criminal activity the defendant agreed to jointly undertake can be considered relevant conduct. The district court had attributed the drugs based on the broader standard of substantive liability under Pinkerton, which allows a defendant to be held liable for the acts of co-conspirators if they are within the scope of the overall conspiracy and reasonably foreseeable to the defendant. The court also found that the district court had erred in applying a threat enhancement in calculating Evans's Sentencing Guidelines range, as the possession of a firearm enhancement could not by itself be the basis for a threat enhancement.
2024-01-05federalUS Court of Appeals for the Fourth Circuithttps://law.justia.com/cases/federal/appellate-courts/ca5/21-60766/21-60766-2024-01-03.htmlWages and White Lion Invest v. FDA2024-01-03T10:30:35-08:002024-01-03T10:30:35-08:00
In the case of Wages and White Lion Investments, L.L.C., doing business as Triton Distribution; Vapetasia, L.L.C., versus the Food & Drug Administration, the court found that the FDA acted arbitrarily and capriciously in its denial of Premarket Tobacco Product Applications (PMTAs) for flavored e-cigarette products.
The petitioners, Triton Distribution and Vapetasia, are manufacturers of flavored e-cigarette liquids. They filed PMTAs for their products, as required by the Family Smoking Prevention and Tobacco Control Act, which prohibits the sale of any “new tobacco product” without authorization from the FDA. The FDA, after issuing detailed guidance on the information it required for approval of e-cigarette products, subsequently denied all flavored e-cigarette applications, including those of the petitioners, on the grounds that they failed to predict new testing requirements imposed by the FDA without notice.
The court found that the FDA had failed to provide the manufacturers with fair notice of the rules, had not acknowledged or explained its change in position, and had ignored the reasonable and serious reliance interests that manufacturers had in the pre-denial guidance. Furthermore, the FDA attempted to cover up its mistakes with post hoc justifications at oral argument.
As a result, the court granted the petitions for review, set aside the FDA's marketing denial orders, and remanded the matters to the FDA. The court rejected FDA's argument that even if it arbitrarily and capriciously denied petitioners’ applications, that error was harmless, stating that the harmless error doctrine is narrow and does not apply to discretionary administrative decisions. The court also rejected FDA's contention that it gave manufacturers fair notice of their obligations to perform long-term scientific studies in its pre-denial guidance documents. <a href="https://law.justia.com/cases/federal/appellate-courts/ca5/21-60766/21-60766-2024-01-03.html" target="_blank">View "Wages and White Lion Invest v. FDA" on Justia Law</a>
In the case of Wages and White Lion Investments, L.L.C., doing business as Triton Distribution; Vapetasia, L.L.C., versus the Food & Drug Administration, the court found that the FDA acted arbitrarily and capriciously in its denial of Premarket Tobacco Product Applications (PMTAs) for flavored e-cigarette products.
The petitioners, Triton Distribution and Vapetasia, are manufacturers of flavored e-cigarette liquids. They filed PMTAs for their products, as required by the Family Smoking Prevention and Tobacco Control Act, which prohibits the sale of any “new tobacco product” without authorization from the FDA. The FDA, after issuing detailed guidance on the information it required for approval of e-cigarette products, subsequently denied all flavored e-cigarette applications, including those of the petitioners, on the grounds that they failed to predict new testing requirements imposed by the FDA without notice.
The court found that the FDA had failed to provide the manufacturers with fair notice of the rules, had not acknowledged or explained its change in position, and had ignored the reasonable and serious reliance interests that manufacturers had in the pre-denial guidance. Furthermore, the FDA attempted to cover up its mistakes with post hoc justifications at oral argument.
As a result, the court granted the petitions for review, set aside the FDA's marketing denial orders, and remanded the matters to the FDA. The court rejected FDA's argument that even if it arbitrarily and capriciously denied petitioners’ applications, that error was harmless, stating that the harmless error doctrine is narrow and does not apply to discretionary administrative decisions. The court also rejected FDA's contention that it gave manufacturers fair notice of their obligations to perform long-term scientific studies in its pre-denial guidance documents.
2024-01-03federalUS Court of Appeals for the Fifth Circuithttps://law.justia.com/cases/federal/appellate-courts/ca11/22-11103/22-11103-2024-01-03.htmlRaper v. Commissioner of Social Security2024-01-03T08:01:21-08:002024-01-03T08:01:21-08:00
In this appeal, Marcus Raper contested the Social Security Administration’s (SSA) 2020 denial of his claim for disability insurance benefits. Raper raised three arguments: (1) that the administrative law judge's (ALJ) initial lack of constitutional appointment under the Appointments Clause tainted his later constitutionally appointed review of his case, (2) that the ALJ failed to clearly articulate good cause for not fully crediting his treating physician’s medical opinion, and (3) that the ALJ wrongly discredited his subjective complaints of pain by not properly considering evidence other than objective medical evidence.
The United States Court of Appeals for the Eleventh Circuit affirmed the lower court’s decision. First, the court found no Appointments Clause violation as the ALJ's initial decision, made when he was unconstitutionally appointed, had been vacated on the merits and the case was remanded to the same ALJ who was then constitutionally appointed. Second, the court held that the ALJ articulated good cause for discounting Raper's treating physician’s opinion, finding the opinion inconsistent with the record. Lastly, the court found that the ALJ had properly considered Raper’s subjective complaints in light of the record as a whole and adequately explained his decision not to fully credit Raper’s alleged limitations on his ability to work. <a href="https://law.justia.com/cases/federal/appellate-courts/ca11/22-11103/22-11103-2024-01-03.html" target="_blank">View "Raper v. Commissioner of Social Security" on Justia Law</a>
In this appeal, Marcus Raper contested the Social Security Administration’s (SSA) 2020 denial of his claim for disability insurance benefits. Raper raised three arguments: (1) that the administrative law judge's (ALJ) initial lack of constitutional appointment under the Appointments Clause tainted his later constitutionally appointed review of his case, (2) that the ALJ failed to clearly articulate good cause for not fully crediting his treating physician’s medical opinion, and (3) that the ALJ wrongly discredited his subjective complaints of pain by not properly considering evidence other than objective medical evidence.
The United States Court of Appeals for the Eleventh Circuit affirmed the lower court’s decision. First, the court found no Appointments Clause violation as the ALJ's initial decision, made when he was unconstitutionally appointed, had been vacated on the merits and the case was remanded to the same ALJ who was then constitutionally appointed. Second, the court held that the ALJ articulated good cause for discounting Raper's treating physician’s opinion, finding the opinion inconsistent with the record. Lastly, the court found that the ALJ had properly considered Raper’s subjective complaints in light of the record as a whole and adequately explained his decision not to fully credit Raper’s alleged limitations on his ability to work.
2024-01-03federalUS Court of Appeals for the Eleventh Circuithttps://law.justia.com/cases/federal/appellate-courts/ca5/23-10246/23-10246-2024-01-02.htmlTexas v. Becerra2024-01-02T16:30:35-08:002024-01-02T16:30:35-08:00
In a case involving the State of Texas, the American Association of Pro-Life Obstetricians & Gynecologists, and the Christian Medical & Dental Associations as plaintiffs, and the United States Department of Health and Human Services (HHS), its Secretary Xavier Becerra, the Centers for Medicare and Medicaid Services (CMS), and other officials as defendants, the United States Court of Appeals for the Fifth Circuit affirmed the district court's decision. The plaintiffs challenged HHS's guidance on the Emergency Medical Treatment and Active Labor Act (EMTALA), which they alleged mandated providers to perform elective abortions beyond HHS's authority and contrary to state law. The plaintiffs sought to enjoin the enforcement of this guidance. The district court granted the injunction within Texas or against any member of a plaintiff organization, and HHS appealed.
The Court of Appeals held that the HHS guidance constituted a final agency action as it binds HHS to a particular legal position and has clear legal consequences should a physician or hospital violate it. The court found that HHS's guidance exceeds the statutory language of EMTALA, which does not mandate any specific type of medical treatment, let alone abortion care. The court also held that HHS was required to subject the guidance to notice and comment as it "establishes or changes a substantive legal standard." The court affirmed the injunction, finding it not overbroad, but rather tailored based on the parties, issues, and evidence before it. <a href="https://law.justia.com/cases/federal/appellate-courts/ca5/23-10246/23-10246-2024-01-02.html" target="_blank">View "Texas v. Becerra" on Justia Law</a>
In a case involving the State of Texas, the American Association of Pro-Life Obstetricians & Gynecologists, and the Christian Medical & Dental Associations as plaintiffs, and the United States Department of Health and Human Services (HHS), its Secretary Xavier Becerra, the Centers for Medicare and Medicaid Services (CMS), and other officials as defendants, the United States Court of Appeals for the Fifth Circuit affirmed the district court's decision. The plaintiffs challenged HHS's guidance on the Emergency Medical Treatment and Active Labor Act (EMTALA), which they alleged mandated providers to perform elective abortions beyond HHS's authority and contrary to state law. The plaintiffs sought to enjoin the enforcement of this guidance. The district court granted the injunction within Texas or against any member of a plaintiff organization, and HHS appealed.
The Court of Appeals held that the HHS guidance constituted a final agency action as it binds HHS to a particular legal position and has clear legal consequences should a physician or hospital violate it. The court found that HHS's guidance exceeds the statutory language of EMTALA, which does not mandate any specific type of medical treatment, let alone abortion care. The court also held that HHS was required to subject the guidance to notice and comment as it "establishes or changes a substantive legal standard." The court affirmed the injunction, finding it not overbroad, but rather tailored based on the parties, issues, and evidence before it.
2024-01-02federalUS Court of Appeals for the Fifth Circuithttps://law.justia.com/cases/iowa/supreme-court/2023/22-1213.htmlIowa Individual Health Benefit Reinsurance Ass’n v. State University of Iowa2023-12-29T07:03:51-08:002023-12-29T07:03:51-08:00
The Supreme Court of Iowa ruled that the State University of Iowa, Iowa State University of Science and Technology, and the University of Northern Iowa were required to be members of the Iowa Individual Health Benefit Reinsurance Association (IIHBRA) and therefore had to pay assessments to the association. The universities had argued that they were not members of IIHBRA and that the statute requiring them to pay assessments violated the Iowa Constitution, which prohibits the state from acting as a surety for another. The court rejected these arguments, finding that the statutory scheme did not violate the constitution and that the universities, as providers of health benefit plans, were indeed members of IIHBRA. The court also ruled that IIHBRA was statutorily authorized to impose late payment fees against its members. However, the court denied IIHBRA's request for attorney fees and costs. The court affirmed in part, reversed in part, and remanded the case for further proceedings. <a href="https://law.justia.com/cases/iowa/supreme-court/2023/22-1213.html" target="_blank">View "Iowa Individual Health Benefit Reinsurance Ass’n v. State University of Iowa" on Justia Law</a>
The Supreme Court of Iowa ruled that the State University of Iowa, Iowa State University of Science and Technology, and the University of Northern Iowa were required to be members of the Iowa Individual Health Benefit Reinsurance Association (IIHBRA) and therefore had to pay assessments to the association. The universities had argued that they were not members of IIHBRA and that the statute requiring them to pay assessments violated the Iowa Constitution, which prohibits the state from acting as a surety for another. The court rejected these arguments, finding that the statutory scheme did not violate the constitution and that the universities, as providers of health benefit plans, were indeed members of IIHBRA. The court also ruled that IIHBRA was statutorily authorized to impose late payment fees against its members. However, the court denied IIHBRA's request for attorney fees and costs. The court affirmed in part, reversed in part, and remanded the case for further proceedings.
2023-12-29stateIowaIowa Supreme CourtMCDONALDhttps://law.justia.com/cases/nevada/supreme-court/2023/84978.htmlEngelson v. Dignity Health2023-12-28T10:09:04-08:002023-12-28T10:09:04-08:00
In the case at hand, the Court of Appeals of the State of Nevada reversed and remanded a district court order that had dismissed a professional negligence action for being time-barred. The case was brought by Gina Engelson, as the special administrator of the estate of Lenore Meyer, against Dignity Health (doing business as St. Rose Dominican Hospital-Siena Campus) and Grape Holdings LLC (doing business as Sage Creek Post-Acute). Lenore Meyer had developed a severe bedsore while being treated at these facilities. Meyer's family alleged that the care provided by the facilities fell below the standard of care in multiple ways, including failing to timely and adequately treat the bedsore. Meyer eventually died, and exactly one year after her death, Engelson filed a professional negligence complaint against the facilities. The district court dismissed the complaint as time-barred, finding that the complaint was filed more than a year after the estate and its special administrator knew or should have known about the relevant legal injury.
Upon review, the Court of Appeals found that the district court erred in dismissing the complaint as time-barred. The Court of Appeals clarified that an affidavit of merit, which is required to support a professional negligence-based wrongful death claim, need not opine as to the element of causation. The Court of Appeals concluded that the evidence did not irrefutably demonstrate that the estate or its special administrator discovered or should have discovered the legal injury more than a year before the filing of the complaint. Therefore, the Court of Appeals reversed the district court's order and remanded for further proceedings. <a href="https://law.justia.com/cases/nevada/supreme-court/2023/84978.html" target="_blank">View "Engelson v. Dignity Health" on Justia Law</a>
In the case at hand, the Court of Appeals of the State of Nevada reversed and remanded a district court order that had dismissed a professional negligence action for being time-barred. The case was brought by Gina Engelson, as the special administrator of the estate of Lenore Meyer, against Dignity Health (doing business as St. Rose Dominican Hospital-Siena Campus) and Grape Holdings LLC (doing business as Sage Creek Post-Acute). Lenore Meyer had developed a severe bedsore while being treated at these facilities. Meyer's family alleged that the care provided by the facilities fell below the standard of care in multiple ways, including failing to timely and adequately treat the bedsore. Meyer eventually died, and exactly one year after her death, Engelson filed a professional negligence complaint against the facilities. The district court dismissed the complaint as time-barred, finding that the complaint was filed more than a year after the estate and its special administrator knew or should have known about the relevant legal injury.
Upon review, the Court of Appeals found that the district court erred in dismissing the complaint as time-barred. The Court of Appeals clarified that an affidavit of merit, which is required to support a professional negligence-based wrongful death claim, need not opine as to the element of causation. The Court of Appeals concluded that the evidence did not irrefutably demonstrate that the estate or its special administrator discovered or should have discovered the legal injury more than a year before the filing of the complaint. Therefore, the Court of Appeals reversed the district court's order and remanded for further proceedings.
2023-12-28stateNevadaSupreme Court of Nevadahttps://law.justia.com/cases/federal/appellate-courts/ca8/23-1107/23-1107-2023-12-28.htmlDoe v. BJC Health System2023-12-28T08:30:30-08:002023-12-28T08:30:30-08:00
In a case before the United States Court of Appeals For the Eighth Circuit, the plaintiffs, a group of patients, sued BJC Health System (BJC) alleging that BJC had violated their medical privacy rights under Missouri state law. Specifically, the plaintiffs claimed that when they accessed their electronic health records (EHRs) through BJC’s online patient portal, their protected health information was shared with third-party marketing services. BJC removed the case to federal court under the federal officer removal statute, arguing that they acted under the United States Department of Health and Human Services (HHS) when creating and operating the online patient portal. BJC's argument was rejected by the district court which ordered the case to be remanded back to Missouri state court. BJC appealed this decision.
The United States Court of Appeals For the Eighth Circuit affirmed the decision of the district court to remand the case to the Missouri state court. The appellate court held that BJC, while receiving federal incentive payments from HHS for creating and operating the online patient portal, was not essentially performing a basic governmental task or duty. Therefore, BJC was not acting under a federal officer in terms of the federal officer removal statute. The court concluded that the creation and operation of an online patient portal was not a basic governmental task, and BJC was not a government contractor or functioning as a federal instrumentality. <a href="https://law.justia.com/cases/federal/appellate-courts/ca8/23-1107/23-1107-2023-12-28.html" target="_blank">View "Doe v. BJC Health System" on Justia Law</a>
In a case before the United States Court of Appeals For the Eighth Circuit, the plaintiffs, a group of patients, sued BJC Health System (BJC) alleging that BJC had violated their medical privacy rights under Missouri state law. Specifically, the plaintiffs claimed that when they accessed their electronic health records (EHRs) through BJC’s online patient portal, their protected health information was shared with third-party marketing services. BJC removed the case to federal court under the federal officer removal statute, arguing that they acted under the United States Department of Health and Human Services (HHS) when creating and operating the online patient portal. BJC's argument was rejected by the district court which ordered the case to be remanded back to Missouri state court. BJC appealed this decision.
The United States Court of Appeals For the Eighth Circuit affirmed the decision of the district court to remand the case to the Missouri state court. The appellate court held that BJC, while receiving federal incentive payments from HHS for creating and operating the online patient portal, was not essentially performing a basic governmental task or duty. Therefore, BJC was not acting under a federal officer in terms of the federal officer removal statute. The court concluded that the creation and operation of an online patient portal was not a basic governmental task, and BJC was not a government contractor or functioning as a federal instrumentality.
2023-12-28federalUS Court of Appeals for the Eighth Circuithttps://law.justia.com/cases/federal/appellate-courts/ca9/20-10288/20-10288-2023-12-27.htmlUSA V. GALECKI2023-12-27T09:01:22-08:002023-12-27T09:01:22-08:00
The United States Court of Appeals for the Ninth Circuit upheld the drug-trafficking and money-laundering convictions of Benjamin Galecki and Charles Burton Ritchie for their distribution of "spice," a synthetic cannabinoid product. The defendants were found guilty of manufacturing and distributing spice through their company, Zencense Incenseworks, LLC. The drug-trafficking charges were based on the premise that the cannabinoid used, XLR-11, was treated as a controlled substance because it was an "analogue" of a listed substance. The court rejected the defendants' arguments that their convictions should be set aside due to Fourth Amendment violations, insufficient evidence, and vagueness of the Controlled Substance Analogue Enforcement Act of 1986. However, the court reversed their mail and wire fraud convictions due to insufficient evidence. The case was remanded for further proceedings. <a href="https://law.justia.com/cases/federal/appellate-courts/ca9/20-10288/20-10288-2023-12-27.html" target="_blank">View "USA V. GALECKI" on Justia Law</a>
The United States Court of Appeals for the Ninth Circuit upheld the drug-trafficking and money-laundering convictions of Benjamin Galecki and Charles Burton Ritchie for their distribution of "spice," a synthetic cannabinoid product. The defendants were found guilty of manufacturing and distributing spice through their company, Zencense Incenseworks, LLC. The drug-trafficking charges were based on the premise that the cannabinoid used, XLR-11, was treated as a controlled substance because it was an "analogue" of a listed substance. The court rejected the defendants' arguments that their convictions should be set aside due to Fourth Amendment violations, insufficient evidence, and vagueness of the Controlled Substance Analogue Enforcement Act of 1986. However, the court reversed their mail and wire fraud convictions due to insufficient evidence. The case was remanded for further proceedings.
2023-12-27federalUS Court of Appeals for the Ninth Circuithttps://law.justia.com/cases/federal/appellate-courts/ca1/22-1547/22-1547-2023-12-22.htmlWard v. Schaefer2023-12-22T11:30:15-08:002023-12-22T11:30:15-08:00
In this case, Virginia Cora Ward, as the administratrix of the estate of Edmund Edward Ward, brought a case against AlphaCore Pharma, LLC (ACP) and Bruce Auerbach. The decedent, Edmund Ward, was a participant in a clinical trial for a drug known as ACP-501, which was developed by ACP and administered by the National Institutes of Health (NIH). The trial took place in Maryland, where Ward traveled from his home in Massachusetts to receive treatment. Ward later withdrew from the trial due to deteriorating kidney function.
In 2016, Ward filed a complaint against ACP, Auerbach, and several others, alleging fraudulent inducement to participate in the clinical trial. ACP and Auerbach moved to dismiss the case for lack of personal jurisdiction, arguing that they lacked sufficient contacts with Massachusetts. The United States District Court for the District of Massachusetts agreed with them and dismissed the case. Ward appealed to the United States Court of Appeals for the First Circuit.
The First Circuit affirmed the district court's decision. The court held that neither ACP nor Auerbach had sufficient related and purposeful contacts in and with Massachusetts to establish personal jurisdiction. The court rejected Ward's claims that ACP and Auerbach had contacts with Massachusetts through their interactions with Ward's Massachusetts-based doctor, their alleged shipment of the drug to Massachusetts, their involvement in drafting the clinical trial protocol, and their alleged reimbursement of Ward's travel expenses. The court found that these claims were either unsupported by evidence or were not sufficient to establish personal jurisdiction. As a result, the court affirmed the district court's dismissal of the case against ACP and Auerbach for lack of personal jurisdiction. <a href="https://law.justia.com/cases/federal/appellate-courts/ca1/22-1547/22-1547-2023-12-22.html" target="_blank">View "Ward v. Schaefer" on Justia Law</a>
In this case, Virginia Cora Ward, as the administratrix of the estate of Edmund Edward Ward, brought a case against AlphaCore Pharma, LLC (ACP) and Bruce Auerbach. The decedent, Edmund Ward, was a participant in a clinical trial for a drug known as ACP-501, which was developed by ACP and administered by the National Institutes of Health (NIH). The trial took place in Maryland, where Ward traveled from his home in Massachusetts to receive treatment. Ward later withdrew from the trial due to deteriorating kidney function.
In 2016, Ward filed a complaint against ACP, Auerbach, and several others, alleging fraudulent inducement to participate in the clinical trial. ACP and Auerbach moved to dismiss the case for lack of personal jurisdiction, arguing that they lacked sufficient contacts with Massachusetts. The United States District Court for the District of Massachusetts agreed with them and dismissed the case. Ward appealed to the United States Court of Appeals for the First Circuit.
The First Circuit affirmed the district court's decision. The court held that neither ACP nor Auerbach had sufficient related and purposeful contacts in and with Massachusetts to establish personal jurisdiction. The court rejected Ward's claims that ACP and Auerbach had contacts with Massachusetts through their interactions with Ward's Massachusetts-based doctor, their alleged shipment of the drug to Massachusetts, their involvement in drafting the clinical trial protocol, and their alleged reimbursement of Ward's travel expenses. The court found that these claims were either unsupported by evidence or were not sufficient to establish personal jurisdiction. As a result, the court affirmed the district court's dismissal of the case against ACP and Auerbach for lack of personal jurisdiction.
2023-12-22federalUS Court of Appeals for the First Circuithttps://law.justia.com/cases/alaska/supreme-court/2023/s-18380.htmlIn the Matter of the Estate of Fe Perez Abad2023-12-22T10:31:28-08:002023-12-22T10:31:28-08:00
In a case before the Supreme Court of the State of Alaska, the court was asked to determine the deadline for filing a claim against a decedent’s estate for reimbursement for Medicaid services provided to the decedent while alive. The probate code of Alaska provides that for claims arising “before the death of the decedent,” the creditor must file within four months after the estate's representative first published notice to creditors. For claims arising “at or after the death of the decedent,” the creditor must file within four months after the claim arose. The court held that Medicaid estate recovery claims arise before death and therefore must be filed within four months after notice to creditors. The court reasoned that although the state may not pursue these claims until after the Medicaid beneficiary has died, these claims arise when Medicaid services are provided, not when the claims become enforceable. The court's decision was based on the interpretation of the probate code, the underlying legislative purpose of the Medicaid estate recovery statute, and the weight of precedent from other jurisdictions. <a href="https://law.justia.com/cases/alaska/supreme-court/2023/s-18380.html" target="_blank">View "In the Matter of the Estate of Fe Perez Abad" on Justia Law</a>
In a case before the Supreme Court of the State of Alaska, the court was asked to determine the deadline for filing a claim against a decedent’s estate for reimbursement for Medicaid services provided to the decedent while alive. The probate code of Alaska provides that for claims arising “before the death of the decedent,” the creditor must file within four months after the estate's representative first published notice to creditors. For claims arising “at or after the death of the decedent,” the creditor must file within four months after the claim arose. The court held that Medicaid estate recovery claims arise before death and therefore must be filed within four months after notice to creditors. The court reasoned that although the state may not pursue these claims until after the Medicaid beneficiary has died, these claims arise when Medicaid services are provided, not when the claims become enforceable. The court's decision was based on the interpretation of the probate code, the underlying legislative purpose of the Medicaid estate recovery statute, and the weight of precedent from other jurisdictions.
2023-12-22stateAlaskaAlaska Supreme CourtBorghesanhttps://law.justia.com/cases/texas/supreme-court/2023/22-0558.htmlSCOTT & WHITE MEMORIAL HOSPITAL v. THOMPSON2023-12-22T07:38:28-08:002023-12-22T07:38:28-08:00
The Supreme Court of Texas handled a case in which a nurse claimed her employer, Scott & White Memorial Hospital, wrongfully terminated her employment in retaliation for reporting potential child abuse or neglect to the Texas Child Protective Services (CPS), which is considered a protected conduct under Section 261.110(b) of the Texas Family Code.
The nurse, Dawn Thompson, had previously received two written reprimands for violating the hospital's personal-conduct policy. On the third occasion, she disclosed a child patient's protected health information to a school nurse without the parents' authorization. This was considered by the hospital as a violation of the Health Insurance Portability and Accountability Act (HIPAA) and a breach of the patient's rights. Consequently, Thompson was terminated.
Thompson filed a lawsuit against the hospital, asserting that her termination was in violation of Family Code Section 261.110(b), which protects professionals who report child abuse or neglect in good faith from adverse employment actions.
The Supreme Court of Texas ruled that Section 261.110 imposes a "but-for causation" requirement, which means that the protected conduct must be such that without it, the adverse employment action would not have occurred when it did. In this case, the court found that Thompson would have been terminated when she was due to her HIPAA violation, regardless of her report to CPS. Therefore, the court rejected Thompson's retaliation claim and reinstated the trial court's summary judgment in favor of the hospital. <a href="https://law.justia.com/cases/texas/supreme-court/2023/22-0558.html" target="_blank">View "SCOTT & WHITE MEMORIAL HOSPITAL v. THOMPSON" on Justia Law</a>
The Supreme Court of Texas handled a case in which a nurse claimed her employer, Scott & White Memorial Hospital, wrongfully terminated her employment in retaliation for reporting potential child abuse or neglect to the Texas Child Protective Services (CPS), which is considered a protected conduct under Section 261.110(b) of the Texas Family Code.
The nurse, Dawn Thompson, had previously received two written reprimands for violating the hospital's personal-conduct policy. On the third occasion, she disclosed a child patient's protected health information to a school nurse without the parents' authorization. This was considered by the hospital as a violation of the Health Insurance Portability and Accountability Act (HIPAA) and a breach of the patient's rights. Consequently, Thompson was terminated.
Thompson filed a lawsuit against the hospital, asserting that her termination was in violation of Family Code Section 261.110(b), which protects professionals who report child abuse or neglect in good faith from adverse employment actions.
The Supreme Court of Texas ruled that Section 261.110 imposes a "but-for causation" requirement, which means that the protected conduct must be such that without it, the adverse employment action would not have occurred when it did. In this case, the court found that Thompson would have been terminated when she was due to her HIPAA violation, regardless of her report to CPS. Therefore, the court rejected Thompson's retaliation claim and reinstated the trial court's summary judgment in favor of the hospital.
2023-12-22stateTexasSupreme Court of Texashttps://law.justia.com/cases/washington/supreme-court/2023/101-561-5.htmlP.E.L. v. Premera Blue Cross2023-12-21T08:10:16-08:002023-12-21T08:10:16-08:00
In this case, the plaintiffs, a minor and her parents, sued their health insurer, Premera Blue Cross, for denying coverage for the minor’s stay in a wilderness therapy program, claiming that the denial violates mental health parity laws. The plaintiffs also alleged breach of contract, insurance bad faith, and violation of the Consumer Protection Act.
The Supreme Court of the State of Washington held that the plaintiffs’ breach of contract claim based on alleged violation of federal parity laws does not form a viable common law action. The Court found that the plaintiffs failed to show that a violation of federal parity law would give rise to a viable common law action for breach of contract.
Furthermore, the Court held that the breach of contract action based on Premera's alleged violation of state parity laws could not succeed based on the statutory language that was in place at the time.
However, the Court did affirm the lower court’s finding that the plaintiffs were not required to produce evidence of objective symptomatology to support their insurance bad faith claim for emotional distress damages. Consequently, the case was remanded to the trial court for further proceedings on the bad faith and Consumer Protection Act claims. <a href="https://law.justia.com/cases/washington/supreme-court/2023/101-561-5.html" target="_blank">View "P.E.L. v. Premera Blue Cross" on Justia Law</a>
In this case, the plaintiffs, a minor and her parents, sued their health insurer, Premera Blue Cross, for denying coverage for the minor’s stay in a wilderness therapy program, claiming that the denial violates mental health parity laws. The plaintiffs also alleged breach of contract, insurance bad faith, and violation of the Consumer Protection Act.
The Supreme Court of the State of Washington held that the plaintiffs’ breach of contract claim based on alleged violation of federal parity laws does not form a viable common law action. The Court found that the plaintiffs failed to show that a violation of federal parity law would give rise to a viable common law action for breach of contract.
Furthermore, the Court held that the breach of contract action based on Premera's alleged violation of state parity laws could not succeed based on the statutory language that was in place at the time.
However, the Court did affirm the lower court’s finding that the plaintiffs were not required to produce evidence of objective symptomatology to support their insurance bad faith claim for emotional distress damages. Consequently, the case was remanded to the trial court for further proceedings on the bad faith and Consumer Protection Act claims.
2023-12-21stateWashingtonWashington Supreme Courthttps://law.justia.com/cases/missouri/supreme-court/2023/sc100030.htmlHarner vs. Mercy Hospital Joplin2023-12-20T18:30:13-08:002023-12-20T18:30:13-08:00
The Supreme Court of Missouri reversed a lower court's judgment in a negligence case involving a hospital and an individual who was shot on the hospital's property. The plaintiff, Steven Harner, had sued Mercy Hospital Joplin, alleging the hospital had breached its duty to protect him from the criminal acts of a third person on its property. The case revolved around the "known third person exception" to the general rule that businesses have no duty to protect invitees from the criminal acts of third parties. According to this exception, a duty may arise when a person known to be violent is present on the premises, or an individual is present who has conducted himself so as to indicate danger, and sufficient time exists to prevent injury. The court found that the defendant, Mercy Hospital, could not have reasonably foreseen that the third person in question, who had committed a non-violent theft on the premises prior to the shooting, would suddenly become violent. As such, the court held that Mercy Hospital did not owe a duty of care to Harner under the known third person exception and reversed the lower court's judgment. The case was remanded for further proceedings. <a href="https://law.justia.com/cases/missouri/supreme-court/2023/sc100030.html" target="_blank">View "Harner vs. Mercy Hospital Joplin" on Justia Law</a>
The Supreme Court of Missouri reversed a lower court's judgment in a negligence case involving a hospital and an individual who was shot on the hospital's property. The plaintiff, Steven Harner, had sued Mercy Hospital Joplin, alleging the hospital had breached its duty to protect him from the criminal acts of a third person on its property. The case revolved around the "known third person exception" to the general rule that businesses have no duty to protect invitees from the criminal acts of third parties. According to this exception, a duty may arise when a person known to be violent is present on the premises, or an individual is present who has conducted himself so as to indicate danger, and sufficient time exists to prevent injury. The court found that the defendant, Mercy Hospital, could not have reasonably foreseen that the third person in question, who had committed a non-violent theft on the premises prior to the shooting, would suddenly become violent. As such, the court held that Mercy Hospital did not owe a duty of care to Harner under the known third person exception and reversed the lower court's judgment. The case was remanded for further proceedings.
2023-12-19stateMissouriSupreme Court of MissouriRansomhttps://law.justia.com/cases/missouri/supreme-court/2023/sc100069.htmlState ex rel. Jayla Ruiz-Morales v. Alessi2023-12-20T18:30:07-08:002023-12-20T18:30:07-08:00
The Supreme Court of Missouri ruled in favor of three employees of a medical facility, Jayla Ruiz Morales, John Kimani, and Valarie Johnson, who were sued for wrongful death by the legal guardian of a patient, Ronald Scheer. Scheer, a resident at the St. Louis Developmental Disabilities Treatment Center-St. Charles Habilitation Center, died after his wheelchair's belt constricted his breathing. The employees were accused of failing to adequately supervise Scheer, failing to ensure that his wheelchair's seatbelt and pelvic harness were properly fastened, among other allegations. The employees argued that they were entitled to official immunity, a doctrine that protects public officials from liability for acts of negligence committed during the course of their official duties. The lower court rejected this argument and the employees sought a writ of prohibition from the Supreme Court of Missouri.
The Supreme Court of Missouri held that the employees were entitled to official immunity. The court found that the tasks they were required to perform were not ministerial (routine or mundane tasks) but required discretion. Tasks such as checking on the patient, repositioning him, and using a seat belt and pelvic harness required the employees to use judgment to determine if Scheer needed additional care, and if so, what care to be administered. Therefore, these tasks were not ministerial and the employees were entitled to official immunity. The court made its preliminary writ of prohibition permanent, barring the lower court from taking further action in the case.
<a href="https://law.justia.com/cases/missouri/supreme-court/2023/sc100069.html" target="_blank">View "State ex rel. Jayla Ruiz-Morales v. Alessi" on Justia Law</a>
The Supreme Court of Missouri ruled in favor of three employees of a medical facility, Jayla Ruiz Morales, John Kimani, and Valarie Johnson, who were sued for wrongful death by the legal guardian of a patient, Ronald Scheer. Scheer, a resident at the St. Louis Developmental Disabilities Treatment Center-St. Charles Habilitation Center, died after his wheelchair's belt constricted his breathing. The employees were accused of failing to adequately supervise Scheer, failing to ensure that his wheelchair's seatbelt and pelvic harness were properly fastened, among other allegations. The employees argued that they were entitled to official immunity, a doctrine that protects public officials from liability for acts of negligence committed during the course of their official duties. The lower court rejected this argument and the employees sought a writ of prohibition from the Supreme Court of Missouri.
The Supreme Court of Missouri held that the employees were entitled to official immunity. The court found that the tasks they were required to perform were not ministerial (routine or mundane tasks) but required discretion. Tasks such as checking on the patient, repositioning him, and using a seat belt and pelvic harness required the employees to use judgment to determine if Scheer needed additional care, and if so, what care to be administered. Therefore, these tasks were not ministerial and the employees were entitled to official immunity. The court made its preliminary writ of prohibition permanent, barring the lower court from taking further action in the case.
2023-12-19stateMissouriSupreme Court of MissouriBRONIEChttps://law.justia.com/cases/delaware/supreme-court/2023/22-2023.htmlLebanon County Employees' Retirement Fund v. Collis2023-12-18T12:02:36-08:002023-12-18T12:02:36-08:00
A case involving Lebanon County Employees' Retirement Fund and Teamsters Local 443 Health Services & Insurance Plan, as plaintiffs-appellants, and Steven H. Collis, Richard W. Gochnauer, Lon R. Greenberg, Jane E. Henney, M.D., Kathleen W. Hyle, Michael J. Long, Henry W. McGee, Ornella Barra, D. Mark Durcan, and Chris Zimmerman, as defendants-appellees, was heard by the Supreme Court of the State of Delaware. The plaintiffs, shareholders in AmerisourceBergen Corporation, brought a derivative complaint against the directors and officers of the Corporation alleging that they failed to adopt, implement, or oversee reasonable policies and practices to prevent the unlawful distribution of opioids. The plaintiffs claimed that this led to AmerisourceBergen incurring liability exceeding $6 billion in a 2021 global settlement related to the Company's role in the opioid epidemic. The Court of Chancery of the State of Delaware initially dismissed the complaint, basing its decision on a separate federal court finding that AmerisourceBergen had complied with its anti-diversion obligations under the Controlled Substances Act. However, the Supreme Court of the State of Delaware reversed the Court of Chancery's dismissal of the complaint, ruling that the lower court had erred in considering the federal court's findings as it changed the date at which demand futility should be considered and violated the principles of judicial notice. The case was remanded for further proceedings. <a href="https://law.justia.com/cases/delaware/supreme-court/2023/22-2023.html" target="_blank">View "Lebanon County Employees' Retirement Fund v. Collis" on Justia Law</a>
A case involving Lebanon County Employees' Retirement Fund and Teamsters Local 443 Health Services & Insurance Plan, as plaintiffs-appellants, and Steven H. Collis, Richard W. Gochnauer, Lon R. Greenberg, Jane E. Henney, M.D., Kathleen W. Hyle, Michael J. Long, Henry W. McGee, Ornella Barra, D. Mark Durcan, and Chris Zimmerman, as defendants-appellees, was heard by the Supreme Court of the State of Delaware. The plaintiffs, shareholders in AmerisourceBergen Corporation, brought a derivative complaint against the directors and officers of the Corporation alleging that they failed to adopt, implement, or oversee reasonable policies and practices to prevent the unlawful distribution of opioids. The plaintiffs claimed that this led to AmerisourceBergen incurring liability exceeding $6 billion in a 2021 global settlement related to the Company's role in the opioid epidemic. The Court of Chancery of the State of Delaware initially dismissed the complaint, basing its decision on a separate federal court finding that AmerisourceBergen had complied with its anti-diversion obligations under the Controlled Substances Act. However, the Supreme Court of the State of Delaware reversed the Court of Chancery's dismissal of the complaint, ruling that the lower court had erred in considering the federal court's findings as it changed the date at which demand futility should be considered and violated the principles of judicial notice. The case was remanded for further proceedings.
2023-12-18stateDelawareDelaware Supreme Courthttps://law.justia.com/cases/federal/appellate-courts/ca1/21-1080/21-1080-2023-12-14.htmlUnited States v. Facteau2023-12-14T14:00:45-08:002023-12-14T14:00:45-08:00
Former executives of medical device manufacturer Acclarent, Inc., William Facteau and Patrick Fabian, were found guilty of multiple misdemeanor violations of the Federal Food, Drug, and Cosmetic Act (FDCA) for commercially distributing an adulterated and misbranded medical device. They appealed their convictions, claiming First Amendment violations, due process violations, and insufficiency of evidence. The United States Court of Appeals for the First Circuit rejected all of these claims and affirmed the convictions. The court held that the use of promotional speech as evidence of a device's intended use did not implicate the First Amendment. The court also found that the term "intended use" was not unconstitutionally vague and that Facteau and Fabian had fair warning of the conduct prohibited under the FDCA. Finally, the court found that the evidence was sufficient to support the convictions and that Fabian's fine did not violate the Eighth Amendment. <a href="https://law.justia.com/cases/federal/appellate-courts/ca1/21-1080/21-1080-2023-12-14.html" target="_blank">View "United States v. Facteau" on Justia Law</a>
Former executives of medical device manufacturer Acclarent, Inc., William Facteau and Patrick Fabian, were found guilty of multiple misdemeanor violations of the Federal Food, Drug, and Cosmetic Act (FDCA) for commercially distributing an adulterated and misbranded medical device. They appealed their convictions, claiming First Amendment violations, due process violations, and insufficiency of evidence. The United States Court of Appeals for the First Circuit rejected all of these claims and affirmed the convictions. The court held that the use of promotional speech as evidence of a device's intended use did not implicate the First Amendment. The court also found that the term "intended use" was not unconstitutionally vague and that Facteau and Fabian had fair warning of the conduct prohibited under the FDCA. Finally, the court found that the evidence was sufficient to support the convictions and that Fabian's fine did not violate the Eighth Amendment.
2023-12-14federalUS Court of Appeals for the First Circuithttps://law.justia.com/cases/california/supreme-court/2023/s272129.htmlRodriguez v. Super. Ct.2023-12-14T10:02:06-08:002023-12-14T10:02:06-08:00
In the case, a defendant, Mario Rodriguez, was charged with several felonies, each carrying a maximum sentence exceeding two years. In 2018, Rodriguez was found mentally incompetent to stand trial and committed to a state hospital. After a certificate indicating his restoration to competency was filed within the two-year time limit, Rodriguez was returned to court. However, due to COVID-19 restrictions, his hearing to confirm his competency did not take place within the two-year period. Rodriguez sought to dismiss the charges against him, claiming the time for commitment had run out.
The Supreme Court of California held that under the relevant statutes, the time between the filing of a certificate of restoration of mental competency and the court's ruling on that certificate counts towards the two-year maximum commitment period mandated by section 1370(c)(1) of the California Penal Code. Therefore, the filing of a certificate of restoration does not end the period of mental incompetency commitment.
The court sent the case back to the Court of Appeal to decide whether the two-year limit was exceeded in this case, and if so, what remedy Rodriguez might be entitled to. The court did not decide whether Rodriguez was entitled to the remedy of dismissal he sought, or whether and how the issue of tolling may affect Rodriguez's entitlement to any relief. <a href="https://law.justia.com/cases/california/supreme-court/2023/s272129.html" target="_blank">View "Rodriguez v. Super. Ct." on Justia Law</a>
In the case, a defendant, Mario Rodriguez, was charged with several felonies, each carrying a maximum sentence exceeding two years. In 2018, Rodriguez was found mentally incompetent to stand trial and committed to a state hospital. After a certificate indicating his restoration to competency was filed within the two-year time limit, Rodriguez was returned to court. However, due to COVID-19 restrictions, his hearing to confirm his competency did not take place within the two-year period. Rodriguez sought to dismiss the charges against him, claiming the time for commitment had run out.
The Supreme Court of California held that under the relevant statutes, the time between the filing of a certificate of restoration of mental competency and the court's ruling on that certificate counts towards the two-year maximum commitment period mandated by section 1370(c)(1) of the California Penal Code. Therefore, the filing of a certificate of restoration does not end the period of mental incompetency commitment.
The court sent the case back to the Court of Appeal to decide whether the two-year limit was exceeded in this case, and if so, what remedy Rodriguez might be entitled to. The court did not decide whether Rodriguez was entitled to the remedy of dismissal he sought, or whether and how the issue of tolling may affect Rodriguez's entitlement to any relief.
2023-12-14stateCaliforniaSupreme Court of CaliforniaGuerrerohttps://law.justia.com/cases/massachusetts/supreme-court/2023/sjc-13439.htmlIn re Estate of Mason2023-12-14T05:04:52-08:002023-12-14T05:04:52-08:00
In the case concerning the estate of Frances R. Mason, the Supreme Judicial Court of Massachusetts ruled on two key issues. First, it considered whether the Massachusetts Medicaid program, MassHealth, could enforce a lien (known as a TEFRA lien) against a member's property after the member's death. The Court concluded that, under Massachusetts law, MassHealth can only enforce such a lien if the property is sold during the member's lifetime. Therefore, MassHealth could not enforce its lien against Mason's property, which was not sold until after her death. This ruling is a restriction on MassHealth's ability to recover Medicaid benefits paid.
Second, the Court addressed the timing of MassHealth's claim for recovery of Medicaid benefits paid on Mason's behalf. The Court concluded that the three-year statute of repose of the Massachusetts Uniform Probate Code (MUPC) does not apply retroactively to bar MassHealth's claim against the estate of a member who died prior to the effective date of the MUPC. Accordingly, MassHealth's claim against Mason's estate, which was filed nearly nine years after her death, was not barred by the MUPC's three-year statute of repose.
The facts of the case were as follows: Frances R. Mason was a recipient of Medicaid benefits from MassHealth. From January to August 2008, MassHealth paid for her care in a residential nursing facility. In May 2008, MassHealth imposed a TEFRA lien against Mason's home, as she was expected to be permanently institutionalized in the facility. Mason died in August 2008 without the property having been sold. MassHealth filed a claim to recover the Medicaid benefits paid for Mason's care in August 2018, after the executor of Mason's will had opened formal probate proceedings in June 2017.
The disposition by the Court was to affirm the order of the Probate and Family Court judge insofar as it struck MassHealth's lien against Mason's home, and to reverse the order insofar as it dismissed MassHealth's claim against her estate. The case was remanded for further proceedings consistent with the Court's opinion. <a href="https://law.justia.com/cases/massachusetts/supreme-court/2023/sjc-13439.html" target="_blank">View "In re Estate of Mason" on Justia Law</a>
In the case concerning the estate of Frances R. Mason, the Supreme Judicial Court of Massachusetts ruled on two key issues. First, it considered whether the Massachusetts Medicaid program, MassHealth, could enforce a lien (known as a TEFRA lien) against a member's property after the member's death. The Court concluded that, under Massachusetts law, MassHealth can only enforce such a lien if the property is sold during the member's lifetime. Therefore, MassHealth could not enforce its lien against Mason's property, which was not sold until after her death. This ruling is a restriction on MassHealth's ability to recover Medicaid benefits paid.
Second, the Court addressed the timing of MassHealth's claim for recovery of Medicaid benefits paid on Mason's behalf. The Court concluded that the three-year statute of repose of the Massachusetts Uniform Probate Code (MUPC) does not apply retroactively to bar MassHealth's claim against the estate of a member who died prior to the effective date of the MUPC. Accordingly, MassHealth's claim against Mason's estate, which was filed nearly nine years after her death, was not barred by the MUPC's three-year statute of repose.
The facts of the case were as follows: Frances R. Mason was a recipient of Medicaid benefits from MassHealth. From January to August 2008, MassHealth paid for her care in a residential nursing facility. In May 2008, MassHealth imposed a TEFRA lien against Mason's home, as she was expected to be permanently institutionalized in the facility. Mason died in August 2008 without the property having been sold. MassHealth filed a claim to recover the Medicaid benefits paid for Mason's care in August 2018, after the executor of Mason's will had opened formal probate proceedings in June 2017.
The disposition by the Court was to affirm the order of the Probate and Family Court judge insofar as it struck MassHealth's lien against Mason's home, and to reverse the order insofar as it dismissed MassHealth's claim against her estate. The case was remanded for further proceedings consistent with the Court's opinion.
2023-12-13stateMassachusettsMassachusetts Supreme Judicial CourtWendlandthttps://law.justia.com/cases/federal/appellate-courts/cafc/22-1960/22-1960-2023-12-13.htmlWINKLER v. HHS 2023-12-13T07:37:02-08:002023-12-13T07:37:02-08:00
In 2017, Donald Winkler received a Tdap vaccination after stepping on rusted metal. Soon after, he developed symptoms of Guillain-Barré Syndrome (GBS), a type of acute monophasic peripheral neuropathy. Winkler filed a petition for relief under the National Vaccine Injury Compensation Program, asserting the Tdap vaccine caused his GBS. However, the Special Master denied his claim, and this decision was upheld by the United States Court of Federal Claims. Winkler appealed to the United States Court of Appeals for the Federal Circuit.
The appellate court affirmed the lower court's decision. The court noted that GBS is not listed as a covered condition for Tdap vaccines, so Winkler had to prove that his GBS was actually caused by the Tdap vaccination. The court applied the three-prong test set forth in Althen v. Secretary of Health and Human Services, requiring Winkler to show a medical theory causally connecting the vaccination and the injury, a logical sequence of cause and effect showing that the vaccination was the reason for the injury, and a proximate temporal relationship between vaccination and injury.
The Special Master found that Winkler had not established the second Althen prong, as he failed to provide preponderant evidence of a logical sequence of cause and effect. The court disagreed with Winkler's argument that the Special Master erred by requiring him to disprove that he suffered from a Campylobacter jejuni infection, a known trigger for GBS, stating that Winkler mischaracterized his burden of proof. The court further stated that Winkler failed to establish a prima facie case of causation of his GBS by the Tdap vaccine, not that he failed to disprove evidence of an infection. Therefore, the court affirmed the Special Master's holding that Winkler failed to prove causation of GBS by the Tdap vaccine by preponderant evidence. <a href="https://law.justia.com/cases/federal/appellate-courts/cafc/22-1960/22-1960-2023-12-13.html" target="_blank">View "WINKLER v. HHS " on Justia Law</a>
In 2017, Donald Winkler received a Tdap vaccination after stepping on rusted metal. Soon after, he developed symptoms of Guillain-Barré Syndrome (GBS), a type of acute monophasic peripheral neuropathy. Winkler filed a petition for relief under the National Vaccine Injury Compensation Program, asserting the Tdap vaccine caused his GBS. However, the Special Master denied his claim, and this decision was upheld by the United States Court of Federal Claims. Winkler appealed to the United States Court of Appeals for the Federal Circuit.
The appellate court affirmed the lower court's decision. The court noted that GBS is not listed as a covered condition for Tdap vaccines, so Winkler had to prove that his GBS was actually caused by the Tdap vaccination. The court applied the three-prong test set forth in Althen v. Secretary of Health and Human Services, requiring Winkler to show a medical theory causally connecting the vaccination and the injury, a logical sequence of cause and effect showing that the vaccination was the reason for the injury, and a proximate temporal relationship between vaccination and injury.
The Special Master found that Winkler had not established the second Althen prong, as he failed to provide preponderant evidence of a logical sequence of cause and effect. The court disagreed with Winkler's argument that the Special Master erred by requiring him to disprove that he suffered from a Campylobacter jejuni infection, a known trigger for GBS, stating that Winkler mischaracterized his burden of proof. The court further stated that Winkler failed to establish a prima facie case of causation of his GBS by the Tdap vaccine, not that he failed to disprove evidence of an infection. Therefore, the court affirmed the Special Master's holding that Winkler failed to prove causation of GBS by the Tdap vaccine by preponderant evidence.
2023-12-13federalUS Court of Appeals for the Federal Circuithttps://law.justia.com/cases/texas/supreme-court/2023/23-0994.htmlIN RE STATE OF TEXAS2023-12-11T15:09:20-08:002023-12-11T15:09:20-08:00
In this case handled by the Supreme Court of Texas, the parents of two children, Kate Cox and Justin Cox, along with their doctor, Dr. Damla Karsan, filed a suit to challenge the enforcement of Texas laws that prohibit abortion. Mrs. Cox was about 20 weeks pregnant with a baby diagnosed with trisomy 18, a serious genetic disorder. The suit sought to apply a medical-necessity exception provided in the Texas law, which allows an abortion if a woman's life is threatened or she faces a serious risk of substantial impairment of a major bodily function due to her pregnancy.
The court, in its decision, clarified that the exception to the abortion prohibition is based on the reasonable medical judgment of a doctor, not a court. It was noted that Dr. Karsan presented a "good faith belief" that Mrs. Cox meets the exception's requirements but did not assert that her belief meets the objective standard of "reasonable medical judgment."
The court held that judges lack the authority to broaden the statutory exception by interpreting it and held the trial court erred in applying a different, lower standard instead of requiring reasonable medical judgment. The court emphasized that the exception requires a doctor's decision whether a pregnant woman’s complications pose the required risks.
The court conditionally granted relief and directed the trial court to vacate the temporary restraining order that had restrained the Attorney General from enforcing the abortion laws against Dr. Karsan and others related to the case, based solely on the verified pleading. The court also noted that nothing in their opinion prevents a physician from acting if, in that physician’s reasonable medical judgment, they determine that the pregnant woman has a life-threatening physical condition. <a href="https://law.justia.com/cases/texas/supreme-court/2023/23-0994.html" target="_blank">View "IN RE STATE OF TEXAS" on Justia Law</a>
In this case handled by the Supreme Court of Texas, the parents of two children, Kate Cox and Justin Cox, along with their doctor, Dr. Damla Karsan, filed a suit to challenge the enforcement of Texas laws that prohibit abortion. Mrs. Cox was about 20 weeks pregnant with a baby diagnosed with trisomy 18, a serious genetic disorder. The suit sought to apply a medical-necessity exception provided in the Texas law, which allows an abortion if a woman's life is threatened or she faces a serious risk of substantial impairment of a major bodily function due to her pregnancy.
The court, in its decision, clarified that the exception to the abortion prohibition is based on the reasonable medical judgment of a doctor, not a court. It was noted that Dr. Karsan presented a "good faith belief" that Mrs. Cox meets the exception's requirements but did not assert that her belief meets the objective standard of "reasonable medical judgment."
The court held that judges lack the authority to broaden the statutory exception by interpreting it and held the trial court erred in applying a different, lower standard instead of requiring reasonable medical judgment. The court emphasized that the exception requires a doctor's decision whether a pregnant woman’s complications pose the required risks.
The court conditionally granted relief and directed the trial court to vacate the temporary restraining order that had restrained the Attorney General from enforcing the abortion laws against Dr. Karsan and others related to the case, based solely on the verified pleading. The court also noted that nothing in their opinion prevents a physician from acting if, in that physician’s reasonable medical judgment, they determine that the pregnant woman has a life-threatening physical condition.
2023-12-11stateTexasSupreme Court of Texashttps://law.justia.com/cases/federal/appellate-courts/ca4/21-2193/21-2193-2023-12-11.htmlEasterbrook v. Kijakazi2023-12-11T11:31:03-08:002023-12-11T11:31:03-08:00
In this case heard before the United States Court of Appeals for the Fourth Circuit, the plaintiff, Daniella Easterbrook, appealed the denial of her application for disability benefits by the Social Security Administration. Easterbrook, who has suffered from persistent back pain since 2011, argued that the Administrative Law Judge (ALJ) failed to provide a "good reason," supported by substantial evidence, for not giving adequate weight to the opinions of her treating physician, Dr. John Kim.
The court agreed with Easterbrook, stating that the ALJ erred in not applying the "treating source rule" to Dr. Kim's opinions and not providing a sufficient justification for giving his opinions less weight. The court noted that Dr. Kim's opinions were well-supported by medically acceptable clinical and laboratory diagnostic techniques and were consistent with the substantial evidence in the record.
The court also found that the ALJ's reasons for discounting Dr. Kim's opinions, such as Easterbrook's decision not to undergo certain treatments, were inappropriate and did not constitute "good reasons." The court stated that a patient's refusal to pursue a specific type of medical treatment does not automatically call into question the severity of her pain.
As a result, the court reversed the Commissioner's decision and remanded the case for a determination consistent with its opinion. <a href="https://law.justia.com/cases/federal/appellate-courts/ca4/21-2193/21-2193-2023-12-11.html" target="_blank">View "Easterbrook v. Kijakazi" on Justia Law</a>
In this case heard before the United States Court of Appeals for the Fourth Circuit, the plaintiff, Daniella Easterbrook, appealed the denial of her application for disability benefits by the Social Security Administration. Easterbrook, who has suffered from persistent back pain since 2011, argued that the Administrative Law Judge (ALJ) failed to provide a "good reason," supported by substantial evidence, for not giving adequate weight to the opinions of her treating physician, Dr. John Kim.
The court agreed with Easterbrook, stating that the ALJ erred in not applying the "treating source rule" to Dr. Kim's opinions and not providing a sufficient justification for giving his opinions less weight. The court noted that Dr. Kim's opinions were well-supported by medically acceptable clinical and laboratory diagnostic techniques and were consistent with the substantial evidence in the record.
The court also found that the ALJ's reasons for discounting Dr. Kim's opinions, such as Easterbrook's decision not to undergo certain treatments, were inappropriate and did not constitute "good reasons." The court stated that a patient's refusal to pursue a specific type of medical treatment does not automatically call into question the severity of her pain.
As a result, the court reversed the Commissioner's decision and remanded the case for a determination consistent with its opinion.
2023-12-11federalUS Court of Appeals for the Fourth Circuithttps://law.justia.com/cases/minnesota/supreme-court/2023/a21-1518.htmlFindling vs. Group Health Plan, Inc.2023-12-11T10:06:54-08:002023-12-11T10:06:54-08:00
The Minnesota Supreme Court ruled that an individual can bring a private action under the Minnesota private attorney general statute to compel a healthcare provider to disclose that individual’s medical records as required by the Minnesota Health Records Act. This decision was based on the interpretation of the private attorney general statute, which the court concluded applies to laws regarding unfair, discriminatory, and other unlawful practices in business, commerce, or trade. The court found that the Minnesota Health Records Act, which mandates the timely disclosure of health records to patients, falls within this category. However, the court also held that an individual does not have a private right of action under the Minnesota Health Care Bill of Rights to compel a healthcare provider to disclose an individual’s medical records. The ruling affirmed in part, reversed in part, and remanded the case to the district court for further proceedings. <a href="https://law.justia.com/cases/minnesota/supreme-court/2023/a21-1518.html" target="_blank">View "Findling vs. Group Health Plan, Inc." on Justia Law</a>
The Minnesota Supreme Court ruled that an individual can bring a private action under the Minnesota private attorney general statute to compel a healthcare provider to disclose that individual’s medical records as required by the Minnesota Health Records Act. This decision was based on the interpretation of the private attorney general statute, which the court concluded applies to laws regarding unfair, discriminatory, and other unlawful practices in business, commerce, or trade. The court found that the Minnesota Health Records Act, which mandates the timely disclosure of health records to patients, falls within this category. However, the court also held that an individual does not have a private right of action under the Minnesota Health Care Bill of Rights to compel a healthcare provider to disclose an individual’s medical records. The ruling affirmed in part, reversed in part, and remanded the case to the district court for further proceedings.
2023-12-06stateMinnesotaMinnesota Supreme CourtTHISSENhttps://law.justia.com/cases/federal/appellate-courts/ca8/22-3101/22-3101-2023-12-11.htmlUnited States v. Ready2023-12-11T08:01:10-08:002023-12-11T08:01:10-08:00
In this case before the United States Court of Appeals for the Eighth Circuit, the defendant, Bradley Ready, appealed his sentence following his guilty plea for possession with intent to distribute methamphetamine and possession of a firearm as an unlawful user of a controlled substance. The court affirmed the district court's decision.
During a search of Ready's residence, law enforcement officers found drug paraphernalia, scales, a loaded hunting rifle, and three bags of methamphetamine. Ready was subsequently charged and pleaded guilty to both counts. At sentencing, the U.S. Probation Office recommended grouping the drug and gun counts together and applying a two-level enhancement due to the possession of a dangerous weapon. Ready objected to this enhancement, but the district court overruled this objection.
On appeal, Ready argued that the district court erred in applying the enhancement for possession of a dangerous weapon and applied the wrong standard in determining his eligibility for safety valve relief. The appellate court found no error in the district court's conclusions.
The appellate court held that the district court did not err in applying the enhancement for possession of a dangerous weapon, as it was not "clearly improbable" that the rifle found in Ready's bedroom was connected to the distribution of methamphetamine from his home. The court also held that the district court did not err in its application of the standard for determining Ready's eligibility for safety valve relief. Therefore, the district court's judgment was affirmed. <a href="https://law.justia.com/cases/federal/appellate-courts/ca8/22-3101/22-3101-2023-12-11.html" target="_blank">View "United States v. Ready" on Justia Law</a>
In this case before the United States Court of Appeals for the Eighth Circuit, the defendant, Bradley Ready, appealed his sentence following his guilty plea for possession with intent to distribute methamphetamine and possession of a firearm as an unlawful user of a controlled substance. The court affirmed the district court's decision.
During a search of Ready's residence, law enforcement officers found drug paraphernalia, scales, a loaded hunting rifle, and three bags of methamphetamine. Ready was subsequently charged and pleaded guilty to both counts. At sentencing, the U.S. Probation Office recommended grouping the drug and gun counts together and applying a two-level enhancement due to the possession of a dangerous weapon. Ready objected to this enhancement, but the district court overruled this objection.
On appeal, Ready argued that the district court erred in applying the enhancement for possession of a dangerous weapon and applied the wrong standard in determining his eligibility for safety valve relief. The appellate court found no error in the district court's conclusions.
The appellate court held that the district court did not err in applying the enhancement for possession of a dangerous weapon, as it was not "clearly improbable" that the rifle found in Ready's bedroom was connected to the distribution of methamphetamine from his home. The court also held that the district court did not err in its application of the standard for determining Ready's eligibility for safety valve relief. Therefore, the district court's judgment was affirmed.
2023-12-11federalUS Court of Appeals for the Eighth Circuit