No CrossRef data available.
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
Published online by Cambridge University Press: 24 February 2021
1 No. 96-2140, 1998 WL 107983 (3d Cir. Mar. 13, 1998).
2 The supersedeas provision provides for workers’ compensation benefits to be suspended by a determination of a utilization review board. See id. at *13.
3 See id. at *21.
4 See id. at *12-14.
5 See id.
6 See id. at *10.
7 See id. at *4.
8 77 PA. CONS. STAT. ANN. §§ 1-2626 (West 1998) [hereinafter Act].
9 See Sullivan, 1998 WL 107983, at *4.
10 See id. a t* 10.
11 See id. at * 13-14.
12 See id. at *12, *19.
13 See id. at * 15-17.
14 See id. at *17.
15 Id. at *19.
16 See id. at *5.
17 See id. at *6.
18 See id.
19 Id. at *7.
20 See Baksalary v. Smith, 579 F. Supp. 218 (E.D. Pa. 1984) (holding that insurers had acted under the color of state law and a similar supersedeas provision of the Act violated the due process requirements of the Fourteenth Amendment).
21 See Barnes v. Legman, 861 F.2d 1383 (8th Cir. 1988) (criticizing the Baksalary opinion).
22 See Sullivan, 1998 WL 107983, at *9.
1 No. 96-9560, 1998 WL 42577 (2d Cir. Jan. 20, 1998).
2 See id. at *6.
3 See id. at *4.
4 See id.
5 See id. at *5.
6 See id. at *2-6 (citing FED. R. Civ. P. 56(c); Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 250(1986)).
7 See id. at *3 (noting that “the Plan language does not on its face limit coverage to specific ‘FDA-approved indications’ or even ‘FDA-approved uses’ of medical drugs“).
8 See id. at *1 (citing 29 U.S.C. § 1001).
9 See id. The beneficiary, patient with acquired immunodeficiency syndrome (AIDS), received Ganciclover in the hospital. Id. Ganciclover decreases a person's white blood cell count, and is thus especially dangerous for AIDS patients. See id. Therefore, the hospital used Neupogen to counteract this effect on the beneficiary. See id. Neupogen is approved by the Food and Drug Administration (FDA) for treating neutropenia in cancer patients. See id. However, the beneficiary was an AIDS patient with neutropenia, and thus the defendant claimed that such treatment was not covered by the policy. Id. at *2.
10 See id. Furthermore, the beneficiary “assigned to [the plaintiff] his insurance benefits under the plan.” Id.
11 See id. at *l-2. The defendant predicated its denial of reimbursement on two reasons: the experimental nature of Neupogen and Leukine, and the lack of specific FDA approval for this treatment. Id.
12 See id. at *1 (noting that the Plan only covered home health care drug treatment if the drugs “are approved by the United States Food and Drug Administration for general use in treating the injury or illness for which they are prescribed“). The Plan contended that the terms of the Plan “restrict[] coverage to those drugs that are FDA-approved for treatment of a particular condition caused by a particular illness.” Id. at *2. The plaintiff asserted that the terms of the Plan “should be read more broadly to cover the use of any FDA-approved drug so long as it is employed in treating the same condition (or symptoms) for which the FDA has permitted the drug to be prescribed.” Id. Furthermore, “[s]uch uses of drugs are termed ‘off-label’ uses.” Id.
13 See id. at *3-4; see also id. at *3 (citing O'Neil v. Retirement Plan, 37 F.3d 55, 59 (2d Cir. 1994)). Moreover, the court remanded for further development of the record the issue of Leukine was “FDA-approved ‘for treating the … illness for which [it] was prescribed.'” Id. at *4.
14 See id.
15 See id. at *5. The plaintiff contended that the defendant's reimbursement to the hospital for Neupogen treatment indicated that such treatment was covered by the Plan, whereas the defendant claimed that the reimbursement was a “claims processing oversight.” Id. The court reasoned that “past inconsistent readings of the Plan language by the [defendant] would certainly count against the [defendant's] current interpretation of that language, [however,] consistent readings of the Plan by [defendants] in no way mean that a factfinder must resolve the Plan's ambiguities in [defendant's] favor.” Id.
16 See id. at *5.
17 Id.
18 See id. at *3.
19 See id. at *5. Moreover, “where the Plan terms are ambiguous and there is some extrinsic evidence suggesting an interpretation contrary to that of the drafter, such rules of construction may play a role.” Id. at *5 n.8.
1 No. 95-1544, 1998 WL 75258 (6th Cir. Feb. 25, 1998)
2 See id. at *10.
3 Id. at *3 (quoting School Bd. v. Arline, 480 U.S. 273, 287 (1987)).
4 See id. at *5.
5 See id. at *9.
6 See id. at *10.
7 See id. at *1.
8 See id.
9 See id.
10 See id.
11 See id.
12 See id.
13 See id.
14 See id.
15 See id.
16 See id.
17 See id. at *4.
18 Id.
19 480 U.S. 273(1987).
20 See Estate ofMauro, 1998 WL 75258, at *4 (factors of the Arline test are: (1) the nature of the risk; (2) the duration of the risk; (3) the severity of the risk; and (4) the probabilities the disease will be transmitted and will cause varying degrees of harm).
21 See id. at *4.
22 See id. at *5.
23 See id. at *5.
24 See id. at *7-8.
25 See id. at *6.
26 See id. at *9.
27 See id. at *2.
28 See id.
1 135 F.3d 740(1 lth Cir. 1998).
2 See id. at 749.
3 See id. at 748.
4 See id.
5 See id. at 746.
6 See id. at 749. Plaintiffs can establish the relevant market either by product or by geography.
7 See id.
8 See id. at 746.
9 See id.
10 See id.
11 See id. at 747.
12 See id. at 748.
13 See id.
14 See id.
15 See id.
16 See id.
17 See id. at 749.
18 See id.
19 See id.
20 See id.
21 Id. at 750.
22 See id.
1 No. 96-16526, 1998 WL 39209 (9th Cir. Feb. 3, 1998).
2 See id. at *4, *7, *8.
3 See id. at *1.
4 See id.
5 See id. at *2.
6 See id. at *1.
7 See id.
8 See id.
9 See id.
10 See id.
11 See id. at *2.
12 See id.
13 See id. at * l - 2.
14 See id. at *3.
15 See id.
16 See id. at *4.
17 Id.
18 See id.
19 See id.
20 See id.
21 See id. at *13.
22 See id. at *6.
23 See id.
24 See id. at *5.
25 See id. at *6.
26 See id. at *7.
27 See id. at *9.
28 See id. at *10.
29 See id. at *2.
30 See id. at * 10.
31 See id. at * 11.
32 See id. at *12-13.
33 See id. at*12.
34 Id.
35 See id.
36 See id. at *5.
37 See id. at *9.
38 See id. at *7.
1 No. 97-1891, 1998 WL 85405 (4th Cir. Feb 27, 1998).
2 See id. at *1.
3 See id.
4 See id.
5 Id.
6 See id. The diagnosis of multiple chemical sensitivity is based on a theory that certain people may suffer recurring and abating symptoms, affecting multiple organ systems, from very low level exposure to diverse chemicals—including copy paper. See, e.g., Frank v. New York, 972 F. Supp. 130, 132(N.D.N.Y. 1997).
7 See Mead Corp., 1998 WL 85405, at *1.
8 See id.
9 See id.
10 See id.
11 See VA. CODE ANN. § 8.01-243(A) (Michie 1992).
12 Id. §8.01-230.
13 See Mead Corp., 1998 WL 85405, at *1.
14 See id.
15 509 U.S. 579(1993).
16 See, e.g., Summers v. Missouri Pac. R.R. Sys., 132 F.3d 599, 603 (10th Cir. 1997).
17 See BARRY R. FURROW ET AL., HEALTH LAW: CASES, MATERIALS, AND PROBLEMS 222-23 (3d ed. 1997).
18 See id. at 222.
19 See id.
20 See id.
21 See, e.g., Mastro v. Brodie, 682 P.2d 1162, 1167 (Colo. 1984).
1 No. 2788, 1998 WL 57450 (S.C. Ct. App. Feb. 2, 1998).
2 See id. at *6.
3 Because most hospitals were originally charitable organizations that served a public service, South Carolina courts had held as early as 1914 that “it would be against public policy to hold a charitable institution [in this case a hospital] responsible for the negligence of servants” who were selected with due care. Id. at *2 (quoting Lindler v. Columbia Hospital, 81 S.E. 512 (S.C. Ct. App. 1914)). As the function of hospitals changed over time, the doctrine of charitable immunity began losing its appeal with South Carolina courts. The South Carolina Supreme Court first scaled back the doctrine's scope in the seminal case of Brown v. Anderson County Hospital Ass'n, holding that hospitals may be held liable if the plaintiff could prove that “the injuries occurred because of the hospital's heedless and reckless disregard” of the plaintiffs rights. Id. (quoting Brown v. Anderson County Hosp. Ass'n, 234 S.E.2d 873 (S.C. Ct. App. 1977)). Four years later, South Carolina formally abandoned the doctrine of charitable immunity in Fitzer v. YMCA, where the court's majority concluded that the doctrine has “no place in today's society” because “the public policies that once supported the doctrine of charitable immunity has changed over the course of time.” Id. (quoting Fitzer v. YMCA, 282 S.E.2d 230 (S.C. Ct. App. 1981)).
4 Id. at * 1.
5 See id. at *5.
6 Id. at *3.
7 See id. at * 1.
8 See id.
9 See id.
10 See id.
11 See id.
12 See id.
13 See id.
14 See id.
15 See id.
16 See id.
17 Id.
18 See id.
19 See id. at *2.
20 See id. at *6.
21 See id. at *3.
22 See id.
23 See id.
24 See id.
25 See id.
26 See id. at *4. The court also noted the commercialization of American medical care as an additional reason for scaling back limitations on hospital liability. See id.
27 See id.
28 See id.
29 See id.
30 See id.
31 See id.
32 See id. at *5.
33 See id.
34 See id.
35 See id.
36 See id.
37 488 S.E.2d 581 (S.C. Ct. App. 1994). In Strickland v. Madden, the plaintiff attempted to prove that the defendant hospital was negligent by inadequately monitoring its medical staffs privileges. See Simmons, 1998 WL 57450, at *5.
38 The Strickland court assumed, without deciding, that corporate negligence was recognized in South Carolina as a cause of action. See id.
39 See id.
40 See id.
41 See id. at *6.
42 See BARRY R. FURROW ET AL., HEALTH LAW CASES, MATERIALS AND PROBLEMS 270 (3d ed. 1997).