Justia Civil Procedure Opinion Summaries
Articles Posted in Health Law
Monroe v. Bowman
The case involves a class action lawsuit filed by transgender women prisoners in Illinois, who allege that the Illinois Department of Corrections (IDOC) has been deliberately indifferent to their gender dysphoria, a serious medical condition. The plaintiffs seek injunctive relief to ensure timely evaluations and treatments, including hormone therapy, gender-affirming surgery, and appropriate support for social transitioning.The United States District Court for the Southern District of Illinois initially issued a preliminary injunction on February 7, 2022, which was intended to address the plaintiffs' claims. The court later issued further injunctions to supplement and modify the terms. However, more than a year and a half after the preliminary injunction was issued, the district court retroactively labeled it as a permanent injunction and issued a final judgment consistent with the February 7, 2022 decision. The defendants appealed several injunctions and a finding of civil contempt by the district court.The United States Court of Appeals for the Seventh Circuit reviewed the case and found that the district court's attempt to retroactively transform the preliminary injunction into a permanent one was not authorized. The appellate court held that under the Prison Litigation Reform Act (PLRA), the preliminary injunction issued on February 7, 2022, expired 90 days later, on May 8, 2022. Consequently, the appellate court vacated all existing injunctions and remanded the case for further proceedings consistent with its opinion. The court also dismissed the portion of the appeal challenging the finding of contempt, as the district court had not yet imposed any sanctions, which are necessary to establish appellate jurisdiction. View "Monroe v. Bowman" on Justia Law
SHELLER v. HHS
Chad Sheller, as the personal representative of the estate of his son Daniel Elias Sheller, sought attorneys' fees after voluntarily dismissing a Vaccine Act petition. Daniel passed away at two months old, two days after receiving several vaccinations. Sheller filed for compensation under the National Childhood Vaccine Injury Compensation Program, relying on the "Triple Risk Model" of vaccine-triggered sudden infant death syndrome (SIDS) proposed by Dr. Douglas Miller. This model had previously been accepted in another case, Boatmon v. Secretary of Health & Human Services.The Special Master denied Sheller's request for attorneys' fees, concluding that the Triple Risk Model did not provide a reasonable basis for the claim. The United States Court of Federal Claims affirmed this decision. The Special Master also struck certain medical articles from the record, which were submitted after the petition was dismissed, deeming them irrelevant.The United States Court of Appeals for the Federal Circuit reviewed the case. The court found that the Special Master abused his discretion by not considering whether the Triple Risk Model was a reasonable basis at the time of filing, given its prior acceptance in the Boatmon case. The court noted that the model was plausible and had succeeded before another special master, making it a reasonable basis for the petition when filed. The court also found that the Special Master did not abuse his discretion in striking the medical articles, as he assessed their relevance appropriately.The Federal Circuit vacated the decision and remanded the case for the Special Master to determine, in his discretion, whether attorneys' fees should be granted, considering the Vaccine Act's objective of maintaining access to qualified legal assistance. View "SHELLER v. HHS " on Justia Law
Shreves v. Montana Dept. of Labor
Richard Shreves, while incarcerated at the Montana State Prison, received medical care and subsequently filed a complaint against Dr. Paul Rees with the Board of Medical Examiners at the Montana Department of Labor and Industry (DLI). The Correctional Health Care Review Team (CHCRT) reviewed the complaint and found no violation of law or practice rules by Dr. Rees, leading to the closure of the complaint without forwarding it to the Board of Medical Examiners. Shreves then petitioned for judicial review, challenging the CHCRT's decision and the lack of detailed findings in their response.The First Judicial District Court dismissed Shreves's petition, concluding that he lacked standing. The court reasoned that the CHCRT process did not implicate Shreves's legal rights, as it was designed to screen complaints for potential disciplinary action against the healthcare provider, not to adjudicate the complainant's rights.The Supreme Court of the State of Montana affirmed the District Court's dismissal. The court held that Shreves did not have standing to petition for judicial review because the statute governing the CHCRT process did not authorize judicial review at the behest of the complainant. The court also found that Shreves's constitutional challenge to the CHCRT's authority did not confer standing, as he lacked a personal stake in the outcome. Additionally, the court determined that any alleged mishandling of filings by the District Court did not affect the outcome, as the legal conclusions regarding standing were correct. View "Shreves v. Montana Dept. of Labor" on Justia Law
Howard Schleider v. GVDB Operations, LLC
The plaintiffs, co-personal representatives of the estate of Sara Schleider, filed a lawsuit in Florida state court against GVDB Operations, LLC, and JSMGV Management Company, LLC. They alleged that the defendants failed to prevent the spread of COVID-19 at their assisted living facility, resulting in Sara Schleider contracting the virus and subsequently dying. The plaintiffs asserted state-law claims for survival and wrongful death under Florida Statute § 429.28, alleging negligence and, alternatively, willful misconduct or gross negligence.The defendants removed the case to the United States District Court for the Southern District of Florida, claiming federal subject matter jurisdiction on three grounds: acting under a federal officer, complete preemption by the Public Readiness and Emergency Preparedness (PREP) Act, and an embedded federal question concerning the PREP Act. The district court concluded it lacked subject matter jurisdiction and remanded the case to state court, finding that the defendants' arguments did not establish federal jurisdiction.The United States Court of Appeals for the Eleventh Circuit reviewed the district court's decision. The appellate court affirmed the remand, holding that the defendants did not act under a federal officer, as their compliance with federal guidelines did not equate to acting under federal authority. The court also determined that the PREP Act did not completely preempt the plaintiffs' state-law claims, as the Act's willful misconduct provision did not wholly displace state-law causes of action for negligence. Lastly, the court found that the plaintiffs' claims did not raise a substantial federal question under the Grable doctrine, as the federal issues were not necessarily raised by the plaintiffs' well-pleaded complaint. Thus, the district court's remand to state court was affirmed. View "Howard Schleider v. GVDB Operations, LLC" on Justia Law
Government of Puerto Rico v. Express Scripts, Inc.
The Government of Puerto Rico sued several pharmaceutical benefit managers (PBMs) and pharmaceutical manufacturers in the Commonwealth of Puerto Rico Court of First Instance. The Commonwealth alleged that the PBMs, including Express Scripts and Caremark, schemed to unlawfully inflate insulin prices through rebate negotiations and price setting. The PBMs removed the case to federal court under 28 U.S.C. § 1442(a)(1), arguing that they acted under federal authority in negotiating rebates and setting drug prices, and that the lawsuit related to their federal service.The United States District Court for the District of Puerto Rico remanded the case back to the Court of First Instance. The district court found that the Commonwealth's disclaimer, which stated that it was not seeking relief related to any federal program or contract, effectively excluded any claims upon which the PBMs could base removal under § 1442(a)(1). The district court concluded that the PBMs could not claim they acted under federal authority for their non-federal PBM services and that dividing the work done for federal and non-federal clients was possible.The United States Court of Appeals for the First Circuit reversed the district court's decision. The appellate court held that the disclaimer did not prevent removal because Caremark's rebate negotiations for federal and non-federal clients were indivisible. The court found that Caremark acted under federal authority when negotiating rebates for FEHBA plans and possessed a colorable federal defense under FEHBA's express preemption provision. The court concluded that the disclaimer did not eliminate the possibility that the Commonwealth would recover for Caremark's official acts, thus justifying removal under § 1442(a)(1). The case was remanded to the district court with instructions to return it to federal court. View "Government of Puerto Rico v. Express Scripts, Inc." on Justia Law
Owlfeather-Gorbey v. Avery
The appellant, a federal prisoner serving a twenty-two-year sentence, has a history of filing numerous lawsuits regarding his prison conditions. In this case, he sought to proceed in forma pauperis (IFP) under the Prison Litigation Reform Act (PLRA) despite having three prior cases dismissed as frivolous, malicious, or for failure to state a claim. He claimed imminent danger of serious physical injury due to worsening glaucoma and alleged that prison officials denied him necessary medical treatment and incited other inmates to assault him.The United States District Court for the District of Columbia denied his motion to proceed IFP, finding that he did not demonstrate imminent danger of serious physical injury. The court dismissed his case without prejudice. The appellant then appealed this decision.The United States Court of Appeals for the District of Columbia Circuit reviewed the case. The court disagreed with the District Court's assessment regarding the appellant's glaucoma, finding that the appellant's allegations of being denied necessary medical treatment for his worsening glaucoma did place him under imminent danger of serious physical injury. Consequently, the court granted the appellant's motion to proceed IFP and reversed the District Court's denial of his motion, allowing his complaint to be docketed.However, the court also found that some of the appellant's claims were frivolous, particularly those against high-ranking officials such as the United States Attorney General and members of the United States Senate Judiciary Committee. These claims were dismissed under the PLRA's mandate to dismiss frivolous claims. The court's decision allowed the appellant to proceed with his claims related to his medical treatment and alleged assaults but dismissed the frivolous claims against the aforementioned officials. View "Owlfeather-Gorbey v. Avery" on Justia Law
The Heights of Summerlin, LLC v. District Court
Aletha Porcaro was admitted to The Heights of Summerlin, a skilled nursing facility, for rehabilitation after surgery. Upon her discharge, she contracted COVID-19 and died eight days later. Her daughter, Rachelle Crupi, filed a lawsuit against The Heights and its parent companies, alleging that they failed to implement effective COVID-19 safety protocols. The claims included negligence, wrongful death, and other related causes of action.The Heights removed the case to federal court, which remanded it back to state court. In state court, The Heights moved to dismiss the case, arguing that the federal Public Readiness and Emergency Preparedness Act (PREP Act) and Nevada’s Emergency Directive 011 granted them immunity from Crupi’s claims. The district court dismissed the professional negligence claim but allowed the other claims to proceed.The Heights then petitioned the Supreme Court of Nevada for a writ of mandamus, seeking to dismiss the remaining claims based on the same immunity arguments. The Supreme Court of Nevada reviewed the petition and concluded that the PREP Act does not apply to a lack of action or failure to implement COVID-19 policies. The court also determined that Directive 011 does not grant immunity to health care facilities, as it applies to individual medical professionals, not facilities.The Supreme Court of Nevada denied the petition for a writ of mandamus, holding that neither the PREP Act nor Directive 011 provided immunity to The Heights for the claims brought by Crupi. The court affirmed the district court’s decision to allow the remaining claims to proceed. View "The Heights of Summerlin, LLC v. District Court" on Justia Law
Natl Infusion Center v. Becerra
The case involves the National Infusion Center Association (NICA) and other plaintiffs challenging the constitutionality of the Drug Price Negotiation Program established by the Inflation Reduction Act. This program requires the Department of Health and Human Services (HHS) to negotiate drug prices with manufacturers, setting a "maximum fair price" between 40% and 75% of the market price. Manufacturers who do not comply face significant fines or must withdraw from Medicare coverage entirely.The United States District Court for the Western District of Texas dismissed NICA's lawsuit for lack of subject-matter jurisdiction. The district court reasoned that NICA's claims had to be "channeled" through HHS as required by 42 U.S.C. § 405, which mandates that claims arising under the Medicare Act be decided by the relevant agency before being brought to federal court. The district court also dismissed the remaining plaintiffs due to improper venue without NICA.The United States Court of Appeals for the Fifth Circuit reviewed the case and found that NICA had standing based on both economic and procedural injuries. The court determined that NICA's claims did not arise under the Medicare Act but rather under the Inflation Reduction Act, and thus did not require channeling through HHS. The court held that the district court had subject-matter jurisdiction over NICA's claims and reversed the lower court's dismissal, remanding the case for further proceedings. View "Natl Infusion Center v. Becerra" on Justia Law
Dignity Health v. Mounts
Dignity Health, operating as French Hospital Medical Center, filed a complaint against orthopedic surgeon Troy I. Mounts, M.D., and his corporation to recover an advance paid under their Physician Recruitment Agreement. Mounts filed a cross-complaint alleging retaliation for his complaints about patient care quality, interference with his economic opportunities, and unlawful business practices. Dignity responded with an anti-SLAPP motion to strike the cross-complaint, which the trial court initially denied. The appellate court reversed this decision and remanded the case for further consideration.Upon remand, the trial court concluded that Mounts had not demonstrated a probability of prevailing on his claims. The court found that Dignity's actions were protected by the litigation privilege, the common interest privilege, and were barred by the statute of limitations. Consequently, the court granted Dignity's motion to strike the cross-complaint and ordered Mounts to pay Dignity's attorney fees and costs.The California Court of Appeal, Second Appellate District, Division Six, reviewed the case. The court affirmed the trial court's decision, holding that all of Mounts' claims were based on conduct protected by the litigation privilege (Civil Code § 47, subd. (b)) and the common interest privilege (Civil Code § 47, subd. (c)). The court also found that Dignity's actions were immune under federal law (42 U.S.C. § 11137) and that some claims were barred by the statute of limitations. The appellate court upheld the trial court's orders granting the motion to strike and awarding attorney fees to Dignity. View "Dignity Health v. Mounts" on Justia Law
United States ex rel. Holt v. Medicare Medicaid Advisors
Elizabeth Holt, a former insurance agent for Medicare Medicaid Advisors, Inc. (MMA), alleged that MMA and several insurance carriers (Aetna, Humana, and UnitedHealthcare) violated the False Claims Act (FCA). Holt claimed that MMA engaged in fraudulent practices, including falsifying agent certifications and violating Medicare marketing regulations, which led to the submission of false claims to the Centers for Medicare and Medicaid Services (CMS).The United States District Court for the Western District of Missouri dismissed Holt's complaint. The court found that no claims were submitted to the government, the alleged regulatory violations were not material to CMS’s contract with the carriers, and the complaint did not meet the particularity standard required by Federal Rule of Civil Procedure 9(b). The court also denied Holt's motion for reconsideration, which introduced a fraudulent inducement theory and requested leave to amend the complaint.The United States Court of Appeals for the Eighth Circuit reviewed the case. The court affirmed the district court's dismissal, agreeing that Holt's allegations did not meet the materiality requirement under the FCA. The court applied the materiality standard from Universal Health Services, Inc. v. United States ex rel. Escobar, considering factors such as whether the government designated compliance as a condition of payment, whether the violations were minor or substantial, and whether the government continued to pay claims despite knowing of the violations. The court found that the alleged violations did not go to the essence of CMS’s contract with the carriers and were not material to the government's payment decisions.The Eighth Circuit also upheld the district court's denial of Holt's motion for reconsideration and request to amend the complaint, concluding that adding a fraudulent inducement claim would be futile given the immateriality of the alleged violations. View "United States ex rel. Holt v. Medicare Medicaid Advisors" on Justia Law