PUBH 6335 2U

Public Health Law

Fall 2022

Exam 3 (take home)

Exam Question # 1(5 points)

Frank was released from prison after serving a sentence for a non-violent crime and returned to his home in the State of Candlyland. While in prison, he volunteered to be part of a team of prisoners sent out to assist firefighters and other emergency first responders fighting the recent wildfires and assisting the communities affected. Frank was provided some limited training through the prison program as an EMT assistant, and he loved the feeling of being of service and was excited to pursue a career as an EMT when he got home. Frank has spent the two years since he has come home completing formal training as an EMT and applied for a Candyland EMT license. He was denied because of his criminal record.

Because EMTs work with vulnerable people, Candyland regulations restrict issuing a license to applicants who have a history of criminal behavior. However, Candyland is experiencing a serious health workforce shortage, and recently lifted their complete ban on convicted felons applying for an EMT license.

The new Candyland law has set specific conditions (separate from the requisite training and credentialing of skills) that must be met before the license is granted to a person with a criminal record. Conditions include:

• Documenting that a at least 3 years has passed between conviction and making an application for an EMT license
• Providing letters of reference from probation officers, employers, therapists or physicians
• Offering a detailed explanation, either in person or in writing of the circumstances that led to the conviction and what the individual has done to rehabilitate him or herself since that time

Once paperwork is submitted, applicants will be called in for an interview at the state licensing office, who then makes a recommendation to the licensing board for approval.

When Frank applied for a license he submitted all of the requested paperwork and documentation, but was denied because he has not been out of prison for 3 years.

Frank is suing the state asserting denial of the license is a violation of his constitutional rights.

Frank's lawyer told the press "A criminal or juvenile record can be a barrier to a person's ability to get a job or an educationeven after years have passed and regardless of the efforts the person has made to put their life on a positive track. In a country where we so readily incarcerate people for non-violent crimes this is an issue that needs to be remedied. For both my client and for the community he wishes to serve."

You are an associate in the law firm representing Frank and have been asked to analyze the issue. Does Frank have a legitimate claim?

Exam Question # 2(7 points)

Peggy Schuyler is an excellent cook and decides she is going to open a restaurant. She is successful at pulling the money together but due to limited funds is only able to afford used cooking and other kitchen equipment. The inspector from the city health department warns Peggy that the used equipment may prove unreliable maintaining the required food temperatures for public safety. Peggy moves ahead with her plans and secures the necessary license to open for business.

She plans her grand opening on the same day a large street festival is set to begin near her location so she can pull in as much as of the foot traffic as possible. The food inspector has ongoing concerns, and the city shows up to perform a routine, unannounced inspection on the 2^nd day of the festival. The inspection identifies a range of code violations, including food temperatures out of safe range and malfunctioning equipment. The inspector provides a notice of all violations and issues an order for the restaurant to remain closed until all violations are corrected.

Peggy seeks legal advice on filing an action in court to challenge the order to close the restaurants and dispute the notice of violations, asserting that her 4^th amendment rights have been violated. How would you advise Peggy Schuyler?

Exam Question #3(5 points)

There is a new mayor in the city of Baltimore and she is passionate about the health of our population. She is frustrated that the most widely available and affordable food in our low-income neighborhoods is generally fast food. In fact, along North Avenue, there are 8 fast food restaurants along a 3-block stretch of road. The mayor and the city council plan to take action. They have hatched a plan to use eminent domain to reclaim the lots that 3 of these adjacent restaurants currently inhabit and build a park where kids can play and the city farmers market can sell fruits and vegetables.

Can Baltimore implement this plan?

Exam Question #4(8 points)

Fred Davis was a frequent visitor to the Bluefield Medical Center (BMC) emergency room. Every few days he would rush in, claim to be on the brink of death, and demand immediate medical attention. Invariably, his concerns proved to be unfounded, and the medical staff had come to see Mr. Davis as a nuisance. In fact, during one visit, Davis heard a doctor tell a nurse that he (the doctor) hated it every time Mr. Davis came to the ER.

Last week, Davis once again arrived at the ER complaining of a sore throat, chest pain while breathing, and dry heaves. Dr. Jennifer Alexander, the physician on duty, performed a battery of tests, including an electrocardiogram (required pursuant to hospital policy for all patients complaining of chest pain), a urine screening, and a blood gas test. The electrocardiogram and blood gas tests revealed nothing out of the ordinary. However, the urine analysis indicated an unusually high level of Anafranil (an antidepressant). In fact, the Anafranil level was high enough to suggest the presence of drug toxicity, but this possibility did not occur to Dr. Alexander.

Anxious to get rid of Davis so that she could attend to the "real" emergencies, Dr. Alexander told Fred Davis to go home. Shortly after leaving the hospital, Davis went into cardiac arrest and died. An autopsy revealed that excessive Anafranil caused the cardiac arrest.

Davis's estate has sued BMC for violating their obligations under EMTALA.

1. BMC is attempting to get the EMTALA claim dismissed and therefore thrown

out ofcourt. How should the court rule and why? (5 points)

1. How, if at all, would your analysis of the EMTALA claim differ if Dr.

Alexander failed to perform the electrocardiogram? Please explain your answer. (5 points)