Justia Legal Ethics Opinion Summaries

Articles Posted in Health Law
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The case involves Jennifer Garcia, who was charged with multiple counts, including making threats to a public officer, disobeying a court order, possessing a weapon in a courthouse, attempted murder, and assault with a deadly weapon. After her counsel declared doubt as to Garcia's mental competence, the trial court suspended the criminal proceedings for a determination of Garcia's mental competence. Based on the evaluations of a licensed psychiatrist and a licensed psychologist, the court found Garcia mentally incompetent to stand trial and lacking capacity to make decisions regarding the administration of antipsychotic medication. Garcia appealed the court's order authorizing the state hospital to involuntarily administer antipsychotic medication to her, alleging errors with the order and ineffective assistance of her trial counsel. The Court of Appeal, Fourth Appellate District, Division One, State of California, affirmed the trial court's order. The appellate court found that substantial evidence supported the trial court's order, the psychologist did not exceed the scope of her license in her evaluation, and the psychiatrist's opinion did not lack statutorily required information. The appellate court also found that the error in the trial court's form order was harmless and Garcia was not prejudiced by any ineffectiveness of her counsel. View "People v. Garcia" on Justia Law

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The 2010 ACA (Patient Protection and Affordable Care Act; Health Care and Education Reconciliation Act) created a three-year Risk Corridors program with the creation of new health-insurance marketplaces, which presented uncertain risks for participating health-insurance companies. Qualified health-plan issuers (QHP issuers) that offered their products in the new marketplaces were entitled to payments from HHS if they suffered sufficient losses, 42 U.S.C. 18062(b).The government failed to make those payments. QHP issuers sued under the Tucker Act, 28 U.S.C. 1491(a)(1). In two such lawsuits, the Quinn law firm was lead counsel for classes of QHP issuers seeking payments. In the opt-in notices sent to potential class members with court approval, Quinn represented that it would seek attorney’s fees out of any recovery, that it would seek no more than 5% of any judgment or settlement, and that the Claims Court would determine the exact amount by considering how many issuers participated, the amount at issue, and a “lodestar cross-check” (based on hours actually worked). Meanwhile, the Supreme Court, in other cases, held that QHP issuers were entitled to collect ACA-promised payments.The Claims Court entered judgments in favor of the classes, totaling about $3.7 billion, then awarded Quinn 5% of the common funds, rejecting objections. The total fee was about $185 million. The Federal Circuit vacated. The Claims Court’s analysis was inconsistent with the class opt-in notices and did not adequately justify the extraordinarily high award. View "Health Republic Insurance Co. v. United States" on Justia Law

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An individual and an advocacy group seek to appeal from the denial of a motion to quash two grand jury subpoenas and an order compelling compliance with one of them. There is no jurisdiction for appeals challenging a grand jury subpoena for production of documents unless (1) the appellant has been held in contempt, or (2) a client-intervenor asserts that documents in the possession of a subpoenaed, disinterested third party are protected by attorney-client privilege.   The Fifth Circuit dismissed the appeal explaining that neither exception applied. The court explained that the subpoenaed documents are in the hands of Appellants. They are interested third parties in that they are being investigated for witness tampering. They have a direct and personal interest in suppressing the documents that could potentially corroborate the witness tampering accusation. Consequently, Appellants obviously have “a sufficient stake in the proceeding to risk contempt by refusing compliance.” Accordingly, the court wrote it lacks jurisdiction over the appeal, and Appellants must either comply with the subpoena or be held in contempt to seek the court’s review. View "In re: Grand Jury Subpoena" on Justia Law

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The issue this case presented for the Washington Supreme Court's review related to the boundaries of the corporate attorney-client privilege and how it operated when in conflict with a plaintiff’s physician-patient privilege. In 2015, Doug Hermanson sideswiped an unoccupied vehicle and crashed into a utility pole. Hermanson was transported to Tacoma General Hospital, which was owned by MultiCare Health System Inc. Hermanson was treated by several MultiCare employees, including two nurses and a crisis intervention social worker. However, the physician who treated Hermanson, Dr. Patterson, was an independent contractor of MultiCare pursuant to a signed agreement between MultiCare and Trauma Trust, his employer. Trauma Trust was created by MultiCare; Dr. Patterson had his own office at Tacoma General Hospital and was expected to abide by MultiCare’s policies and procedures. During Hermanson’s treatment, an unidentified person at Tacoma General Hospital conducted a blood test on Hermanson that showed a high blood alcohol level. As a result, someone reported this information to the police, and the police charged Hermanson with first degree negligent driving and hit and run of an unattended vehicle. Based on this disclosure of his blood alcohol results, Hermanson sued MultiCare and multiple unidentified parties for negligence, defamation/false light, false imprisonment, violation of Hermanson’s physician-patient privilege, and unauthorized disclosure of Hermanson's confidential health information. MultiCare retained counsel to jointly represent MultiCare, Dr. Patterson, and Trauma Trust, reasoning that while Dr. Patterson and Trauma Trust were not identified parties, Hermanson’s initial demand letter implicated both parties. Hermanson objected to this joint representation and argued that MultiCare’s ex parte communications with Dr. Patterson violated Hermanson’s physician-patient privilege. The Supreme Court determined that Dr. Patterson still maintained a principal-agent relationship with MultiCare, and served as the "functional equivalent" of a MultiCare employee; therefore MultiCare could have ex parte communications with the doctor. The nurse and social worker privilege were "essentially identical in purpose" to the physician-patient privilege, making ex parte communications permissible between MultiCare and the nurse and social worker. View "Hermanson v. Multicare Health Sys., Inc." on Justia Law

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The Supreme Court extended an August 27, 2020 order for first circuit criminal matters, which was extended pursuant to a September 11, 2020 order, until November 16, 2020, determining that changing conditions wrought by the COVID-19 pandemic required flexibility and vigilance regarding the need to protect the health and safety of court users and Judiciary personnel.In July 2020, there was a surge of COVID-19 cases in Hawaii, included cases in community correctional centers and facilities, particularly at the O'ahu Community Correctional Center. As a result, the time requirements for preliminary hearings under Haw. R. Pen. P. (HRPP) 5(c)(3) was impacted. In August 2020, the Supreme Court entered an order providing that the first circuit may temporarily extend the time requirements for preliminary hearings no longer than reasonably necessary to protect public health and safety. In September, the order was extended. Because the transports of custody defendants from all O'ahu correctional facilities remained suspended and the exponential number of citations issued for Haw. Rev. Stat. ch. 127A violations remained high, the Supreme Court extended the August order for first circuit criminal matters until November 16, 2020. View "In re Judiciary’s Response to COVID-19 Outbreak" on Justia Law

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QHG of Enterprise, Inc., d/b/a Medical Center Enterprise ("QHG"), appealed a circuit court's judgment awarding Amy Pertuit ("Amy") $5,000 in compensatory damages and $295,000 in punitive damages. Leif Pertuit ("Leif") had been married to Deanna Mortensen; they had one child, Logan. Leif and Mortensen divorced in 2007. At some point, Mortensen was awarded sole physical custody of Logan, and Leif was awarded visitation. Leif later married Amy, a nurse. At the time of their marriage, Leif and Amy resided in Mobile, Alabama, and Mortensen resided in Enterprise. Eventually, tensions arose between Leif and Mortensen regarding the issue of visitation. In March 2014, Mortensen began sending text messages to Leif accusing Amy of being addicted to drugs. Around that time, Mortensen visited the attorney who had represented her in divorce from Leif. Mortensen expressed concern that Logan was in danger as a result of the visitation arrangement and asked her attorney to assist with obtaining a modification of Leif's visitation. In April 2014, Mortensen contacted Dr. Kathlyn Diefenderfer, a physician whom QHG employed as a hospitalist at Medical Center Enterprise. Mortensen had been Dr. Diefenderfer's patient, and Dr. Diefenderfer's son played sports with Logan. Mortensen informed Dr. Diefenderfer that Logan was scheduled to ride in an automobile with Amy from Enterprise to Mobile for Leif's visitation and expressed concern regarding Amy's ability to drive, given her belief that Amy was using drugs and had lost her nursing license. Dr. Diefenderfer used a hospital computer to check on Amy's drug prescriptions. After reviewing that information,Dr. Diefenderfer told Mortensen: "All I can tell you is I would not put my son in the car." Mortensen went back to her attorney, informing him that Dr. Diefenderfer had acquired the necessary proof of Amy's drug use. Amy received a copy of the modification petition, and was convinced her private health information had been obtained in violation of HIPAA, and filed complaints to the Enterprise Police Department, the US Department of Health and Human Services, the Alabama Bar Association, and the Alabama Board of Medical Examiners. A grand jury indicted Mortensen and Dr. Diefenderfer, which were later recalled, but the two entered diversion agreements with the district attorney's office. Amy then filed suit alleging negligence and wantonness, violation of her right to privacy, the tort of outrage and conspiracy. The Alabama Supreme Court determined the trial court erred by denying QHG's motion for a judgment as a matter of law with respect to Amy's asserted theories of respondeat superior; ratification; and negligent and wanton training, supervision, and retention because there was not substantial evidence indicating that QHG was liable to Amy as a consequence of Dr. Diefenderfer's conduct under any of those theories. The trial court's judgment awarding Amy $5,000 in compensatory damages and $295,000 in punitive damages was reversed, and judgment rendered in favor of QHG. View "QHG of Enterprise, Inc., d/b/a Medical Center Enterprise v. Pertuit" on Justia Law

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Cottingham sought compensation under the National Vaccine Injury Compensation Program, 42 U.S.C. 300aa-10, alleging that a Gardasil® vaccination received by her minor daughter, K.C., in 2012, for the prevention of HPV, caused K.C. injuries. The claim was filed immediately before the limitations period ran out.The government stated argued that a "reasonable basis for bringing the case may not be present.” Cottingham’s counsel was granted additional time but was unable to submit an expert opinion supporting her claim. The Special Master denied compensation. Cottingham sought attorneys’ fees and litigation costs ($11,468.77), 42 U.S.C. 300aa-15(e)(1). The Master found no evidence to support the "vaguely asserted claims" that the vaccination caused K.C.’s headaches, fainting, or menstrual problems." While remand was pending the Federal Circuit held (Simmons) that although a looming statute of limitations deadline may impact the question of whether good faith existed to bring a claim, that deadline does not provide a reasonable basis for asserting a claim. The Master decided that Simmons did not impact his analysis, applied a “totality of the circumstances” standard, and awarded attorneys’ fees. The Claims Court vacated and affirmed the Special Master’s third decision, finding no reasonable basis for Cottingham’s claim.The Federal Circuit vacated, noting that there is no dispute that Cottingham filed her claim in good faith. Simmons did not abrogate the “totality of the circumstances inquiry.” K.C.’s medical records paired with the Gardasil® package insert constitute circumstantial, objective evidence supporting causation. View "Cottingham v. Secretary of Health and Human Services" on Justia Law

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The Supreme Court affirmed the order of the circuit court finding attorney Jonathan Streit in contempt of court and assessing a $100 fine, holding that substantial evidence supported the court's decision that Streit's actions displayed a lack of regard for the court's integrity and demonstrated disrespect.Streit appeared before the circuit court on a petition for permanent guardianship. At the hearing, the circuit court noted several deficiencies in the case file. The circuit court was unwilling to let the matter to proceed without compliance with the statutory requirements, and Streit argued that the circuit court took issue with him because he successfully reversed the circuit court in a separate case. The circuit court then found Streit in contempt of court and assessed a fine. The Supreme Court affirmed, holding that substantial evidence supported the court's decision to hold Streit in contempt. View "Streit v. State" on Justia Law

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In this guardianship proceeding, the Supreme Court denied mandamus relief, holding that the trial court did not abuse its discretion by refusing to disqualify counsel for the guardianship applicant due to a purported conflict of interest.Jamie Rogers, represented by Alfred Allen, filed an application for temporary guardianship of Verna Thetford's person and a management trust for her estate. Verna moved to disqualify Allen as Jamie's counsel, asserting that Allen had represented Verna and that she objected to his representation of Jamie in violation of his fiduciary duties to her. The trial court denied the motion to disqualify and appointed Jamie as temporary guardian for Verna. Verna argued before the Supreme Court that the Texas Disciplinary Rules of Professional Conduct required that Allen be disqualified. The Supreme Court held (1) the Rules permit such representation in limited circumstances and that a trial court's decision regarding disqualification, based on a careful, thorough consideration of the evidence, is entitled to great deference by an appellate court; and (2) there was no reason to disturb the trial court's discretion in this case. View "In re Thetford" on Justia Law

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Al-Shaikh, an orthopedic surgeon, moved his Fremont practice and sought approval by the Department of Health Care Services (DHCS), under Medi-Cal regulations. He had been an approved Medi-Cal provider in Fremont for six years. DHCS denied his application, claiming that Al-Shaikh’s fee arrangement with his billing service was unlawful. Al-Shaikh appealed. DHCS agreed the provisions it had cited were inapplicable but cited another state law, incorporating a federal Medicaid regulation. Al-Shaikh filed suit, then relocated his Auburn practice, for which he used the same billing service; the relocation was approved by a different DHCS regional office. Al-Shaikh cited an Office of the Inspector General publication that expressly states his fee arrangement does not violate federal law. DHCS approved the Fremont office after three years. The court dismissed the case as moot. Al-Shaikh moved for fees under Code of Civil Procedure 1028.5, which allows a small business or a licensee that prevails in an action against a state regulatory agency to recover a maximum of $7,500 in fees if the agency acted without substantial justification. The court of appeal directed the superior court to award Al-Shaikh the full amount recoverable under section 1028.5. DHCS has an obligation to be knowledgeable about the law it is charged with implementing and was unable to cite a case or regulatory decision supporting its position; it acted without substantial justification. View "Al-Shaikh v. State Department of Health Care Services" on Justia Law