Justia Civil Procedure Opinion Summaries

Plaintiff YDM Management Company, Inc. (YDM) appeals from a judgment of the trial court in favor of defendant Sharp Community Medical Group, Inc. (Sharp), after Sharp successfully moved for summary judgment of YDM's operative complaint. YDM purchased accounts receivable from Doctors Express, a company that operated urgent care facilities in San Diego, for services rendered to Sharp managed care members. In its role as an Independent Practice Association (IPA), Sharp provided health insurance to its managed care members, and paid claims for services provided to its members. At the time that it provided the services at issue to Sharp members, Doctors Express did not have a preferred provider contract with Sharp. Providers without a contract with an IPA were reimbursed for nonemergency medical services provided to the IPA's members at amounts significantly less than the "reasonable and customary value for the health care services rendered." However, an IPA such as Sharp was required by regulation to reimburse out of network providers for the full "reasonable and customary value" for any emergency medical services provided to its members. As the assignee of Doctors Express, YDM filed this lawsuit seeking additional reimbursement from Sharp for services provided by Doctors Express to members of Sharp's health plan, beyond the amount that Sharp had already reimbursed Doctors Express for those services. The trial court granted summary judgment in favor of Sharp. On appeal, YDM contended the trial court erred in granting summary judgment in Sharp's favor based on the declaration of a Sharp employee, and that the court erred in failing to give adequate consideration to the declaration of YDM's expert in concluding that there was no triable issue of material fact. The Court of Appeal concluded the trial court did not err in granting summary judgment in favor of Sharp. View "YDM Management Co., Inc. v. Sharp Community Med. etc." on Justia Law

In 2012, petitioners Saint Francis Hospital, Inc., Neurological Surgery, Inc., and Douglas Koontz, M.D. performed decompressive laminectomies of respondent Johnson John’s spine at the C2-3, C3-4, C4-5, C5-6 and C6-7 regions. After the operation, respondent allegedly became partially paralyzed, suffered constant pain, was hospitalized for four months and submitted to additional medical treatment. Respondent filed suit against petitioners in 2016, alleging negligence, gross negligence, medical malpractice and sought punitive damages for petitioners’ failure to render reasonable medical care, breach of the duty of care owed and respondent’s resulting injuries. In commencing the action, respondent failed to attach an affidavit of merit to the Petition or otherwise comply with Okla. Stat. tit. 12, section 19.1. In lieu of answer, petitioners filed their respective motions to dismiss and asserted, among other things, respondent’s failure to include the statutorily required affidavit of merit or, in the alternative, obtain a statutorily recognized exception. Respondent averred that the statutory directive unconstitutionally restrained a litigant's right to access the courts and was an unconstitutional special law. The district court provided notice to the Attorney General's office concerning the challenged statute. As intervenor, the Attorney General essentially urged the district court to enforce the affidavit requirements. The district court ultimately overruled petitioners’ motions to dismiss, and rejected respondent’s special law challenge. The court determined that section 19.1 unconstitutionally imposed a substantial and impermissible impediment to access to the courts, and this barrier was unconstitutional regardless of the financial worth of a litigant and was not cured by exercising the indigent from this burden. The Oklahoma Supreme Court agreed with the district court’s ruling, and found section 19.1 was an impermissible barrier to court access and an unconstitutional special law. Section 19.1 was therefore stricken. View "John v. St. Francis Hospital" on Justia Law

Plaintiff-appellant Paul Kendall's second amended complaint made several types of class-wide claims that challenged the billing and collection practices of the health facility operating an emergency room where he received care, defendant and respondent Scripps Health (Scripps). Kendall contended that "selfpay" patients, who signed a form during the reception process at the emergency room (an "Agreement for Services at a Scripps Facility"), were being unfairly billed under that contractual agreement at prescribed rates that are listed on a publicly available "charge description master" (Charge Master). This appeal arose out of the trial court's order denying Kendall's motion to certify a proposed class of self-pay patients for the pursuit of two overriding legal theories that applied to both the declaratory relief and statutory claims. Scripps opposed the motion, arguing a class action was not shown to be an appropriate method to pursue the case because of a lack of predominant common issues and of any convincing showing of an ability to ascertain the identity of all the proposed class members. The trial court denied the motion for class certification, concluding that Kendall had not presented any substantial evidence showing there were predominant common issues of law and fact among the putative class members. On appeal, Kendall contends the trial court's order denying class certification of his statutory claims reflects the use of improper criteria and an incorrect legal analysis. Finding no abuse of discretion or lack of substantial evidence, the Court of Appeal affirmed the order denying class certification. View "Kendall v. Scripps Health" on Justia Law

This case centered on a public records request made by defendant Oregonian Publishing Company, LLC (The Oregonian), a newspaper, to plaintiff Oregon Health and Sciences University (OHSU), a public health and research university that provided patient care at its hospital, conducted research, and educated health care professionals and scientists. The circuit court ordered OHSU to disclose the requested record, and OHSU appealed. The Court of Appeals reversed and remanded to the circuit court to examine the public records at issue and then determine whether state and federal exemptions permitted OHSU to withhold some of the requested information. On review, the issues narrowed to whether the requested record contained “protected health information” and student “education records” under federal and Oregon law and, if so, whether that information nonetheless had to be disclosed pursuant to ORS 192.420(1), a provision of the Oregon Public Records Law (OPRL). The Oregon Supreme Court concluded the requested record contained protected health information and that ORS 192.420(1) did not require the disclosure of that information. The Court declined to consider whether the part of the requested record consisting of tort claim notices filed by students contained “education records,” and, if so, whether those records were exempt from disclosure. The Court therefore reversed in part, and affirmed in part the decision of the Court of Appeals. View "OHSU v. Oregonian Publishing Co., LLC" on Justia Law

B.A.C. appealed a district court order for involuntary hospitalization and involuntary treatment with medication. B.A.C. was admitted to the North Dakota State Hospital on June 6, 2017. Prior to being admitted, B.A.C. drove his car into a pond near Devils Lake. He then walked barefoot away from the pond and invaded a private residence. When confronted inside, B.A.C. offered to buy the property. After B.A.C. was ordered to leave, he walked approximately two miles further before he was apprehended by police. In talking to the police officers, B.A.C. made several delusional statements about Bill Gates, Bill Clinton, and Donald Trump, which included stating that he himself was the richest man in the world and that was why Bill Clinton wanted to kill him. The police took B.A.C. to a hospital in Devils Lake. He was then transported to the North Dakota State Hospital in Jamestown. The State Hospital petitioned the district court for involuntary commitment of B.A.C. At the State Hospital, B.A.C. had refused to take prescribed medication and expressed his wish to leave the hospital. An examination was performed by a doctor of psychology at the State Hospital, who found B.A.C. to be mentally ill and noted that if "untreated on an inpatient basis he would likely place himself at risk, as he did just prior to the current admission." A psychiatrist performed an independent evaluation on B.A.C. and found him to have a primary psychotic disorder, and also believed releasing B.A.C. from the hospital without treatment would likely result in self-harm. The North Dakota Supreme Court affirmed the district court order, concluding that B.A.C.'s release did not moot this appeal and that the district court did not clearly err when it found by clear and convincing evidence that B.A.C. was a mentally ill person requiring inpatient treatment. View "Interest of B.A.C." on Justia Law

Women’s Surgical Center, LLC d/b/a Georgia Advanced Surgery Center for Women (the “Center”) planned to add a second operating room to its premises in order to create opportunities to form contracts with additional surgeons who could then use the Center in connection with their medical practices. However, any such change to the Center could only be legally accomplished if the Center sought and was granted a certificate of need (“CON”) by the Georgia Department of Community Health (the “Department”). Because the Center believed that it should not be subject to the CON requirements, it filed an action for declaratory and injunctive relief against the Department in an effort to have Georgia’s applicable CON law and the regulations authorizing it declared unconstitutional. The Department moved to dismiss the complaint, arguing, among other things, that the trial court lacked jurisdiction over the case because the Center failed to exhaust its administrative remedies before filing its lawsuit. The trial court denied the motion to dismiss, then both the Center and the Department filed motions for summary judgment with regard to the Center’s constitutional claims. The trial court rejected all of the Center’s constitutional challenges and granted summary judgment to the Department. In Case No. S17A1317, the Center appealed that ruling, and in Case No. S17X1318, the Department appealed the denial of its motion to dismiss. Finding no reversible error, the Georgia Supreme Court affirmed in both cases. View "Womens Surgical Center, LLC v. Berry" on Justia Law

The petition underlying this appeal challenged a trial court order summarily adjudicating a cause of action under the Elder Abuse and Dependent Adult Civil Protection Act (the Act), a cause of action for fraud by concealment, and another for medical battery, while allowing other claims, including one for medical negligence, to proceed to trial. Petitioner Maxine Stewart was the representative of Anthony Carter, a man who died after admission to a hospital owned by real parties in interest, St. Joseph’s Health (et al.). She alleged the hospital “denied and withheld from Mr. Carter the right to refuse an unnecessary surgery, denied and withheld from Mr. Carter the right to be involved in secret hospital meetings to invalidate his designated consent, and denied and withheld from Mr. Carter his right to a second opinion prior to proceeding with an unwarranted surgery that resulted in a hypoxic injury, brain damage, cardiac arrest and his untimely death.” Having concluded the petition might have merit, the Court of Appeal stayed the action in the trial court and requested an informal response. Having received and read the “return by verified answer” that was filed by real parties in interest, the Court then set an order to show cause and requested further briefing on a specific issue. Real parties in interest decided to stand on their informal response in lieu of filing another brief, and Stewart declined to file a traverse. After review, the Court then granted the petition: in the published portion of this opinion, the Court discussed the cause of action for elder abuse to explain how, in its view, a substantial impairment of this right can constitute actionable “neglect” of an elder within the meaning of both the little-invoked catchall definition contained in Welfare and Institutions Code section 15610.57(a)(1), and two of the types of neglect set forth in section 15610.57(a)(2). View "Stewart v. Superior Court" on Justia Law

When Arvada, Colorado police officers responded to a reported domestic disturbance in Terry Ross’s home, Ross went into a bedroom and shot himself. Officers radioed for an ambulance whose crew delivered him to the hospital. There, doctors treated Ross’s wounds as Arvada officers kept watch over him. When Ross, and later his estate, could not pay for his care, the hospital billed the City of Arvada nearly $30,000. The question presented by this case was essentially whether Arvada had to pay the tab. The trial court and court of appeals said yes; both read Colorado’s “Treatment while in custody” statute as entitling the hospital to relief. Relying on Poudre Valley Health Care Inc. v. City of Loveland, 85 P.3d 558 (Colo. App. 2003), the trial court decided the statute assigned police departments (or any agency that detains people) a duty to pay healthcare providers for treatment of those in custody. The court of appeals affirmed on essentially the same grounds. The Colorado Supreme Court, however, concluded the statute did not create any duty to a healthcare provider. Furthermore, the Court concluded that the hospital’s claim for unjust enrichment survived. Because that claim was contractual, the Court concluded the Colorado Governmental Immunity Act did not prohibit it. Therefore, the Court reversed the judgment of the court of appeals in part and remanded for further proceedings. View "City of Arvada ex rel. Arvada Police Department v. Denver Health" on Justia Law

In March 2016, Catholic Health Initiatives Colorado (d/b/a Centural Health – St. Anthony North Hospital) filed suit against architectural firm Earl Swensson Associates (“ESA”) after ESA designed Catholic Health’s new hospital, Saint Anthony North Health Campus (“Saint Anthony”). Catholic Health alleged that ESA breached its contract and was professionally negligent by failing to design Saint Anthony such that it could have a separately licensed and certified Ambulatory Surgery Center (“ASC”). In December 2016, Catholic Health filed its first expert disclosures, endorsing Bruce LePage and two others. Catholic Health described LePage as an expert with extensive experience in all aspects of preconstruction services such as cost modeling, systems studies, constructability, cost studies, subcontractor solicitation, detailed planning, client relations, and communications in hospital and other large construction projects. Catholic Health endorsed LePage to testify about the cost of adding an ASC to Saint Anthony. At a hearing, ESA argued that the lack of detail in LePage’s report prevented ESA from being able to effectively cross-examine him. ESA further argued that striking LePage as an expert was the proper remedy because Rule 26(a)(2)(B)(I) limits expert testimony to opinions that comply with the Rule, and LePage offered no opinions in compliance. In 2015, the Colorado Supreme Court amended Colorado Rule of Civil Procedure 26(a)(2)(B) to provide that expert testimony “shall be limited to matters disclosed in detail in the [expert] report.” In this case, the trial court concluded that this amendment mandated the exclusion of expert testimony as a sanction when the underlying report fails to meet the requirements of Rule 26. The Supreme Court concluded the amendment created no such rule of automatic exclusion. Instead, the Court held that the harm and proportionality analysis under Colorado Rule of Civil Procedure 37(c) remained the proper framework for determining sanctions for discovery violations. Because the trial court here did not apply Rule 37(c), the Court remanded for further development of the record. View "Catholic Health v. Swensson" on Justia Law

On May 9, the Hospital's mental health facility director filed a petition seeking emergency inpatient admission of Linda under 405 ILCS 5/3-600, stating that Linda was admitted on April 22. Section 3-611 provides: “Within 24 hours, excluding Saturdays, Sundays and holidays, after the respondent’s admission ... the facility director … shall file 2 copies of the petition ... with the court … the court shall set a hearing to be held within 5 days … after receipt of the petition. On June 11, the court held a hearing. Testimony focused on the fact that Linda had been admitted to a medical unit with medical problems but, while there, received psychiatric care. The court granted the petition. The appellate court first noted that Linda’s 90-day hospitalization had ended, rendering the appeal moot, but applied the public interest exception to mootness. The court determined that Linda’s “physical” admission to the hospital was not synonymous with “legal” admission and the medical floor, arguably, was not a “mental health facility” under the statute, so the petition was timely. The Illinois Supreme Court affirmed. The court disagreed with the distinction drawn between the medical floor and the mental health unit but reasoned that legal status may change while one is in a mental health facility. Linda did not demonstrate that her physical entry into the facility and her initial treatment were involuntary and, therefore, did not establish that the petition was not timely. View "In re Linda B." on Justia Law