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

Jody arrived at the Indiana University Health emergency room with severe abdominal pain. Doctors determined she needed emergency surgery to remove a dying portion of her intestine. Because they believed (incorrectly) that the problem stemmed from earlier gastric bypass surgery, they transferred her to another facility to be operated on by the bariatric surgeon who had performed the bypass. Jody died two days later. Her husband sued, alleging that IU’s failure to operate on Jody violated its obligation under the federal Emergency Medical Treatment and Labor Act to “stabilize” Jody when it decided to transfer her without first performing the laparotomy and removing the ischemic portions of her intestine, 42 U.S.C. 1395dd(b)(1)(A).The Seventh Circuit affirmed the summary judgment rejection of the suit. The Act authorizes pre-stabilization transfer where one of two triggering conditions is satisfied and the transfer is “appropriate.” No reasonable jury could conclude that IU did not satisfy both requirements. A physician certified that “[b]ased upon the information available to [him] at the time of transfer, … the medical benefits reasonably expected from the provision of appropriate medical treatment at another facility outweigh the increased risks to [Jody] … from undertaking the transfer.” The court cited the “Treatment Act’s narrow purpose as an anti-dumping law rather than a federal cause of action for medical malpractice.” View "Martindale v. Indiana University Health Bloomington, Inc." on Justia Law

Lash, a 60-year-old, obese man with a remote history of smoking and high blood pressure, was traveling when he experienced shortness of breath and chest discomfort. He went to Sparta hospital. An EKG, blood work, and a chest x-ray revealed no signs of a previous heart attack, but his white blood cells and blood sugar were slightly elevated, suggesting a cardiac event. Dr. Panico identified mild congestive failure and an enlarged right hilum, a part of the lung. He recommended a CT scan to rule out a mass. Dr. Motwani, the main physician responsible for treating Lash, diagnosed an “anxiety reaction” and prescribed medications. Lash was not informed of his congestive heart failure nor that an enlarged right hilum could mean heart failure or cancer. One nurse mentioned only that Lash was seen for an “anxiety reaction.” The next evening, Lash went into cardiac arrest. He was taken to the emergency room, where he was pronounced dead.In a malpractice suit by Lash’s estate, the district court granted Sparta hospital summary judgment. Motwani settled the case and was dismissed from the lawsuit. The Seventh Circuit affirmed. . The Illinois Tort Immunity Act provides that “a local public entity,” such as Sparta, is not liable for an employee’s negligent “diagnosis.” Lash never received any treatment, so no doctor could have failed to disclose information that might have changed his decisions. View "Lash v. Sparta Community Hospital" on Justia Law

Dr. Dubnow, a board-certified physician with more than 40 years of experience, was Chief of the Emergency Department at Lovell Federal Health Care Center (FHCC). In 2017, he diverted an ambulance transporting an infant to Lake Forest Hospital, located a few minutes away from the FHCC. Lake Forest has a Level-II trauma center and is staffed with pediatric specialists. The child was pronounced dead upon arriving at Lake Forest. The FHCC, a VA hospital, investigated Dubnow’s diversion decision. This investigation eventually resulted in his removal. A review board concluded that none of the grounds for his removal were supported but the final reviewing authority reversed the review board’s decision. The district court affirmed the VA’s removal decision.The Seventh Circuit vacated the removal. The VA failed to properly apply the deferential “clearly contrary to the evidence” standard when reviewing the board’s decision to overturn Dubnow’s removal; the decision was arbitrary. The relevant question was whether the diversion was appropriate; if so, Dubnow’s removal could not be sustained. To conclude that treating the patient at the FHCC was possible, or even appropriate, is not to conclude that diverting the ambulance to a better-equipped hospital was inappropriate. A “conclusion that there was ‘no need’ to divert the patient is two steps removed from the analysis” under 38 U.S.C. 7462(d). View "Dubnow v. McDonough" on Justia Law

In 2015, Talignani, a U.S. military veteran, consulted a VA neurosurgeon, who recommended that he undergo neck surgery. Because the VA could not perform a timely surgery, the surgeon suggested Talignani obtain evaluation and treatment at Saint Louis University Hospital. Talignani agreed and expressed a preference for the Hospital because he had previously undergone surgery there. A nurse obtained the VA’s approval to secure treatment for Talignani at a non-VA provider. The VA agreed to pay for “evaluation and treatment rendered pursuant to the non-VA provider’s plan of care.” The VA then sent a request for outpatient services to the Hospital. The Hospital agreed to treat Talignani and asked the VA to conduct several pre-operative tests. In January 2016, Dr. Mercier performed neck surgery on Talignani using the Hospital’s facility and staff. Talignani died shortly after being released.Talignani’s estate alleged he was prescribed excessive pain medication prior to his discharge, which proximately caused his death. An administrative complaint with the VA was denied. The Seventh Circuit affirmed the summary judgment rejection of a suit under the Federal Tort Claims Act, 28 U.S.C. 1346(b). The Act waives sovereign immunity for certain torts committed by “employee[s] of the Government.” The estate’s claim does not involve a government employee. View "Talignani v. United States" on Justia Law

Suing under the Federal Tort Claims Act, 42 U.S.C. 233(a) Clanton alleged that nurse practitioner Jordan, an employee of the U.S. Public Health Service, failed to educate him about his severe hypertension or to monitor its advancement; his hypertension developed into Stage V kidney disease so that Clanton required dialysis and, at the age of 35, a kidney transplant. The district court rejected the government’s comparative negligence argument as to Clanton and awarded Clanton nearly $30 million in damages. The Seventh Circuit upheld the damages calculation but remanded for the court to assess Clanton’s comparative negligence under Illinois’s reasonable-person standard, noting that Clanton had external clues that he was seriously unwell, such as two employment-related physicals which showed dangerously high blood pressure.On remand, the court again concluded that comparative negligence was inapplicable. The Seventh Circuit affirmed. The district court made findings as to what an objectively reasonable person would understand as to hypertension and found that a reasonable person would not understand the potential for damage absent any symptoms, and therefore would not understand the need to take medication or see a medical provider when asymptomatic. Based on those findings, the court held that Clanton’s actions were not inconsistent with the due care that would be expected of a reasonable person. The government did not challenge whether the fact-findings and conclusion were supportable; the court properly identified and applied the standard. View "Clanton v. United States" on Justia Law

Scholz was honorably discharged following her 2006-2008 Army tour of duty in Iraq but the mental and physical toll of her service continued. Scholz required a range of medical treatments. Scholz sought two courses of inpatient mental health treatment at the Tomah VA Medical Center in 2011. Later, while receiving outpatient mental health treatment through the Tomah VAMC, she consulted surgeons at the Zablocki VA Medical Center about elective breast reduction surgery. An unrelated psychological assessment performed at Zablocki VAMC raised concerns about Scholz’s mental health. Zablocki VAMC surgeons performed elective breast reduction surgery in 2012, igniting multiple complications. Scholz continued to receive outpatient mental health treatment, including prescription medications, from various VA providers through late 2018.Scholz has two lawsuits pending against the government under the Federal Tort Claims Act (FTCA), 28 U.S.C. 1346(b), 2671–2680. The government argued that the second suit on the same, or essentially the same, operative facts, was precluded on claim-splitting grounds. The Seventh Circuit affirmed the dismissal of the suit. Scholz’s theory amounts to “arbitrarily splitting the treatment timeline.” In both suits, she mentions her treatment for mental health issues, her breast reduction surgery, the unsafe prescribing of medications, and improper record handling. Both suits arise out of Scholz’s treatment at various VA locations in 2011-2018 and mention the same alleged incidents. View "Scholz v. United States" on Justia Law

Dean, incarcerated since 2012, developed kidney cancer. Seven months after he first presented symptoms, Dean had kidney-removal surgery. The cancer had already spread to his liver, Dean remains terminally ill. Dean sued his doctors and their employer, Wexford, a private corporation that contracts to provide healthcare to Illinois inmates, alleging deliberate indifference to his serious medical needs in violation of the Eighth Amendment. Dean cited delays in his diagnosis and treatment, caused by his doctors’ failure to arrange timely off-site care, and on a policy that requires Wexford’s corporate office to pre-approve off-site care.A jury awarded $1 million in compensatory damages and $10 million in punitive damages, which was reduced to $7 million. The Seventh Circuit reversed. Dean has endured great suffering, but he did not produce enough evidence to hold any of the defendants liable for violating the Eighth Amendment. Dean’s claim against Wexford hinged on two expert reports from another case that critique the medical care, and process for medical care, that Illinois provides, through Wexford, to its prisoners. Those reports are hearsay, but the district court allowed Dean to use them for a non-hearsay purpose: to prove that Wexford had prior notice of the negative assessments of its review policy. One report postdated all events relevant to Dean and could not have given Wexford prior notice. The other report alone was insufficient to hold Wexford liable under the exacting “Monell” requirements in this single-incident case. View "Dean v. Wexford Health Sources, Inc." on Justia Law

Vargas received extensive medical care from the Veterans Administration. In his suit under the Federal Tort Claims Act, 28 U.S.C. 2671–80, he argued that a VA nurse was negligent in failing to order additional tests after receiving the results of urinalysis in October 2015. More testing, Vargas contended, would have revealed that he suffered from a urinary tract infection; failure to diagnose that infection led to a heart attack, which led to extended hospitalization, which led to pain and inflammation.The Seventh Circuit affirmed the rejection of his claims, upholding the district judge’s decision to allow testimony from a board-certified urologist. Federal Rule of Evidence 702 governs the admissibility of expert evidence in suits under the FTCA. The district judge was entitled to consider the urologist’s view that the applicable standard of care did not require follow-up testing to look for a urinary tract infection. If even a board-certified urologist would not have seen anything in the test result calling for further lab work, then a nurse practitioner’s identical decision cannot be negligent. Illinois does not hold nurses to the higher standard of specialists. View "Love v. United States" on Justia Law

Stark had surgery in 2007 to implant a pelvic mesh device. The surgery was not successful, and she had follow-up surgeries that also were not successful. In 2018, she learned for the first time that her problems with the pelvic mesh device might have resulted from a defect in the product itself. She consulted a lawyer and later that year filed this suit against the manufacturer. The district court concluded that Stark should have realized much earlier that the product might have been defective and granted summary judgment based on the two-year statute of limitations.The Seventh Circuit reversed. The statute of limitations began to run only when Stark should have realized that her mesh-related complications might have been wrongfully caused by another person. As a general rule, the failure of a medical procedure or product to cure a patient does not necessarily signal that anyone acted wrongfully, particularly when the patient experiences known complications that do not necessarily result from tortious actions. In addition here, Stark’s medical history included Ehlers-Danlos syndrome, which two of her doctors told her could explain her continued problems. The combination of that general principle and her specific circumstances could allow a reasonable jury to decide that this suit was timely. View "Stark v. Johnson & Johnson and Ethicon, Inc." on Justia Law

Paramedics rushed Millicent to Franciscan, a designated acute‐stroke‐ready hospital. Franciscan transferred her to its intensive care unit. Three days later, Millicent suffered a stroke. Her condition deteriorated and she was put on life support. The family expressed concern about the adequacy of care and sought to transfer Millicent to another facility. Franciscan assisted in submitting transfer paperwork to two other hospitals. Both declined the requests for insurance reasons. While a third transfer request was pending, Franciscan advised the family that Millicent was brain dead and that it had decided to stop treatment. Nearly two years later, Nartey reviewed Millicent’s medical records, which she claimed lacked the transfer paperwork and test results.Nartey, acting pro se, sued. The court grouped Nartey’s complaint into claims that Franciscan violated the federal Emergency Medical Treatment and Active Labor Act (EMTALA) by failing to provide adequate care or to transfer Millicent, 42 U.S.C. 1395dd; that Franciscan violated Title VI, which prohibits federally funded programs from discriminating on the basis of race, color, or national origin, 42 U.S.C. 2000d, and that Franciscan fraudulently concealed test results, preventing Nartey from timely bringing a medical malpractice claim.The Seventh Circuit affirmed the dismissal of the suit. Although Nartey missed filing deadlines, the court addressed the merits. EMTALA is not a malpractice statute covering treatment after an emergency patient is screened and admitted. While Nartey presented some statistical evidence that hospital transfers are less common among racial minorities, Franciscan was not responsible for Millicent remaining there. A reasonable inquiry would have discovered the alleged concealment. View "Nartey v. Franciscan Health Hospital" on Justia Law