Articles Posted in Health Law

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Plaintiff worked as an anesthesiologist at the hospital, beginning in 1991. In 2011, the California Department of Public Health conducted an unannounced “medication error reduction plan” survey at the hospital, found that Plaintiff was responsible for numerous deficiencies regarding the use of the drug droperidol and that the deficiencies “placed patients at risk for undue adverse medical consequences,” and declared that the hospital was in “immediate jeopardy.” The medical group that is responsible for providing the hospital with physicians agreed to remove Plaintiff from the anesthesia schedule pending further investigation. Plaintiff went through required remediation, returned to work, and continued to improperly use the drug. The practice group terminated his “staff privileges, membership, or employment” with the hospital “based on a medical disciplinary cause or reason” without giving prior notice and a hearing under Business and Professions Code section 809. The trial court awarded Plaintiff damages. The court of appeal affirmed. A hospital may not avoid its obligation to provide notice and a hearing before terminating a doctor’s ability to practice in the hospital for jeopardizing the quality of patient care, by directing the medical group employing the doctor to refuse to assign the doctor to the hospital View "Economy v. Sutter East Bay Hospitals" on Justia Law

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Plaintiffs are four parents and their children residing throughout California and a California nonprofit corporation, A Voice for Choice, Inc. This case rose constitutional challenges to Senate Bill No. 277, which repealed the personal belief exemption to California’s immunization requirements for children attending public and private educational and child care facilities. Plaintiffs sued claiming Senate Bill No. 277 violated their rights under California’s Constitution to substantive due process, privacy, and a public education. The trial court sustained the defendants’ demurrer to plaintiffs’ complaint without leave to amend and plaintiffs appealed. On appeal, plaintiffs also raised an additional argument that Senate Bill No. 277 violated their constitutional right to free exercise of religion, although they did not allege a separate cause of action on that basis in their complaint. The Court of Appeal found "[p]laintiffs' arguments are strong on hyperbole and scant on authority." Finding no violation of plaintiffs' constitutional rights, the Court of Appeal affirmed the trial court. View "Love v. California Dept. of Education" on Justia Law

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In 2015, the California Governor issued a proclamation convening a special session of the Legislature for certain specified purposes, including to “[i]mprove the efficiency and efficacy of the health care system, reduce the cost of providing health care services, and improve the health of Californians.” Pertinent to this appeal, the Legislature enacted the End of Life Option act, which legalized physician-assisted suicide for the terminally ill. During a special session, the Legislature passed the Act. Plaintiffs were five individual physicians along with a professional organization that promoted ethical standards in the medical profession (collectively the Ahn parties), who asserted causes of action for violations of due process, of equal protection, and of California constitutional limitations on the power of the Legislature to act in special session. In February 2018, the Ahn parties filed a motion for judgment on the pleadings. After hearing argument, the trial court ruled that it would grant the motion, without leave to amend. On May 24, 2018, the trial court entered judgment in favor of the Ahn parties, and enjoined enforcement of the Act. Days later, three nonparties5 (collectively the Fairchild parties) filed an ex parte application to vacate the judgment, which was denied. The State filed a petition for writ of mandate to the Court of Appeal along with a request for an immediate stay. The Court granted a temporary stay, during which the Fairchild parties filed an appeal of the judgment, contending that, as a result of the denial of their ex parte application to vacate the judgment, they had standing to appeal and, in that appeal, to challenge the judgment on the merits. The Ahn parties disputed this. The issue this case presented for the Court of Appeal’s review was not whether the Fairchild parties are parties to the appeal, but only whether they were parties to this writ proceeding. Admittedly, the State’s writ petition did not name the Fairchild parties, nor did the Fairchild parties formally move to intervene. “However, a person can become a party to an action, even if not named in the complaint, by appearing and participating without any objection by the other parties. We see no reason why this principle should not also apply to a writ proceeding. This is not to say that they are necessarily proper parties.” The Court ultimately concluded the Ahn parties lacked standing on any of the theories they asserted in this appeal. The Court was unclear whether, on remand, they would be able to amend their complaint so as to allege standing, whether the trial court will grant them leave to do so, or whether they will be able to prove up their amended allegations. “It is possible (though by no means certain) that we will see this case again; if so, however, at least we will be sure that the constitutional issue is properly presented.” The Court issued a writ of mandate to direct the superior court to vacate its order granting the motion for judgment on the pleadings and to vacate the judgment. View "California v. Superior Court (Ahn)" on Justia Law

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Harvey Cohoon was diagnosed with a treatable form of cancer and was residing at Victoria Healthcare Center while he underwent treatment and recovered from various injuries he had suffered. For 19 days, Cohoon did well at Victoria Center. On the 20th day, he was observed to have difficulty swallowing thin liquids, and after evaluation, his diet was changed. Plaintiff contended that change was not properly communicated to the kitchen, and that night he was served a dinner that did not comport with his new diet. Less than 20 minutes after being served dinner, a nurse found him in respiratory arrest. The paramedics had to remove large pieces of chicken from his throat before intubating him. More pieces of chicken were removed from his airway at the hospital. He died the following day due to complications from oxygen deprivation to his brain. Donna Cochrum, Cohoon’s niece, filed suit against Victoria Center, asserting causes of action for elder abuse and negligence. As personal representative of Cohoon’s estate, Cochrum asserted a wrongful death cause of action. A jury returned a verdict in favor of Cochrum on all causes of action. Subsequently, the trial court granted a motion for judgment notwithstanding the verdict (JNOV), finding insufficient evidence of recklessness to support the elder abuse cause of action. It also adjusted the remaining damages pursuant to Civil Code section 3333.2. Cochrum appealed the amended judgment, contending the evidence supported the elder abuse cause of action. Two of the defendants cross-appealed, contending the court improperly applied the Medical Injury Compensation Reform Act of 1975 cap. Finding no reversible error, the Court of Appeal affirmed the amended judgment. View "Cochrum v. Costa Victoria Healthcare, LLC" on Justia Law

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The California Legislature reduced Medicaid hospital payments 10 percent between 2008-2011; the federal agency administering the Medicaid program approved the rate reductions. Hospitals alleged the reductions violated the Medicaid Act (42 U.S.C. 1396), which sets out procedural and substantive requirements the state must follow when establishing reimbursement rates. Hospitals unsuccessfully sought to have the rates declared void and almost $100 million in recalculated rates. The court of appeal affirmed, concluding that healthcare providers alleging a violation of section 1396a(a)(30)(A) may not obtain a writ of mandate against state officials to contest Medicaid rates approved by the federal agency that administers the program. Their recourse is an administrative action against the federal agency that approved the rates. While plaintiffs may obtain a writ of mandate for violations of the procedural requirements of section 13(A), no such violation occurred here. View "Santa Rosa Memorial Hospital v. Kent" on Justia Law

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Petitioners sought a writ of mandate directing the superior court to vacate its order denying their motion for summary judgment and issue an order granting the motion. The Court of Appeal issued a stay pending this court's resolution of the petition and an order to show cause why a writ of mandate should not issue. In this case, real party in interest's complaint alleged that petitioners' breakfast cereals were required by California's Proposition 65 to display cancer and reproductive harm warnings because they contain acrylamide. The court held that the Proposition 65 claim was preempted by federal law and granted the petition. The court directed the superior court to vacate its order denying petitioners' motion and enter a new and different order granting the motion. View "Post Foods, LLC v. Superior Court" on Justia Law

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The Court of Appeal affirmed the trial court's order dismissing plaintiffs' challenge to an amendment to California law that eliminated the previously existing "personal beliefs" exemption from mandatory immunization requirements for school children. Senate Bill No. 277 eliminated the personal beliefs exemption from the requirement that children receive vaccines for specified infectious diseases before being admitted to any public or private elementary or secondary school, day care center or the like. The court held that plaintiffs failed to cite any authority for their assertion that SB 277 violated freedom of religion and plaintiffs' free exercise claim was meritless; SB 277 did not violate plaintiffs' constitutional right to attend school; SB 277 did not violate the equal protection clause where the statutory classifications and exemptions plaintiffs disputed did not involve similarly situated children, or were otherwise entirely rational classifications; SB 277 was not void for vagueness where it was sufficiently clear to give fair warning of the required conduct; and SB 277 did not violate Health and Safety Code 24175 subdivision (a). View "Brown v. Smith" on Justia Law

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Plaintiffs were 23 federally qualified health centers (FQHC’s) and rural health clinics (RHC’s) that served medically underserved populations (the Clinics). The dispute before the Court of Appeal centered on coverage for adult dental, chiropractic, and podiatric services the FQHC’s and RHC’s provided to Medi-Cal patients for a period between 2009 and 2013. Prior to July 1, 2009, the Department processed and paid claims for these services. In 2009, in a cost-cutting measure due to budget problems, the Legislature enacted Welfare and Institutions Code section 14131.101 to exclude coverage for these services (and others) “to the extent permitted by federal law.” After the Department stopped paying claims for these services, various FQHC’s and RHC’s challenged the validity of section 14131.10, claiming it conflicted with federal Medicaid law. In California Assn. of Rural Health Clinics v. Douglas, 738 F.3d 1007 (9th Cir. 2013), the Ninth Circuit held section 14131.10 was invalid to the extent it eliminated coverage for these services when provided by FQHC’s and RHC’s because the federal Medicaid Act imposed on participating states the obligation to cover these services by these providers. In response to CARHC, the Department announced it would reimburse FQHC’s and RHC’s for these services for dates of service only on or after September 26, 2013, the date of the Ninth Circuit’s mandate. Seeking reimbursement for services provided prior to September 26, 2103, the Clinics petitioned for a writ of mandate to compel the Department to accept, process, and pay claims for these services for the period July 1, 2009, to September 26, 2013. The trial court granted the petition in part and entered judgment for the Clinics. The Department appeals. Characterizing the Clinics’ writ petition as a suit for damages, it contended: (1) sovereign immunity barred the Clinics’ claims for retroactive payment; (2) the CARHC decision was retroactive because the Medicaid Act is spending clause legislation and its terms were not sufficiently clear as to the requirement to cover adult dental, chiropractic, and podiatric services provided by FQHC’s and RHC’s; and (3) retroactive relief violated the separation of powers doctrine because it forces the Legislature to appropriate money. The Court of Appeal disagreed with the Department’s characterization of the Clinics’ lawsuit. "Rather than a suit for damages, the lawsuit seeks an order to compel performance of a mandatory duty and did not result in a money judgment. Under well-settled California law, such a mandamus proceeding is not barred by sovereign immunity. The Department’s contentions based on spending clause legislation and separation of powers are new arguments raised for the first time on appeal. We exercise our discretion to consider only the spending clause argument. We reject it because the Department has not shown its obligations under Medicaid law, as determined by CARHC, came as a surprise. The separation of powers argument raises factual issues about appropriations that should have been presented in the trial court and we decline to consider this new argument." Accordingly, the Court affirmed the judgment. View "American Indian Health etc. v. Kent" on Justia Law

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This case raised issues concerning the legal obligations imposed on health care providers when a patient's health care directives conflict with the providers' opinions that the requested care would be medically ineffective and may cause harm. Elizabeth Alexander, a 70-year-old woman suffering from end-stage terminal pancreatic cancer, died four days after she was transferred from a skilled nursing facility to Scripps Memorial Hospital La Jolla (Scripps). Elizabeth had an advance health care directive stating she wanted all measures taken to prolong her life. Defendants declined to provide Elizabeth with certain advanced life support measures on the basis that such measures would have been ineffective and caused her to suffer further harm. After Elizabeth's death, her estate (Estate) and children, Clenton Alexander, Christopher Alexander, and Jacquelyn McDermet (together, Plaintiffs), sued Scripps and numerous medical professionals, alleging Elizabeth died after defendants failed to provide the life-sustaining treatment and comfort care requested in her advance health care directive. The trial court resolved Plaintiffs' claims in favor of Defendants either by sustaining demurrers or granting summary judgment. The Court of Appeal concluded the trial court properly sustained Defendants' demurrers to Plaintiffs' causes of action for elder abuse because Plaintiffs did not allege Defendants' conduct was sufficiently egregious to constitute elder abuse within meaning of the Elder Abuse and Dependent Adult Civil Protection Act, and Plaintiffs did not meet the pleading requirements for their elder abuse claims. Plaintiffs' allegations, at best, stated a claim for professional negligence; the Court concluded the trial court properly granted Defendants summary judgment. On Plaintiffs' professional negligence and wrongful death claims, they could not defeat summary judgment because their expert did not set forth sufficient reasoning or explanation for his opinion that Defendants' breaches of the standard of care and violations of the Probate Code caused Elizabeth injury or death. Plaintiffs' negligent misrepresentation claims failed because the statements they relied upon were not positive assertions by Defendants, and Plaintiffs did not justifiably rely on Defendants' statements. The Court found Defendants were immune from liability under section 4740 for alleged violations of sections 4730 concerning communication of health care decisions; 4732 concerning recordation of information about a patient's capacity; 4736 concerning a health care provider's or institution's duties upon declining to comply with a patient's health care instructions; and 4742, subdivision (b) concerning liability for concealing or coercing or fraudulently inducing an individual to change an advance health care directive. View "Alexander v. Scripps Memorial Hospital La Jolla" on Justia Law

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The Court of Appeal affirmed the trial court's judgment of dismissal based on the sustaining of a demurrer to plaintiffs' class action complaint under the California Safe Drinking Water and Toxic Enforcement Act of 1986, challenging the Proposition 65 warning provided by defendants for wines that contain purportedly unsafe levels of inorganic arsenic. The court held that the trial court properly sustained the demurrer based on the trial court's reasoning that disclosure of chemical ingredients in alcoholic beverages was not a requirement of the Act, and compliance with Proposition 65 was established as a matter of law where, as here, it was undisputed that the safe harbor warning for alcoholic beverages was provided to consumers of defendants' wines. The court also held that the demurrer would properly be sustained on res judicata grounds. View "Charles v. Sutter Home Winery, Inc." on Justia Law