Justia U.S. 7th Circuit Court of Appeals Opinion Summaries

Textron began operations at its fastener manufacturing plant in Rochester, Indiana, in 1954; it remained in operation through 2006. The plant released vinyl chloride, a toxic gas, which eventually seeped into the groundwater, contaminating nearby residential wells. One of those wells belonged to the Woods. Both Textron and the Indiana Department of Environmental Management performed testing on the Woods’ well. The family left immediately. While living at the Rochester house, their adopted children, C.W. and E.W., experienced gastrointestinal issues (vomiting, bloody stools), immunological issues, and neurological issues. Both children were younger than two years old when the family left the house; their health improved after leaving. The parents sued on behalf of their children, alleging negligence, negligence per se, negligent infliction of emotional distress, and willful and wanton misconduct. The court excluded their three expert witnesses, finding they did not use reliable bases to support their opinions, and granted Textron summary judgment. The Seventh Circuit affirmed, finding that the district court properly applied the Daubert framework to the experts and, without the experts, the plaintiffs could not prove causation. View "C.W. & E.W. v. Textron, Inc." on Justia Law

Defendant-appellant Dr. Kamal Patel was a physician who commonly prescribed home health care services for his patients. Federal investigators learned that defendant had been receiving undisclosed payments from Grand Home Health Care. Patel was charged with six counts of violating (and one count of conspiring to violate) the Anti-Kickback Statute. During his bench trial, at the close of the government’s evidence, defendant moved to acquit, arguing that he had not “referred” any patients to Grand because there was no evidence that he steered or directed his patients to Grand; rather, the patients independently chose Grand as their provider after defendant prescribed home health care. The district court rejected that argument, holding that, even if a patient had initially chosen Grand, defendant “referred” the patient to Grand when he certified or recertified that the patient needed care, that the care would be provided by Grand, and that Grand could be reimbursed by Medicare for services provided. On appeal, defendant argued that the district court erred by holding that the certification and recertification, via a standardized Medicare form (Form 485), of patients for treatment constituted a “referral” under the Anti-Kickback Statute. He also argued that even if those certifications were referrals, there was insufficient evidence to conclude that Patel was paid “in return for” certifications, as required by the statute. Finding no reversible error, the Seventh Circuit affirmed the district court's judgment. View "United States v. Patel" on Justia Law

Scrogham, then age 53, applied for disability benefits under the Social Security Act, submitting medical conditions including degenerative discs, spinal stenosis, sleep apnea, hypertension, arthritis, atrial fibrillation and restless leg syndrome. An ALJ denied the application and the Appeals Council denied his request for review. The district court affirmed, holding that the ALJ did not err in giving less weight to the opinion of a treating physician than to the opinions of nontreating physicians, that the ALJ permissibly found Scrogham not to be credible and that the ALJ’s decision otherwise was supported by substantial evidence. The Seventh Circuit reversed and remanded. The ALJ impermissibly ignored a line of evidence demonstrating the progressive nature of Scrogham’s degenerative disc disease and arthritis and inappropriately undervalued the opinions of Scrogham’s treating physicians, whose longitudinal view of Scrogham’s ailments should have factored prominently into the ALJ’s assessment of his disability status. Even considering only “the snapshots of evidence that the ALJ considered,” that limited evidence does not build the required logical bridge to her conclusions. The ALJ apparently misunderstood or at least considered only partially some of the evidence about Scrogham’s daily activities, rehabilitation efforts and physicians’ evaluations.View "Scrogham v. Colvin" on Justia Law

Two nurses, formerly employed by Momence, alleged that, during their employment at Momence, they uncovered evidence that Momence knowingly submitted "thousands of false claims to the Medicare and Medicaid programs” in violation of the False Claims Act (FCA) and Illinois Whistleblower Reward and Protection Act. They filed a qui tam action on behalf of the government and alleged that Momence retaliated against them for reporting its fraud. A jury awarded the government more than $3 million in compensatory damages and imposed about $19 million in fines for the qui tam claims. Pursuant to the FCA, the compensatory damages were trebled to more than $9 million. The district court set aside the fines as violating the Excessive Fines Clause of the Eighth Amendment. The jury also awarded the nurses $150,000 and $262,320, respectively, on their retaliation claims. The Seventh Circuit vacated. Both claims failed as a matter of law. Rejecting claims of “worthless services” and false certification, the court stated that, at best, a reasonable jury might be able to say that some of Momence’s claims were false, but that is not enough to satisfy the burden of proof. The employment of one nurse was not terminated, the other’s employment was terminated for an unrelated matter.View "Absher v. Momence Meadows Nursing Ctr., Inc." on Justia Law

Hansen’s employer has an attendance policy, under which employees accumulate points for unexcused absences. When an employee incurs 10 points within a year, his employment is subject to termination. Leave under the Family and Medical Leave Act (FMLA), 29 U.S.C. 2601–2654 is not counted. As of May 2, 2011, Hansen had nine points. He was absent from work from May 3-6 and May 9. On May 3, he requested FMLA leave for depression. On May 11, he provided medical certification, documenting episodic flare-ups periodically preventing him from performing his job. Hansen’s absences earlier that month were approved as FMLA leave. Hansen requested FMLA leave for eight days in June and incurred no attendance points for these absences. Based on the doctor’s faxed response to an inquiry, three subsequent requests were denied. Hansen accumulated 13 points in one year and his employment was terminated because he “exceeded [his] frequency” under which he could “miss 4 times every 6 months.” Later, the doctor sent a letter, modifying his original certification. The letter did not mention the July absences. The company did not retract the termination. Hansen sued under the FMLA alleging interference and retaliation. The district court granted summary judgment in favor of the employer, holding that without expert testimony Hansen could not show that his serious health condition rendered him unable to work during the absences for which he was terminated. The Seventh Circuit reversed. The law does not require a plaintiff to present expert testimony as to his incapacity, and Hansen’s evidence has raised a genuine issue of material fact for trial. View "Hansen v. Fincantieri Marine Grp LLC" on Justia Law

To compensate teaching hospitals for the extra financial burden of providing training, the Medicare program provides additional reimbursement for expenses beyond the immediate costs of patient care, including for “indirect medical education” (IME) costs to account for the time medical interns and residents spend in ways that enhance their ability to provide patient care but that are not connected to the treatment of any particular patient, 42 U.S.C. 1395ww(d)(5)(B)(ii). The district court held that time spent by interns and residents in research activities wholly unrelated to the diagnosis or treatment of patients could be counted as part of this indirect-education time and that Rush University Medical Center, was entitled to Medicare reimbursements for these activities between the years 1983 and 2001. The Seventh Circuit reversed and remanded, noting that the Secretary of Health and Human Services has interpreted the Medicare Act consistently since 1983 to exclude pure research activities from compensable IME costs. Congress codified this exclusion for Fiscal Years 2001 onward in the Patient Protection and Affordable Care Act of 2010, but explicitly declined to lay down a rule for the years 1983 to 2001. The Secretary has now promulgated a regulation excluding pure research from the IME cost calculation for all years since 1983. View "Rush Univ. Med. Ctr v. Sebelius" on Justia Law

Yurt suffers from a psychotic disorder which causes him to experience auditory hallucinations and bouts of uncontrollable rage. He also has obsessive compulsive disorder, moderately severe chronic obstructive pulmonary disease (COPD), and chronic bifrontal tension headaches. He has worked as a cook and a janitor, last working in May 2010, when he suffered a mental break and was terminated for threatening a coworker with a knife. He applied for Disability Insurance Benefits from the Social Security Administration, but an ALJ denied his application. The Appeals Council declined review. The district court affirmed. The Seventh Circuit reversed and remanded, agreeing that the ALJ erred by failing to include many of his medical limitations in the hypothetical that she posed to the vocational expert. View "Yurt v. Colvin" on Justia Law

E.Y., a child, was diagnosed with diplegic cerebral palsy. His mother alleges that E.Y.’s illness resulted from medical malpractice by the federally-funded Friend Family Health Center, where she received her prenatal care, and the private University of Chicago Hospital, where she gave birth. Federal law makes a suit against the Center a suit against the United States under the Federal Tort Claims Act (FTCA) that had to be filed within the FTCA’s two-year statute of limitations, 28 U.S.C. 2401(b). The district court granted summary judgment for the government, finding that the suit was filed about two weeks too late. The mother argued that although she was aware she might have a claim against the University Hospital more than two years before filing this suit, she remained unaware that the Friend Center might be involved until she received a partial set of medical records on December 14, 2006, making her suit timely. The Seventh Circuit reversed. A reasonable trier of fact could find that Ms. Wallace the mother was unaware and had no reason to be aware of the Friend Center’s potential involvement in her son’s injuries until less than two years before she filed suit. View "E. Y., v. United States" on Justia Law

Townsend applied for social security disability benefits and supplemental security income in 2003, at age 44, claiming that she had become incapable of full‐time gainful employment in May 2002 when she had stopped working as a result of multiple physical and psychiatric ailments, including fibromyalgia. In 2012 an ALJ decided that she had become totally disabled in November 2008. By the time that decision was rendered she had died (of pulmonary diseases apparently unrelated to the ailments alleged to have made her totally disabled). Her father was substituted for her. The district court upheld the decision. The Seventh Circuit reversed and remanded, noting multiple errors in determining the onset of total disability. View "Williams v. Colvin" on Justia Law

Breedlove pleaded guilty to drug trafficking and firearms offenses. Before his sentencing hearing, Breedlove filed a “Notice of Ineffective Counsel,” complaining of a conspiracy between his counsel, co-defendants and the court. Breedlove was provided new counsel, who recommended that Breedlove be evaluated for competence. Dr. Szyhowski diagnosed Breedlove as having paranoid schizophrenia. Breedlove was committed to a federal medical facility in Butner, North Carolina. The Bureau of Prisons requested authorization to involuntarily administer antipsychotic medications. At a hearing, the government presented a psychologist and a psychiatrist who jointly authored the report that recommended involuntary medication. In the psychiatrist's opinion, Breedlove’s delusions would remain fixed and prevent him from consenting to medication. Both doctors testified that Breedlove would be closely monitored while at Butner, but acknowledged that when Breedlove was returned to Illinois, they did not know the extent to which he would be monitored. The defense did not call witnesses, but merely submitted testimony from another case that the 79% success-rate figure in the Butner study was too high. The district court granted the request to medicate and denied Breedlove’s motion for reevaluation. The Seventh Circuit affirmed. In Sell v. United States (2003) the Supreme Court determined that to allow involuntary medication, the government must prove by clear and convincing evidence that: important governmental interests are at stake; involuntary medication would significantly further those interests; no viable alternative exists; and administration of the drugs is in the patient’s best medical interest. The district court’s findings were adequate on each factor. View "United States v. Breedlove" on Justia Law