Health Care

National Federation of Independent Business v. Sebelius; Obamacare; Affordable Care Act; Commerce Clause; health insurance; healthcare; individual mandate; minimum coverage; pre-existing conditions; premiums; Chief Justice Roberts.

Obamacare

National Federation of Independent Business v. Sebelius; Affordable Care Act; ACA; Taxation Clause; Congress authority to levy taxes; health insurance; healthcare; individual mandate; minimum coverage; pre-existing conditions; premiums.

Affordable Care Act

National Federation of Independent Business v. Sebelius; Obamacare; Medicaid expansion; Spending Clause; Congress spending power; Medicaid funding; health insurance; healthcare; individual mandate; pre-existing conditions; premiums.

apparent agency vicarious liability

Roessler v. Novak; a principal may be held liable for the acts of an agent if the principal permits the appearance of authority in the agent. Independent contractor.

National Childhood Vaccine Injury Act

Pafford v. Secretary of Health & Human Servs. Under the National Childhood Vaccine Injury Act, a plaintiff may demonstrate causation only by proving that a vaccine was both a but-for cause and a substantial factor in causing her injury.

The Medical Devise Amendments Prempt State Law

Riegel v. Medtronic, Inc.; The Medical Device Amendments preempt state requirements that are different from, or in addition to, any requirements applicable to a medical device under federal law; preemption.

Juries May Impose Higher Warning Standards than the FDA

Wyeth v. Levine; Where it is not impossible for a drug manufacturer to comply with both state and federal law, common law claims do not stand as an obstacle to the accomplishment of Congress's purposes in the Food, Drug and Cosmetic Act.

Hospital Liability for Discharging Unstable Patients

Lewellen v. Schneck Medical Center; A hospital must provide appropriate medical screening within emergency department; the patient may not be discharged until he has received stabilizing treatment or has been appropriately transferred.

Student Acting Under Doctor Authority Does Not Commit Battery

Mullins v. Parkview Hospital, Inc; In order to state a claim for battery, the plaintiff must show that the defendant acted intending to cause a harmful or offensive contact with the plaintiff.

Res Ipsa Loquitur in Med Mal

Sides v. St. Anthony's Medical Center. A plaintiff in a medical malpractice case can use res ipsa loquitur theory where the plaintiff offers a medical expert's opinion that the injury would not have occurred in the absence of negligence by the defendant.

Newman v. Sathyavaglswaran

Property interests of next of kin in bodies of their family members are firmly entrenched, and state may not alter those interests via exceptions to general rule that lack firm basis in traditional property principles. Due process.

Jacobson v. Massachusetts

Public health laws are within police powers of states, and state is given broad discretion in making those laws.

State Board of Registration for the Healing Arts v. McDonagh

Appropriate standard of care is degree of skill and learning used by members of profession in similar circumstances.

Fairfax Nursing Home, Inc. v. U.S. Dep't of Health & Human Services

When imposing sanctions for deficient care, situation of all similar patients at facility must be considered, not just status of individual patient or patients. Administative law judge; civil penalty.

Campbell v. Delbridge

Emotional distress; issues in medical malpractice case that are only peripheral to medical decisions do not require expert testimony.

Perez v. Wyeth Laboratories Inc.

Learned intermediary doctrine. Prescription drug manufacturers that market directly to consumers are subject to failure-to-warn claims by consumers if advertising fails to provide adequate warning of products dangerous propensities.

Hardi v. Mezzanotte

Under discovery rule, medical malpractice claim does not accrue until patient has some knowledge of (1 )injury, (2) the injury's cause in fact, and (3) evidence of wrongdoing on part of person responsible. ocurrence rule.

Doe v. Medlantic Health Care Group, Inc.

Tort of breach of confidential relationship consists of unconsented, unprivileged disclosure to third party of nonpublic information learned within confidential relationship.

Simmons v. Tuomey Regional Medical Center

Hospital owes its emergency room patients nondelegable duty to render competent services.

Johnson v. Hillcrest Health Center, Inc.

Expert testimony is not necessary in medical malpractice case to show standard of care or deviations from that, if common knowledge of laypersons would enable jury to determine applicable standard of care and whether breach caused injury.

Douglass v. Salem Community Hospital

Duty to act affirmatively to aid or protect another exists when there is a special relationship between parties that justifies imposing such duty.

Williams v. United States

State anti-discrimination laws and regulations do not create cause of action against hospital that refuses to provide care for racial reasons.

Rush Prudential HMO, Inc. v. Moran

ERISA does not preempt state insurance regulatory scheme that does not provide new cause of action under state law and that does not authorize new form of ultimate relief. HMO.

DiFelice v. Aetna U.S. Health care

Claims that are not related to provision or denial of benefit under policy are not preempted by ERISA.

Horvath v. Keystone Health Plan East

ERISA requires disclosure to plan beneficiaries if they ask for information, if disclosure of information would protect beneficiaries from misinformed decisions or if harm would result from failure to disclose material information.

Westside Mothers v. Haveman

Medicaid is not merely contract, it is federal law that may be enforced by private right of action brought under 42 U.S.C. § 1983. spending power; supreme law of land.

Mahan v. Avera St. Luke's

Medical staff of a hospital has no authority over any corporate decisions, unless such authority is explicitly granted in corporate bylaws.

N.L.R.B. v. Kentucky River Community Care

Employee is supervisor if he or she exercises independent professional judgment, including judgment used in directing less-skilled employees to deliver services. Bargaining unit.

Manhattan Eye, Ear and Throat Hospital v. Spitzer

In order to obtain judicial approval of a sale of all or substantially all of non-profit corporation assets, the board must show that consideration and terms of transaction are fair and that purposes of corporation will be promoted.

IHC Health Plans, Inc. v. Commissioner of Internal Revenue

Organization will not be considered charitable unless it is operated primarily to serve public rather than private interest.

IHC Health Plans, Inc. v. Commissioner of Internal Revenue

Organization that is not itself tax-exempt may become tax-exempt if it operates solely to provide goods or services to exempt organizations that are essential to the operation of that exempt organization.

United States ex rel. Mikes v. Straus

Claim is legally false for purposes of False Claims Act only when party certifies compliance with statute or regulation as condition to governmental payment. Act qui tam action.

Prato-Morrison v. Doe

Business records exception. Person may not bring an action to establish parentage unless that person can produce evidence that he or she is genetic parent of child.

Guardianship of J.D.S.

Guardian ad litem. Unborn child is not person within meaning of statutes authorizing appointment of guardian over person. Plenary.

Greenberg v. Miami Children's Hospital Research Institute

Donor has no property rights in body tissue and genetic matter donated for purposes of research. Unjust enrichment.

Conservatorship of Wendland

Decision to withdraw life-sustaining treatment must be supported by clear and convincing evidence that patient either wished to refuse treatment or that withdrawal would be in best interest of patient. Parens patriae.

Guardianship of Schiavo

Advance directive; living will. In absence of instructions, court may make decision on whether life support should be withdrawn, based on clear and convincing evidence of what patient would want.

Miller v. HCA

Physician does not commit legal wrong when he provides treatment to minor without parental consent under emergent circumstances,if death is likely to result immediately upon failure to perform treatment.

United States v. Oakland Cannabis Buyers' Cooperative

Medical necessity is not defense available under Controlled Substances Act to distributors and manufacturers of marijuana.

Grimes v. Kennedy Krieger Institute, Inc.

Relationship between researchers and human subjects in nontherapeutic research projects may create special duties, breach of which may be basis for negligence action.

Medical Evidence Establishing Standard Of Care

Berry v. Cardiology Consultants, P.A.; scientific evidence is relevant if it is probative of an issue in the case, such as the standard of care; Learned Treatise Rule; admissability of expert testimony.

No Duty to Provide Medical Treatment

Esqueval v. Watters; a sonogram technician owes no legal duty to provide medical treatment, diagnosis, or advice because no duty exists outside the physician-patient relationship.

Doctor Negligence Possible Outside Physician Patient Relationship

Millard v. Corrado; physician duty of due care to a non-patient if the physician's allegedly negligent acts or omissions do not involve medical science, and public policy favors existence of a duty or harm is particularly foreseeable; negligence action.

Physicians Guarantees Create Common Law Liability for Breach of Warranty

Mills v. Pate; a negligence action may not be recast as a contractual claim so as to avoid statutory requirements governing healthcare liability claims.

Unauthorized Disclosure of Patient Medical Records

Herman v. Kratche; honest mistake by healthcare provider is no defense to claim for unauthorized disclosure of confidential medical records if fiduciary relationship breached, causing patient damages. invasion of privacy; right of privacy.

HIPAA Requirements Establish Standard of Care

Acosta v. Byrum et al.; HIPAA compliance violations may give rise to civil liability for negligence although HIPAA confers no private right of action, but create SOC for a negligence claim; negligent infliction of emotional distress.

Algorithms Establishing General Physician Guidelines are Admissible

Hinlicky v. Dreyfuss; hearsay evidence is admissible in negligence cases when used as demonstrative evidence to assist the jury in understanding the medical decision-making of a treating physician.

Negligent Infliction of Emotional Distress

Strasel v. Seven Hills Ob-Gyn Assoc., Inc.; damages for her fear of birth defects in unborn child gives a cause of action for the negligent infliction of serious emotional distress if plaintiff-bystander reasonably appreciated the peril that took place.

Off Label Use of Prescription Drugs

Richardson v. Miller; drug's labeling or PDR reference of approved uses admissable regarding whether the drug appropriate if introduced with other expert evidence on the standard of care; presented an unacceptable risk to the patient.

Question of Fact for the Jury

Robins v. Garg; differing interpretations of undisputed facts suffice to create a question of fact for the jury to establish causation in a wrongful death action; but-for cause causation; malpractice; proximate cause.

Grimm v. Summit County Children Servs. Bd.

violation of a statutory obligation to report child abuse constitutes negligence per se by hospital; vicariously liable for negligence of employees; negligence per se; respondeat superior; vicarious liability.

Respondeat Superior

Scott v. SSM Healthcare St. Louis; hospitals deemed to "control" physicians even though they cannot dictate the treatment given to patients; independent contractor; agent; principal; vicarious liability.

Apparent Agency

Burless v. West Virginia University Hospitals, Inc.; hospital liable for physician's negligence if hospital acted or failed to act so reasonable person believed physician was an agent of hospital and patient relied on apparent agency; apparent agent.

Hospital Duty of Care to Patients

Carter v. Hucks-Folliss; a hospital should consider a doctor's board certification status when granting hospital privileges for physician conducting surgery.

Hospital Negligence for Giving Doctor Credentials

Larson v. Wasemiller; hospitals may be liable for negligently giving credentials to physicians; a common-law cause of action for negligent credentialing does exist, and is not precluded by the peer-review statute.

Negligent Misrepresentation by Hospital Regarding Physician

Kadlec Med. Ctr. v. Lakeview Anesthesia Assoc.; hospitals may face liability for failing to disclose a former anesthesiologist's suspected drug abuse.

HMO Liability for Negligent Selection of Providers

Pagarigan v. Aetna U.S. Healthcare of California, Inc.; an HMO that contracts out coverage decisions and the responsibility for patient care for capitation fee owes enrollees a duty of due care when choosing providers and in making contracts.

HMO Doctor Compensation Contract

Brannan v. Northwest Permanente, P.C.; an HMO physician's compensation history is irrelevant to a patient's negligence case; a defendant's motive for acting is irrelevant to whether he breached the standard of care in malpractice lawsuit.

ERISA Preemption

Retail Industry Leaders Association v. Fiedler; ERISA preempts state laws requiring employers to pay health insurance costs; or if directly regulates or effectively mandates some part of structure or administration of employers' ERISA plans.

ERISA Preempts All State Actions For Denial Of Benefits

Aetna Health, Inc. v. Davila; All actions brought for the denial of benefits by an ERISA-regulated benefit plan fall within the scope of, and are preempted by, ERISA.

Administrative Discretion Under the Medicare Act

Bellevue Hospital Center v. Leavitt; when assessing the propriety of agency action or regulation, only if there is silence or ambiguity on an issue, the agency has discretion as to how it implements a statute.

Must Follow Federal Rules if Take Federal Benefits

Lankford v. Sherman; Medicaid is a voluntary federal-state program, so a state that elects to participate in the program is bound by the requirements of federal law and regulations.

Supervisory Employees under Union Labor Collective Bargaining Agreement

Oakwood Healthcare, Inc.; supervisory employees use independent judgment in performing their jobs; National Labor Relations Act NLRA; National Labor Relations Board NLRB.

Selection of Hospitals

Federal Trade Commission v. Tenet Healthcare Corp.; a hospital merger did not deprive patients of practicable healthcare alternatives or choices.

Market Leverage from Merger

In the Matter of Evanston Northwestern Healthcare Corp.; a hospital failed to establish non-merger justifications for price hikes; substantially inflating prices violates federal antitrust law; Clayton Act; divestiture.

Sperm Donor Agreement Must Be in Writing

In the Interest of K.M.H.; requiring written agreements to establish sperm donor paternity does not violate equal protection or due process.

Child Endangerment Statute Does Not Protect Unborn Children

State v. Wade; in absence of specific legislative direction, illegal drug use by a pregnant mother does not constitute child endangerment.