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United States of America, United States Court of Appeals of Wisconsin, 25 May 2022, Allen Gahl v. Aurora Healthcare

Case overview

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Country
United States of America
Case ID
Allen Gahl v. Aurora Healthcare
Decision date
25 May 2022
Deciding body (English)
United States Court of Appeals of Wisconsin
Type of body
Court
Type of Court (material scope)
Civil Court
Type of jurisdiction
Single jurisdiction system
Type of Court (territorial scope)
State Court
Instance
Appellate on fact and law
Area
Healthcare management (Covid related, excluding vaccination)
Outcome of the decision
Claim inadmissible or rejected

Case analisys

General Summary

The Plaintiff held a healthcare power of attorney for his uncle, who tested positive for Covid-19 and was a patient at the Defendant’s hospital. The Plaintiff requested that Ivermectin be administered to his uncle, which was denied by the hospital professionals under the justification that the use of such medicine for Covid-19 was below the standard of care. The Plaintiff then filed an action against the hospital and the District Court granted him injunctive relief, determining that a physician of the Plaintiff’s choice could have permission to enter the hospital and administer the proposed treatment. The hospital appealed and the Court of Appeals concluded that the District Court did not show that the plaintiff had established the four criteria for injunctive relief. The Court also did not identify any claim set forth in the Plaintiff's petition which supported the request for relief, much less the legal authority supporting the claim. Therefore, the Court of Appeals reversed the decision.

Facts of the case

The Plaintiff had health care power of attorney for his uncle, a patient in the intensive care unit at the Aurora Medical Center (the hospital). The patient "came down with Covid-19 on September 16, 2021." He was admitted to the hospital on September 19, 2021, and was transferred to the i ntensive care unit. On October 3, 2021 he was intubated and placed on a ventilator. The patient's condition then "deteriorated quickly." The patient was offered and received other treatments than that requested by the Plaintiff, who agreed to some, but declined to continue others. Based on his internet research, the Plaintiff sought to compel the Aurora Medical Center to administer a medication called Ivermectin (the proposed treatment) to the patient. Aurora filed its response on October 11, 2021. According to the Chief Medical Officer at Aurora Medical Center, "Ivermectin is a drug primarily used as an anti-parasitic in farm animals or administered to humans for treatment of certain parasites and scabies, and there is significant controversy in the public sphere surrounding its use for patients diagnosed with Covid-19." The Plaintiff filed an action seeking injunctive relief against the negative response of the hospital towards the proposed treatment.

Type of measure challenged
Local government measure
Measures, actions, remedies claimed
Injunctive relief
Individual / collective enforcement
Individual action brought by one or more individuals or legal persons exclusively in their own interest.
Nature of the parties
  • Claimant(s)
    Private individual
  • Defendant(s)
    Private individual
Type of procedure
Urgency
Reasoning of the deciding body

The Court analyzed the arguments of the plaintiff and the defendant and reasoned as to whether the circuit court had the legal authority to issue an injunction compelling a private healthcare provider to administer treatment that, in its professional judgment, was below the standard of care, or to compel the hospital to credential a non-Aurora medical provider to administer such treatment. Regarding this analysis, the Court argued that the circuit court may issue a temporary injunction if the movant establishes four criteria: (1) the movant is likely to suffer irreparable harm if a temporary injunction is not issued; (2) the movant has no other adequate legal remedy; (3) a temporary injunction is necessary to preserve the status quo; and (4) the movant has a reasonable probability of success on the merits. The Court concluded that in failing to identify a viable legal claim supporting a declaratory judgment and setting forth reasoned analysis as to why the Plaintiff had a reasonable probability of success, the court erred by plowing ahead and granting temporary relief on the basis of these. Furthermore, the Court analyzed the Plaintiff’s argument that he had healthcare power of attorney and that there had been a breach of contract. The Court rejected both claims since the Plaintiff had failed to present proof of a legal foundation for these claims. According to the Court of Appeals, nothing in the case involved a court's inherent powers. The power to compel a health care provider to provide a requested treatment, especially one that the provider deemed to be below the standard of care, did not clearly fall within any of the areas in which inherent authority was exercised. The Court thus stated that the judiciary could compel the health care provider to administer treatment, but not to choose which treatment should be administered.

Conclusions of the deciding body

The Court concluded that: 

  1. The circuit court erroneously exercised its discretion in granting the Plaintiff's requested relief. The Court failed to identify any viable claim upon which the temporary injunctive relief was granted and, as such, the Plaintiff did not show a reasonable likelihood of success on the merits.
  2. The Court also failed to explain how granting the Plaintiff's requested relief was necessary to avoiding irreparable harm—given that there was no legal authority to compel the Defendant to provide treatment below the standard of care.
  3. Finally, the Court's order neither preserved nor restored the status quo between the parties, but instead altered the status quo and granted much, if not all, of the relief ultimately sought by the Plaintiff in this case.

The Court therefore concluded that the Circuit Court had no legal authority to compel a private healthcare provider to provide care that was below its standard of care and had no legal authority to compel the Aurora Medical Center to credential an outside provider to administer care that was below its own standard of care. Accordingly, the Court reversed the Circuit Court's order which granted the temporary injunction.

Balancing Fundamental Rights and Fundamental Freedoms

Fundamental Right(s) involved
Right to health (inc. right to vaccination, right to access to reproductive health)
Rights and freedoms specifically identified as (possibly) conflicting with the right to health
Health (public) v. access to health services
Author of the case note
Maíra Tito, Research Assistant, NOVA School of Law, Lisbon
Published by Marco Nicolò on 26 November 2022

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