HomeHealth LawPREP Act Immunity: Baghikian v. Windfall Well being & Servs.

PREP Act Immunity: Baghikian v. Windfall Well being & Servs.

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We’re medical system and pharmaceutical attorneys, so preemption is our factor.  It could not make for scintillating cocktail dialog, however we discover the intersection between Constitutional regulation (the Supremacy Clause and the federal/state stability of energy) and public coverage points (well being and security, and regulation versus litigation as one of the best ways to advertise identical) to be a reasonably attention-grabbing matter. 

To not point out, it’s a highly effective protection for our purchasers in product legal responsibility issues as a result of it may possibly foreclose legal responsibility and plaintiffs’ use of tort lawsuits (invariably creatures of state regulation origin) to impose necessities on medical units or prescribed drugs that the federal FDA didn’t.

What might be higher than preemption?  How about “immunity”?  Or is it that the identical factor by a special identify?

And that brings us to the Public Readiness and Emergency Preparedness Act (or “PREP Act”), 42 U.S.C. §§ 247d-6d, 247d-6e.  The PREP Act has captured our consideration earlier than, however lately, in Baghikian v. Windfall Well being & Companies, No. CV 23-9082-JFW(JPRX), __ F.Supp.3d __, 2024 U.S. Dist. LEXIS 22420, 2024 WL 487769 (C.D. Cal. Feb. 6, 2024), the Central District of California regarded on the PREP Act within the traditional context during which we cope with preemption:  A tort lawsuit (involving product legal responsibility and associated state regulation tort claims) towards a medical product producer (right here, the producers of the COVID 19 antiviral drugs remdesivir and tocilizumab).

A Primer on the PREP Act.  By the PREP Act, Congress hoped to facilitate the short deployment of essential medical assets throughout public well being emergencies, partially by liberating “coated particular person[s]” from the specter of civil litigation and legal responsibility.  In related half, it supplies that:

“a coated particular person shall be immune from swimsuit and legal responsibility underneath Federal and State regulation with respect to all claims for loss attributable to, arising out of, regarding, or ensuing from the administration to or the use by a person of a coated countermeasure.”

42 U.S.C. § 247d-6d(a)(1) (emphasis added). 

The one exception to this broad grant of immunity is a fairly specific “unique Federal reason for motion towards a coated particular person for dying or severe bodily damage proximately attributable to willful misconduct,” though that treatment is barely obtainable (1) in the US District Court docket for the District of Columbia; (2) requires pleading with particularity, a criticism supported by a verification underneath oath, a physician’s affidavit, and licensed medical information; (3) requires conduct extra harmful than negligence or recklessness; (4) could be pursued solely after the plaintiff first pursues an administrative declare; and (5) have to be confirmed by clear and convincing proof.  42 U.S.C. §§ 247d-6d & 247d-6e.

Different key PREP Act provisions:

  • “Coated particular person[s]” embody producers and distributors of “coated countermeasures.”  42 U.S.C. § 247d-6d(i)(2)(B)(i)–(ii). 
  • “Coated countermeasures” embody “certified pandemic or epidemic product[s]” so designated by a declaration of the Secretary of Well being and Human Companies. 42 U.S.C. § 247d-6d(i)(7). 
  • “All claims” within the PREP Act’s immunity clause means all claims with “a causal relationship” to the coated countermeasure’s “design, improvement, scientific testing or investigation, manufacture, labeling, distribution, formulation, packaging, advertising and marketing, promotion, sale, buy, donation, shelling out, prescribing, administration, licensing, or use.” 42 U.S.C. § 247d-6d(a)(2)(B).
  • Paying homage to the Vaccine Harm Compensation Act, 42 USC §300aa-22(b-c), the PREP Act additionally created an alternate no-fault system for people to hunt restoration in the event that they consider they’ve been injured by a coated countermeasure.  See 42 U.S.C. § 247d-6e(a) (creating the “Coated Countermeasure Course of Fund”).

The Baghikian Opinion.  Not all that lengthy after the PREP Act handed, the COVID-19 pandemic began, shortly confirming the significance of liberating authorities and trade to work collectively to deploy each kind of desperately wanted medical useful resource.  The federal government issued the mandatory “public well being emergency” declaration in March 2020, and the PREP Act kicked in.

The Baghikian defendants’ antiviral drugs had been and are an necessary a part of the battle towards COVID-19.  One defendant developed and manufactures remdesivir, coated by an Emergency Use Authorization issued by the FDA in Might 2020 and full approval in October 2020.  The opposite defendant manufactures a rheumatoid arthritis drugs, tocilizumab, however contracted with the federal authorities to conduct scientific trials concerning its use in treating COVID-19 resulting in an Emergency Use Authorization in June 2021 and full approval for COVID-19 use in December 2022.

The plaintiffs alleged that the decedent had been hospitalized for COVID-19 and handled with the defendants’ antivirals with out sufficient knowledgeable consent, and handed away after three weeks.  They didn’t, nonetheless, contest that defendants had been “coated particular person[s]” or that the antiviral drugs had been “coated countermeasures.” 

As a substitute, the plaintiffs argued that an allegedly inadequate knowledgeable consent in regards to the therapies vitiated the PREP Act’s immunity provision—a rivalry the Baghikian court docket shortly rejected as unfounded within the statute’s language and unsupported by any caselaw.

The plaintiffs additionally took a shot at arguing for software of the “willful misconduct” exception to PREP Act immunity.  However even setting apart the procedural issues (just like the requirement that such claims be pursued solely within the District of Columbia), the plaintiffs’ assertions of strict legal responsibility or, at most, recklessness, fell in need of the “willful misconduct” wanted underneath the PREP Act.

As the primary case straight addressing the PREP Act in a product legal responsibility case towards producers, Baghikian is important, and its rejection of legal responsibility was clearly the fitting consequence.  Baghikian already has been adopted in Fust v. Gilead Sciences, Inc., No. 2:23-cv-2853 WBS DB, 2024 U.S. Dist. LEXIS 30894 (E.D. Cal. Feb. 21, 2024)).

One remaining merchandise of be aware in regards to the PREP Act:

Defendants shouldn’t get carried away making an attempt to take away PREP Act claims to federal court docket, probably hurting themselves on the principle concern (immunity) over a skirmish about jurisdiction.  In Saldana v. Glenhaven Healthcare LLC, 27 F.4th 679, 686 (ninth Cir. 2022), the Ninth Circuit held that the PREP Act doesn’t lead to “full” preemption.  Full preemption will not be a protection to legal responsibility and isn’t the identical as discipline preemption;  it’s a jurisdictional doctrine.  Full preemption permits elimination of a case to federal court docket, based mostly on the understanding that any try to state a declare on the related topic is deemed to be based mostly on federal regulation as an alternative.  See Retail Prop. Tr. v. United Bhd. of Carpenters & Joiners of Am., 768 F.3d 938, 941 (ninth Cir. 2014).  Full preemption will get you into federal court docket, however not dismissed from the case, and Saldana says it doesn’t apply to PREP Act claims in any occasion.

That stated, Baghikian does spotlight one potential, albeit uncommon, path to federal court docket: the federal officer elimination statute, 28 U.S.C. § 1442(a)(1), obtainable as a result of the claims had been based mostly on actions the tocilizumab producer took on the route of a federal officer.   

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