Justia Civil Procedure Opinion Summaries

Phillip and Marcia Eldridge filed a medical malpractice suit against Dr. Gregory West (West), Lance Turpin, PA-C (Turpin), and Summit Orthopaedics Specialists, PLLC (Summit), alleging Phillip became infected with Methicillin-Resistant Staphylococcus Aureus (MRSA) as a result of malpractice committed by West, Turpin, and agents of Summit. West performed hip replacement surgery on Phillip’s right hip in October 2009. In 2012, West performed what he later described as exploratory surgery on Phillip’s hip to determine the source of Phillip’s pain, as well as the potential replacement of components if an infection were found. All of the test results from the samples sent to the pathology department indicated there was no infection in the hip. Rather than explant the hip in its entirety, West replaced only the metal ball at the head of the femur with a ceramic ball. Following the second surgery, Phillip experienced numerous adverse complications. Phillip would have another revision a few months later, during which the MRSA was discovered. The Eldridges claimed West and Turpin breached the standard of care that was due them and as a result, sustained damages. The district court granted various motions, including a motion to dismiss certain causes of action against West, Turpin, and Summit, as well as a motion for summary judgment brought by Turpin and Summit, and a motion for partial summary judgment brought by West. In their appeal, the Eldridges contended the district court erred by: (1) dismissing their claims for negligent and intentional infliction of emotional distress, gross negligence, and reckless, willful, and wanton conduct; (2) denying their motion to strike the affidavits of West and Turpin; (3) limiting their claim for damages; and (4) concluding that the Eldridges could only present evidence of damages, specifically medical bills, after the Medicare write-offs had been calculated. In affirming in part and reversing in part, the Idaho Supreme Court concluded the district court erred in refusing to strike portions of West’s first affidavit and Turpin’s affidavit because they were conclusory. Furthermore, the district court abused its discretion in precluding the Eldridges from putting on proof of damages that arose after April 24, 2013, and their presentation of damages. Orders granting summary judgment to West regarding the Eldridges’ informed consent claim and Turpin were affirmed. The matter was remanded for further proceedings. View "Eldridge v. West" on Justia Law

Central Mississippi Medical Center (CMMC) appealed a Chancery Court decision denying its appeal of a Division of Medicaid (DOM) hearing. The DOM had determined that CMMC owed it $1.226 million due to overpayment. The Mississippi Supreme Court recently decided a reimbursement dispute involving the DOM, Crossgates River Oaks Hosp. v. Miss. Div. of Medicaid, 240 So. 3d 385 (Miss. 2018). In Crossgates, the hospitals prevailed because the DOM had failed to adhere to the Medicare State Plan Agreement. Applying the same legal principles to this case, the Supreme Court ruled the DOM prevailed because the DOM adhered to the Plan. The chancellor found sufficient evidence to support the DOM’s decision, decreed that it was neither arbitrary nor capricious, and decreed that it did not exceed the DOM’s authority or violate any of CMMC’s statutory or constitutional rights. View "Central Mississippi Medical Center v. Mississippi Division of Medicaid" on Justia Law

Stacey Janssen alleged Lawrence Memorial Hospital ("LMH") engaged in two healthcare schemes to fraudulently receive money from the United States. Janssen first contended LMH falsified patients’ arrival times in order to increase its Medicare reimbursement under certain pay-for-reporting and pay-for-performance programs the Government used to study and improve hospitals’ quality of care. Second, Janssen contended LMH falsely certified compliance with the Deficit Reduction Act in order to receive Medicare reimbursements to which it was otherwise not entitled. LMH moved for summary judgment below, arguing Janssen failed to show her allegations satisfied the Act’s materiality requirement - that the alleged falsehoods influenced the Government’s payment decision as required under the FCA. The district court granted LMH summary judgment on all of Janssen’s claims on this basis, and finding no reversible error, the Tenth Circuit affirmed. View "United States ex rel. Janssen v. Lawrence Memorial Hospital" on Justia Law

Shane and Rebecca Ackerschott sued Mountain View Hospital, LLC, doing business as Redicare (“Redicare”), after Shane sustained an injury leading to paraplegia. A jury found Redicare’s treatment of Shane breached the standard of care and awarded the Ackerschotts $7,958,113.67 in total damages. After judgment was entered, Redicare filed a motion for judgment notwithstanding the verdict, or in the alternative, a new trial. The Ackerschotts also moved to alter or amend the judgment. All post-trial motions were denied. Redicare appealed, arguing the district court erred by not submitting an instruction on comparative negligence to the jury and by allowing testimony of the Ackerschotts’ expert witness. The Ackerschotts cross-appealed, arguing the cap on noneconomic damages imposed by Idaho Code section 6-1603 was unconstitutional. After review, the Idaho Supreme Court affirmed as to Redicare’s direct appeal, and declined to reach the merits of the Ackerschotts’ constitutional claim on cross-appeal. View "Ackerschott v. Mtn View Hospital; Redicare" on Justia Law

The Louisiana Supreme Court granted writs in consolidated matters to consider whether allegations of negligent credentialing against two healthcare providers were claims that fell within the purview of Louisiana’s Medical Malpractice Act or, alternatively, sounded in general negligence. Mariah Charles was born prematurely in October 2014 at Lafayette General Medical Center (LGMC) and hospitalized there until March 2015, when she was transferred to Women’s and Children’s Hospital of Lafayette (W&C) until her release a month later. Dr. Geeta Dalal, a pediatric cardiologist with clinical privileges at both hospitals, contributed to Mariah’s care during and after Mariah’s hospitalization. While Mariah remained at LGMC, Dr. Dalal ordered and interpreted eight echocardiograms that, according to the petition, revealed abnormal findings that could cause pulmonary artery hypertension, yet, the petition alleged Dr. Dalal took no action other than ordering additional echocardiograms. After Mariah’s transfer to W&C, Dr. Dalal interpreted more echocardiograms, again noted abnormalities, and allegedly failed to properly diagnose or treat Mariah. Mariah’s mother initiated Medical Review Panel proceedings with the Patient’s Compensation Fund against Dr. Dalal and the hospital defendants alleging medical malpractice and seeking damages for their alleged failure to properly diagnose and treat Mariah. In addition to the Medical Review Panel proceedings, Mariah's mother filed suit against the hospitals, The Regional Health System of Acadiana, LLC, Women’s & Children’s Hospital, Inc., HCA Holdings, Inc., and Health Care Indemnity, Inc. (W&C), as well as Lafayette General Medical Center, Inc. and/or Lafayette General Health System, Inc. (LGMC), for damages related to Mariah’s care. The petition for damages asserted a single cause of action that LGMC and W&C were liable under general tort law because they “negligently credentialed Dr. Dalal and negligently provided her with privileges to practice” in their facilities “even though [they] knew or should have known she was not board certified in the field of pediatric cardiology.” LGMC and W&C filed dilatory exceptions of prematurity to this suit, asserting that they were qualified healthcare providers under the MMA and were entitled to have Thomas’s negligent credentialing claims presented first to a medical review panel pursuant to R.S. 40:1231.8(B)(1)(a)(i). Based on the allegations presented by the petition, the provisions of the LMMA, and application of the "Coleman" factors, the Supreme Court found the trial court correctly sustained the exceptions of prematurity raised by LGMC and W&C, therefore reversing the court of appeal's judgment and reinstated the trial court’s judgment. View "Thomas v. Regional Health System of Acadiana, LLC" on Justia Law

BBH BMC, LLC, d/b/a Brookwood Baptist Medical Center ("Brookwood") petitioned the Alabama Supreme Court for a writ of mandamus to direct the Jefferson Circuit Court to vacate its order compelling Brookwood to respond to certain interrogatories and requests for production. Donna Gaston arrived at Brookwood Baptist Medical Center ("the medical center") to participate in a voluntary psychiatric outpatient-treatment program. At approximately 8:40 a.m., Donna registered for the 9:00 a.m. outpatient group-therapy session in which she had enrolled. She then left the therapy area, accessed a parking deck on the premises of the medical center, and leaped to her death. Charles Gaston, Donna's husband, filed a wrongful-death action seeking to hold Brookwood liable for Donna's suicide. Specifically, he alleged the conduct of Brookwood's nurses and security fell below the applicable standard of care. The Supreme Court determined that although Gaston could discover information concerning those acts or omissions by those employees whose conduct was detailed specifically and factually described in the complaint as rendering Brookwood liable for Donna's death, Gaston was not entitled to discovery regarding acts or omissions by Brookwood related to other incidents. Therefore, because the requested discovery sought evidence of other acts or omissions of Brookwood and its employees beyond the alleged standard of care owed to Donna, Brookwood had shown a clear legal right to have the trial court's discovery order vacated. View "Ex parte BBH BMC, LLC, d/b/a Brookwood Baptist Medical Center." on Justia Law

Among its reforms, the Patient Protection and Affordable Care Act (“ACA”) required private health insurers to provide coverage for individuals regardless of their gender or health status, including preexisting conditions. Congress anticipated these reforms might hamper the ability of insurers to predict health care costs and to price health insurance premiums as more individuals sought health insurance. To spread the risk of enrolling people who might need more health care than others, Congress established a risk adjustment program for the individual and small group health insurance markets. Congress tasked the Department of Health and Human Services (“HHS”) with designing and implementing this risk adjustment program with the states. HHS developed a formula to calculate how much each insurer would be charged or paid in each state. The formula relied on the “statewide average premium” to calculate charges and payments. Plaintiff-Appellee New Mexico Health Connections (“NMHC”), an insurer that was required to pay charges under the program, sued the HHS Defendants-Appellants under the Administrative Procedure Act (“APA”), alleging that HHS’s use of the statewide average premium to calculate charges and payments in New Mexico from 2014 through 2018 was arbitrary and capricious. The district court granted summary judgment to NMHC, holding that HHS violated the APA by failing to explain why the agency chose to use the statewide average premium in its program. It remanded to the agency and vacated the 2014, 2015, 2016, 2017, and 2018 rules that implemented the program. After the district court denied HHS’s motion to alter or amend judgment under Federal Rule of Civil Procedure 59(e), HHS appealed. The Tenth Circuit Court of Appeals: (1) determined NMHC’s claims regarding the 2017 and 2018 rules were moot, so the matter was remanded to the district court to vacate its judgment on those claims and dismiss them as moot; (2) reversed the district court’s grant of summary judgment to NMHC as to the 2014, 2015, and 2016 rules because it determined HHS acted reasonably in explaining why it used the statewide average premium in the formula. Because the Court reversed the district court on its summary judgment ruling in favor of NMHC, it did not address the denial of HHS’s Rule 59(e) motion. View "New Mexico Health Connections v. HHS" on Justia Law

This case involved Cobb Hospital, Inc.'s and Kennestone Hospital, Inc.'s (collectively, “Wellstar”) challenge to the decision by the Georgia Department of Community Health (“DCH”) to grant Emory University Hospital Smyrna (“Emory”) a new certificate of need (“CON”) to renovate a hospital that Emory had recently acquired. After DCH made an initial decision granting the CON, Wellstar appealed to the CON Appeal Panel. The panel’s hearing officer affirmed the decision, ruling that as a matter of law he could not consider Wellstar’s arguments regarding the validity of Emory’s existing CON, and that he would not allow Wellstar to present evidence related to those arguments. Wellstar then appealed the hearing officer’s decision to the DCH Commissioner, allegedly arguing among other things that the decision violated Wellstar’s constitutional right to due process. The Commissioner affirmed the hearing officer’s decision without ruling on the constitutional claim. In Division 2 of its opinion in this case, the Georgia Supreme Court determined the Court of Appeals erred by holding that the constitutional due process claim enumerated by Wellstar was not preserved for appellate review because it was not ruled on during the administrative proceeding that led to the filing of this case in the trial court. The Supreme Court thus granted Wellstar’s petition for a writ of certiorari to address that issue, reversed the Court of Appeals’s opinion, and remanded for that court to reconsider Wellstar’s constitutional claim. View "Cobb Hospital v. Department of Community Health et al." on Justia Law

Plaintiffs alleged in 2016, an anonymous hacker stole the personally identifiable information, including Social Security numbers, addresses, birth dates, and health insurance details, of at least 200,000 current and former patients of Athens Orthopedic Clinic (“the Clinic”) from the Clinic’s computer databases. The hacker demanded a ransom, but the Clinic refused to pay. The hacker offered at least some of the stolen personal data for sale on the so-called “dark web,” and some of the information was made available, at least temporarily, on Pastebin, a data-storage website. The Clinic notified plaintiffs of the breach in August 2016. Each named plaintiff alleges that she has “spent time calling a credit reporting agency and placing a fraud or credit alert on her credit report to try to contain the impact of the data breach and anticipates having to spend more time and money in the future on similar activities.” Plaintiffs sought class certification and asserted claims for negligence, breach of implied contract, and unjust enrichment, seeking damages based on costs related to credit monitoring and identity theft protection, as well as attorneys’ fees. They also sought injunctive relief under the Georgia Uniform Deceptive Trade Practices Act (“UDTPA”), and a declaratory judgment to the effect that the Clinic must take certain actions to ensure the security of class members’ personal data in the future. The Clinic filed a motion to dismiss based on both OCGA 9-11-12 (b) (1) and OCGA 9-11-12 (b)(6), which the trial court granted summarily. The Georgia Supreme Court concluded the injury plaintiffs alleged they suffered was legally cognizable. Because the Court of Appeals held otherwise in affirming dismissal of plaintiffs’ negligence claims, the Supreme Court reversed that holding. Because that error may have affected the Court of Appeals’s other holdings, the Court vacated those other holdings and remanded the case. View "Collins et al. v. Athens Orthopedic Clinic, P.A." on Justia Law

This was a permissive appeal brought by Phillip and Marcia Eldridge1 in a medical malpractice action they filed against Dr. Gregory West (West), Lance Turpin, PA-C (Turpin), and Summit Orthopaedics Specialists, PLLC (Summit). The Eldridges alleged that Phillip became infected with Methicillin-Resistant Staphylococcus Aureus (MRSA) as a result of malpractice committed by West, Turpin, and agents of Summit. The Eldridges claimed West and Turpin breached the standard of care that was due them and as a result, sustained damages. The district court granted various motions, including a motion to dismiss certain causes of action against West, Turpin, and Summit, as well as a motion for summary judgment brought by Turpin and Summit, and a motion for partial summary judgment brought by West. On appeal, the Eldridges contended the district court erred in: (1) dismissing their claims for negligent and intentional infliction of emotional distress, gross negligence, and reckless, willful, and wanton conduct; (2) denying their motion to strike the affidavits of West and Turpin; (3) limiting their claim for damages; and (4) concluding that the Eldridges could only present evidence of damages, specifically medical bills, after the Medicare write-offs had been calculated. The Idaho Supreme Court concurred with the Eldridges, reversed the district court and remanded for further proceedings. View "Eldridge v. West, Turpin & Summit" on Justia Law