Justia Government & Administrative Law Opinion Summaries

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 Powell was given an opportunity to disclose whether his clinical privileges had ever been revoked by any medical facility.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

The question this case presented for the Oregon Supreme Court's review was whether a statute limiting a state employee’s tort liability violated either the remedy clause of Article I, section 10, of the Oregon Constitution or the jury trial clauses of Article I, section 17, and Article VII (Amended), section 3, of the Oregon Constitution. The trial court held that the statute, as applied to the state employee, violated each of those provisions and entered a limited judgment against the employee for the full amount of the jury’s verdict. Plaintiff’s six-month-old son developed a cancerous mass on his liver. Two doctors at Oregon Health & Science University (OHSU) participated in an operation to remove the mass: Dr. Harrison, a specialist in pediatric surgery, and Dr. Durant, a pediatric surgical fellow in training. During the operation, the doctors inadvertently transected blood vessels going to the child’s liver, resulting in the child having to undergo a liver transplant, removal of his spleen, additional surgeries, and lifetime monitoring due to the risks resulting from the doctors’ act. Plaintiff brought this action on her son’s behalf against Harrison, Durant, OHSU, and Pediatric Surgical Associates, P.C. The trial court granted Pediatric Surgical Associates’ motion for summary judgment, and dismissed Durant as a result of an agreement among plaintiff, OHSU, and Harrison. Pursuant to that agreement, Harrison and OHSU admitted liability for the child’s injuries and plaintiff’s case against Harrison and OHSU went to the jury to determine the amount of the child’s damages. The jury found that plaintiff’s son had sustained and will sustain economic damages of $6,071,190.38 and noneconomic damages of $6,000,000. After the jury returned its verdict, OHSU and Harrison filed a motion to reduce the jury’s verdict to $3,000,000 based on the Oregon Tort Claims Act. The trial court granted the motion as to OHSU. The trial court, however, denied the motion as to Harrison. Harrison appealed. The Supreme Court reversed and remanded, concluding that applying the Tort Claims Act limit to plaintiff’s claim against defendant did not violate the remedy clause in Article I, section 10, nor does giving effect to that limit violate the jury trial clauses in Article I, section 17, or Article VII (Amended), section 3. View "Horton v. OHSU" on Justia Law

In 1988, Department of Professional Regulation investigator visited Gekas, a Springfield, Illinois dentist, and expressed concern that Gekas had administered nitrous oxide to a child. He ordered Gekas to provide information on all prescriptions on a continuing basis. Gekas contacted Deputy Governor Riley for assistance. After a meeting, the Department imposed less onerous requirements. In 2002, a Department investigator raided Gekas’ offices, with the assistance of the Federal Drug Enforcement Agency. After failed negotiations, the Department issued a cease and desist order against Gekas for the unlicensed practice of medicine and prescribing controlled substances while not a licensed physician and sought to have his license suspended, on grounds that Gekas had prescribed 4,600 doses of Hydrocodone and Vicoprofen to a patient. Gekas contacted his Senator. In 2008, the cease-and-desist was vacated and the complaint dismissed. Gekas submitted a FOIA request concerning the administrative complaint. The Department responded that no public documents were available. In 2009, Gekas filed suit; it was dismissed by stipulation in 2010. Meanwhile, a Chairman on the Illinois Board of Dentistry issued subpoenas against Gekas, stating that there was reasonable cause to believe that Gekas had violated the Illinois Dental Practice Act. Gekas filed suit, alleging First Amendment retaliation. The district court granted defendants summary judgment, finding no evidence of retaliatory motive. The Seventh Circuit affirmed. View "Gekas v. Vasiliades" on Justia Law

Askew, a military veteran and a former U.S. Postal Service employee, underwent a cardiac stent placement at the St. Louis Veterans Administration Medical Center. He was readmitted with an infection and the medical center responded negligently. As a result of the infection and attendant loss of blood, Askew suffered severe anoxic brain injury and amputation of his right leg. In Askew’s suit under the Federal Tort Claims Act, 28 U.S.C. 2674, the government did not dispute liability. The government requested that the court structure an award for future medical damages as a trust to provide periodic payments to Askew, with a reversionary interest in favor of the government upon Askew’s death. The district court declined to order a reversionary trust, awarded $253,667 in past economic damages, $525,000 in past non-economic damages, $4,000,000 in future economic damages, and $2,000,000 in future non-economic damages to Dirk Askew. The court awarded $1,525,000 to Askew’s wife for loss of consortium. The Eighth Circuit vacated and remanded, describing the reversionary trust remedy as the most reasonable analogy to the relief available against a private individual in like circumstances under Missouri law. View "Askew v. United States" on Justia Law

This case centered on a claim for reimbursement made by California's State Department of Health Care Services for funds expended on behalf of an injured party by the state's Medi-Cal program. The injured party, Ashlynn Aguilera, filed a special motion to determine the Department's lien under Welfare & Institutions Code section 14124.76. When Ashlynn was two months old she suffered injuries as a result of the negligence of a physician. She underwent a hemispherectomy (removal of half of the cerebral portion of her brain). Ashlynn suffered from global developmental delay, mental retardation and behavioral disorders. Ashlynn filed an action for medical malpractice and her parents settled the action for $950,000. The settlement was near the defendant's liability policy limits. The trial court approved the settlement, along with the request of Ashlynn's counsel for attorney fees and costs totaling $253,006. Ashlynn's parents received $85,000 of the settlement as a resolution of their prospective wrongful death action against the defendant. The balance of the settlement was placed in a special needs trust. The Department asserted a lien on Ashlynn's recovery, based on the $211,191 that it spent on her behalf. Ashlynn supported her special motion with declarations from her counsel and two physicians, presenting evidence regarding: her life expectancy; the care she will need throughout her life; the cost of future care; lost earning capacity; and the value of her pain and suffering. Among other things, Ashlynn presented evidence that she needs 16 hours per day of licensed vocational nurse (LVN) attendant care until she reaches the age of 21, and 24 hours per day LVN attendant care for the rest of her life. Upon review, the Court of Appeal concluded the trial court properly employed the methodology used in "Arkansas Dept. of Health and Human Services v. Ahlborn,"(547 U.S. 268 (2006)) but erred when it refused to reduce the Department's lien to account for the attorney fees and expenses Ashlynn incurred. The matter was remanded to the trial court to set aside the order and conduct further proceedings: (1) regarding whether the cost of Ashlynn's future at-home attendant care and medical care should be included in its Ahlborn calculation; and (2) apply section 14124.72 (d) to determine the Department's share of Ashlynn's attorney fees and costs. View "Aguilera v. Loma Linda Univ. Med. Center" on Justia Law