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

Articles Posted in Medical Malpractice
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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

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During 2012-2013, three undercover DEA agents posed as patients during an investigation into Dr. Zaidi’s controlled substances prescription practices. As a result, the DEA Deputy Administrator suspended Zaidi’s controlled substances prescription privileges, finding that his continued registration posed an imminent danger to the public health and safety, 21 U.S.C. 824(d). DEA agents also seized controlled substances from Zaidi’s offices. Following a hearing, an ALJ recommended that the suspension and seizure be affirmed and that Zaidi's registration be revoked. The Administrator affirmed the suspension and seizure, but found the registration issue was moot due to the expiration of Zaidi’s registration and his decision not to seek renewal. The Sixth Circuit affirmed, rejecting arguments that the ALJ arbitrarily and capriciously denied Zaidi the opportunity to present testimony from an expert, employees, and former patients; there was insufficient evidence to support the suspension; the government failed to make a prima facie showing that Zaidi’s continued registration was inconsistent with the public interest; Zaidi’ prescriptions to the three undercover officers were not outside the usual course of professional practice and did not lack a legitimate medical purpose; Zaidi did not falsify medical records; and the sanction imposed was disproportionately harsh. View "Akhtar-Zaidi v. Drug Enforcement Administration" on Justia Law

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Means, 18 weeks pregnant, went into labor. She went to Mercy Health, the only hospital within 30 minutes of her residence. Doctors diagnosed preterm premature rupture of the membrane, which usually results in a stillbirth or the baby's death. Means’s unborn baby still had a heartbeat. Mercy sent her home with pain medication without telling Means that the baby would likely not survive or that continuing her pregnancy could endanger her health. The next morning, Means returned with a fever, excruciating pain, and bleeding. Mercy did not give her additional treatment or options, although Means’s physician suspected she had a serious bacterial infection. Mercy sent her home. Means returned that night with contractions. The baby was delivered and died. The pathology report confirmed that Means had acute bacterial infections. Two years later, a public health educator discovered and inquired into Means’s case. Mercy explained that its Directives (ethical guidelines dictated by Catholic doctrine) prohibited inducing labor or similar action. The limitations period had run out on medical malpractice claims. Means sued the Conference of Catholic Bishops, alleging negligence for promulgating and enforcing the Directives. The Sixth Circuit affirmed dismissal. The only link to the Eastern District, where the case was filed, was the decision of Catholic Health Ministries to adopt the Directives. Each individual defendant lives out of state. Means lives in and Mercy is located in the Western District. Means did not allege that the defendants, by adopting the Directives, caused her any cognizable injury.. View "Means v. United States Conference of Catholic Bishops" on Justia Law

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Hawver claims that the Jackson, Michigan, Center for Family Health a federally qualified health center, caused her mother’s death by providing negligent medical care. The Federal Tort Claims Act provides the exclusive remedy for claims against federally qualified health centers such as Family Health, 42 U.S.C. 233. By the time Hawver filed suit, the two-year statute of limitations applicable to claims under the Act had run. The district court dismissed, holding that failure to satisfy the Act’s statute of limitations requirements doubles as a failure to satisfy the subject matter jurisdiction requirements of the federal courts and precludes equitable tolling. After the district court’s decision, the Supreme Court’s 2015 decision, United States v. Kwai Fun Wong, held that the Act’s statute of limitations requirements do not implicate the subject matter jurisdiction of the federal courts and that equitable tolling may save a late claim in some circumstances. The Sixth Circuit remanded to the district court to determine whether equitable tolling saves Hawver’s claim. View "Hawver v. United States" on Justia Law

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Volkman, a University of Chicago M.D. and Ph.D. (pharmacology), board-certified in emergency medicine, was in financial distress after lawsuits. Hired by Tri-State, a cash-only clinic, he was paid $5,000 to $5,500 per week. Soon, 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 drug safe. Follow-up inspections disclosed poorly maintained 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, unclean environment. Tri-State fired Volkman, who opened his own shop; 12 patients died. Volkman and Tri-State’s 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). The owners accepted plea agreements and testified against Volkman, The Sixth Circuit affirmed his conviction on most counts, and a sentence of four consecutive life terms. On remand from the Supreme Court, in light of Burrage v. United States (2014), the Sixth Circuit again found the evidence of but-for causation sufficient. View "United States v. Volkman" on Justia Law

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When Colonel Antoon (U.S. Air Force, retired) learned that he needed prostate surgery, he researched options and specialists, which led him to the Cleveland Clinic and Dr. Kaouk. Antoon interviewed Kaouk and arranged for him to perform the operation. When Antoon experienced complications following the surgery, his further investigation caused him to suspect that Kaouk did not actually perform the surgery, but passed off major duties to a surgical resident. Antoon lodged several complaints and filed a medical malpractice action in state court, which was dismissed voluntarily. Antoon then filed suit as a relator under the qui tam provisions of the False Claims Act (FCA), premised on the theory that Kaouk billed the government for work he did not perform, and promoted the robotic surgical device he recommended in violation of the anti-kickback statute, 42 U.S.C. 1302a-7b(b)(2). The United States declined to intervene. The district court dismissed. The Sixth Circuit affirmed, based on a jurisdictional bar. Antoon does not have any direct and independent knowledge of the information upon which his fraud allegations are based; therefore he cannot qualify as an original source of that information, and cannot establish standing as a qui tam plaintiff under the FCA, 31 U.S.C. 3730(e)(4)(B). View "Antoon v. Cleveland Clinic Found." on Justia Law

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Approximately 10 years after Marc Silverman, D.D.S. performed a root canal on one of Newberry’s teeth, Newberry returned to Silverman because the tooth was hurting. Silverman examined the tooth, offered a tentative diagnosis unrelated to the root canal, and sent Newberry on his way. Several years later, Newberry and Silverman repeated this exercise, with the same outcome. Finally, in 2012, Newberry sought a second opinion and found out that his original root canal had not been properly completed. When Newberry requested his records, Silverman claimed that the old records were no longer available. Newberry sued. The district court dismissed for failure to state a claim. The Sixth Circuit vacated and remanded for further proceedings with respect to Newberry’s fraud claim, but affirmed on all other grounds. Newberry’s claims of dental malpractice, negligence, and infliction of emotional distress were time-barred. The spoiliation claim failed because Newberry’s complaint against Silverman was not disrupted by the allegedly destroyed dental records. View "Newberry v. Silverman" on Justia Law

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While working as a home care provider, Carl experienced a psychotic break, urinating on one client’s head. Muskegon County prosecutors charged Carl with vulnerable-adult abuse. He was held at the county jail, which contracted mental health services to CMH. CMH employees examined Carl at the jail. McLaughlin, a physician’s assistant, indicated that Carl was “floridly psychotic,” that he had considered suicide, and that he required treatment in a psychiatric facility. McLaughlin had previously prescribed Carl an anti-psychotic medication but noted that it was “not very effective.” Weinert, a limited licensed psychologist, documented that Carl was “paranoid” and “require[d] intensive psychiatric treatment” and hospitalization. Dr. Jawor, a CHM independent contractor, examined Carl two days later. Carl denied feeling depressed, suicidal,or homicidal, and denied having paranoid delusions and hallucinations. Carl stated that he was “messing with” Weinert and McLaughlin. Jawor concluded that he did not meet the criteria for involuntary hospitalization. Carl sued (42 U.S.C. 1983) arguing that, due in part to Jawor’s negative certification, he did not receive mental health services he needed and that his uncontrolled psychotic state worsened, seriously harming his mental and physical health while detained. All defendants except Jawor were dismissed after signing a settlement agreement. The district court held that Jawor was not a state actor. The Sixth Circuit reversed, holding that Jawor acted under color of state law because she performed a public function by evaluating an individual in state custody.View "Carl v. Muskegon Cnty." on Justia Law

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Nancy and Lester's Kentucky pain-management clinic closed after the DEA confiscated the doctor’s license for overprescribing narcotics. They then opened two clinics in Ohio. Patients would arrive before they opened, filling the parking lot, where they used drugs and traded prescription forms. Patients often traveled long distances (in groups), although most lived closer to other clinics. After paying their $150 appointment fee (cash only), patients would meet an “assessor” who would review their “day sheet” and provide a completed prescription form for hydrocodone, oxycodone, or other pain medication. Staff completed day sheets and prescription forms in advance. Patients then met the doctor for a minute. About 100 people per day completed this “five minute” process. The clinics also treated phantom patients. Nancy supervised the updating of files for people who had never visited the clinics. The doctor would sign prescriptions for phantom patients, staff would fill the prescriptions, and the pain pills were sold on the street by a Sadler relative. The clinics ordered drugs directly from pharmaceutical companies, but never obtained a license to dispense controlled substances. The Sadlers were convicted of conspiring to distribute controlled substances illegally and maintaining a premises for distributing the substances; Nancy was also convicted of wire fraud and money laundering. The district court sentenced Lester to 151 months and Nancy to 210 months. The Sixth Circuit vacated the wire fraud conviction, but otherwise affirmed. Nancy may have had many bad motives in buying the pills, but unfairly depriving the distributors of their property was not among them; she ordered pills and paid the asking price. View "United States v. Sadler" on Justia Law