Lawsuit says hospital discriminated against New City patient because of past opioid use

A former patient is claiming in federal court that Good Samaritan Hospital denied him proper treatment for a painful diabetes-related leg infection and subsequent amputation, all because he is in recovery for opioid abuse.

Legal Action Center and New City resident Shawn Landau are suing for relief under the Americans With Disabilities Act, Section 504 of the Rehabilitation Act of 1973, the Patient Protection and Affordability Act and New York State Human Rights Law.

A spokesman for the hospital said that they would not comment on active litigation.

Landau's case breaks ground in its challenge of how care decisions are made for people with substance use disorder, said Rebekah Joab, senior staff attorney at the Legal Action Center, which fights discrimination against people with arrest or convictions records, substance use disorders, HIV or AIDS.

"This case is really trying to expose the stigma against people with substance use disorder, even within the health care system," said Joab, part of the team representing Landau.

Stigmatization as 'junkie'

Landau suffers from myriad complications and side effects of chronic diabetes. He also had been in successful treatment for opioid use disorder, a federally recognized disability.

“This lawsuit challenges the type of medical treatment discrimination that people with SUD and other disabilities experience all too often," said Sally Friedman, LAC’s senior vice president of legal advocacy. "People’s lives hang in the balance as negative attitudes and biases around this treatable illness remain pervasive. ... We at LAC are committed to combatting discrimination, holding providers legally accountable, and advancing the rights of people with SUDs.” According to a complaint filed Aug. 15 by Landau and the Legal Action Center in U.S. District Court in the Southern District, the hospital wouldn’t provide Landau methadone, a federally approved and standard medication to treat substance use disorder. Hospital providers also refused letting him leave with a PICC line, a catheter that would provide intravenous access and make it easier for him to receive doctor-recommended antibiotic treatment.

Those hospital decisions caused Landau anxiety, painful withdrawal from a federally recommended medication and stigmatization as a “junkie,” according to the plaintiff's demand for a jury trial.

Named as defendants: Good Sam and its affiliates Westchester Medical Center Health Network and Bon Secours Charity Healthcare System.

'Ironic roadblock to care'

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"There's this ironic roadblock to care within the health care system that this case is really highlighting," Joab said. Attitudes like what Joab said were shown by Good Sam toward people with substance use disorder could create a "chilling effect."

"If you are disincentivized to disclose (substance use disorder) if you're worried health care providers are going to see that and going to discredit you (and) deny you standard treatment," Joab said. "It's incredibly important ... that the needs of individuals are actually considered and evaluated based on clinical standards."

The lawsuit aims to stop what LAC asserts are discriminatory actions in the future, and make the hospital pay Landau for legal fees and award him damages.

He also seeks compensatory damage, as well as payment for emotional distress and physical pain and suffering.

Treatment decisions made

Key dates and actions include:

In August 2020, the 50-year-old was admitted to the hospital with a foot infection. Although his records showed he took methadone and he reported that to medical staff, he was denied the medication. That led to symptoms of withdrawal, according to the complaint. Landau then arranged for his partner to bring his methadone from home so he could continue his treatment.

Within weeks, Landau was to be discharged and his doctor placed a PICC line so he could continue intravenous antibiotics. However, hospital staff declined to complete his discharge with the device in place. A physician said it was hospital policy to deny a PICC line to people with a history of intravenous drug use because it allowed easy access to abuse drugs.

Landau, who said he had no desire to abuse drugs and said he had a stable home environment, was given the following options: Go to a skilled nursing facility to receive IV medications or visit an infusion center daily. He didn’t want to be inpatient at a facility because he was worried about COVID cases in congregant settings that were spiking at the time.

Landau ended up traveling to an infusion center around 35 times, getting a new IV with each treatment. "If he had home care, he wouldn't have been traveling to and from the infusion center, which led to increased pressure in using his foot where he had ulcers," Joab said. "That was a factor in problem healing."

In January 2021, Landau was back at Good Sam for a worsening infection. He was again denied a PICC line to deliver IV antibiotics. Ultimately, he was sent home with oral antibiotics.

In February 2021, Landau’s physician set up a PICC line placement and home antibiotic infusions. Landau completed the treatment without incident.

In August 2021, Landau ended up having to undergo a left leg amputation below the knee, a complication of diabetes and earlier injury to his leg.

Good Sam staff again denied him methadone, the lawsuit states.

“I experienced a hospital staff that was prejudiced and distrustful of me because I used to use drugs, and I was worried about my recovery," Landau said in a statement. "For a hospital, which should be focused on improving the health and quality of life for all of its patients, to discriminate against me and threaten all of the hard work I have put into my recovery is painful."

Nancy Cutler covers People & Policy for lohud.com and the USA Today Network New York. Reach her at ncutler@lohud.com.

This article originally appeared on Rockland/Westchester Journal News: Lawsuit: Rockland hospital denied treatment because of past opioid use