Justia U.S. 4th Circuit Court of Appeals Opinion Summaries

Articles Posted in Health Law
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Antonio Davis, who was serving a 210-month prison sentence for conspiracy to possess with intent to distribute heroin, petitioned the district court for compassionate release due to his elevated risk of severe COVID-19 and a change in the law regarding his career offender status. The district court denied his request, concluding that Davis was not due compassionate release based on his susceptibility to COVID-19 and did not fully consider each of Davis’s arguments.Davis was indicted on charges of conspiracy to distribute and conspiracy to possess with intent to distribute heroin in January 2013. He pled guilty to conspiracy to possess with intent to distribute heroin in June of that year. Davis received a career offender enhancement because he had previously been convicted of certain other offenses and because the offense at issue here was a “controlled substance offense” at the time of conviction. In February 2021, Davis filed a pro se motion for compassionate release under 18 U.S.C. § 3582(c)(1)(A), arguing that he was uniquely susceptible to the potential spread of COVID-19 due to his type-2 diabetes and hypertension. He also argued that a recent court decision invalidated his career offender Guidelines designation.The United States Court of Appeals for the Fourth Circuit affirmed in part, vacated and remanded in part the district court's decision. The court concluded that the district court did not abuse its discretion in finding that Davis failed to show extraordinary and compelling reasons for release based on the pandemic. However, the court found that the district court did not properly address Davis’s arguments regarding intervening changes in law and rehabilitation. Therefore, the court vacated the district court’s denial of compassionate relief and remanded for further proceedings. View "United States v. Davis" on Justia Law

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The case involves Vanda Pharmaceuticals, a drug manufacturer, and the Centers for Medicare & Medicaid Services (CMS). Vanda challenged a 2020 regulation by CMS that expanded the definition of a "line extension" drug under the Medicaid Drug Rebate Program. This program requires drug manufacturers to reimburse Medicaid if they increase their prices faster than inflation. A "line extension" drug, which is a new formulation of an existing drug, can also be liable for price increases of the original drug. Vanda argued that the regulation expanded the definition of a line extension beyond what the Medicaid statute permitted.Previously, the district court granted summary judgment to CMS, disagreeing with Vanda's argument. The court held that the agency's regulation was within the bounds of the Medicaid statute.The United States Court of Appeals for the Fourth Circuit affirmed the district court's decision. The court found that the agency's definitions of "line extension" and "new formulation" were within the Medicaid statute's ambit. It also held that the agency's interpretation of the oral-solid-dosage-form requirement was not contrary to law. The court rejected Vanda's argument that the agency's rulemaking process was arbitrary and capricious, finding that the agency had reasonably considered the relevant issues and explained its decision. View "Vanda Pharmaceuticals, Inc. v. Centers for Medicare & Medicaid Services" on Justia Law

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The United States Court of Appeals for the Fourth Circuit ruled on a case involving a plaintiff, Joann Ford, and a healthcare provider, Sandhills Medical Foundation, Inc. Ford, a former patient of Sandhills, alleged negligence, breach of implied contract, invasion of privacy, and breach of confidentiality against Sandhills for failure to protect her personally identifying information (PII). Her PII was stolen from Sandhills' third-party computer system in a cyberattack after she had ceased being a patient.The district court had previously granted Sandhills immunity from the suit, concluding that the theft of Ford's PII arose out of Sandhills' performance of “medical, surgical, dental, or related functions,” as per 42 U.S.C. § 233(a), thus substituting the United States as the defendant. However, the Fourth Circuit Court disagreed with the lower court's interpretation of § 233(a).The appellate court determined that data security does not fall under a “related function” within the meaning of the statute. The court emphasized that § 233(a) immunity applies when alleged damages arise from the provision of healthcare, which was not the case here. Ford’s injury did not arise from Sandhills’ provision of healthcare, but from a data security breach that occurred at least a year after she ceased being a patient at Sandhills.Therefore, the court concluded that Sandhills was not immune from the suit under § 233(a) and that the United States could not be substituted as the defendant. The case was vacated and remanded for further proceedings. View "Ford v. Sandhills Medical Foundation, Inc." on Justia Law

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This case was heard in the United States Court of Appeals for the Fourth Circuit and involved the Estate of Arturo Giron Alvarez and 773 other plaintiffs, who brought claims against The Rockefeller Foundation (TRF), alleging the foundation's involvement in nonconsensual human medical experiments in Guatemala from 1946 to 1948. The experiments involved exposing people to sexually transmitted diseases (STDs) to study the diseases and potential treatments. The defendants had previously filed a motion for summary judgment, which was granted by the district court. The plaintiffs appealed this decision, specifically challenging the decision relating to TRF.The appeal hinged on the question of whether Dr. Soper, an Associate Director of TRF who was assigned to the Pan-American Sanitary Bureau (PASB) in Guatemala during the time of the experiments, was acting as an agent of TRF, thus making TRF liable for his actions. The court found that despite TRF paying Dr. Soper's salary during his time at the PASB, there was no indication that TRF was directing or controlling Dr. Soper’s work. Furthermore, the evidence showed that Dr. Soper considered himself no longer with TRF, and the PASB's constitution prohibited him from taking outside direction.The court concluded that TRF's connection to the experiments was too tenuous to be held liable for them. It affirmed the district court's grant of summary judgment in favor of TRF, stating that Dr. Soper was not an agent of TRF during the time of the experiments. View "In re Estate of Alvarez v. Rockefeller Foundation" on Justia Law

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The United States Court of Appeals for the Fourth Circuit addressed a case where an inmate with celiac disease sued a doctor for depriving him of a gluten-free diet. The district court had granted summary judgment to the doctor because the plaintiff did not have an expert witness to testify about the standard treatment for celiac disease or the causal link between the doctor’s conduct and the plaintiff’s alleged harm. The appeals court held that no expert testimony was needed to avoid summary judgment in this case. The court found that the plaintiff had presented sufficient evidence to create a genuine dispute of material fact about the doctor's knowledge of his celiac disease and the excessive risk it posed by failing to respond reasonably, even without an expert.The court also clarified that expert testimony is not necessary to establish an Eighth Amendment claim of deliberate indifference. The court held that while determining whether medical professionals responded reasonably to a particular risk can involve an examination of the relevant standard of care, the fact that expert testimony may be necessary in some cases does not mean it was in this one. The court vacated the district court’s judgment and remanded the case for further proceedings. View "Phoenix v. Amonette" on Justia Law

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This case was before the United States Court of Appeals for the Fourth Circuit where the City of Huntington and Cabell County Commission (plaintiffs) brought a suit against AmerisourceBergen Drug Corporation, Cardinal Health, Inc., and McKesson Corporation (defendants), three distributors of opioids. The plaintiffs alleged that these companies perpetuated the opioid epidemic by repeatedly shipping excessive quantities of opioids to pharmacies, thus creating a public nuisance under West Virginia common law. The district court ruled in favor of the distributors, holding that West Virginia’s common law of public nuisance did not cover the plaintiffs’ claims.After a bench trial in 2021, the district court held that the common law of public nuisance in West Virginia did not extend to the sale, distribution, and manufacture of opioids. The court found that the application of public nuisance law to the sale, marketing, and distribution of products would invite litigation against any product with a known risk of harm, regardless of the benefits conferred on the public from proper use of the product. The court also rejected the plaintiffs’ proposed remedy, a 15-year “Abatement Plan” developed by an expert in opioid abatement intervention. The court held that this relief did not qualify as an abatement as it did not restrict the defendants' conduct or their distribution of opioids but generally proposed programs and services to address the harms caused by opioid abuse and addiction.The plaintiffs appealed the decision to the United States Court of Appeals for the Fourth Circuit, which certified the following question to the Supreme Court of Appeals of West Virginia: Under West Virginia’s common law, can conditions caused by the distribution of a controlled substance constitute a public nuisance and, if so, what are the elements of such a public nuisance claim? View "City of Huntington v. Amerisourcebergen Drug Corporation" on Justia Law

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The case involves Joel Smithers, who was a doctor of osteopathy and was convicted on 861 counts associated with his opioid prescription practices. He was sentenced to a total of 480 months in prison. Smithers was charged under 21 U.S.C. § 841(a)(1), which makes it unlawful for any person knowingly or intentionally to manufacture, distribute, or dispense a controlled substance without authorization. Authorization is defined by Drug Enforcement Agency regulations as a prescription issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice. Following his conviction, the Supreme Court in Ruan v. United States clarified the mens rea required to convict someone of unauthorized dispensing or distributing of a controlled substance. The United States Court of Appeals for the Fourth Circuit found that, in light of the Ruan decision, Smithers' jury instructions were incorrect, and the errors were not harmless. Therefore, the court vacated the convictions and remanded the case to the district court for a new trial. View "United States v. Joel Smithers" on Justia Law

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In a case before the United States Court of Appeals for the Fourth Circuit, Laura Tartaro-McGowan, a clinical manager with Inova Home Health, was terminated after failing to perform direct patient care field visits by a specified date. Tartaro-McGowan, who suffers from chronic arthritis in her knees due to bilateral knee replacement surgeries, sued her employer under the Americans with Disabilities Act (ADA) for failure to accommodate, discrimination, and retaliation. The district court granted summary judgment in favor of the defendants, Inova Home Health, LLC and Alternate Solutions Health Network, LLC.Amidst the COVID-19 pandemic, Inova Home Health experienced a severe shortage of field clinicians and informed all staff members, including clinical managers, that they would be required to perform direct patient care field visits. Tartaro-McGowan requested an accommodation to be excused from performing direct patient care field visits due to her physical limitations caused by her chronic arthritis. In response, the defendants proposed an accommodation that involved allowing Tartaro-McGowan to screen and select appropriate visits that would greatly reduce the possibility of injury. Tartaro-McGowan refused this accommodation and was later terminated for not performing any direct patient care field visits by the specified date.On appeal, the Fourth Circuit affirmed the district court's decision. The court determined that Tartaro-McGowan failed to prove the defendants denied her a reasonable accommodation, an essential element of her ADA claim. The court noted that the circumstances surrounding the pandemic were exceptional, and given the severe shortage of field nurses, the defendants' proposed accommodation was reasonable. The court also found that Tartaro-McGowan failed to establish a prima facie case for her discrimination and retaliation claims. View "Tartaro-McGowan v. Inova Home Health, LLC" on Justia Law

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Elaine Neidig, individually and on behalf of a class, sued Valley Health System, a health care provider, for unfair and deceptive practices, unjust enrichment, and breach of contract. Neidig had received three mammograms at Valley Health's Winchester Medical Center between March 2016 and June 2019. In July 2019, federal inspectors found that the center's staff were not correctly positioning or compressing women's breasts during mammograms, leading to serious image quality deficiencies. Valley Health then had to alert all at-risk patients, including Neidig, of the mammography quality problems. Neidig, who did not allege any physical or emotional harm resulting from the low-quality mammograms, sued Valley Health in August 2022. Valley Health moved to dismiss the case on the basis that it was filed beyond the two-year statute of limitations provided by the West Virginia Medical Professional Liability Act. The United States District Court for the Northern District of West Virginia agreed with Valley Health and dismissed Neidig's claims as untimely. Neidig appealed the decision to the United States Court of Appeals for the Fourth Circuit.Upon review, the Fourth Circuit concluded that the case presented a novel issue of state law that needed to be addressed by the Supreme Court of Appeals of West Virginia. The issue was whether a plaintiff's claims can fall under the West Virginia Medical Professional Liability Act if the plaintiff does not claim any form of physical or emotional injury. The Fourth Circuit certified this question to the Supreme Court of Appeals of West Virginia for resolution. View "Neidig v. Valley Health System" on Justia Law

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The defendant, Rodriquies Evans, was convicted of four criminal offenses related to his involvement in a multistate conspiracy to transport and distribute methamphetamine and other controlled substances. The district court sentenced him to the statutory maximum of 80 years in prison. The Fourth Circuit United States Court of Appeals found that the district court had erred in calculating Evans’s Sentencing Guidelines range and vacated his sentence, remanding the case for resentencing. The court determined that the district court had incorrectly attributed nearly three kilograms of crystal methamphetamine seized from a co-conspirator to Evans. The court held that for sentencing purposes under the Sentencing Guidelines, only acts that fall within the scope of the criminal activity the defendant agreed to jointly undertake can be considered relevant conduct. The district court had attributed the drugs based on the broader standard of substantive liability under Pinkerton, which allows a defendant to be held liable for the acts of co-conspirators if they are within the scope of the overall conspiracy and reasonably foreseeable to the defendant. The court also found that the district court had erred in applying a threat enhancement in calculating Evans's Sentencing Guidelines range, as the possession of a firearm enhancement could not by itself be the basis for a threat enhancement. View "US v. Evans" on Justia Law