Justia Civil Procedure Opinion Summaries

Allstate Insurance Company et al. (Allstate) filed a complaint on behalf of itself and the People of California (qui tam) against Dr. Sonny Rubin and related medical providers (Rubin). Allstate generally alleged Rubin prepared fraudulent patient medical reports and billing statements in support of insurance claims. Rubin filed an anti-SLAPP motion, arguing the preparation and submission of its medical reports and bills were protected litigation activities. The trial court denied Rubin’s motion. "Litigation is not 'under [serious] consideration' - and thereby protected activity under the anti-SLAPP statute - if the ligation is merely a 'possibility.'" The Court of Appeal found that Rubin failed to show its medical reports and bills were prepared outside of its usual course of business in anticipation of litigation that was “under [serious] consideration.” Thus, the Court affirmed the trial court’s order denying Rubin’s anti-SLAPP motion. View "California ex rel. Allstate Ins. Co. v. Rubin" on Justia Law

Medical Recovery Services, LLC, (MRS) sued Michael Eddins to collect on debts that had purportedly been assigned to MRS by Intermountain Emergency Physicians and Intermountain Anesthesia. After a bench trial, the magistrate court dismissed MRS’s complaint, holding MRS lacked standing because it failed to prove a valid assignment occurred. MRS appealed to the district court. That court reversed, holding the magistrate court erred in limiting the admission of two exhibits that MRS relied upon to establish that Eddins’ accounts had been validly assigned to it. Alternatively, the district court held Eddins was judicially estopped from raising the assignment issue at trial because he did not raise it earlier during the litigation. Eddins timely appealed to the Idaho Supreme Court. After review, the Court affirmed the district court’s decision on the magistrate court’s abuse of discretion in limiting the admission of "Exhibit 2." The Court likewise affirmed the district court’s conclusion about an agent of MRS and its standing for the purposes of prosecuting this case. The Court reversed as to all other issues and remanded for further proceedings. View "Medical Recovery Svcs v. Eddins" on Justia Law

Carolyn Bowen sued Cottage Grove Nursing Home for wrongful death and medical negligence on behalf of her husband, Guy Bowen. Guy Bowen had been a resident of Cottage Grove since June 2016. In May 2017, Guy was diagnosed with prostate cancer that had metastasized into his organs and bones. In October 2017, Guy fell in the shower at Cottage Grove and sustained multiple fractures. The attending radiologist noted that the fractures were likely pathologic. Guy was transferred to a rehabilitation facility and then to Pleasant Hill Nursing Home. Guy did not return to Cottage Grove. On March 18, 2018, Guy presented to the emergency department at UMMC with various pain. A CT scan showed diffuse metastatic disease through his liver and widespread osseous disease in his bones. Guy died five days later. Carolyn in her suit, Carolyn claimed that Guy’s fall at Cottage Grove, in which he sustained multiple fractures, was the cause of Guy’s death five months later. Cottage Grove filed a summary-judgment motion for Carolyn’s failure to produce medical-expert testimony. The Mississippi Supreme Court determined the trial court erred by denying Cottage Grove’s summary-judgment motion. "Cottage Grove met its summary-judgment burden by showing that Carolyn had failed to produce sworn expert testimony establishing a prima facie case of medical negligence." View "Cottage Grove Nursing Home, L.P. v. Bowen" on Justia Law

John Dee and Brenda Peterson appealed the grant of summary judgment in favor of Triad of Alabama, LLC, d/b/a Flowers Hospital ("Triad") on the Petersons' claims asserted in their medical-malpractice action. John was admitted to Flowers Hospital ("the hospital") in August 2014 for treatment of abdominal pain and fever that was caused by colitis. John was suffering from chronic lymphocytic leukemia, end-stage renal disease, and diabetes. While he was admitted to the hospital in August 2014, John had a peripherally inserted central catheter ("PICC line") in his left shoulder. According to the Petersons, after John had suffered "constant pain and aggravation" around the area where the PICC line was inserted, a doctor agreed to have the PICC line removed the following morning. The Petersons asserted that, a nurse, Matthew Starr, was busy with other patients to immediately remove the line. The Petersons contended that another doctor was then called, that the doctor advised the nurses treating John to take out the PICC line, and that the nurses refused. The Petersons asserted that Starr "abandoned" John. Thereafter, John experienced a deep vein thrombosis ("DVT") in his upper left arm, which caused swelling and tissue necrosis. The Alabama Supreme Court affirmed, finding that the Petersons did not make an argument supported by sufficient authority to demonstrate the trial court erred. "They failed to present expert medical testimony from a similarly situated health-care provider to establish the applicable standard of care, a deviation from that standard, and proximate causation linking the actions of hospital staff to John's injury." View "Peterson v. Triad of Alabama, LLC, d/b/a Flowers Hospital" on Justia Law

Yshekia Fletcher appealed the grant of summary judgment entered in favor of the Health Care Authority of the City of Huntsville d/b/a Huntsville Hospital ("the Authority") on Fletcher's claims asserted in her medical-malpractice action. In 2016, Fletcher was admitted to Huntsville Hospital to undergo a laparoscopic tubal-ligation surgery. Before the surgery, Fletcher's doctor, Dr. Leon Lewis, explained to Fletcher that he might have issues performing the surgery because of her obesity. During the procedure, Fletcher was placed in a Trendelenburg position - a position that lowers the head of the patient by manipulating the angle of the operating table. While in Trendelenburg, Fletcher began to slip downward off the operating table. Nursing staff caught Fletcher’s body and gently placed her on the operating room floor, where the surgeon removed the trocars and closed the incisions. After the procedure, Fletcher underwent a CT scan of her head, neck, and hip, which were normal. She was admitted overnight and discharged the following day. Fletcher later complained of hip pain after the incident. She was evaluated by an orthopedic surgeon, who noted that she had a contusion and that she had had right-hip surgery as a child. Fletcher was admitted to the hospital overnight and discharged the following day with a walker. The Alabama Supreme Court concluded the trial court correctly entered summary judgment in favor of the Authority based on Fletcher's failure to present expert medical testimony. View "Fletcher v. Health Care Authority of the City of Huntsville d/b/a Huntsville Hospital" on Justia Law

Rite Aid’s “Rx Savings Program” provides generic prescription drugs at reduced prices. The program is free and widely available but excludes customers whose prescriptions are paid by publicly funded healthcare programs like Medicare or Medicaid. Federal regulations require pharmacies to dispense prescriptions for beneficiaries of those programs at their “usual and customary charge to the general public” (U&C rate). Rahimi alleged that Rite Aid overbilled the government programs because the amounts it charged did not take into account the lower Rx Savings Program prices. Rahimi claimed Rite Aid's submission of bills for those covered by publicly funded health insurance, representing the price to be the U&C rate, violated the False Claims Act, 31 U.S.C. 3729(a).The Sixth Circuit affirmed the dismissal of Rahimi’s claim. The Act’s public disclosure bar precludes qui tam actions that merely feed off prior public disclosures of fraud. From the beginning, communications about the Rx Savings Program have stated that publicly funded health care programs were ineligible for the discounted prices. Before Rahimi’s disclosures, Connecticut investigated membership discount prices; the Department of Health and Human Services announced that it would review Medicaid claims for generic drugs to determine the extent to which large chain pharmacies are billing Medicaid the usual and customary charges for drugs provided under their retail discount generic programs; and a qui tam action was unsealed in California, describing an identical scheme. View "Rahimi v. Rite Aid Corp." on Justia Law

The hospital, located in Philadelphia, received a reclassification into the New York City area, which would sizably increase the hospital’s Medicare reimbursements due to that area’s higher wage index, 42 U.S.C. 1395ww(d). Although a statute makes such reclassifications effective for three fiscal years, the agency updated the geographical boundaries for the New York City area before the close of that period and reassigned the hospital to an area in New Jersey with an appreciably lower wage index. The hospital successfully sued three agency officials in the Eastern District of Pennsylvania.The Third Circuit vacated and remanded for dismissal. The Medicare Act, 42 U.S.C. 1395oo(f)(1), channels reimbursement disputes through administrative adjudication as a near-absolute prerequisite to judicial review. The hospital did not pursue its claim through administrative adjudication before suing in federal court. By not following the statutory channeling requirement, the hospital has no valid basis for subject-matter jurisdiction. View "Temple University Hospital, Inc. v. Secretary United States Department of Health & Human Services" on Justia Law

The 2010 Patient Protection and Affordable Care Act required most Americans to obtain minimum essential health insurance coverage and imposed a monetary penalty upon most individuals who failed to do so; 2017 amendments effectively nullified the penalty. Several states and two individuals sued, claiming that without the penalty, the Act’s minimum essential coverage provision, 26 U.S.C. 5000A(a), is unconstitutional and that the rest of the Act is not severable from section 5000A(a).The Supreme Court held that the plaintiffs lack standing to challenge section 5000A(a) because they have not shown a past or future injury fairly traceable to the defendants’ conduct enforcing that statutory provision. The individual plaintiffs cited past and future payments necessary to carry the minimum essential coverage; that injury is not “fairly traceable” to any “allegedly unlawful conduct” of which they complain, Without a penalty for noncompliance, section 5000A(a) is unenforceable. To find standing to attack an unenforceable statutory provision, seeking only declaratory relief, would allow a federal court to issue an impermissible advisory opinion.The states cited the indirect injury of increased costs to run state-operated medical insurance programs but failed to show how that alleged harm is traceable to the government’s actual or possible enforcement of section 5000A(a). Where a standing theory rests on speculation about the decision of an independent third party (an individual’s decision to enroll in a program like Medicaid), the plaintiff must show at the least “that third parties will likely react in predictable ways.” Nothing suggests that an unenforceable mandate will cause state residents to enroll in benefits programs that they would otherwise forgo. An alleged increase in administrative and related expenses is not imposed by section 5000A(a) but by other provisions of the Act. View "California v. Texas" on Justia Law

In the lawsuit underlying these consolidated writ proceedings, the People of the State of California, by and through the Santa Clara County Counsel, the Orange County District Attorney, the Los Angeles County Counsel, and the Oakland City Attorney, filed an action against defendants— various pharmaceutical companies involved in the manufacture, marketing, distribution, and sale of prescription opioid medications. The People alleged the defendants made false and misleading statements as part of a deceptive marketing scheme designed to minimize the risks of opioid medications and inflate their benefits. This scheme, the People alleged, caused a public health crisis in California by dramatically increasing the number of opioid prescriptions, the use and abuse of opioids, and opioid-related deaths. These proceedings pertained to a discovery dispute after several of the defendants served subpoenas on two nonparty counties, petitioners County of Los Angeles and County of Alameda, seeking records of patients in various county programs, including individual prescription data and individual patient records related to substance abuse treatment. After petitioners and the Johnson & Johnson defendants engaged in various informal and formal means to attempt to resolve the dispute, the superior court issued a discovery order granting the Johnson & Johnson defendants’ motions to compel production of the records. The Court of Appeal concluded petitioners established that the superior court’s order threatened a serious intrusion into the privacy interests of the patients whose records were at issue: the Johnson & Johnson defendants failed to demonstrate their interests in obtaining “such a vast production of medical information” outweighed the significant privacy interests that the nonparty petitioners identified. Accordingly, the Court granted petitioners’ writ petitions and directed the superior court to vacate its order compelling production of the requested documents, and to enter a new order denying Johnson & Johnson defendants’ motions to compel. View "County of Los Angeles v. Superior Ct." on Justia Law

Linda Black sustained second-degree burns on her back while undergoing electrotherapeutic treatment at Superior Physical Therapy (“SPT”). Black’s treatment was performed by Bart McDonald, a licensed physical therapist and the sole owner of SPT. Black brought a product liability claim against the manufacturer and seller of the self- adhesive carbon electrode pads used during her treatment. The manufacturer moved for summary judgment on the grounds that Black was unable to prove that the electrode pads were defective or that the injuries Black sustained were proximately caused by its negligence. The district court ruled that: (1) McDonald’s conclusory statements that the electrode pads were defective were inadmissible because he was not a qualified expert; (2) the doctrine of res ipsa loquitur did not apply to Black’s case; and (3) Black’s prima facie case failed because there was evidence of abnormal use of the electrode pads and other reasonable secondary causes that could have contributed to Black’s injury. The district court granted summary judgment in favor of the manufacturer. Finding no reversible error, the Idaho Supreme Court affirmed the district court’s decision. View "Black v. DJO Global" on Justia Law