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

A medical malpractice lawsuit was filed by Dwan and Aaron Bray, individually and on behalf of their minor child, against Dr. Timothy J. Thress and various other medical entities. The suit, which was initially filed in state court, related to alleged negligence in Dwan Bray's prenatal care and the subsequent birth of their child. However, Thress was employed by a federally funded health center during his treatment of Bray. Under the Federally Supported Health Centers Assistance Act (FSHCAA), the lawsuit was removed to federal court and the United States was substituted as the defendant.The U.S. government moved to dismiss the case, arguing that the plaintiffs failed to satisfy the Federal Tort Claims Act’s (FTCA) administrative exhaustion requirement. The plaintiffs countered by moving to remand the action to state court, arguing that the FSHCAA did not apply. The district court denied both of plaintiffs’ motions, finding the FSHCAA applicable and any attempt to amend plaintiffs’ complaint futile. The district court dismissed plaintiffs’ FTCA claim without prejudice and remanded plaintiffs’ claims against the remaining defendants to state court. The plaintiffs appealed the district court’s denial of their motion to remand and its dismissal of their FTCA claim.The U.S. Court of Appeals for the Sixth Circuit affirmed the district court's decisions. It held that Thress's conduct was covered by the FSHCAA, and that the plaintiffs' attempts to amend their complaint were futile since they had failed to exhaust their administrative remedies under the FTCA before instituting the lawsuit. View "Bray v. Bon Secours Mercy Health, Inc." on Justia Law

The U.S. Court of Appeals for the Sixth Circuit affirmed a district court decision in a medical malpractice case where the plaintiff's mother died in a nursing home. The plaintiff, Chappelle Gales, alleged that her mother died due to inadequate care provided by the nursing home, and she sought to support her claim with expert testimony. However, the district court excluded the testimony of the plaintiff's expert witness, Dr. Edwin Polverino, due to his unfamiliarity with local medical standards in Memphis, Tennessee where the nursing home is located. The district court subsequently granted summary judgment in favor of the nursing home, Allenbrooke Nursing and Rehabilitation Center, on the basis that without expert testimony, the plaintiff could not establish the essential elements of a state law medical malpractice claim.The Court of Appeals held that the district court did not abuse its discretion in excluding the expert's testimony. According to Tennessee's Healthcare Liability Act, for a medical malpractice action, the plaintiff must establish the "recognized standard of acceptable professional practice" in the community where the defendant practices or in a similar community. However, the plaintiff's expert witness, who practiced in Virginia, admitted that he had not looked into the standard of care in Memphis. The court held that a national standard of care could not be substituted for a local standard of care under Tennessee law. The court further held that the plaintiff had failed to establish that the expert was familiar with the standard of care in a community similar to Memphis. As a result, without admissible medical expert testimony regarding the recognized standard of professional care in Memphis or a similar community, the nursing home was entitled to summary judgment. View "Gales v. Allenbrooke Nursing and Rehabilitation Center, LLC" on Justia Law

Bauer worked as a physician for over 50 years, most recently in pain management at ANA. Bauer’s practice, which included regular prescribing controlled substances, became the subject of a DEA investigation. Bauer was indicted for knowingly or intentionally” distributing or dispensing controlled substances “except as authorized,” 21 U.S.C. 841(a), concerning 14 patients. The prosecution’s expert, Dr. King, opined that Bauer did not sufficiently establish a diagnosis and ignored “red flags.” Each patient had a history of at least two mental health conditions; several had histories of illegal drug use. Bauer drastically exceeded recommended thresholds and prescribed opioids together with other controlled substances. One patient died from an accidental overdose. None showed improvement. A drug task force officer alerted Bauer that a patient was selling his pills. Bauer did not terminate the patient but provided additional prescriptions. Several pharmacies would not fill his prescriptions. Dr. King opined that Bauer prescribed opioids “in most cases” to support “addiction and dependency,” “without a legitimate medical purpose.”The Sixth Circuit affirmed Bauer’s convictions and 60-month sentence (below the Guidelines range). A jury could reasonably find that Bauer knew his prescriptions were without authorization, satisfying the mens rea requirement clarified by the Supreme Court in 2022. The district court did not plainly err in its jury instruction on the good-faith defense. The court rejected Bauer’s challenges to the exclusion of his proffered expert witnesses and his argument that he had a constitutional right to testify as an expert in his own defense. View "United States v. Bauer" on Justia Law

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

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

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

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

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

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

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