Justia Civil Procedure Opinion Summaries
Articles Posted in Health Law
Williams v. St. Alphonsus Medical Center
Appellants-patients Nathaniel Valencia and Emily Williams were self-pay patients who received emergency medical services at Saint Alphonsus Medical Center—Nampa, Inc. (“Saint Alphonsus”) in 2015. During their respective visits, Patients agreed to pay for “all charges incurred” for services rendered to them. Patients were billed in accordance with Saint Alphonsus’ “chargemaster” rates. Patients sought declaratory relief requesting the district court to rule Saint Alphonsus was only entitled to bill and seek collection of the reasonable value of the treatment provided to self-pay patients. Saint Alphonsus moved the district court to dismiss the complaint pursuant to Idaho Rule of Civil Procedure 12(b)(6). The district court treated the motion to dismiss as a motion for summary judgment pursuant to I.R.C.P. 12(d). Ultimately, the district court granted summary judgment for Saint Alphonsus, and Patients timely appealed. Finding no reversible error, the Idaho Supreme Court affirmed. View "Williams v. St. Alphonsus Medical Center" on Justia Law
DePhillips v. Hospital Service Dist. No. 1 of Tangipahoa Parish d/b/a North Oaks Medical Center et al.
This matter arose from alleged violations of the Health Care Consumer Billing and Disclosure Protection Act (“Balance Billing Act” or “Act”). The Louisiana Supreme Court granted certiorari review to resolve the question of whether a patient’s claims against a contracted healthcare provider for an alleged violation of La. R.S. 22:1874(A)(1) were delictual in nature. The consolidated lawsuits in this matter were filed by Matthew DePhillips and Earnest Williams, individually and on behalf of putative classes, against Hospital District No. 1 of Tangipahoa Parish d/b/a North Oaks Medical Center/North Oaks Health System (“North Oaks”). In February, 2011, Williams was injured in a motor vehicle accident. He sought emergency medical treatment from North Oaks. At the time of the accident, Williams was insured under an insurance policy administered by Louisiana Health Service & Indemnity Company d/b/a Blue Cross and Blue Shield of Louisiana (“BCBS”). North Oaks is a contracted healthcare provider with BCBS pursuant to a certain Member Provider Agreement (the “MPA”) between North Oaks and BCBS. After Williams’ treatment, North Oaks filed a claim with BCBS, and BCBS paid a discounted rate on the claims as provided by the MPA. Thereafter, North Oaks sought to collect from Williams by filing a medical lien against his liability insurance claim for the full and undiscounted charges. Williams alleged that North Oaks filed this lien despite being a contracted healthcare provider with BCBS and despite its legal and contractual requirements to accept the insurance as payment in full. The trial court denied the exceptions of no right of action for breach of contract and prescription, but granted the North Oaks’ exception of no cause of action for claims arising before the effective date of the Balance Billing Act. The court of appeal granted writs in part, finding DePhillips did not have a right of action to assert a claim for breach of the MPA, as he was neither a party nor a third-party beneficiary to that agreement. The appellate court denied North Oaks’ writ application insofar as it related to the trial court’s denial of its exception of prescription. After review, the Supreme Court determined plaintiff's claims were delictual in nature, subject a one-year prescriptive period. View "DePhillips v. Hospital Service Dist. No. 1 of Tangipahoa Parish d/b/a North Oaks Medical Center et al." on Justia Law
Bowden v. The Medical Center
The Court of Appeals affirmed a superior court decision to certify a class action lawsuit against The Medical Center, Inc. ("TMC"). Class representatives were uninsured patients who received medical treatment from TMC and who claimed that TMC charged them unreasonable rates for their medical care, which rates TMC then used as a basis for filing hospital liens against any potential tort recovery by the patients. The Court of Appeals also ruled on the causes of action raised by the plaintiffs. The Georgia Supreme Court granted certiorari to answer three questions: (1) whether the Court of Appeals erred in its determination that class certification was proper; (2) whether the Court of Appeals erred in affirming the denial of summary judgment for TMC on common law claims of fraud and negligent misrepresentation; and (3) whether the Court of Appeals erred in reversing the denial of summary judgment to TMC on claims brought under the Georgia RICO Act. The Supreme Court concluded the Court of Appeals erred with regard to the first two questions, but not the third. Therefore, judgment was reversed in part, affirmed in part and remanded for further proceedings. View "Bowden v. The Medical Center" on Justia Law
In re: MDL 2700 Genentech
This appeal stemmed from a group of fourteen diversity cases that were consolidated by the Judicial Panel on Multidistrict Litigation and transferred to the Northern District of Oklahoma. The plaintiffs in all fourteen cases were cancer treatment providers who purchased multi-dose vials of Herceptin, a breast cancer drug, from defendant Genentech, Inc. (Genentech). Plaintiffs alleged that Genentech violated state law by failing to ensure that each vial of Herceptin contained the labeled amount of the active ingredient, and by misstating the drug concentration and volume on the product labeling. After the cases were consolidated, Genentech moved for summary judgment, arguing that plaintiffs’ claims were pre-empted by federal law. The district court agreed with Genentech and granted its motion for summary judgment. Plaintiffs appealed. The Tenth Circuit disagreed with the district court's conclusion that plaintiffs' claims were preempted, and consequently, reversed summary judgment and remanded for further proceedings. View "In re: MDL 2700 Genentech" on Justia Law
Methodist Specialty Care Center v. Mississippi Division of Medicaid
Methodist Specialty Care Center was the only nursing facility for the severely disabled (NFSD) in Mississippi. NFSDs generally incur higher costs than other nursing facilities, and because of this, Methodist received a percentage adjustment to its new-bed-value (NBV) calculation when the Mississippi Division of Medicaid (DOM) determined how much it should reimburse Methodist for its property costs through the DOM’s fair-rental system. A NBV was intended to reflect what it would cost to put a new bed into service in a nursing facility today. Methodist had received a NBV adjustment of 328.178 percent added to the standard NBV every year since it opened in 2004 until State Plan Amendment (SPA) 15-004 was enacted. During the 2014 Regular Session, the Mississippi Legislature passed House Bill 1275, which authorized the DOM to update and revise several provisions within the State Plan; one such amendment changed Methodist's adjustment rate, and made the facility experience a substantial decrease in its NBV, while all other nursing facilities in the state received increases. Methodist appealed the DOM’s changes to its NBV that were enacted in SPA 15-004. After a hearing, an Administrative Hearing Officer (AHO) upheld the decreased percentage adjustment to Methodist’s NBV, but also determined the DOM had miscalculated Methodist’s NBV adjustment. The DOM had planned to calculate Methodist’s adjustment as 175 percent of the base NBV, but the AHO found that Methodist’s adjusted NBV should be calculated in the same manner as it was calculated preamendment - by taking 175 percent of the standard NBV and adding that value to the standard NBV. Methodist still felt aggrieved because its NBV adjustment rate had not been restored to the preamendment rate. Methodist appealed the DOM’s final decision to the Chancery Court. When the chancellor affirmed the DOM’s final decision, Methodist appealed to the Mississippi Supreme Court. After review, the Supreme Court found the DOM’s final decision was supported by substantial evidence, was not arbitrary or capricious, did not violate Methodist’s constitutional or statutory rights and that the DOM was acting within its power in reaching and adopting its final decision. View "Methodist Specialty Care Center v. Mississippi Division of Medicaid" on Justia Law
Thomas v. Regional Health System of Acadiana, LLC.
Mariah Charles was born prematurely in October 2014 at Lafayette General Medical Center (LGMC) and hospitalized there until transferred to Women’s and Children’s Hospital of Lafayette (W&C). She was released in April 2015 release. 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. The petition alleged Dr. Dalal took no action other than ordering additional echocardiograms. After Mariah’s transfer to W&C, Dr. Dalal interpreted three more echocardiograms, again noted abnormalities, and allegedly failed to properly diagnose or treat Mariah. On May 8, Mariah was admitted to the pediatric intensive care unit at W&C and examined by another pediatric cardiologist who diagnosed pulmonary artery hypertension. Mariah was transferred by helicopter to Children’s Hospital of New Orleans where medical staff confirmed the diagnosis and performed a heart catheterization procedure. Mariah’s mother, Megan Thomas (Thomas), 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, Thomas filed suit against the hospitals: The Regional Health System of Acadiana, LLC, Women’s & Children’s Hospital, Inc., HCA Holdings, Inc. W&C, and LGMC. The issue presented for the Louisiana Supreme Court's review centered on allegations of negligent credentialing against Dr. Dalal, and whether those allegations fell within the scope of the Louisiana Medical Malpractice Act, or alternatively, sounded in general negligence. The Supreme Court reversed the appellate court, and reinstated the trial court's judgment sustaining the hospital defendants' exceptions of prematurity. View "Thomas v. Regional Health System of Acadiana, LLC." on Justia Law
Lowery v. Kindren Healthcare Operating, Inc.
Goros, age 92, filed suit alleging that Kindred Healthcare violated the Elder Abuse and Dependent Adult Civil Protection Act (Welf. & Inst. Code 15600) by failing to timely obtain medical treatment for her after she suffered a stroke while a patient at their nursing home. After Goros’s death about two years later, her daughter substituted in as successor in interest and added a claim for wrongful death. The trial court granted the defendants summary judgment, predicated on the exclusion of the opinion of the plaintiff’s expert on the issue of causation.The court of appeal affirmed. The plaintiff’s expert failed to provide any basis for his opinions and stated only that “his opinion is based on his experience and documented medical literature.” The plaintiff cites no evidence contradicting the court’s finding that her expert did not have the education or experience to render an opinion about the cause or treatment of Goros’s stroke, as required by Evidence Code section 720(a). Qualifications on a related subject matter are insufficient. View "Lowery v. Kindren Healthcare Operating, Inc." on Justia Law
Yang v. Tenet Healthcare Inc.
In June 2018, plaintiffs-respondents Suzanne Yang and Doc Yang Medical Corporation sued defendants-appellants Tenet Healthcare Inc. doing business as John F. Kennedy Memorial Hospital (the hospital), its medical staff, and individual doctors, alleging defamation and nine other causes of action. Defendants filed a special motion to strike (anti-SLAPP motion) targeting only the defamation cause of action. Dr. Yang alleged that since March 2016, defendants conspired to drive her practice out of business in various ways, including by making defamatory statements. Defendants’ anti-SLAPP motion contended that the statements were protected activity because they were made in connection with the hospital’s peer review process, and because they were made in furtherance of the exercise of the right of free speech in connection with a public issue or an issue of public interest. Defendants also contended that Dr. Yang could not demonstrate a probability of prevailing because she consented to the peer review process that the statements were purportedly in connection with, and because the statements were privileged. Applying the California Supreme Court's recent opinion in FilmOn.com Inc. v. DoubleVerify, Inc., 7 Cal.5th 133 (2019), and concluded defendants’ conduct arose from protected activity because their allegedly defamatory statements were made in connection with an issue of public interest. Furthermore, the Court concluded Dr. Yang did not demonstrate a probability of prevailing on the merits. The Court therefore reversed the trial court, which denied the anti-SLAPP motion. View "Yang v. Tenet Healthcare Inc." on Justia Law
Mullinnex et al . v. Menard et al.
Defendants Michael Touchette and Centurion Healthcare brought an interlocutory appeal of a trial court's certification of a class of plaintiffs in a Vermont Rule 75 action. The certified class was comprised of people in the custody of the Vermont Department of Corrections (DOC), each of whom suffered from opioid-use disorder, and alleged defendants’ medication-assisted treatment (MAT) program did not meet prevailing medical standards of care as required by Vermont law. Defendants, the former Commissioner of the DOC and its contract healthcare provider, argued the trial court erred both in finding that plaintiff Patrick Mullinnex exhausted his administrative remedies before filing suit, and in adopting the vicarious-exhaustion doctrine favored by several federal circuits in order to conclude that Mullinnex’s grievances satisfied the exhaustion requirement on behalf of the entire class. Defendants also contended the trial court’s decision to certify the class was made in error because plaintiffs did not meet Rule 23’s numerosity, commonality, typicality, and adequacy-of- representation requirements. After review, the Vermont Supreme Court reversed, concluding that - even if the vicarious-exhaustion doctrine was appropriately applied in Vermont - it could not apply in this case because, on the record before the trial court, no member of the putative class succeeded in exhausting his administrative remedies. Because plaintiffs’ failure to exhaust left the courts without subject-matter jurisdiction, the Supreme Court did not reach defendants’ challenges to the merits of the class-certification decision. View "Mullinnex et al . v. Menard et al." on Justia Law
In the Matter of the Necessity for the Hospitalization of M.B.
The respondent in an involuntary commitment proceeding, "Meredith B.," appealed the ex parte order authorizing her hospitalization for evaluation and the subsequent 30-day commitment order. Respondent argued that the screening investigation was inadequate because she was not interviewed. She asserted that, as a result, both the order hospitalizing her for evaluation and the 30-day commitment order should have been reversed and vacated. Further, she challenged the 30-day commitment order finding she was (1) "gravely disabled" and there (2) was a reasonable expectation she could improve with treatment. After review of the order at issue, the Alaska Supreme Court found the superior court's decision was supported by clear and convincing evidence. "If there was an error during the screening investigation, the error was harmless, because the respondent had the opportunity to testify at the 30-day commitment hearing." View "In the Matter of the Necessity for the Hospitalization of M.B." on Justia Law