Justia Medical Malpractice Opinion Summaries

Articles Posted in US Court of Appeals for the Sixth Circuit
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Ethicon manufactures a mesh sling, used to treat stress urinary incontinence, and a posterior mesh “Prolift, “designed to treat pelvic organ prolapse. In 2009, Dr. Guiler surgically implanted both devices to treat Thacker. Before the surgery, Thacker reviewed and signed an informed consent form that listed several risks, including: “infections and/or erosions of the mesh” which could require additional follow-up surgeries, urinary retention, “[p]ainful intercourse and vaginal shortening,” and treatment failure. After the surgery, Thacker’s incontinence worsened, and she suffered from shooting pain in her groin area and severe abdominal swelling and bloating. In 2010, Thacker started experiencing severe and unbearable pain during intercourse.Thacker ultimately sued Ethicon, alleging strict liability and negligence claims under the Kentucky Product Liability Act for design defect and failure to warn. The district court granted Ethicon summary judgment. The Sixth Circuit reversed. Dr. Guiler’s testimony suggested that he likely would have recommended a different course of treatment had Ethicon given adequate information. Thacker’s expert testified that no reasonable physician would have used the Pelvic Mesh Devices to treat Thacker had Ethicon given adequate information in 2009. A jury could accept that expert’s opinion that a feasible alternative design would have prevented Thacker’s injuries. View "Thacker v. Ethicon, Inc." on Justia Law

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Dr. Paulus was prosecuted for healthcare fraud. Government consultants reviewed 496 of Paulus’s procedures and concluded that 146 (about 30%) were unnecessary. King’s Daughters Medical Center (KDMC) consultants also reviewed a random selection of Paulus’ procedures. Three experts at trial concluded that Paulus overstated his patients’ arterial blockage and inserted medically unnecessary stents. A jury convicted Paulus. After remand, before sentencing, the government disclosed to Paulus for the first time the “Shields Letter,” stating that when KDMC faced previous legal trouble, it hired independent experts to review 1,049 of Paulus’s cases; they flagged about 7% of his procedures as unnecessary. The defense viewed this evidence as exculpatory and consistent with diagnostic differences of opinion. Before trial, the district court had held that the information was inadmissible and that the parties “[we]re not to disclose” any information about the KDMC Review to Paulus.The Sixth Circuit vacated Paulus’s convictions and remanded, finding that the Shields Letter was material to Paulus’s defense and that failure to disclose it violated Paulus’s “Brady” rights. On remand, the government subpoenaed KDMC for additional information regarding the study referenced in the Shields Letter. KDMC objected, citing the attorney-client, work-product, and settlement privileges. The government filed a motion to compel, which was granted. KDMC sought a writ of mandamus. The Sixth Circuit denied KDMC’s petition. KDMC’s disclosure of some information regarding its experts’ study waived its privilege over the related, undisclosed information now being sought. View "In re: King's Daughters Health System, Inc." on Justia Law

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Albright was severely injured in a car accident and used opioids to manage her chronic pain. She became addicted to opioids. Seeking treatment for her addiction, Albright turned to Dr. Christensen to administer a one-week in-patient detoxification program. Christensen started Albright with a patient-controlled analgesia pump to supply her with hydromorphone, a pain reliever; he also gave Albright phenobarbital, which depresses the central nervous system. Christensen terminated these treatments after Albright became “anxious and tearful” while the two discussed the treatment. Changing tack, Christensen twice administered Suboxone—an opioid-replacement medication—to Albright. On both occasions, Albright immediately developed muscle spasms, pain, contortions, restlessness, and feelings of temporary paralysis. She refused further treatment and was discharged. Albright still suffers shaking, muscle spasms, and emotional distress.The Sixth Circuit reversed the dismissal of Albright’s suit against Christensen. The suit sounds in medical malpractice rather than negligence. Michigan’s affidavit-of-merit and pre-suit-notice rules for medical-malpractice actions conflict with the Federal Rules of Civil Procedure and do not apply in diversity cases in federal court. Federal Rule 3 requires only the filing of a complaint to commence an action—nothing more. The district court mistakenly invoked Erie and applied the pre-suit-notice rule in Albright’s case. View "Albright v. Christensen" on Justia Law

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Tomei went to Parkwest Hospital after he injured his foot and leg. He is deaf and communicates using American Sign Language. He asked for an interpreter. Parkwest never provided one. Medical staff gave him an antibiotic and ibuprofen and sent him home. Days later he went to the emergency room, where doctors determined he had blood clots in his leg. Parkwest offered only to connect Tomei with an off-site interpreter via webcam. The connection was so glitchy that Tomei could not effectively communicate. After surgery, Tomei could not tell the medical staff that he was still experiencing pain. Tomei was sent home. Tomei’s family doctor sent him to the University of Tennessee Medical Center, where interpreters helped him through a second surgery. Ultimately, doctors amputated nearly one-third of his leg. About 15 months after he was first denied an interpreter, Tomei sued under section 1557 of the Patient Protection and Affordable Care Act (ACA).The Sixth Circuit rejected an argument that the suit was untimely under Tennessee’s one-year statute of limitations for personal injury suits. Unless federal law provides otherwise, a civil action “arising under” a federal statute enacted after December 1, 1990, is subject to a four-year statute of limitations. 28 U.S.C. 1658(a). Tomei brought his discrimination claim under the ACA—not the Rehabilitation Act. No statute or regulation explicitly sets a statute of limitations for violating the ACA’s discrimination bar. View "Tomei v. Parkwest Medical Center" on Justia Law

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On April 4, Debra went to Kentucky’s Manchester Memorial Hospital emergency room where she presented with numbness from the waist down, pain in both legs, with the right leg being worse and cold. On April 19, Debra’s right leg was amputated below the knee at the University of Kentucky Medical Center due to serious clots that restricted blood flow. Debra sued healthcare providers for failing to consider that Debra’s symptoms were caused by vascular issues rather than musculoskeletal abnormalities. The only remaining defendant is the government which was substituted under the Federal Tort Claims Act, 28 U.S.C. 1346, 2671–80, for its employee, Dr. Madden, who examined Debra at the federally-supported health center on April 12.The district court entered judgment in favor of the United States. The Sixth Circuit reversed. The proper framing of the causation inquiry was not whether it would have made a difference as to the ultimate outcome if Dr. Madden had properly diagnosed the condition on April 12 but whether it would have made a difference to Debra’s outcome if Madden had considered the possibility of vascular causes as the source of her symptoms on April 12. The district court declined to resolve a dispute as to whether Debra suffered from ischemia from April 4 to April 13, or whether she suffered sudden ischemia on April 13, after she being seen by Madden. View "Chesnut v. United States" on Justia Law

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In 2011-2012, Godofsky was a doctor at a “pill mill,” the Central Kentucky Bariatric and Pain Management clinic. The clinic accepted payment by only cash (later by debit card), at $300 for the first visit and $250 per visit thereafter, and did not give change. The clinic had thousands of dollars in cash on hand every day, so the manager was armed with a handgun and patrolled the clinic with a German Shepherd. The clinic scheduled multiple “patients” at the same time, every 15 minutes, and was often open until after 10:00 p.m. The clinic received hundreds of “patients” per day, many of whom had traveled long distances and waited for hours for a few minutes with a doctor who would then provide a prescription for a large amount of opioids, usually oxycodone. The Sixth Circuit affirmed Godofsky’s conviction for prescribing controlled substances, 21 U.S.C. 841(a), and the below-guidelines 60-month prison term and $500,000 fine, upholding the trial court’s refusal to use a jury instruction titled “Good Faith,” which would have instructed the jurors that his “good intentions” were enough for his acquittal or, rather, that the prosecutor had to prove that he had not personally, subjectively, believed that the oxycodone prescriptions would benefit his patients. View "United States v. Godofsky" on Justia Law

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While in federal prison in Ohio, Gallivan had surgery. According to Gallivan, the surgery left him permanently disabled and the Bureau of Prisons was to blame. The Bureau found no evidence that its employees had done anything wrong. Gallivan sued the United States for negligence under the Federal Tort Claims Act (FTCA), 28 U.S.C. 1346(b)(1). The district court believed Ohio Civil Rule 10(D)(2) governed and required a person alleging medical negligence to include a medical professional’s affidavit stating that the claim has merit. Gallivan did not include an affidavit with his complaint; the district court dismissed his case. The Sixth Circuit vacated and remanded. The FTCA expressly requires courts to use the Federal Rules. Federal Rule of Civil Procedure 8(a) requires that a complaint include a short and plain jurisdictional statement, a short and plain statement of the claim, and an explanation of the relief sought. Rule 8 implicitly excludes other requirements that must be satisfied for a complaint to state a claim for relief. Rule 8 does not require litigants to file any affidavits. Nor does Rule 12, which does not demand “evidentiary support” for a claim to be plausible. View "Gallivan v. United States" on Justia Law

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Ace, a licensed physician, and Lesa Chaney owned and operated Ace Clinique in Hazard, Kentucky. An anonymous caller told the Kentucky Cabinet for Health and Family Services that Ace pre-signed prescriptions. An investigation revealed that Ace was absent on the day that several prescriptions signed by Ace and dated that day were filled. Clinique employees admitted to using and showed agents pre-signed prescription blanks. Agents obtained warrants to search Clinique and the Chaneys’ home and airplane hangar for evidence of violations of 21 U.S.C. 841(a)(1), knowing or intentional distribution of controlled substances, and 18 U.S.C. 1956(h), conspiracies to commit money laundering. Evidence seized from the hangar and evidence seized from Clinique that dated to before March 2006 were suppressed. The court rejected arguments that the warrants’ enumeration of “patient files” was overly broad and insufficiently particular. During trial, an alternate juror reported some “concerns about how serious[ly] the jury was taking their duty.” The court did not tell counsel about those concerns. After the verdict, the same alternate juror—who did not participate in deliberations—contacted defense counsel; the court conducted an in camera interview, then denied a motion for a new trial. To calculate the sentencing guidelines range, the PSR recommended that every drug Ace prescribed during the relevant time period and every Medicaid billing should be used to calculate drug quantity and loss amount. The court found that 60 percent of the drugs and billings were fraudulent, varied downward from the guidelines-recommended life sentences, and sentenced Ace to 180 months and Lesa to 80 months in custody. The Sixth Circuit affirmed, rejecting challenges to the constitutionality of the warrant that allowed the search of the clinic; the sufficiency of the evidence; and the calculation of the guidelines range and a claim of jury misconduct. View "United States v. Chaney" on Justia Law

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Rhinehart, then a prisoner, filed suit under 42 U.S.C. 1983, alleging that medical providers associated with the Michigan Department of Corrections (MDOC) denied him necessary treatment for his end-stage liver disease (ESLD). When he died, his brothers filed an amended complaint on behalf of his estate. The district court granted two doctors summary judgment on their Eighth Amendment claims. The Sixth Circuit affirmed. To establish a prison official’s deliberate indifference to a serious medical need, an inmate must show that the alleged wrongdoing was objectively harmful enough to establish a constitutional violation and that the official acted with a culpable enough state of mind, rising above gross negligence. The Rhineharts failed to establish those elements. View "Rhinehart v. Scutt" on Justia Law

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Dr. Paulus, a cardiologist at Ashland, Kentucky’s KDMC, was first in the nation in billing Medicare for angiograms. His annual salary was around $2.5 million, under KDMC’s per-procedure compensation package. In 2008, HHS received an anonymous complaint that Paulus was defrauding Medicare and Medicaid by performing medically unnecessary procedures, 42 U.S.C. 1320c-5(a)(1), 1395y(a)(1), placing stents into arteries that were not blocked, with the encouragement of KDMC. An anti-fraud contractor selected 19 angiograms for an audit and concluded that in seven cases, the blockage was insufficient to warrant a stent. Medicare denied reimbursement for those procedures and continued investigating. A private insurer did its own review and concluded that at least half the stents ordered by Paulus were not medically necessary. The Kentucky Board of Medical Licensure subpoenaed records and concluded that Paulus had diagnosed patients with severe stenosis where none was apparent from the angiograms. Paulus had retired; he voluntarily surrendered his medical license. A jury convicted Paulus on 10 false-statement counts and on the healthcare fraud count. It acquitted him on five false-statement counts. The court set aside the guilty verdicts and granted Paulus a new trial. The Sixth Circuit reversed. The degree of stenosis is a fact capable of proof. A doctor who deliberately inflates the blockage he sees on an angiogram has told a lie; if he does so to bill a more expensive procedure, then he has also committed fraud. View "United States v. Paulus" on Justia Law