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

Articles Posted in Health Law
by
In 2006 Buechel was incarcerated at FCI-Greenville federal correctional institution, where he contracted Methicillin-Resistant Staphylococcus aureus, (MRSA), a staph infection resistant to certain antibiotics. Buechel was hospitalized for more than 40 days and was left with serious and permanent damage to his heart and lungs. He sued under the Federal Tort Claims Act, 28 U.S.C. 1346(b), alleging that his injuries were caused by the prison’s negligence. The district court issued a pretrial order that limited Buechel’s negligence claim to a theory that he contracted MRSA from contact with one fellow inmate, in the prison laundry in July 2006, or more generally as a result of sloppy procedures in handling infected prison laundry. After a bench trial, the court held that Buechel had not proved that he contracted MRSA from either the inmate or the laundry procedures and entered judgment in favor of the government. The Seventh Circuit affirmed the finding that Buechel failed to prove that he contracted MRSA from the inmate or as a result of inadequate laundry procedures, but vacated and remanded for consideration of a broader theory. Buechel’s administrative claim and complaint presented a broader theory that the prison was negligent more generally in its failure to adhere to its MRSA-containment policies.View "Buechel v. United States" on Justia Law

by
The Affordable Care Act, 42 U.S.C. 300gg-13(a)(4), requires health insurance providers (including third party administrators) to cover certain preventive services without cost to the insured, including, “with respect to women … preventive care and screenings,” including all FDA-approved contraceptive methods, sterilization, and patient education for women with reproductive capacity. The University of Notre Dame self‐insures employees’ medical expenses; Meritain administers the employee health plan. For students’ medical needs, Notre Dame has a contract with Aetna. Because Catholic doctrine forbids the use of contraceptives, Notre Dame has never paid for contraceptives for employees or permitted Aetna to insure the expense of contraceptives. Because of those religious objections and the Religious Freedom Restoration Act, 42 U.S.C. 2000bb‐1(a), the government created a religious exemption, 45 C.F.R. 147.130(a)(1)(iv)). New regulations enlarged the exemption, so that Notre Dame came within its scope. To exercise its right to opt out of paying for coverage for contraceptives, the university completed a form that alerts insurers that Notre Dame is not going to pay, so they will have to pay. The government will reimburse at least 110 percent of the third‐party administrator’s costs and Aetna can expect to recoup its costs from savings on pregnancy medical care. Several months after the regulations were promulgated, the University unsuccessfully sought a preliminary injunction. The Seventh Circuit affirmed, noting that the University had not indicated exactly what it wanted enjoined at this stage. The insurance companies were not parties, and, therefore, could not be enjoined from providing the required coverage. A religious institution has no right to prevent other institutions from engaging in acts that merely offend the institution and the University has complied by completing the required form. View "Univ. of Notre Dame v. Sebelius" on Justia Law

by
Charlie has Type 1 diabetes, managed with an insulin pump, a personal diabetes manager, and a continuous glucose monitor. Before Charlie entered kindergarten, his parents worked with the school district to develop a “504 plan” to enable him to attend public school. Charlie’s plan incorporated doctor’s orders for how insulin doses and snacks would be administered at school; required his school to train three “Diabetes Personnel;” and that all staff members who would interact with Charlie be given general training about diabetes. The school hired a licensed nurse, to perform Charlie’s care and held one general training session and one session specific to Charlie’s equipment, attended by almost all staff who would interact with Charlie. In Charlie’s second year, the parents complained to the Department of Education that the school was violating the 504 plan by failing to have three Trained Diabetes Personnel and refusing to allow the nurse to adjust insulin doses on a case-by-case basis. A mediated agreement required the school to conduct training for three nurses and generally required the school to follow the 504 plan. The parents continued to be dissatisfied and moved Charlie to a private school with no medically trained staff and no formal plan for his diabetes care. The district court rejected their suit under the Rehabilitation Act, 29 U.S.C. 794, and the Americans with Disabilities Act, 42 U.S.C. 12132. The Seventh Circuit affirmed, finding neither intentional discrimination nor failure to reasonably accommodate Charlie’s diabetes.View "CTL v. Ashland Sch. Dist." on Justia Law

by
Chhibber, an internist, operated a walk‐in medical office on the south side of Chicago. For patients with insurance or Medicare coverage, Chhibber ordered an unusually high volume of diagnostic tests, including echocardiograms, electrocardiograms, pulmonary function tests, nerve conduction studies, carotid Doppler ultrasound scans and abdominal ultrasound scans. Chhibber owned the equipment and his staff performed the tests. He was charged with eight counts of making false statements relating to health care matters, 18 U.S.C. 1035, and eight counts of health care fraud, 18 U.S.C. 1347. The government presented witnesses who had worked for Chhibber, patients who saw him, and undercover agents who presented themselves to the Clinic as persons needing medical services. Chhibber’s former employees testified that he often ordered tests before he even arrived at the office, based on phone calls with staff. Employees performed the tests themselves with little training, and the results were not reviewed by specialists; normally, the tests were not reviewed at all. Chhibber was convicted of four counts of making false statements and five counts of health care fraud. The Seventh Circuit affirmed, rejecting challenges to evidentiary rulings. View "United States v. Chhibber" on Justia Law

by
In 2004 Spurling began working for C&M as a packer assigned to the third (night) shift. In 2009, she began to experience decreased consciousness and alertness, for which she received several disciplinary warnings. Spurling received a Final Warning/Suspension in February 2010 after she left her work site to use the restroom and did not return for more than 20 minutes. After her suspension, Spurling met with her manager and supervisors and indicated that her sleep issues were caused by a prescribed medication; she produced a note to the same effect. Spurling continued to experience difficulty remaining conscious at work and received a Final Warning/Suspension, Spurling informed human resources that her performance issues might be related to a medical condition. Although her doctor indicated that she had a disability, C&M concluded that she did not and terminated her employment. The district court entered summary judgment in favor of C&M, rejecting claims of violation of the Americans with Disabilities Act and of the Family and Medical Leave Act. The Seventh Circuit reversed in part. Spurling established disputed issues of material facts as to whether C&M failed to properly engage in the interactive process required by the ADA, but did not provide sufficient notice to establish a claim under the FMLA.View "Spurling v. C&M Fine Pack, Inc." on Justia Law

by
Dalton worked in coal mine jobs from 1957 until 1991 and was exposed to substantial coal and rock dust. He developed trouble breathing; he quit his job and was never employed again. In 1999 Dalton sought benefits under the Black Lung Benefits Act, 30 U.S.C. 901‐45. In 2003, an ALJ awarded benefits, finding that Dalton was a “miner,” that Frontier was the “responsible operator,” and that Dalton had established clinical pneumoconiosis, based on the opinions of pulmonary experts, but could not determine the date of onset of total disability, so Dalton’s benefits began in 1999. The Board vacated, finding that the ALJ had not properly evaluated CT scans. The ALJ again awarded benefits beginning in 1999. In 2007, the case was again remanded. A new ALJ reweighed the evidence and ordered benefits to begin in 1999. Dalton died in 2007. The ALJ denied a motion by Dalton’s children to substitute as claimant. The Board dismissed an appeal and a cross‐appeal. The District Director returned the case to its third ALJ, who allowed the children’s motion, modified the date for commencement of benefits to 1991, and awarded attorneys’ fees and expenses. The Board vacated with respect to the onset date. The Seventh Circuit remanded for entry of the 1991 onset date, rejecting a claim that the children lacked standing. Substantial evidence supported the ALJ’s finding that 1991 marked the time of onset for Dalton’s total disability on account of pneumoconiosis. View "Dalton v. Office of Workers' Compensation Programs" on Justia Law

by
In 2013, the Governor of Wisconsin signed into law a statute that prohibits a doctor, under threat of heavy penalties, from performing an abortion unless he has admitting privileges at a hospital no more than 30 miles from the clinic in which the abortion is performed. Wis. Stat. 253.095(2). Planned Parenthood and others challenged the law under 42 U.S.C. 1983. The district court entered a preliminary injunction against enforcement of the law. The Seventh Circuit affirmed. The court noted that the seven doctors affected by the law had applied for, but after five months, had not been granted, admitting privileges; that all Wisconsin abortion clinics already have transfer agreements with local hospitals to facilitate transfer of clinic patients to the hospital emergency room. A hospital emergency room is obliged to admit and to treat a patient requiring emergency care even if the patient is uninsured, 42 U.S.C. 1395dd(b)(1). Had enforcement of the law, with its one-weekend deadline for compliance, not been stayed, two of the state’s four abortion clinics would have had to shut down and a third clinic would have lost the services of half its doctors. View "Planned Parenthood of WI v. Van Hollen" on Justia Law

by
Garcia, previously a construction worker and then age 40, applied for social security disability benefits in 2010, claiming abdominal pain caused by cirrhosis of the liver, severe low platelet count, hepatitis C, and an umbilical hernia, all of which had been diagnosed by several physicians that year. All were caused or exacerbated by alcoholism, but he stopped drinking and alcoholism is no longer a “contributing factor” barring him from obtaining disability benefits, 42 U.S.C. 423(d)(2)(C). An ALJ ruled that Garcia is capable of doing limited sedentary work. The district court affirmed. The Seventh Circuit reversed, noting that Garcia would be a candidate for a liver transplant, but was not on the list because he was too sick for surgery. His platelet count was too low to for even a liver biopsy. Garcia has been repeatedly hospitalized and treated for pain with morphine and other opium derivatives, with limited success. He has lupus, anemia, colitis, anxiety and other psychological problems, and chronic fatigue. One physician described Garcia’s condition as “chronic and terminal.” The court stated that Garcia is “one of the most seriously disabled applicants for social security disability benefits whom we’ve encountered in many years … We are surprised that the Justice Department would defend such a denial.” View "Garcia v. Colvin" on Justia Law

by
Gogos, a pipe welder for 45 years, has taken blood pressure medication for more than eight years. He began working for AMS in December 2012 as a welder and pipe-fitter. The next month, his blood pressure spiked and he experienced intermittent vision loss and a red eye. His supervisor agreed that he could leave to seek immediate medical treatment. As Gogos left work, he saw his general foreman and stated that he was going to the hospital because “my health is not very good lately.” The foreman immediately fired him. After pursuing a charge with the Equal Employment Opportunity Commission, Gogos sued. He applied to proceed in forma pauperis and requested that the court recruit counsel, stating that he cannot afford an attorney; that he has only a grammar-school education; and that English is not his primary language. The district court dismissed, reasoning that Gogos’s medical conditions were “transitory” and “suspect.” The Seventh Circuit vacated, reasoning that Gogos stated a claim under the Americans with Disabilities Act, 42 U.S.C. 12112.View "Gogos v. AMS-Mech. Sys., Inc." on Justia Law

by
In 2005, Indianapolis and Marion County passed an ordinance prohibiting smoking in most buildings frequented by the general public, with exceptions for bars and taverns with liquor licenses that neither served nor employed people under the age of 18, tobacco bars, and bowling alleys. In 2012, the City-County Council expanded the ordinance by eliminating many exceptions. As amended, the ordinance included exceptions for private residences, retail tobacco stores, tobacco specialty bars, and private clubs that voted to permit smoking. Bar owners affected by the ordinance sought declaratory and injunctive relief, asserting due process, equal protection, takings and freedom of association claims under both the federal and Indiana constitutions. The district court upheld the ban. The Seventh Circuit affirmed. View "Goodpaster v. City of Indianapolis" on Justia Law