Justia Government & Administrative Law Opinion Summaries

Sarah DeMichele, M.D., was a board-certified psychiatrist licensed to practice medicine in Pennsylvania. From August 2011 through February 2013, Dr. DeMichele provided psychiatric care to M.R. M.R. struggled with suicidal ideations and engaged in a pattern of self-harming behavior, which she discussed regularly with Dr. DeMichele. In December 2012, M.R.’s self-inflicted injuries necessitated emergency medical treatment. M.R. ultimately was transferred to a Trauma Disorders Program in Maryland. In the program, M.R. was treated by psychiatrist Richard Loewenstein, M.D., and psychologist Catherine Fine, Ph.D. During the course of his treatment of M.R., Dr. Loewenstein obtained M.R.’s medical records from Dr. DeMichele. In 2014, Dr. Loewenstein submitted a complaint to the Professional Compliance Office of Pennsylvania’s State Board of Medicine (“Board”), in which he alleged that Dr. DeMichele’s care of M.R. was professionally deficient. Dr. Loewenstein’s complaint prompted an investigation and, ultimately, the initiation of disciplinary proceedings against Dr. DeMichele. In 2015, the Pennsylvania Department of State’s Bureau of Professional and Occupational Affairs (“Bureau”) filed an order directing Dr. DeMichele to show cause as to why the Board should not suspend, revoke, or restrict her medical license, or impose a civil penalty or the costs of investigation. In advance of the hearing, Dr. DeMichele requested that the hearing examiner issue subpoenas for the testimony of M.R. and the medical records of Dr. Loewenstein, Dr. Fine, the program, and M.R.’s former treating psychologist, April Westfall, Ph.D. Relying upon the authority provided under 63 P.S. 2203(c), the hearing examiner issued the requested subpoenas. However, when served with the subpoenas, all of M.R.’s treatment providers refused to release their records absent a court order or M.R.’s authorization. M.R. subsequently refused to authorize the release of her records. In this direct appeal, the Pennsylvania Supreme Court was asked to consider the enforceability of the subpoenas, as well as related questions regarding the scope and applicability of numerous statutes that protect a patient’s medical information. The Commonwealth Court granted the physician’s petition to enforce the subpoenas. Because the Supreme Court concluded the Commonwealth Court lacked subject matter jurisdiction to decide the issue, it vacated that court’s order. View "In Re: Enforcement of Subpoenas b/f the Bd of Med." on Justia Law

Plaintiff Millard Lance Lemmings (“Lance”) was born at a government-operated hospital in Ada, Oklahoma. During his birth, Lance suffered a brain injury. Lance and his parents, suing as “parents and next friends,” sued Defendants Comphealth, Inc. and Comphealth Medical Staffing, Inc. for medical malpractice under the Federal Tor Claims Act. The parties settled the case on September 28, 2001. Lance’s parents were simultaneously engaged in a state court proceeding regarding guardianship of Lance. On the morning of October 25, 2001, Lance’s parents filed an application for an order approving the agreed settlement, attorneys’ fees, and litigation costs in the state court action. The state district court appointed Lance’s parents as the guardians of Lance’s estate. Following that court order, Lance’s parents withdrew their state court application for an order approving the settlement. Later that day, Lance’s parents appeared before the federal district court for a fairness hearing regarding the settlement and represented him at the fairness hearing. The district court did not appoint a guardian ad litem. Appellants Barbara Lemmings and Oran Hurley, Jr. filed a motion fifteen years later seeking to intervene, in which they contended: (1) the parties presented materially inaccurate information to the district court in 2001 in order to obtain the district court’s approval; (2) the district court did not have jurisdiction to approve the settlement because it did not appoint a guardian ad litem to represent Lance; and (3) a conflict of interest existed between Lance and his parents which required the appointment of a guardian ad litem. Belatedly, Appellants further sought access to the 2001 sealed fairness hearing transcript. In the motion to intervene, Appellants asserted that Lance’s parents spent a large portion of the proceeds and abandoned him in 2011, leaving him in the care of his paternal grandmother, Appellant Barbara Lemmings. The state district court appointed her Lance’s guardian in January 2017. After Ms. Lemmings suffered a health issue, the state court appointed Appellant Oran Hurley, Jr. as co-guardian. Appellants sought to reopen the district court action, vacate the dismissal, intervene, and rewrite the terms of the Irrevocable Governmental Trust in order to access the proceeds contained in that trust. The United States objected. The Tenth Circuit rejected Appellants' contention that Federal Rule of Civil Procedure 17 required the formal appointment of a guardian ad litem, and rejected the contention that an inherent conflict of interest always existed where a minor was represented by a parent who was a party to the same lawsuit as the minor. View "Kile v. United States" on Justia Law

Scotty, born in 1979 at Madigan Army Medical Center, suffered injuries during childbirth, resulting in brain damage, cerebral palsy, seizures, and blindness, necessitating ongoing, around-the-clock care. The Shaws sued and agreed to a settlement, which stated that payments described in paragraph 5 and the purchase of annuities described in paragraph 6 “shall constitute a complete release.” Paragraph 5 provided that the government would pay: $500,000 to the Shaws; $500,000 to Scotty's medical trust; $850,000 to the Shaws’ attorneys; and, for the purchase of annuities to provide payments set forth in paragraph 6, $2,950,000.00. Paragraph 6 set forth the terms for the annuities. Four annuities are at issue: one each for Mr. and Ms. Shaw, one for the guardianship for the benefit of Scotty, and one for the medical trust. The government made each of the specified payments, including $2,846,095 to purchase the annuities. The agreement stated that payments from the annuities for Mr. and Ms. Shaw “are guaranteed for a period of twenty (20) years.” Paragraph 7 noted that the “settlement is contingent on a total, final cost of $4,800,000.00.” The annuities were purchased from ELNY, which later encountered financial difficulties and entered into court-ordered liquidation in 2012. The Shaws's annuity payments were reduced by 20%; payments to the guardianship and the medical trust were reduced by 62.4%. The Shaws sued. The Federal Circuit affirmed summary judgment in favor of the government, which was obligated to guarantee the annuity payments only for the first 20 years. The reduction in payments began after that period. The Shaws lacked standing to sue on behalf of the medical trust. View "Shaw v. United States" on Justia Law

Appellants’ action brought under the Federal Tort Claims Act (FTCA), 28 U.S.C. 1346(b), 2671-2680, seeking compensatory damages for the allegedly negligent act of a federal employee was time-barred under the FTCA’s statute of limitations.On April 22, 2013, Appellants filed a medical malpractice complaint pursuant to the FTCA against the United States Department of Health and Human Services (USDHHS). The district court granted summary judgment for USDHHS, concluding that the complaint was time-barred for failing to file compulsory administrative claims within the FTCA’s two-year statute of limitations. On appeal, Appellants argued that their claim was timely under the “discovery rule.” The First Circuit affirmed, holding that, at least by March 8, 2010, Appellants knew of sufficient facts for their cause of action to accrue, and therefore, Appellants’ action was time-barred. View "Morales-Melecio v. United States" on Justia Law

The Board of Directors (the Board) of Bear Valley Community Hospital (Bear Valley) refused to promote Dr. Robert O. Powell from provisional to active staff membership and reappointment to Bear Valley's medical staff. Dr. Powell appealed the superior court judgment denying his petition for writ of mandate to void the Board's decision and for reinstatement of his medical staff privileges. Dr. Powell practiced medicine in both Texas and California as a general surgeon. In 2000, the medical executive committee of Brownwood Regional Medical Center (Brownwood), in Texas, found that Dr. Powell failed to advise a young boy's parents that he severed the boy's vas deferens during a hernia procedure or of the ensuing implications. Further, the committee found that Dr. Powell falsely represented to Brownwood's medical staff, on at least two occasions, that he fully disclosed the circumstances to the parents, behavior which the committee considered to be dishonest, obstructive, and which prevented appropriate follow-up care. Based on the committee's findings, Brownwood terminated Dr. Powell's staff membership and clinical privileges. In subsequent years, Dr. Powell obtained staff privileges at other medical facilities. In October 2011, Dr. Powell applied for appointment to the medical staff at Bear Valley. On his initial application form, Dr. Powell was given an opportunity to disclose whether his clinical privileges had ever been revoked by any medical facility. In administrative hearings generated by the Bear Valley Board’s decision, there was a revelation that Dr. Powell had not been completely forthcoming about the Brownwood termination, and alleged the doctor mislead the judicial review committee (“JRC”) about the circumstances leading to that termination. Under Bear Valley's bylaws, Dr. Powell had the right to an administrative appeal of the JRC's decision; he chose, however, to bypass an administrative appeal and directly petition the superior court for a writ of mandamus. In superior court, Dr. Powell filed a petition for writ of mandate under Code of Civil Procedure sections 1094.5 and 1094.6, seeking to void the JRC's/Board's decision and to have his medical privileges reinstated. The trial court denied the petition, and this appeal followed. On appeal of the superior court’s denial, Dr. Powell argued he was entitled to a hearing before the lapse of his provisional staff privileges: that the Board surreptitiously terminated his staff privileges, presumably for a medical disciplinary cause, by allowing his privileges to lapse and failing to act. The Court of Appeal determined the Bear Valley Board had little to no insight into the true circumstances of Dr. Powell’s termination at Brownwood or the extent of his misrepresentations, thus the Board properly exercised independent judgment based on the information presented. In summary, the Court of Appeal concluded Bear Valley provided Dr. Powell a fair procedure in denying his request for active staff privileges and reappointment to the medical staff. View "Powell v. Bear Valley Community Hospital" on Justia Law

Dr. Erdle was arrested for possession of cocaine. He successfully completed drug treatment under a deferred entry of judgment program. Before completion of his drug program and dismissal of his criminal matter, the Medical Board filed an accusation. Erdle argued that he could not be disciplined because the action was based entirely on information obtained from his arrest record. Penal Code 1000.4 provides that “[a] record pertaining to an arrest resulting in successful completion of a pretrial diversion program shall not ... be used in any way that could result in the denial of any employment, benefit, license, or certificate.” Business and Professions Code section 492, however, states: “Notwithstanding any other provision of law, successful completion of any diversion program under the Penal Code . . . shall not prohibit" disciplinary action by specific agencies, "notwithstanding that evidence of that misconduct may be" in an arrest record. The ALJ concluded that section 492 permits discipline but that arrest records should not be permitted at the hearing; that testimony by the arresting officer was allowable; and that cause for discipline existed. The court of appeal held that section 492 creates a blanket exemption from the restrictions contained in section 1000.4 for licensing decisions made by the specified healing arts agencies. View "Medical Board of California v. Superior Court" on Justia Law

Erie is a Chicago “Federally Qualified Health Center” (FQHC), 42 U.S.C. 254b (2012). FQHCs rely heavily on federal grants and Medicaid reimbursement. Erie Employees are federal employees under the Federal Tort Claims Act, 42 U.S.C. 233(a). Erie was founded as a project between Northwestern Memorial Hospital (NMH) and Erie Neighborhood House in 1957. NMH provides financial support and technical assistance, but Erie physicians seeking NMH privileges are required to apply for them. In 2005, Yarbrough went to the Erie after searching for a clinic that would not require insurance coverage. Yarbrough was informed that she would have her ultrasounds done at Northwestern and would likely deliver her baby at NMH. Based upon information she received during the visit, Yarbrough believed that Erie and NMH were the same entity. Yarbrough sued NMH. based on her daughter’s premature birth, alleging medical negligence. The Illinois Supreme Court answered a certified question: A hospital cannot be held vicariously liable under the doctrine of apparent agency set forth in Gilbert v. Sycamore, for the acts of the employees of an unrelated, independent clinic that is not a party to the litigation. Yarbrough sought treatment at Erie but looks to impose liability on NMH. Erie is neither owned nor operated by NMH. While Erie receives some charitable assistance from NMH, it relies heavily on federal money. Erie does not utilize the Northwestern name, Northwestern-related branding, or Northwestern’s trademark purple color. View "Yarbrough v. Northwestern Memorial Hospital" on Justia Law

The Alaska professional licensing division brought an accusation of professional misconduct against doctor David Odom, M.D., alleging that he acted incompetently when he prescribed phentermine and thyroid hormone for one of his patients. The division sought disciplinary sanctions against the doctor. Following a hearing, an administrative law judge issued a proposed decision concluding that the division had failed to show that the doctor’s conduct fell below the standard of care in his field of practice and that no disciplinary sanctions were warranted. But the Medical Board instead adopted as its decision the proposal for action submitted by the division and revoked the doctor’s medical license. On appeal to the superior court, the case was remanded to the Board for consideration of the doctor’s own late-filed proposal for action. The Board reaffirmed its decision to revoke the doctor’s medical license, and the superior court affirmed that decision. The doctor appealed to the Alaska Supreme Court. Because the Medical Board’s decision to revoke the doctor’s medical license was not supported by substantial evidence, the Court reversed the superior court’s affirmance of that decision. View "Odom v. Alaska Div. of Corporations, Bus. & Prof. Licensing" on Justia Law

The issue this case presented for the Louisiana Supreme Court's review was a res nova issue of whether a claim for negligent credentialing fell within the purview of the Louisiana Medical Malpractice Act (LMMA) and was, therefore, subject to its statutory cap on damages. After completion of the medical review process, plaintiffs Brandi, Veronica, and Joseph Billeaudeau proceeded in their suit against Opelousas General Hospital Authority (OGH), among other defendants, for injuries Brandi sustained allegedly arising from the medical malpractice of Dr. Kondilo Skirlis-Zavala, an independent contractor working in the OGH’s emergency department (ED). Along with their medical malpractice claims, plaintiffs specifically alleged OGH was negligent in credentialing Dr. Zavala and subsequently moved for partial summary judgment, seeking a determination that their negligent credentialing claim was not subject to the LMMA’s cap on damages. The District Court granted the motion and ultimately certified the judgment as final. The Court of Appeal affirmed on appeal. The Supreme Court found plaintiffs’ negligent credentialing claim did not fall within the provisions of the LMMA. Accordingly, the Court affirmed the Court of Appeal. View "Billeaudeau v. Opelousas General Hospital Authority" on Justia Law

Pike underwent complex surgery at Virginia Commonwealth University Medical Center to reconstruct the back of his mouth and was taken, for recovery, to the Surgical Trauma Intensive Care Unit. Unit patients are often in very critical condition and each nurse is responsible for two patients at most. Following a surgery such as Pike’s, it is important to keep the patient’s head stable to enable blood to flow. Pike's doctors did not write any orders specifically governing the position of his head or neck. A surgeon at the hospital testified that he would rely on the skill and expertise of the nurse to position the patient’s head. Five days after the surgery, Pike was found in a position that would cause “venous compromise.” The staff was instructed to avoid this practice. That afternoon, Pike’s physician found Pike again in that position, his face and neck massively swollen. Pike had to undergo further surgery, which was not successful. Pike's malpractice complaint was dismissed on the basis of sovereign immunity. Pike argued that Hagaman, a registered nurse, was not entitled to sovereign immunity. The Supreme Court of Virginia affirmed, noting that Hagaman’s discretion was cabined by physicians’ orders, that she could not refuse to accept a particular patient, that the hospital “had a high degree of control over Hagaman," who was supervised by senior staff, and that she was subject to hospital policies. The hospital pays her wages and determines her schedule. View "Pike v. Hagaman" on Justia Law