Justia Government & Administrative Law Opinion Summaries
Articles Posted in Health Law
In the Matter of the Necessity for the Hospitalization of M.B.
The respondent in an involuntary commitment proceeding, "Meredith B.," appealed the ex parte order authorizing her hospitalization for evaluation and the subsequent 30-day commitment order. Respondent argued that the screening investigation was inadequate because she was not interviewed. She asserted that, as a result, both the order hospitalizing her for evaluation and the 30-day commitment order should have been reversed and vacated. Further, she challenged the 30-day commitment order finding she was (1) "gravely disabled" and there (2) was a reasonable expectation she could improve with treatment. After review of the order at issue, the Alaska Supreme Court found the superior court's decision was supported by clear and convincing evidence. "If there was an error during the screening investigation, the error was harmless, because the respondent had the opportunity to testify at the 30-day commitment hearing." View "In the Matter of the Necessity for the Hospitalization of M.B." on Justia Law
Valentine v. Collier
Plaintiffs filed suit alleging that TDCJ's adoption and implementation of measures guided by changing CDC recommendations in regards to the COVID-19 pandemic do not go far enough. Plaintiffs filed a class action alleging violations of the Eighth Amendment's prohibition against cruel and unusual punishment, and the Americans with Disabilities Act, seeking a preliminary injunction.The Fifth Circuit granted TDCJ's motion to stay the district court's preliminary injunction, which regulates the cleaning intervals for common areas, the types of bleach-based disinfectants the prison must use, the alcohol content of hand sanitizer that inmates must receive, mask requirements for inmates, and inmates' access to tissues (amongst many other things). The court held that TDCJ is likely to prevail on the merits of its appeal because: (1) after accounting for the protective measures TDCJ has taken, plaintiffs have not shown a "substantial risk of serious harm" that amounts to "cruel and unusual punishment"; and (2) the district court committed legal error in its application of Farmer v. Brennan, by treating inadequate measures as dispositive of defendants' mental state. In this case, even assuming that there is a substantial risk of serious harm, plaintiffs lack evidence of defendants' subjective deliberate indifference to that harm. The court also held that TDCJ has shown that it will be irreparably injured absent a stay, and that the balance of the harms and the public interest favor a stay. Finally, the court held that plaintiffs have not exhausted their administrative remedies as required in the Prison Litigation Reform Act (PLRA), and the district court's injunction goes well beyond the limits of what the PLRA would allow even if plaintiffs had properly exhausted their claims. View "Valentine v. Collier" on Justia Law
Baptist Memorial Hospital – Golden Triangle, Inc. v. Azar
In this case, the parties dispute the proper method for calculating the hospital specific limit for annual DSH payments. The Hospitals filed suit challenging the 2017 final rule clarifying that hospitals' "costs incurred" are net of payments from third parties, liked Medicare and private insurers. The Hospitals contend that the Secretary's definition of "costs incurred" conflicted with the Medicaid Act, 5 U.S.C. 706(2)(C).The Fifth Circuit reversed the district court's grant of summary judgment for the Hospitals, and joined three other circuits in holding that the 2017 rule was consistent with the Medicare Act. The court could not agree with the Hospitals that the ordinary meaning and dictionary definitions of "costs" and "payments" rendered the disputed language unambiguous; the court was unpersuaded by the Hospitals' argument that the statute draws a "clear line" between costs and payments; the court rejected the Hospitals' contention that Congress, by expressly excluding payments from Medicaid and the uninsured, meant to exclude only those payments and no others; the court rejected the Hospitals' argument that the express exclusion of third-party payments in a related Medicaid provision indicates that Congress chose not to deduct third-party payments in 42 U.S.C. 1396r-4(g)(1)(A); and the court saw no basis for the Hospitals' argument that the 2017 Rule conflicts with the statutory purpose of the hospital-specific limit. Accordingly, the court remanded for further proceedings. View "Baptist Memorial Hospital - Golden Triangle, Inc. v. Azar" on Justia Law
Birchansky v. Clabaugh
Plaintiffs, health care providers and their patients, filed suit against Iowa's Department of Public Health and its Health Facilities Council, alleging that Iowa's Certificate of Need laws violate the Fourteenth Amendment's Due Process, Equal Protection, and Privileges and Immunities Clauses.The Eighth Circuit held that plaintiffs' Privileges and Immunities Clause claim was foreclosed by the Slaughter-Houses cases. Applying rational basis review to the Certificate of Need (CON) regime and capital expenditures exemption, the court held that Iowa's CON requirement is rationally related to a legitimate state interest in full-service hospital viability. Furthermore, Iowa's decision to exempt competitors who are non-hospital CON-holders is rationally related to its interest in protecting the viability of full-service hospitals. Therefore, the court affirmed the district court's orders dismissing plaintiffs' Privileges and Immunities claim and granting summary judgment in favor of the state defendants on the remaining claims. View "Birchansky v. Clabaugh" on Justia Law
In re: Gregg Abbott
The Fifth Circuit granted a writ of mandamus directing vacatur of the district court's issuance of a temporary restraining order (TRO) against executive order GA-09 as applied to abortion procedures. In order to preserve critical medical resources during the escalating COVID-19 pandemic, the Governor of Texas issued GA-09, which postpones non-essential surgeries and procedures until 11:59 p.m. on April 21, 2020.The court held that the drastic and extraordinary remedy of mandamus was warranted in this case because the district court ignored the framework governing emergency public health measures, like GA-09, in Jacobson v. Commonwealth of Massachusetts, 197 U.S. 11 (1905); the district court wrongly declared GA-09 an "outright ban" on previability abortions and exempted all abortion procedures from its scope, rather than apply the Jacobson framework to decide whether GA-09 lacks a "real or substantial relation" to the public health crisis or whether it is "beyond all question, a plain, palpable invasion" of the right to abortion; the district court failed to apply the undue-burden analysis in Planned Parenthood v. Casey, 505 U.S. 833, 857 (1992), and thus failed to balance GA-09's temporary burdens on abortion against its benefits in thwarting a public health crisis; and the district court usurped the state's authority to craft emergency health measures, substituting instead its own view of the efficacy of applying GA-09 to abortion. Therefore, the court found that the requirements for a writ of mandamus are satisfied in light of the extraordinary nature of these errors, the escalating spread of COVID-19, and the state's critical interest in protecting the public health. View "In re: Gregg Abbott" on Justia Law
Kirt v. Metzinger
Elaine Kirt died in 2010, due to complications that developed shortly after undergoing eye surgery. On September 23, 2011, her son, Neville Kirt, appearing in person and on behalf of his deceased mother and his two brothers, filed a request with the Division of Administration asking for a medical review panel to review the care provided to his mother by three defendants: Dr. Rebecca Metzinger, the attending surgeon; Dr. Theodore Strickland III, the anesthesiologist for the procedure; and Tulane Medical Center. In a reply letter to Neville, the Patient’s Compensation Fund Oversight Board (PCF) acknowledged receipt of the request; confirmed Dr. Metzinger, Dr. Strickland, and Tulane University Hospital & Clinic were qualified under the Louisiana Medical Malpractice Act (Act); informed Kirt a filing fee of $100 per qualified defendant was due; and requested payment of $300. The notice stated the failure to pay would render the request invalid, without effect, and would not suspend the time to file suit. Days later, then appearing through counsel, the Kirts sent a second letter asking to amend its previous request, adding two additional nurses. The Kirts included a $500 check to cover filing fees. A medical review panel convened, reviewed the care provided by all named healthcare providers, and found no breach of the standard of care. The Kirts thereafter filed against the doctors and nurses. Claims against the doctors were dismissed by summary judgments because there was no proof they breached the standard of care while treating Elaine Kirt. Those judgments expressly barred allocating fault to the dismissed parties and prohibited introducing evidence at trial to establish their fault. The nurses then filed peremptory exceptions of prescription, claiming the request for a medical review panel was invalid because the Kirts failed to pay the final $100 filing fee, and prescription was not suspended for any claims. The trial court concurred with the nurses and granted an exception of prescription. The Supreme Court determined that because the Kirts paid filing fees for five of six named defendants, dismissal of one of the nurses was proper for lack of a filing fee. The Court determined the lower courts did not consider or decide the merits of the Kirts' argument that they could not have reasonable known about the claims against two of the nurse defendants until one was deposed. Because the lower courts did not consider or decide the merits of the Kirts' basis for the exception of prescription, which could have turned on factual findings, the Supreme Court pretermitted consideration of these arguments and remanded the matter to the trial court for further disposition of the exception. View "Kirt v. Metzinger" on Justia Law
Ehrhart v. King County
Brian Ehrhart died within days of contracting hantavirus near his Issaquah, Washington home in early 2017. His widow, Sandra Ehrhart, sued King County’s public health department, Swedish Medical Center, and an emergency room physician, arguing all three had negligently caused Brian's death. King County asserted public duty as an affirmative defense, arguing it was not liable for Brian’s death because it did not owe him any duty as an individual. Ehrhart moved for partial summary judgment asking the court to dismiss this defense and others. The trial court granted Ehrhart’s motion but conditioned its ruling on the jury finding particular facts. King County appealed, and the Washington Supreme Court accepted direct discretionary review. The issues presented were: (1) whether the trial court could properly grant summary judgment conditioned on the jury finding particular facts; and (2) whether the regulations governing King COunty's responsibility to issue health advisories created a duty owed to Brian individually as opposed to a non actionable duty owed to the public as a whole. The Supreme Court determined the trial court could not properly grant summary judgment conditioned on the jury finding particular facts; summary judgment was appropriate only when there were no genuine issues of material fact. The Court concluded King County did not owe an individualized duty to Brian, and no exception to the public duty doctrine applied in this case. The Supreme Court therefore reversed the trial court, and remanded for entry of judgment in favor of King County on its public duty doctrine defense. View "Ehrhart v. King County" on Justia Law
Vicksburg Healthcare, LLC v. Mississippi Dept. of Health & Wound Care Management, LLC
The Mississippi State Department of Health entered a final order approving a Certificate of Need for Wound Care Management, LLC, d/b/a MedCentris for the “[p]rovision of [d]igital [s]ubtraction [a]ngiography (DSA) services (Limb Salvage Program).” Vicksburg Healthcare, LLC, d/b/a Merit Health River Region, a hospital in Vicksburg that opposed the certificate of need, appealed the Department’s statutorily affirmed decision pursuant to Mississippi Code Section 41-7-201(2) (Rev. 2018). After considering the record and issues presented, the Mississippi Supreme Court entered an order on its own motion requiring supplemental briefing regarding whether Section 41-7-201(2), as amended, governed the appeal process pertaining to facilities established for the private practice, either independently or by incorporated medical groups of physicians. The Supreme Court held that River Region lacked the right to petition the chancery court for review of the certificate of need under Section 41-7-201(2). Accordingly, the Supreme Court dismissed the case and remanded it to the Hinds County Chancery Court for further proceedings. View "Vicksburg Healthcare, LLC v. Mississippi Dept. of Health & Wound Care Management, LLC" on Justia Law
Reinaas v. Saul
Until 2010, Reinaas, now in his mid‐fifties, worked as a machine operator. He injured his spine and tore his rotator cuff on the job, and underwent two neck fusion surgeries. Reinaas planned to return to work but continued to suffer from severe headaches (treated with hydrocodone), shoulder pain, and a decreased range of motion. A neurologist diagnosed him with cervicogenic headaches, and his family doctor diagnosed “long term nuchal headaches” and “[p]ermanent pain syndrome post cervical fusion.” Dr. Bodeau, a Mayo Clinic occupational physician, opined that Reinaas could not return to his factory job and suggested surgical intervention. In 2013, Reinaas had shoulder surgery and attended physical therapy; he took naproxen and Vicodin for pain.Reinaas applied for social security disability benefits. Benefits were denied after state‐retained physicians reviewed his records and concluded that Reinaas’s accounts of his symptoms were not fully credible. Dr. Bodeau opined that Reinaas had “deteriorated significantly” and was “highly unlikely to successfully regain employment at any physical demand level.” The ALJ concluded that Reinaas was not disabled. In determining Reinaas’s residual functional capacity, the ALJ afforded great weight to the opinions of the two non‐examining physicians and gave little weight to Dr. Bodeau’s opinion, explaining that Bodeau lacked knowledge of Social Security disability rules and that his report was based on subjective complaints of questionable credibility.The Seventh Circuit vacated. Substantial evidence does not support the ALJ’s decision to discount the treating physician’s opinion and the ALJ did not adequately evaluate Reinaas’s subjective complaints. View "Reinaas v. Saul" on Justia Law
Dolin v. GlaxoSmithKline LLC
Dolin was prescribed Paxil, the brand-name version of the drug paroxetine, to treat his depression. The prescription was filled with a generic paroxetine product. Six days later, Dolin died by suicide. Federal law preempted an "inadequate labeling" state-law claim against the generic manufacturer. Mrs. Dolin sued GSK, the manufacturer of brand-name Paxil, arguing that GSK was responsible for the labeling for all paroxetine, no matter who made and sold it, and had negligently omitted an adult suicide risk. The Seventh Circuit reversed her jury verdict, based on preemption, citing the complex regulation of drug labels and of Paxil/paroxetine’s label in particular. GSK had attempted to change the Paxil label in 2007 to add an adult suicide warning. The FDA rejected that change. The court concluded that GSK lacked new information after 2007 that would have allowed it to add an adult-suicidality warning under the existing regulations.Eight days after denying Dolin certiorari, the Supreme Court decided another case, further explaining the “clear evidence” standard for impossibility preemption for prescription drug labels. Dolin filed an unsuccessful motion under FRCP 60(b)(6), arguing that the 2018 judgment should be set aside based on a change in law so that GSK could not establish its defense of impossibility preemption. The Seventh Circuit affirmed and did not impose sanctions. The Supreme Court provided important guidance but did not break new ground that would change the result in Dolin’s case. Her motion was not frivolous. View "Dolin v. GlaxoSmithKline LLC" on Justia Law