Justia U.S. 8th Circuit Court of Appeals Opinion Summaries

Articles Posted in Health Law
by
Law enforcement executed a search warrant at Ryan Dewayne Myrick’s apartment, discovering 69.01 grams of methamphetamine, drug packaging, a digital scale, and other paraphernalia. In his vehicle, they found additional drug packaging. Myrick was charged with conspiracy to distribute methamphetamine and possession with intent to distribute. He pleaded guilty to the latter charge, admitting to possessing 69.01 grams of methamphetamine, with the intent to distribute at least 50 grams. The government agreed to dismiss the conspiracy charge and recommend a reduction for acceptance of responsibility, contingent on Myrick’s continued demonstration of acceptance.The United States District Court for the Southern District of Iowa reviewed the case. The Presentence Investigation Report (PSR) recommended holding Myrick responsible for 4.5 kilograms or more of methamphetamine, resulting in a base offense level of 38. It also suggested a two-level enhancement for maintaining a premises for drug distribution and a three-level reduction for acceptance of responsibility. Myrick objected to the drug quantity and the premises enhancement, while the government objected to the reduction for acceptance of responsibility. The district court overruled Myrick’s objections and sustained the government’s, resulting in a total offense level of 40 and an advisory Guidelines range of 360 months to life. Myrick was sentenced to 300 months of imprisonment and 5 years of supervised release.The United States Court of Appeals for the Eighth Circuit reviewed the case. Myrick challenged the district court’s drug quantity determination, the premises enhancement, and the denial of a reduction for acceptance of responsibility. The appellate court found no clear error in the district court’s findings, including the credibility of witness testimony and the application of relevant conduct principles. The court affirmed the district court’s judgment, upholding Myrick’s sentence. View "United States v. Myrick" on Justia Law

by
This case involves a qui tam action under the False Claims Act (FCA) and the Iowa False Claims Act (IFCA) brought by Stephen Grant, a sleep medicine practitioner, against Steven Zorn, Iowa Sleep Disorders Center, and Iowa CPAP. Grant alleged that the defendants had knowingly overbilled the government for initial and established patient visits and violated the Anti-Kickback Statute and the Stark Law by knowingly soliciting and directing referrals from Iowa Sleep to Iowa CPAP. The district court found the defendants liable for submitting 1,050 false claims to the United States and the State of Iowa and imposed a total award of $7,598,991.50.The district court had rejected the defendants' public disclosure defense and awarded summary judgment to the defendants on the Anti-Kickback Statute and Stark Law claim. After a bench trial, the district court found the defendants liable on several claims, including that Iowa Sleep had violated the anti-retaliation provisions of the FCA and IFCA by firing Grant. The district court also concluded that the defendants had overbilled on initial patient visits but not on established patient visits.On appeal, the United States Court of Appeals for the Eighth Circuit affirmed in part, vacated in part, and remanded for further proceedings. The court held that the public disclosure bar was inapplicable because Grant’s complaint did not allege “substantially the same allegations” contained in the AdvanceMed letters. The court also held that the district court did not abuse its discretion in admitting expert testimony on extrapolation and overbilling. However, the court found that the district court erred in its determination of damages and civil penalties, violating the Eighth Amendment’s Excessive Fines Clause. The court vacated the punitive sanction and remanded the case for further proceedings. View "Grant v. Zorn" on Justia Law

by
In this case, Amy Bricker, a high-ranking executive, moved from Cigna Corporation to CVS Pharmacy, Inc., both of which are major healthcare conglomerates. Cigna sued Bricker and CVS, seeking to enforce a non-compete agreement that Bricker had signed while employed at Cigna. The district court granted a temporary restraining order and a preliminary injunction to preserve the status quo and protect Cigna's business interests. Bricker and CVS appealed the preliminary injunction.Previously, the district court had found that Cigna's protected interests were numerous and substantial, spanning multiple lines of products and services. It also found that Bricker likely retained a considerable amount of protected information from her time at Cigna. The court concluded that Cigna had a fair chance of demonstrating that the non-compete agreement was reasonable and enforceable under Missouri law.The United States Court of Appeals for the Eighth Circuit affirmed the district court's decision. The court agreed with the lower court's findings and concluded that the non-compete agreement was likely enforceable under Missouri law. The court also found that Cigna would likely suffer irreparable harm if the preliminary injunction was not granted, as Bricker could potentially disclose Cigna's trade secrets to CVS. The court concluded that the balance of equities favored Cigna and that the public interest supported the enforcement of contractual obligations. Therefore, the court held that the district court did not abuse its discretion in granting the preliminary injunction. View "Cigna Corporation v. Bricker" on Justia Law

by
Mohamed Gamar Ahmed was charged with possession of cocaine and fentanyl with intent to distribute, and possession of a firearm in furtherance of a drug trafficking crime. The charges stemmed from a search warrant executed at Ahmed's residence in Nebraska, where law enforcement officers discovered loaded handguns, ammunition, drug paraphernalia, marijuana, cocaine, and counterfeit Percocet pills containing fentanyl. Ahmed pleaded guilty to the charges. The United States Probation Office prepared a presentence investigation report (PSR), which alleged that Ahmed had supplied one of the fentanyl-laced pills to a minor female, who overdosed after ingesting it. The Government filed a motion for an upward departure or variance on the drug-possession count, arguing that the United States Sentencing Guidelines range of 15-21 months’ imprisonment failed to adequately account for the extent of the harm caused by Ahmed’s drug-dealing.The District Court for the District of Nebraska conducted an evidentiary hearing at sentencing that involved testimony from two witnesses. After hearing the direct- and cross-examinations of both witnesses, the district court overruled Ahmed’s objection to the PSR, finding that the testimony was consistent with the allegation that Ahmed supplied the pill that caused the minor to overdose. The district court then proceeded to sentencing, stating that it had considered all the federal sentencing factors enumerated in 18 U.S.C. § 3553(a), including the serious nature of the offense and Ahmed’s history and characteristics. The district court varied upward on the drug-possession count to reflect the seriousness of the offense, to promote respect for the law, and to provide just punishment, ultimately sentencing Ahmed to 48 months’ imprisonment. Ahmed also received a mandatory minimum term of 60 months’ imprisonment on the firearm-possession count, to be served consecutively, for a total of 108 months’ imprisonment.Ahmed appealed to the United States Court of Appeals for the Eighth Circuit, alleging that the district court committed procedural error and imposed a substantively unreasonable sentence. The appellate court affirmed the district court's decision, finding no procedural error and concluding that the district court imposed a substantively reasonable sentence. View "United States v. Ahmed" on Justia Law

by
In this case, the United States Court of Appeals for the Eighth Circuit was asked to determine whether Arkansas Code § 23-92-604(c), also known as Act 1103, was preempted by federal law. Act 1103 prohibits pharmaceutical manufacturers from limiting the ability of healthcare providers, who are eligible for drug pricing discounts under the Section 340B Program, to contract with outside pharmacies for drug distribution.The Pharmaceutical Research and Manufacturers of America (PhRMA) sued the Commissioner of the Arkansas Insurance Department, arguing that Act 1103 was unconstitutional because it was preempted by the Section 340B Program and the Federal Food, Drug, and Cosmetic Act, under theories of field, obstacle, and impossibility preemption.The court, however, disagreed with PhRMA's arguments. The court found that Act 1103 did not create an obstacle for pharmaceutical manufacturers to comply with 340B, rather it assisted in fulfilling the purpose of 340B. The court also found that Act 1103 did not make it impossible for drug manufacturers and wholesale distributors to comply with the Risk Evaluation and Mitigation Strategies (REMS) Program under the Federal Food, Drug, and Cosmetic Act.Therefore, the court held that Act 1103 was not preempted by either the Section 340B Program or the Federal Food, Drug, and Cosmetic Act. As such, the court affirmed the district court’s decision in favor of the Intervenors and against PhRMA. View "Pharmaceutical Research and Mfrs of America v. McClain" on Justia Law

by
Catherine Brennan, after being prescribed psychotropic medications due to a stressful job transition, began to experience symptoms of akathisia, a neuropsychiatric syndrome associated with psychomotor restlessness often seen in individuals using antipsychotic medications. Despite having no prior history of mental illness, Brennan was treated by multiple providers and was diagnosed with bipolar disorder, depression, and generalized anxiety disorder between 2015 and 2018. In 2019, Brennan was committed due to displaying signs of mental health decompensation. She was diagnosed with bipolar disorder involving current manic episodes with psychotic features, suicidal ideations, and medication noncompliance. Brennan was committed for a period of six months. After this commitment, she commenced a federal action alleging wrongful commitment and unlawful forced medication, arguing that her symptoms were side effects of the prescribed medications and were mistaken for psychosis and mania.The United States Court of Appeals for the Eighth Circuit, however, upheld the district court's dismissal of Brennan's claims. The court held that Brennan could not proceed with her wrongful commitment claim because her commitment order was still valid, as per the precedent set in Heck v. Humphrey and Thomas v. Eschen. Regarding Brennan's claim of forcible administration of neuroleptic medications, the court found that Brennan failed to show deliberate indifference on the part of the defendants. The court noted that deliberate indifference is more than negligence and requires a plaintiff to show that an objectively serious medical need was knowingly disregarded by the defendants. The court ruled that Brennan did not adequately plead deliberate indifference as she failed to identify how her care exceeded gross negligence or demonstrate when the defendants knew or should have known that her psychiatric problems were the result of akathisia and not mental illness. The court thus affirmed the district court's judgment dismissing Brennan's claims. View "Brennan v. Cass County Health" on Justia Law

by
In the case before the United States Court of Appeals For the Eighth Circuit, the defendant, Kaycee Heard, appealed his 180-month sentence for involvement in a drug-trafficking conspiracy that transported oxycodone and fentanyl pills from Michigan to North Dakota for distribution. Heard pleaded guilty to conspiring to distribute and possess with intent to distribute controlled substances, and his sentence exceeded his Guidelines range of 135 to 168 months. Heard's appeal centered around three key claims: the district court miscalculated his criminal history score, wrongly applied a Guidelines enhancement for his role in the conspiracy, and issued an unreasonable sentence.The Court of Appeals rejected all three of Heard's claims. First, the court found that the district court was correct to assess a criminal history point for a two-year probation term Heard served under Michigan’s Holmes Youthful Trainee Act. Despite Heard's argument that this sentence should not have counted towards his criminal history score as no conviction was entered and the underlying charges were dismissed, the Appeals Court ruled that Heard's admission of guilt by pleading guilty meant the probation term was correctly counted as a "prior sentence".Second, the Appeals Court upheld the district court's application of a three-level enhancement for Heard's role in the conspiracy, finding that Heard had exhibited sufficient managerial or supervisory authority to warrant this enhancement. The court pointed to evidence that Heard had recruited co-conspirators, used a co-conspirator’s apartment as a stash house, directed a co-conspirator to travel to get pills for distribution, and received proceeds from the pills’ sale.Finally, the court found Heard's sentence to be both procedurally and substantively reasonable. The district court had varied up from the Guidelines range based on Heard's conduct in pretrial detention, including his participation in a prison riot and assaults on two inmates. The Appeals Court found no clear error in the district court's determination that Heard had participated in the riot, and concluded that the 180-month sentence was within the realm of reasonableness given Heard's drug trafficking and pretrial detention misconduct. The court also rejected Heard's claim that his sentence created unwarranted disparities with his co-conspirators, stating that the need to avoid unwarranted sentence disparities refers to national disparities, not differences among co-conspirators. The court therefore affirmed the district court’s judgment. View "United States v. Heard" on Justia Law

by
In this appeal before the United States Court of Appeals For the Eighth Circuit, the defendant, Linda Riaski, who was convicted of one count of conspiracy to distribute methamphetamine and one count of possession of a firearm in furtherance of a drug trafficking crime, appealed the denial of her request for a hearing under Franks v. Delaware. The case involves a search warrant that was issued based on an affidavit prepared by Deputy Sheriff Jerry Brisky, who relied on information provided by a confidential informant (CI). The CI claimed to have observed Riaski packaging methamphetamine for distribution and to have seen Riaski with a black 9 millimeter handgun. The search of Riaski's residence resulted in the discovery of methamphetamine and firearms.Riaski's appeal was based on the argument that the district court erred in denying her request for a Franks hearing to challenge the validity of the search warrant. She claimed that the affidavit supporting the search warrant was misleading because it omitted information about the CI’s credibility, her criminal history, her drug use, the financial arrangement between her and Deputy Brisky, and certain facts alleged in Riaski’s own affidavit.The court affirmed the district court's decision, holding that Riaski failed to make a substantial preliminary showing that Deputy Brisky intentionally or recklessly omitted facts with the intent to mislead the issuing judge, and that the affidavit, even if supplemented by the omitted information, could still support a finding of probable cause. The court reasoned that the omitted information about the CI's criminal history and drug use would not have altered the probable cause determination, as the affidavit had already provided a basis for the CI’s reliability, disclosing that she previously had provided accurate information and had made controlled purchases under Brisky’s supervision. The court also found that the omission of the details and existence of the agreement between Brisky and the CI did not render the affidavit misleading. The judgment was affirmed. View "United States v. Riaski" on Justia Law

by
In a case before the United States Court of Appeals For the Eighth Circuit, the plaintiffs, a group of patients, sued BJC Health System (BJC) alleging that BJC had violated their medical privacy rights under Missouri state law. Specifically, the plaintiffs claimed that when they accessed their electronic health records (EHRs) through BJC’s online patient portal, their protected health information was shared with third-party marketing services. BJC removed the case to federal court under the federal officer removal statute, arguing that they acted under the United States Department of Health and Human Services (HHS) when creating and operating the online patient portal. BJC's argument was rejected by the district court which ordered the case to be remanded back to Missouri state court. BJC appealed this decision.The United States Court of Appeals For the Eighth Circuit affirmed the decision of the district court to remand the case to the Missouri state court. The appellate court held that BJC, while receiving federal incentive payments from HHS for creating and operating the online patient portal, was not essentially performing a basic governmental task or duty. Therefore, BJC was not acting under a federal officer in terms of the federal officer removal statute. The court concluded that the creation and operation of an online patient portal was not a basic governmental task, and BJC was not a government contractor or functioning as a federal instrumentality. View "Doe v. BJC Health System" on Justia Law

by
In this case before the United States Court of Appeals for the Eighth Circuit, the defendant, Bradley Ready, appealed his sentence following his guilty plea for possession with intent to distribute methamphetamine and possession of a firearm as an unlawful user of a controlled substance. The court affirmed the district court's decision.During a search of Ready's residence, law enforcement officers found drug paraphernalia, scales, a loaded hunting rifle, and three bags of methamphetamine. Ready was subsequently charged and pleaded guilty to both counts. At sentencing, the U.S. Probation Office recommended grouping the drug and gun counts together and applying a two-level enhancement due to the possession of a dangerous weapon. Ready objected to this enhancement, but the district court overruled this objection.On appeal, Ready argued that the district court erred in applying the enhancement for possession of a dangerous weapon and applied the wrong standard in determining his eligibility for safety valve relief. The appellate court found no error in the district court's conclusions.The appellate court held that the district court did not err in applying the enhancement for possession of a dangerous weapon, as it was not "clearly improbable" that the rifle found in Ready's bedroom was connected to the distribution of methamphetamine from his home. The court also held that the district court did not err in its application of the standard for determining Ready's eligibility for safety valve relief. Therefore, the district court's judgment was affirmed. View "United States v. Ready" on Justia Law