The Medicaid statute’s anti-lien provision, 42 U. S. C. 1396p(a)(1), pre-empts state efforts to take any portion of a tort judgment or settlement not “designated as payments for medical care.” A North Carolina statute requires that up to one-third of damages recovered by a beneficiary for a tortious injury be paid to the state to reimburse it for payments made for medical treatment on account of the injury. E. M. A. suffered serious birth injuries that require her to receive 12 to 18 hours of skilled nursing care per day and that will prevent her from working or living independently. North Carolina’s Medicaid program pays part of the cost of her ongoing care. E. M. A. and her parents filed a medical malpractice suit against the physician who delivered her and the hospital where she was born and settled for $2.8 million, due to insurance policy limits. The settlement did not allocate money among medical and nonmedical claims. The state court placed one-third of the recovery into escrow pending a judicial determination of the amount owed by E. M. A. to the state. While that litigation was pending, the North Carolina Supreme Court held in another case that the irrebuttable statutory one-third presumption was a reasonable method for determining the amount due the state for medical expenses. The federal district court, in E.M.A.’s case, agreed. The Fourth Circuit vacated. The Supreme Court affirmed. The federal anti-lien provision pre-empts North Carolina’s irrebuttable statutory presumption that one-third of a tort recovery is attributable to medical expenses. North Carolina’s irrebuttable, one-size-fits-all statutory presumption is incompatible with the Medicaid Act’s clear mandate View "Wos v. E. M. A." on Justia Law

The Estate filed a malpractice suit against the deceased's health care providers under the Federal Tort Claims Act (FTCA), 28 U.S.C. 2671 et seq., alleging in part that they failed to provide appropriate follow-up care after discovering a mass in the deceased's stomach. The court affirmed the district court's grant of summary judgment for the United States based on its finding that the Estate's expert report failed to establish the relevant standard of care or create a question of fact as to the remaining elements of a malpractice claim under Mississippi law. View "Estate of Ira J. Sanders v. United States" on Justia Law

Volkman, an M.D. and a Ph.D. in pharmacology from University of Chicago, was board-certified in emergency medicine and a “diplomat” of the American Academy of Pain Management. Following lawsuits, he had no malpractice insurance and no job. Hired by Tri-State, a cash-only clinic with 18-20 patients per day, he was paid $5,000 to $5,500 per week. After a few months, pharmacies refused to fill his prescriptions, citing improper dosing. Volkman opened a dispensary in the clinic. The Ohio Board of Pharmacy issued a license, although a Glock was found in the safe where the drugs were stored. Follow-up inspections disclosed poorly maintained dispensary logs; that no licensed physician or pharmacist oversaw the actual dispensing process; and lax security of the drug safe. Patients returned unmarked and intermixed medication. The dispensary did a heavy business in oxycodone. A federal investigation revealed a chaotic environment. Cup filled with urine were scattered on the floor. The clinic lacked essential equipment. Pills were strewn throughout the premises. Months later, the owners fired Volkman, so he opened his own shop. Twelve of Volkman’s patients died. Volkman and the Tri-State owners were charged with conspiring to unlawfully distribute a controlled substance, 21 U.S.C. 841(a)(1); maintaining a drug-involved premises, 21 U.S.C. 856(a)(1); unlawful distribution of a controlled substance leading to death, 21 U.S.C. 841(a)(1) and 841(b)(1)(C), and possession of a firearm in furtherance of a drug-trafficking crime, 18 U.S.C. 24(c)(1) and (2). The owners accepted plea agreements and testified against Volkman, leading to his conviction on most counts, and a sentence of four consecutive terms of life imprisonment. The Sixth Circuit affirmed. View "United States v. Volkman" on Justia Law

Inmate Santiago, complaining of severe pain and a rash, was seen by Dr.Mosher on January 31. Mosher prescribed Tylenol for pain and antibiotics to treat what she thought might be Methicillin-resistant Staphylococcus aureus (MRSA). The next day Dr. Ringle diagnosed erythema nodosum (EN), an uncomfortable but non-dangerous skin inflammation that typically disappears in about six weeks but may recur. EN has no known cure. Ringle prescribed an anti-inflammatory and an antibiotic. Four days later, Santiago was transferred to OSU Medical Center, where he was diagnosed with EN and arthralgias, a severe joint-pain condition, and prescribed an anti-ulcer agent and a different anti-inflammatory. Santiago was seen on February 20 by an OSU dermatologist, who recommended a topical steroid, compression hose, and SSKI, which may help treat EN but is not standard treatment. Each day, February 22- 25, Santiago asked prison nursing staff about the treatments. Staff denied knowledge until, on the 25th, nurses found Santiago’s unsigned chart on Ringle’s desk. Ringle had been on vacation. Mosher signed the order on February 27. Santiago received the topical steroid on February 29 and compression stockings on March 10. Santiago waited longer for the SSKI, which is a non-formulary drug. The district court rejected Santiago’s suit (42 U.S.C. 1983) based on the delays. The Sixth Circuit affirmed. Santiago did not prove that the delay caused a serious medical need or deliberate indifference.View "Santiago v. Ringle" on Justia Law

On January 21, 2009, Amburgey sought treatment for his persistent pneumonia from Dr. Alam at a Whitesburg, Kentucky clinic run by MCHC. He died that same day from a severe allergic reaction to an intravenous contrast dye that was administered in preparation for a CT scan, despite an allergy notation in his chart. His wife, Delma, sued Dr. Alam, MCHC, and, because MCHC is an agency of the federal government, the United States. On January 20, 2011, Delma mailed the required form for asserting a wrongful-death claim against the government to MCHC. MCHC received the form four days later and in turn forwarded it to the U.S. Department of Health and Human Services, the appropriate federal agency for notification purposes under 28 U.S.C. 2401(b). The district court dismissed the claim as untimely. The Sixth Circuit reversed and remanded, holding that Delma’s claim did not accrue until after she had received the autopsy report in April 2009 View "Amburgey v. United States" on Justia Law

Plaintiffs, minors who were born with permanent brachial plexus injuries, sued through their mothers and next friends, alleging separately that their injuries were caused by the application of excessive traction during delivery. At both trials, the defense introduced into evidence a case report that purported to document an instance of brachial plexus injury occurring in a delivery. Plaintiffs lost their medical malpractice cases and subsequently sued the authors of the report, the journal in which it was published, and the publisher, contending that the report was false and that Defendants engaged in fraudulent conduct in publishing the report. The district court dismissed the complaint for failure to state a claim upon which relief could be granted. The First Circuit Court of Appeals affirmed, holding that, because the causation allegation was wholly speculative, Plaintiffs' claim did not reach the plateau of plausibility that is the "new normal in federal civil procedure." View "A.G. v. Elsevier, Inc." on Justia Law

Augutis had reconstructive surgery on his foot at a VA hospital. Complications led to amputation of his leg. Augutis claims that the amputation was the result of negligent treatment and filed an administrative complaint with the Department of Veterans Affairs. The VA denied the claim. Augutis timely requested reconsideration on March 21, 2011. On October 3, the VA informed him that it had not completed reconsideration, but that suit could be filed or additional time could be permitted to allow it to reach a decision. The letter noted that Federal Tort Claims Act claims are governed by both federal and state law and that some state laws may bar a claim or suit. Days later, the VA denied reconsideration. The letter explained that a claim could be presented to a district court within six months, but again noted that state laws might bar suit. Augutis filed suit on April 3, 2012, more than five years after the surgery, but within six months of the VA’s final dismissal. The district court dismissed under Illinois’s statute of repose, 735 ILCS 5/13‐212(a), which requires that a medical malpractice claim be brought within four years of the date of the alleged malpractice. The Seventh Circuit affirmed, rejecting an argument that the state limitations period was preempted by the FTCA period. View "Augutis v. Uniited States" on Justia Law

Jamie Gaddy appealed a circuit court judgment that dismissed with prejudice Gaddy's medical-malpractice action against certified nurse anesthetist Lisa Brascho. According to Gaddy, the reason she requested the dismissal of her trial court case against Brascho was to seek appellate review of the trial court's decision granting Brascho's motion in limine. However, the Supreme Court has previously stated that "where the plaintiff knowingly and willingly agrees to a stipulation of dismissal, he has no standing to appeal." Therefore, based on Gaddy's failure to demonstrate to the Supreme Court that it had jurisdiction over Gaddy's appeal, the Court dismissed the appeal. View "Gaddy v. Brascho " on Justia Law

At issue in this case was a medical malpractice claim brought against a physician's assistant, two supervising physicians and Rocky Mountain Emergency Physicians, LLC. Plaintiff-Appellant Heather Hall went to the emergency room complaining of headache, blurred vision and sensitivity to light. The assistant examined her, and in the process, plaintiff alleged the assistant touched her inappropriately while trying to listen to plaintiff's heartbeat through a stethoscope. Plaintiff's medical expert opined that this conduct fell below the standard of care for a physician's assistant working in an emergency room in Pocatello. Rocky Mountain moved for summary judgment, arguing that the expert lacked proper foundation. The district court granted Rocky Mountain's motion and dismissed the suit. Finding no error in the district court judgment, the Supreme Court affirmed. View "Hall v. Rocky Mtn Emergency Physicians" on Justia Law

In the first appeal of this medical malpractice suit, the Supreme Court reversed and remanded a judgment for defendant Dr. Linda Peterson, holding that the trial court abused its discretion when it misconstrued the rules of evidence on the relevancy and admissibility of plaintiff Lita St. John's proffered evidence. On remand, defendant asked for reconsideration of the evidentiary rulings and reinstatement of the judgment. Concluding that the Supreme Court's opinion still left open the question whether the evidence was admissible, and ruling that it was not, the trial court declined to grant plaintiff a new trial and reinstated the judgment for defendant. Upon re-review, the Supreme Court reversed and remanded. "Many issues addressed by motions in limine, including evidentiary issues, are frequently reexamined during trial and the trial court may change rulings based on the actual evidence at trial. Thus, it was an error for the trial court in this case to reinstate a judgment based on reconsidering and ruling on a motion in limine outside of the context of a trial. We reverse the trial court's decision and remand for a new trial." View "St. John v. Peterson" on Justia Law