Justia U.S. 1st Circuit Court of Appeals Opinion Summaries

A 68-year-old man experiencing abdominal pain was brought to a hospital emergency room in Bayamón, Puerto Rico, in January 2016. After a delayed CT scan revealed a perforated intestine, he underwent surgery and remained in intensive care until his death in February 2016. His son, a physician residing in Florida, later learned of the seriousness of his father’s condition during a visit. The son filed a lawsuit against several doctors, the hospital, and related entities, alleging that negligent medical care led to his father’s death.The United States District Court for the District of Puerto Rico reviewed the case after a contentious discovery period. The court granted summary judgment in favor of five defendants: three doctors, a corporate entity managing the emergency room, and the emergency room’s medical director. The court found that the claims against the doctors and the corporate entity were time-barred under Puerto Rico’s one-year statute of limitations for tort claims, and that Puerto Rico law did not provide a basis for liability against the medical director, as he had not directly treated the patient. The court also disregarded certain evidence submitted by the plaintiff and denied his motion for reconsideration.On appeal, the United States Court of Appeals for the First Circuit found that the district court erred in converting two doctors’ motions to dismiss into motions for summary judgment without giving the plaintiff adequate notice or an opportunity to present evidence. The appellate court also held that the district court abused its discretion in disregarding the plaintiff’s declaration regarding when he learned of one doctor’s involvement. The court vacated and remanded the summary judgments for the three doctors and the medical director on the first cause of action, but affirmed summary judgment for the corporate entity and the medical director on the second cause of action. Each party was ordered to bear its own costs. View "Calderon-Amezquita v. Rivera-Cruz" on Justia Law

A husband and wife brought a lawsuit after the wife suffered a pelvic fracture during a forceps-assisted delivery performed by a doctor at a women’s health group. They alleged that the doctor failed to obtain the wife’s informed consent by not disclosing the risks associated with the procedure. The plaintiffs claimed that this omission violated Massachusetts law and sought damages for the resulting injury.The United States District Court for the District of Massachusetts handled the case initially. During pretrial proceedings, the defendants moved to strike the plaintiffs’ expert witnesses, arguing that the plaintiffs had not made their experts available for deposition as required by the Federal Rules of Civil Procedure. The plaintiffs did not respond to this motion, and the District Court granted it, excluding the expert testimony. The plaintiffs later failed to appear at a pretrial conference, citing email issues, and only addressed the missed conference, not the exclusion of their experts. The District Court declined to vacate its order striking the experts, finding the plaintiffs’ delay and lack of explanation unjustified. Subsequently, the District Court granted summary judgment to the defendants, concluding that expert testimony was necessary to support the informed consent claim under Massachusetts law.On appeal, the United States Court of Appeals for the First Circuit reviewed the District Court’s decisions. The appellate court held that the District Court did not abuse its discretion in refusing to reconsider the order striking the expert witnesses, given the plaintiffs’ prolonged inaction and failure to address the underlying issues. The First Circuit also held that, under Massachusetts law, expert testimony was required to establish that the risk of pelvic fracture from a forceps-assisted delivery was more than negligible, and thus, summary judgment for the defendants was appropriate. The judgment of the District Court was affirmed. View "Meka v. Haddad" on Justia Law

Melissa Allen experienced multiple seizures at home and was taken to Lowell General Hospital, where she was found to be seven months pregnant and suffering from severe hypertension. Dr. Fernando Roca, an obstetrician affiliated with Lowell Community Health Center (LCHC), determined an emergency caesarian section was necessary. After the procedure, Allen suffered a devastating neurological injury and died eleven days later at a Boston hospital. The cause of death was listed as intracranial hemorrhage and eclampsia.Brad O'Brien, as personal representative of Allen’s estate, initially filed a wrongful death medical malpractice suit in Massachusetts state court against Dr. Roca and the hospital. At the time of the incident, Dr. Roca was employed by LCHC, a federally funded health center deemed under the Public Health Service Act (PHSA) to have federal employee status for certain purposes. The United States substituted itself as defendant and removed the case to the United States District Court for the District of Massachusetts, which dismissed the suit as time-barred under the Federal Tort Claims Act (FTCA). On O'Brien’s first appeal, the United States Court of Appeals for the First Circuit vacated the substitution order due to reliance on the wrong statutory basis and remanded for further proceedings. On remand, the district court again substituted the United States as defendant and dismissed the complaint.The United States Court of Appeals for the First Circuit reviewed the case de novo and affirmed the district court’s decision. The court held that the Secretary’s regulation allowing for “pre-deeming” FTCA coverage in certain hospital on-call scenarios was consistent with the PHSA, and that Dr. Roca’s treatment of Allen fell within this coverage. The court also held that O’Brien’s claim was untimely under the FTCA’s statute of limitations and that the FTCA’s savings clause did not apply. The judgment of dismissal was affirmed. View "O'Brien v. United States" on Justia Law

In October 2016, parents sought emergency medical care for their nineteen-month-old son, who was experiencing convulsions and seizures. The child was treated at three different medical facilities in Puerto Rico, including by Dr. Fernando Vega-Moral at HIMA San Pablo Bayamón hospital. After being transferred between hospitals, the child suffered cardiac arrest and died. The parents, along with other family members, initially filed a medical malpractice and negligence suit in Puerto Rico Commonwealth court against the medical centers and unnamed doctors, but did not specifically name Dr. Vega. That case was dismissed without prejudice in May 2018.Subsequently, in May 2019, the parents filed a new lawsuit in the United States District Court for the District of Puerto Rico, this time naming Dr. Vega and others as defendants and asserting claims under Puerto Rico’s tort statutes. The district court dismissed some defendants and granted summary judgment to Dr. Vega, finding that the claims against him were time-barred. The court determined that, although the parents’ initial Commonwealth complaint was timely due to extensions following Hurricane María, the federal complaint did not toll the statute of limitations as to Dr. Vega because he was not named in the earlier suit. The court also denied the parents’ motion for reconsideration, holding that their new arguments and evidence should have been presented earlier.On appeal, the United States Court of Appeals for the First Circuit affirmed the district court’s rulings. The First Circuit held that Dr. Vega properly raised the statute of limitations defense and that, under Puerto Rico law, the burden shifted to the parents to show that the limitations period was tolled as to Dr. Vega. The parents failed to provide competent evidence to meet this burden. The court also found no abuse of discretion in denying reconsideration, as the parents’ new arguments and evidence were untimely. View "Cruz-Cedeno v. Vega-Moral" on Justia Law

The plaintiffs, Norene Rodríguez and Iris Rodríguez, sued Encompass Health Rehabilitation Hospital of San Juan, Inc. and Dr. José Báez Córdova for medical malpractice related to the treatment of their mother, Gloria Rodríguez González, who died after being treated for COVID-19. They alleged negligence in her care, particularly in failing to provide timely prophylactic medication for deep vein thrombosis, which they claimed led to her death.The United States District Court for the District of Puerto Rico granted summary judgment in favor of the defendants. The court concluded that the plaintiffs had not demonstrated any genuine issue of material fact and that the defendants were entitled to judgment as a matter of law. The court also found that Dr. Báez was immune from suit under Puerto Rico law, as he was acting within his duties as a faculty member of the University of Puerto Rico (UPR) at the time of the alleged malpractice. Consequently, Encompass could not be held vicariously liable for his actions. The plaintiffs' remaining claims were deemed waived for lack of development.The United States Court of Appeals for the First Circuit reviewed the case and affirmed the district court's decision. The appellate court agreed that Dr. Báez was immune from suit under Puerto Rico law, as he was acting in his capacity as a UPR faculty member supervising medical residents. The court also upheld the district court's application of the local anti-ferret rule, which disregarded certain facts not adequately supported by specific citations to the record. The plaintiffs' argument that Encompass was vicariously liable for the actions of other non-immune personnel was deemed waived, as it was not raised in the lower court. The appellate court found no abuse of discretion in the district court's denial of an evidentiary hearing. View "Rodriguez v. Encompass Health Rehabilitation Hospital of San Juan, Inc." on Justia Law

Plaintiffs, representing their minor son, sued a hospital and a doctor for medical malpractice after their baby suffered birth injuries during delivery. They sought $6,000,000 in damages. Under Puerto Rico law, damages would be capped at $150,000 if the doctor was a faculty member at the hospital at the time of the birth. The defendants claimed the doctor was a faculty member, but could not produce a contract to prove it. The district court held a pretrial evidentiary hearing and concluded that the doctor was a faculty member, thus applying the statutory cap on damages.The U.S. District Court for the District of Puerto Rico adopted a magistrate judge's Report & Recommendation, which stated that the applicability of the statutory cap was a matter of law. The district court found that the doctor was a faculty member based on testimony and letters from the medical school, despite the absence of a contract. Plaintiffs appealed, arguing that the applicability of the statutory cap was a factual question that should have been decided by a jury.The United States Court of Appeals for the First Circuit reviewed the case. The court held that whether the doctor was a faculty member at the time of the birth was a factual question requiring a jury's determination. The court found that the evidence was not one-sided enough to compel the district court's conclusion and that the district court improperly took the question from the jury. The First Circuit vacated the district court's order and remanded the case for further proceedings consistent with its opinion. View "Perez-Perez v. Hospital Episcopal San Lucas Inc." on Justia Law

Dr. Thomas C. Franchini, the former Chief of Podiatry at the Department of Veterans' Affairs Maine Healthcare System at Togus, sued several publishers and reporters for defamation. Franchini alleged that articles written by the defendants, which described malpractice allegations related to his treatment of veterans at VA Togus, were libelous and defamatory. He also claimed negligent infliction of emotional distress and fraudulent or negligent misrepresentation against some defendants.The United States District Court for the District of Maine granted summary judgment in favor of the defendants, finding that Franchini was a voluntary public figure and had failed to plead actual malice in his Second Amended Complaint (SAC). The court determined that the issues surrounding the quality of care at VA Togus were matters of public concern and that Franchini had voluntarily injected himself into the controversy through his actions, including creating a blog and giving an interview to a reporter. The court also found that Franchini's claims of negligent infliction of emotional distress and fraudulent or negligent misrepresentation were not supported by sufficient evidence.The United States Court of Appeals for the First Circuit affirmed the district court's decision. The appellate court agreed that a public controversy existed regarding the quality of care at VA Togus and that Franchini had voluntarily become a limited-purpose public figure by engaging in public discussions about the controversy. The court also held that Franchini failed to show that the defendants acted with actual malice, as required for a public figure to succeed in a defamation claim. The court noted that the defendants had conducted due diligence in their reporting and included Franchini's statements in their articles. Consequently, the appellate court affirmed the district court's grant of summary judgment in favor of the defendants. View "Franchini v. Bangor Publishing Co., Inc." on Justia Law

The case concerns parents of a child who suffered severe and permanent injuries at birth due to alleged negligence of the medical staff at Hospital Damas. The parents sued Fundación Damas, Inc., alleging that it operated the hospital at the time of the malpractice. The district court granted summary judgment to Fundación on the basis of issue preclusion, concluding that the parents were "virtually represented" in earlier proceedings by the parents of another child who also suffered injuries at the hospital.The United States Court of Appeals for the First Circuit reversed the district court's decision. The appellate court found that the theory of virtual representation, which the district court relied on, was inapplicable to this case. According to the Supreme Court's precedent, issue preclusion generally does not apply to those who were not party to the prior litigation. The court noted that the Supreme Court had rejected the broad theory of virtual representation, which was the basis for the district court's decision. The court explained that the exceptions to the rule against nonparty preclusion are narrow and specific, and none applied in this case. Therefore, the court reversed the grant of summary judgment and remanded the case for further proceedings. View "Santiago-Martinez v. Fundacion Damas, Inc." on Justia Law

In this case, the plaintiff, Virginia Cora Ward, the administratrix of the estate of Edmund Edward Ward, appealed against the verdict in favor of Dr. Ernst J. Schaefer. Edmund Edward Ward, who suffered from a rare genetic deficiency that caused his body to refrain from producing a critical blood enzyme, was a subject of experimental enzyme therapy developed by Dr. Schaefer and others. The plaintiff claimed that Dr. Schaefer fraudulently induced Ward to participate in the experimental protocol and failed to obtain informed consent for his participation. However, the jury disagreed and returned a verdict in favor of Dr. Schaefer.On appeal, the United States Court of Appeals for the First Circuit affirmed the judgment of the lower court. The appellate court found that the district court did not err in excluding the patent for the experimental drug from evidence, as its probative value was substantially outweighed by the potential for confusion. Further, the court found no error in the jury instructions provided by the district court regarding the nature of the doctor-patient relationship and the application of the doctrine of res ipsa loquitur. The court concluded that the jury instructions sufficiently conveyed the legal standards to be applied, and the plaintiff failed to show that the occurrence of a medical condition during the experimental protocol implied that the protocol caused the condition. View "Ward v. Schaefer" on Justia Law

This case involves a medical malpractice suit against Hospital San Cristobal (HSC), Dr. Iris Vélez García, and Dr. Zacarías A. Mateo Minaya by the children of Ramona Rodríguez Rivera, who passed away while in the care of HSC. The plaintiffs alleged that their mother received negligent care at HSC during and following an abdominal surgery performed by Dr. Vélez and Dr. Mateo, leading to her death. The United States District Court for the District of Puerto Rico granted summary judgment in favor of the defendants.On appeal, the United States Court of Appeals for the First Circuit affirmed the district court's decision. The appellate court held that the district court did not err in excluding the plaintiffs' expert witness's testimony under Federal Rule of Evidence 702. The expert's report failed to identify the standard of care that HSC staff should have adhered to in their management of the patient's diabetes and how the staff deviated from that standard. Without this expert testimony, the plaintiffs could not establish a breach of the defendants' duty of care, a necessary element of a negligence claim. The appellate court also found no error in the district court's grant of summary judgment to the defendants as there was no evidence in the record that could show the defendants' negligence. View "Rivera Rodriguez v. Hospital San Cristobal" on Justia Law