Justia U.S. 6th Circuit Court of Appeals Opinion Summaries

Tennessee participates in Medicaid through “TennCare,” Tenn. Code 71-5-102. The Medicaid Act requires that TennCare administer an Early and Periodic Screening, Diagnosis, and Treatment program for all enrollees under age 21, 42 U.S.C. 1396a(a)(43), 1396d(r) and must provide outreach to educate its enrollees about these services. In 1998 plaintiffs filed a putative class action under 42 U.S.C. 1983, alleging that TennCare had failed to fulfill these obligations. The district court entered a consent decree that explained in detail the requirements that TennCare had to meet to “achieve and maintain compliance” with the Medicaid Act, based on the assumption that the Act created rights enforceable under section 1983. Eight years later, the Sixth Circuit held that one part of the Medicaid Act was unenforceable under section 1983. Following a remand, the district court vacated paragraphs of the decree that were based on parts of the Act that are not privately enforceable. After a thorough review of TennCare’s efforts, the court then vacated the entire decree, finding that TennCare had fulfilled the terms of the decree’s sunset clause by reaching a screening percentage greater than 80% and by achieving current, substantial compliance with the rest of the decree. The Sixth Circuit affirmed. View "John B. v.Emkes" on Justia Law

Fulgenzi was prescribed the generic drug metoclopramide (FDA approved in 1980), sold originally under the brand name Reglan, a drug approved for short-term treatment of patients suffering from gastroesophageal reflux disease. In her suit, claiming failure to adequately warn of risks, she alleged that taking the drug caused her to develop tardive dyskinesia, an often-irreversible neurological disorder that causes involuntary movements, especially of the lower face. In 2009, the Supreme Court held that with respect to branded drug manufacturers, state failure-to-warn suits were not preempted by the federal Food Drug and Cosmetic Act , 21 U.S.C. 301. In 2011 the Court held that such suits could not go forward against generic drug manufacturers, as it is impossible to comply simultaneously with their state duty to adequately warn and their federal duty of sameness (federal law requires generic drug labels to be the same as their branded counterpart). The district court dismissed. The Sixth Circuit reversed, noting that after the branded-drug manufacturer of metoclopramide strengthened warnings on its label, the generic manufacturer failed to update its label as required by federal law, rendering compliance with both federal and state duties no longer impossible. View "Fulgenzi v. PLIVA, Inc." on Justia Law

Gayheart applied for Social Security disability insurance benefits in 2005 due to manifestations of anxiety, panic disorder, bipolar disorder, and depression. After an initial denial and three separate hearings, an administrative law judge (ALJ) found that the limitations caused by Gayheart’s impairments did not preclude him from performing a significant number of jobs available in the national economy and denied Gayheart’s application. Gayheart’s request for an administrative appeal was denied. The Report and Recommendation issued by the federal court’s assigned magistrate judge concluded that the ALJ’s decision was not supported by substantial evidence and that Gayheart should be awarded benefits. But the district court sustained the Commissioner’s objections and affirmed the ALJ’s decision. The Sixth Circuit reversed and remanded, holding that the ALJ failed to weigh the medical opinions according to 20 C.F.R. 404.1527. View "Gayheart v. Comm'r of Soc. Sec." on Justia Law

Plaintiff, a teacher since 1976, was diagnosed with Type 2 diabetes. By 1999, she required insulin injections. Until 2008, plaintiff was never disciplined. In 2008, plaintiff was summoned to address allegations that she had been sleeping during class. Plaintiff claimed that she was not sleeping but rather exhibiting symptoms of diabetes. She was formally reprimanded and requested accommodations: training in recognizing symptoms of diabetes; assistance if she appeared asleep; and breaks for insulin injections. The superintendent allowed her to keep snacks in her classroom, to use the nurse’s office if she first obtained classroom coverage, and to disseminate diabetes information to students and staff. Plaintiff was subsequently suspended for missing classes, sleeping in class, and referring to Playgirl Magazine in class discussion. The Board decided to terminate her contract. Plaintiff was 71 years old. A referee upheld the termination. Instead of appealing, plaintiff filed suit, alleging age discrimination under Ohio law; failure to make reasonable accommodations (ADA, 42 U.S.C. 12112, and state law); retaliation for engaging in protected activity (ADA and state law); and intentional infliction of emotional distress. The district court granted summary judgment to defendants. The Sixth Circuit affirmed with respect to age discrimination, but reversed on other claims. View "Smith v. Perkins Bd. of Educ." on Justia Law

Quigley was 23 years old, with no known life-threatening physical conditions when he was transferred from one Michigan Department of Corrections (MDOC) facility to an MDOC guidance center, where he was under the care of CMS, a service provider with which MDOC contracted. CMS employees Dr. Thai and physician’s assistant Garver treated Quigley for moderate depression and prescribed medications. After about a month, Quigley was found dead in his cell. The medication chart confirmed that Quigley had been administered both Amitriptyline and Trazodone the previous three days. The autopsy report concluded that Quigley died of an epileptic seizure disorder. Quigley’s estate obtained affidavits from a forensic pathologist, who concluded that Quigley likely died from a fatal drug interaction between the tricyclic Amitriptyline and tetracyclic Trazodone and from a psychiatrist, who similarly concluded that the fatal drug interaction likely killed Quigley. Thai provided three medical-expert affidavits, all concluding that the best explanation for Quigley’s death is epileptic seizure. Quigley’s estate sued Thai, Garver, and CMS under 42 U.S.C. 1983. The district court denied a motion asserting qualified immunity. The Sixth Circuit affirmed, finding that there were unresolved material questions of fact concerning the cause of death. View "Quigley v. Thai" on Justia Law

USCA is a non-profit national civic league with approximately 27,000 members that devotes itself to conservative values and opposes efforts of the federal government to interfere with market processes. Some of USCA’s uninsured members object to the purchase of private health insurance because they do not believe in the effectiveness of traditional medicine, prefer alternative and integrative medicine, or prefer to focus on preventative care that is not covered by traditional health insurance policies. Two individual plaintiffs do not have, nor do they wish to acquire, health insurance, but they are not exempt from the Patient Protection and Affordable Care Act’s individual mandate, 26 U.S.C. 5000A. They challenged the mandate as violating the Commerce Clause, rights to freedom of expressive and intimate association, rights to liberty, and rights to privacy. The district court dismissed in part, without substantive analysis, holding that plaintiffs failed to satisfy the “plausibility standard” and entered summary judgment on the Commerce Clause challenge. The Sixth Circuit affirmed, stating that the Supreme Court’s opinion in National Federation of Independent Business v. Sebelius controls the outcome on the Commerce Clause count and the remaining constitutional claims were correctly dismissed for failure to state a claim. View "U.S. Citizens Ass'n v. Sebelius" on Justia Law

Stoudemire, then age 23, entered the Michigan Department of Corrections system in 2002, suffering from systemic lupus erythematosus, a chronic, painful autoimmune disease; hypercoagulapathy, a related disorder involving tendency to develop blood clots; and depression. Stoudemire bore a significant risk of experiencing kidney and liver damage, heart attacks, amputations, and chronic pain. Stoudemire’s health quickly deteriorated. She experienced a heart attack, liver failure, and life-threatening embolisms. She underwent three amputations, losing both legs below the knee. At her 2007 parole, she suffered from chronic depression, posttraumatic stress disorder, and conditions related to medications. In her suit under 42 U.S.C. 1983, the Americans with Disabilities Act, 42 U.S.C. 12132; and Michigan law, Stoudemire, alleged that she was placed in a segregation unit following her amputation that lacked accommodations for disabled persons, and was subjected to a strip search that served no legitimate purpose. The district court denied motions by the warden and an officer, seeking summary judgment on qualified immunity grounds. The Sixth Circuit vacated with respect to the warden, stating that the court did not adequately analyze deliberate indifference, but affirmed with respect to the officer, stating that the excessively invasive nature of the search outweighed any need to conduct it. View "Stoudemire v. MI Dep't of Corrs." on Justia Law

Since enacting a program for black-lung benefits in 1969, known as the Black Lung Benefits Act,83 Stat. 742, Congress has repeatedly amended the claim-filing process, sometimes making it harder for miners and survivors to obtain benefits, sometimes making it easier. The most recent adjustment, part of the 2010 Patient Protection and Affordable Care Act, reinstated a presumption that deceased workers who had worked for at least 15 years in underground coal mines and had developed a totally disabling respiratory or pulmonary impairment were presumed to be totally disabled by pneumoconiosis and to have died from it. The presumption is rebuttable. The Act also reinstated automatic benefits to any survivor of a miner who had been awarded benefits on a claim filed during his lifetime, 124 Stat. at 260. Groves, a miner for 29 years, filed a claim for benefits in 2006 and died four months later. An ALJ denied his widow benefits. The law changed while her appeal was pending. The Benefits Review Board concluded that the new law covered this claim. The Sixth Circuit affirmed. View "Vision Processing, LLC v. Groves" on Justia Law

Sexton, a smoker, spent 25 years working in coal mines. He first applied for Black Lung Act (30 U.S.C. 901) benefits in 1973. The application was unsuccessful as were two other claims. In 2001, two years after the denial became final, Sexton filed a subsequent claim. The district director recommended an award of benefits. Buck Creek Coal requested a formal hearing. While his claim was pending Sexton died. His widow filed her own claim and the district director issued a proposed order awarding benefits in the survivor claim. Buck Creek requested a hearing. The administrative law judge considered four medical opinions, and based on that new evidence, determined that Sexton suffered a total disability from clinical and legal pneumoconiosis and that Sexton established a change in an applicable condition of entitlement pursuant to 20 C.F.R. 725.309 and awarded benefits. The Benefits Review Board affirmed with respect to Sexton’s claim and affirmed in part and vacated in part with respect to the survivor claim. The Sixth Circuit affirmed, holding that 20 C.F.R. 725.309 is valid and was correctly applied and that the Board’s decision did not violate principles of finality or res judicata. View "Buck Creek Coal Co. v. Sexton" on Justia Law

Keith has been deaf since his birth in 1980. Wearing a sound transmitter, he can detect noises. He is unable to speak and communicates using American Sign Language (ASL). In 2007, Keith successfully completed a lifeguard training program, with assistance from an ASL interpreter, and applied for a position at the county’s wave pool. Stavale, the county recreation specialist, explained to her supervisors that Keith had requested an ASL interpreter for meetings and classroom instruction. Having received no objection, Stavale extended an offer of employment, conditioned upon a pre-employment physical. During that physical, the doctor stated: “He’s deaf; he can’t be a lifeguard” and “I have to [fail him]. If something happens … they’re going to come after me.” Aquatic safety and risk management consultants expressed concern about whether a deaf individual could perform effectively as a lifeguard. Stavale identified accommodations that she believed could successfully integrate Keith. The employment offer was withdrawn. The district court granted the county summary judgment in his suit under the Americans with Disabilities Act, 42 U.S.C. 12101, and the Rehabilitation Act, 29 U.S.C. 794. The Sixth Circuit reversed, holding that issues of material fact exist regarding whether Keith is otherwise qualified to be a lifeguard, with or without reasonable accommodation. View "Keith v. Cnty. of Oakland" on Justia Law