# Correnia Profitt v. Highlands Hosp. Corp.

> Court of Appeals for the Sixth Circuit · August 1, 2024

URL: https://www.frixlaw.com/law-library/cases/10494390

## Case

- **Court:** Court of Appeals for the Sixth Circuit
- **Decided:** August 1, 2024
- **Precedential status:** Unpublished
- **Opinion:** Opinion
- **Cited by:** 0 later opinions in the Frix Law Library

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## Opinion text

NOT RECOMMENDED FOR PUBLICATION
File Name: 24a0338n.06

No. 23-5965

UNITED STATES COURT OF APPEALS
FOR THE SIXTH CIRCUIT

CORRENIA J. PROFITT, individually and as ) FILED
Administratrix of the Estate of Corbin Raie Hill; ) Aug 01, 2024
SHAWN D. HILL, ) KELLY L. STEPHENS, Clerk
)
Plaintiffs-Appellants, )
) ON APPEAL FROM THE
v. ) UNITED STATES DISTRICT
) COURT FOR THE EASTERN
HIGHLANDS HOSPITAL CORPORATION, et al., ) DISTRICT OF KENTUCKY
Defendants, )
) OPINION
UNITED STATES OF AMERICA, )
)
Defendant-Appellee.
)

Before: KETHLEDGE, THAPAR, and DAVIS, Circuit Judges.

KETHLEDGE, J., delivered the opinion of the court in which THAPAR and DAVIS, JJ.,
joined. THAPAR, J. (pp. 13–15), delivered a separate concurring opinion.

KETHLEDGE, Circuit Judge. Correnia J. Profitt received an emergency caesarean with

only local anesthesia. Her newborn son, Corbin Raie Hill, died two days later. Profitt and Corbin’s

father, Shawn Hill, sued the hospital and the United States, alleging claims of medical negligence.

After a bench trial, the district court found that Profitt’s obstetrician was not negligent. We affirm.

I.

A.

On January 2, 2017, plaintiff Correnia Profitt was 38 weeks pregnant with her son, Corbin

Raie Hill. Profitt received prenatal care at Physicians for Women and Families, a federally funded
No. 23-5965, Profitt, et al., v. Highlands Hosp. Corp., et al.

medical center in Floyd County, Kentucky. Profitt’s midwife at Physicians for Women, Krissy

Marcum, had previously designated Profitt’s pregnancy as “high risk” because Profitt used

methadone.

At around 5:00 p.m. on January 2, Profitt arrived at the Highlands Regional Medical Center

complaining of severe abdominal pain, decreased fetal movement, and potential fluid leakage.

Two nurses, Nurse Tiffany Burke and Nurse Andrea Hopson, treated Profitt. Burke first performed

a vaginal examination on Profitt to confirm that she was not going into labor, checked the softness

of Profitt’s abdomen between contractions, and placed an external fetal monitor on Profitt to track

Corbin’s fetal heart rate. She also regularly asked Profitt about her symptoms. Burke’s notes

indicate that Profitt told Burke she had no vaginal bleeding or fluid leakage.

At 6:25 p.m., Burke called Dr. Sammie Gibson, Highlands’ on-call obstetrician, to report

Profitt’s symptoms. Gibson worked for Physicians for Women but had never met Profitt. Gibson

told Burke to continue monitoring Profitt for “a couple hours.”

At 7:00 p.m., Hopson took over monitoring Profitt. About an hour later, according to

Hopson’s notes, Profitt said she was no longer feeling any abdominal pain. Hopson called Gibson

at 9:00 p.m. and told her that Profitt’s cervix had not changed, that Corbin had a normal heart rate

(130 beats per minute), and that she had noticed no fluid leakage or blood during Profitt’s most

recent vaginal examination. Hopson also relayed that Corbin was so active that she had needed to

move the fetal monitor several times. Gibson reviewed Profitt’s fetal heart strips, which tracked

Corbin’s heart rate, from home. After speaking with Hopson, Gibson told her to discharge Profitt.

The hospital staff discharged Profitt at 9:28 p.m.

Sometime after Profitt left the hospital, she experienced a concealed placental abruption,

which occurs when the placenta separates from the uterine wall before the baby is born. Placental

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abruptions block the transportation of oxygen through the placenta, preventing the baby from

receiving oxygen.

Profitt returned to the hospital just a few hours later, at 2:32 a.m. She again complained of

abdominal pain, fluid leakage, and no fetal movement. A nurse noted that Profitt’s abdomen was

“rock hard.” At 2:53 a.m., Corbin’s heart rate was in the 90s and decelerating, which meant that

he was oxygen deprived and at risk of brain damage or death.

Hopson called Gibson at 2:58 a.m. to report Profitt’s symptoms. Gibson concluded that

Profitt was likely experiencing a placental abruption and ordered the nurses to prepare Profitt for

an emergency caesarean. Gibson also told Hopson to contact an anesthesia provider and the on-

call pediatrician. The nursing staff contacted a Certified Registered Nurse Anesthetist (CRNA),

Brenda Watson, to assist. Staff also attempted to reach the on-call anesthesiologist, Dr. Raymond

Monaco, but he did not answer the phone.

Gibson then began driving to the hospital. On the drive, she called the hospital again to

tell the staff to call Monaco; Gibson wanted both the CRNA and the anesthesiologist present for

the caesarean.

Gibson’s operating notes say that she “arrived” at approximately 3:20 a.m., though the

parties dispute whether that means she arrived at the hospital or the operating room. She ran from

the parking lot to the operating room, at which point she realized that neither Watson nor Monaco

were present. Corbin’s heart rate was 74 beats per minute when Gibson arrived—which meant

that he was suffocating and beginning to experience brain damage.

Once in the operating room, Gibson rolled Profitt on her side to find Corbin’s heart rate,

but it was no longer detectable. Gibson then rolled Profitt onto her back and told Profitt that she

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needed to perform an emergency caesarean with only local anesthesia. Profitt told Gibson to “do

whatever you have to do to save my baby.”

Gibson asked Hopson to get lidocaine, a local anesthetic. As Hopson went to remove the

lidocaine from the Pyxis machine, which stores medication, Gibson squirted antiseptic on her

hands and put on gloves and a gown. By the time Gibson stepped back to the operating table,

Hopson had retrieved the lidocaine. Gibson then injected Profitt with lidocaine and, without

waiting for it to become fully effective, began the caesarean. According to Gibson’s notes, Corbin

was delivered at approximately 3:25 a.m. Gibson said that Corbin was delivered within one minute

of starting the caesarean; Hopson said that Corbin was delivered “just a few minutes” after Gibson

arrived in the operating room.

At birth, Corbin had no heartbeat, so hospital staff immediately began chest compressions

on him. Once CRNA Watson arrived at 3:30 a.m., Gibson directed her to care for Corbin. Watson

intubated Corbin at 3:32 a.m. The pediatrician, Dr. Leslieann Dotson, arrived a few moments after

Watson arrived.

After Corbin was intubated, Watson asked if Gibson wanted Watson to give Profitt

something to “put her to s[l]eep or give her some Pitocin” (a synthetic oxytocin). Gibson said

“no.” Gibson implored the staff to once again call Monaco, the anesthesiologist on call, since

Watson was still tending to Corbin. During this conversation, Profitt was conscious and without

pain relief. Monaco finally arrived at the hospital around 4:00 a.m., at which point he administered

anesthesia and Gibson completed the caesarean.

Corbin’s doctors later determined that Corbin’s right lung had collapsed, which the

plaintiffs allege was the result of improper intubation. Corbin was airlifted to the University of

Kentucky Medical Center, where he died two days later.

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B.

In 2019, Profitt and Corbin’s father, Shawn Hill, sued the United States, alleging claims of

medical negligence under the Federally Supported Health Centers Assistance Act and the Federal

Tort Claims Act. 42 U.S.C. §§ 233, et seq.; 28 U.S.C. § 2671. Those Acts make the United States

liable for the medical negligence of its agents or employees. All parties agree that Gibson, who

received federal funding, was an agent or employee of the United States. The plaintiffs also

brought claims against the hospital and Monaco, the on-call anesthesiologist who failed to show

up until 4:00 a.m. The parties settled those claims.

At the start of litigation, the district court set a scheduling order that gave the parties a

deadline of October 1, 2019, to file any motions to join additional parties or amend the pleadings.

The parties then proceeded to discovery. The plaintiffs took ten depositions, as permitted by

Federal Rule of Civil Procedure 30, and then moved to depose two more witnesses—one of whom

was Dotson, Corbin’s pediatrician. The district court granted the plaintiffs’ motion to depose

Dotson, and the plaintiffs did so on April 8, 2021. The parties completed all fact discovery by

January 29, 2021.

On June 18, 2021—two months after Dotson’s deposition and twenty months after the

deadline for amendments—the plaintiffs moved to amend their complaint, alleging claims against

the United States based on Dotson’s alleged negligence. The district court denied the motion,

reasoning that the plaintiffs knew about Dotson’s involvement in Corbin’s care well before the

October 1, 2019 amendment deadline and thus had not been diligent in pursuing their claim.

In June 2022, the district court held a bench trial. Over the course of four days, the court

heard testimony from nine witnesses, including two expert witnesses: Dr. Ronald Jacobs for the

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plaintiffs and Dr. Mary D’Alton for the government. The district court also considered the

deposition transcripts of eleven medical providers, including two more plaintiffs’ experts.

After hearing all the evidence, the district court issued a 28-page opinion rejecting each of

the plaintiffs’ negligence claims. At the outset, the district court found that the plaintiffs’ expert,

Dr. Jacobs, had lacked “a firm understanding of the concept of the standard of care” during his

testimony and that he had sometimes conflated his personal standards with the more objective

standard of care. The district court concluded that the government’s expert, Dr. D’Alton, by

contrast, “displayed an understanding of the standard of care.”

The court next concluded that Gibson had not breached the standard of care by discharging

Profitt on January 2 without personally examining her. Specifically, the court found that Profitt’s

symptoms had resolved before Gibson discharged her; that Gibson had no reason to think Profitt

was at risk for a placental abruption; and that Profitt had not displayed any symptoms of a placental

abruption during her first visit. Next, the district court concluded that Gibson had not breached

the standard of care in performing the emergency caesarean. Specifically, the court made findings

as to the sequence of events between Gibson’s arrival and Corbin’s birth, and held that the

plaintiffs lacked evidence that Gibson had “wasted any time” in performing the procedure or

otherwise deviated from the standard of care. Finally, the district court rejected the plaintiffs’

post-trial theory that Gibson had breached the standard of care by waiting for Monaco to arrive

before administering anesthesia; to the contrary, the court found, the only person who could have

administered anesthesia—Watson—was tending to Corbin until Monaco finally arrived at 4 a.m.

This appeal followed.

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II.

A.

The plaintiffs argue that the district court should have granted them leave to amend the

complaint after the scheduling deadline expired. We review that decision for an abuse of

discretion. Leary v. Daeschner, 349 F.3d 888, 904 (6th Cir. 2003).

The district court set an October 1, 2019, deadline by which parties could move to amend

their pleadings. Profitt filed her motion to amend on June 18, 2021, “long after” that deadline,

“which means the court’s discretion to allow [the amendment] was limited by Civil Rule 16(b).”

In re Nat’l Prescription Opiate Litig., 956 F.3d 838, 843-44 (6th Cir. 2020). That rule requires

the district court to issue a scheduling order that sets a deadline for amending pleadings and thus

“ensure[s] that at some point both the parties and the pleadings will be fixed.” Leary, 349 F.3d at

906 (internal quotation marks omitted). When a party misses that deadline, the court may grant

leave to amend only if the party shows “good cause” for its failure to make the amendments before

the deadline. See Fed. R. Civ. P. 16(b)(4). That requires parties to show that “despite their

diligence they could not meet the original deadline.” Leary, 349 F.3d at 907.

Here, to show “good cause,” the plaintiffs argue that Dotson’s deposition revealed new

facts regarding her involvement in Corbin’s care, as well as evidence that Dotson breached the

standard of care. But a party cannot show diligence when it is “aware of the basis of [a] claim for

many months” and fails to pursue that claim. Id. at 908. And here the medical records—which

the plaintiffs possessed well before October 1, 2019—repeatedly identified Dotson as Corbin’s

pediatrician, attending doctor, and “infant care provider.” For example, Gibson’s notes direct the

reader to see “Dr. Dotson’s documentation concerning the infant, Apgars, resuscitation, etc.”

Corbin’s medical records, in turn, note that Dotson was intimately involved in Corbin’s care after

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she arrived at the hospital at 3:30 a.m. Staff placed Corbin’s umbilical catheter “per Dr. Dotson.”

Staff gave Corbin “epi” (epinephrine) and “NS” (saline) “per Dr. Dotson.” Corbin was placed

under a radiant warmer “per Dr. Dotson,” though the warmer was later “turned off per Dr.

[D]otson’s order.” The “STAT CXR” (chest X-Ray) to check the “placement of ET tube” was

ordered “per Dr. Dotson.” Profitt’s proposed amendments to her pleadings concern Dotson’s

“allegedly negligent supervision of Corbin’s care.” Order at 8, R. 258, PageID 3557. Given the

information plainly available in those records, she could have developed her claim against Dotson

much sooner than she did. Profitt therefore cannot show that her claim of Dotson’s negligence

“was unavailable prior to [Dotson’s] deposition.” Garza v. Lansing Sch. Dist., 972 F.3d 853, 879

(6th Cir. 2020).

The plaintiffs counter that whether Dotson deviated from the standard of care is a “complex

medical question” that a layperson could not reasonably assess “absent the assistance of a qualified

medical expert.” But most claims of medical malpractice are complicated—and Rule 16(b) applies

to them nonetheless. The plaintiffs also say that the “medical records were so vague and scarce in

details” that even their medical expert could not be certain that Dotson committed medical

malpractice before reviewing Dotson’s deposition. But pleading standards have never required

certainty on behalf of litigants. See Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). The district court

had ample grounds for its conclusion that the plaintiffs could have asserted a claim based on

Dotson’s actions before the deadline.

Nor do we have any basis to reject the court’s conclusion that an untimely amendment

would have prejudiced the defendants, given that (as the court found) the amendment would have

required “re-opening discovery” and “extensive further legal briefing.” Order at 10, R. 258,

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PageID 3559. The district court did not abuse its discretion in denying plaintiffs’ untimely motion

to amend.

B.

Despite that denial, the plaintiffs moved for partial summary judgment against the United

States based on Dotson’s alleged negligence. We review the district court’s denial of that motion

de novo. Messing v. Provident Life & Accident Ins. Co., 48 F.4th 670, 682 (6th Cir. 2022).

The plaintiffs assert that, when a defendant receives “sufficient notice and opportunity to

defend against a theory or claim not pleaded in the complaint, the theory or claim may be

considered on summary judgment.” But the United States had no opportunity to defend against

the claim regarding Dotson. Plaintiffs raised it after the close of fact discovery, denying the United

States the ability to “investigate [it] when [it] conducted its own discovery.” Tucker v. Union of

Needletrades, Indus. & Textile Emps., 407 F.3d 784, 788 (6th Cir. 2005) (cleaned up). Moreover,

though the plaintiffs say that the United States had “ample time and opportunity to retain an

opinion witness to address Dotson’s conduct,” the United States had no reason to do so—since the

court had correctly denied the plaintiffs’ motion to amend their complaint to include that claim.

The plaintiffs sought summary judgment on a claim that was not part of the case; the district court

was right to deny it.

C.

The plaintiffs also challenge certain of the district court’s findings and conclusions after its

four-day bench trial regarding their claims that Dr. Gibson was negligent. We give the district

court’s factual findings “considerable deference” and review them only for clear error. Atkins v.

Parker, 972 F.3d 734, 739 (6th Cir. 2020).

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Kentucky law governs this action. Ward v. United States, 838 F.2d 182, 184 (6th Cir.

1988). Here, under Kentucky law, the plaintiffs needed to prove (among other things) that Gibson

violated the relevant standard of care. Reams v. Stutler, 642 S.W.2d 586, 588 (Ky. 1982).

The plaintiffs first challenge the court’s conclusion that Gibson complied with the standard

of care when, on January 2, she relied on two nurses’ reports to decide whether to discharge Profitt.

The court found that Corbin’s fetal-monitoring strips—whose data Gibson reviewed from home—

were “normal” and “did not indicate any problem” that would require Gibson to go to the hospital;

that the two nurses who treated Profitt, Burke and Hopson, accurately relayed Profitt’s symptoms

and statements to Gibson; and that Profitt’s symptoms (abdominal pain and reduced fetal

movement) had resolved before Gibson discharged her.

Plaintiffs dispute none of these facts, but instead point to Jacobs’ testimony that relying on

information conveyed by “inexperienced” nurses—like, they say, Burke and Hopson—violates the

standard of care. As the district court observed, however, Jacobs “conceded that he does not

personally inquire about the experience of the nurses on a delivery team.” And D’Alton testified

that relying on a nurse’s statement for patient information does not violate the standard of care—

to the contrary, doctors do it “all the time” because nurses are their “eyes and ears.” Moreover,

the district court’s decision to credit D’Alton over Jacobs was not clearly erroneous, given that

Jacobs sometimes confused his own standards with the standard of care. As Jacobs himself

admitted, he “confused sometimes being furious with falling below the standard of care.” The

district court’s conclusion that Dr. Gibson did not violate the standard of care by relying on the

nurses’ reports is thus “plausible in light of the record viewed in its entirety.” Atkins, 972 F.3d at

739.

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The plaintiffs next challenge the court’s conclusion that Gibson complied with the standard

of care when performing Profitt’s caesarean. Both experts agreed that when dealing with an

oxygen-deprived baby like Corbin, “every second counts.” The district court, for its part, found

that Gibson pulled into the hospital parking lot and raced up two flights of steps to the operating

room, where she realized that no anesthesia provider had arrived. Gibson tried to detect Corbin’s

heartbeat but found nothing, so she told Profitt that that an emergency caesarean—without

anesthesia—was necessary. Once she obtained Profitt’s consent, she sent the nurse to get lidocaine

as Gibson washed and dressed for surgery, administered the lidocaine when the nurse returned,

and immediately proceeded with the emergency caesarean. Thus, the court concluded, Gibson had

not “wasted any time” before completing the caesarean.

The plaintiffs contend that Gibson wasted five minutes waiting for an anesthesia provider.

As evidence, they point to an order log for the lidocaine, which they say shows that Gibson did

not order lidocaine until 3:25 a.m. (after arriving at 3:20 a.m.). But the district court found that

Gibson was busily engaged in an unbroken “sequence” of specific events from the time of her

arrival in the “OR” to Corbin’s delivery minutes later. Moreover, nearly all relevant evidence

indicates that Corbin was delivered at approximately 3:25 a.m., a “few minutes” after Gibson

arrived at the hospital.

The plaintiffs likewise contend that Gibson should not have taken time to administer

lidocaine to Profitt before the caesarean. But Jacobs (the plaintiffs’ expert) testified that he had

never performed a caesarean without anesthesia and that doing so would increase the time the

procedure takes. The district court did not clearly err in finding that Dr. Gibson wasted no time in

performing the caesarean.

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Finally, the plaintiffs challenge the district court’s finding that Gibson provided Profitt with

pain relief as soon as Gibson was able to do so. Specifically, the court found that Gibson repeatedly

tried to summon Dr. Monaco before and after the caesarean. Moreover, the court found, the record

was “clear that Dr. Gibson observed that CRNA Watson was attending to Corbin after his birth

until the arrival of Dr. Monaco.” True, Watson testified in her deposition that she had offered to

administer anesthesia to Profitt after Corbin was delivered. But we have no basis to reject the

district court’s conclusion that “Dr. Gibson needed to prioritize the resuscitation of Corbin.”

Dr. Gibson, Correnia Profitt, and Corbin alike were dealt a dreadful hand in the OR during

the early morning of January 3, 2017. The district court concluded that the plaintiffs had not

proved that Gibson violated the standard of care in addressing that situation. We have no lawful

basis to set aside that conclusion.

* * *

The district court’s judgment is affirmed.

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THAPAR, Circuit Judge, concurring. I agree with the majority’s thoughtful opinion. I

write separately to flag a Seventh Amendment concern that I’ve raised elsewhere. See Bray v. Bon

Secours Mercy Health, Inc., 97 F.4th 403, 418–21 (6th Cir. 2024) (Thapar, J., concurring).

Correnia Profitt originally sued private doctors and health centers in state court. There, she

had a right to try her medical-malpractice suit in front of a Kentucky jury. See Ky. Const. § 7.

And the Seventh Amendment ensured that her jury-trial right remained intact when Highlands

removed her case to federal court. U.S. Const. amend. VII. Yet Profitt received a bench trial.

Why? Because the U.S. government substituted itself as the defendant under the Federally

Supported Health Centers Assistance Act (FSHCAA) and the Federal Tort Claims Act (FTCA).

Together, these statutes preclude jury trials and prevent Profitt from seeking remedies against the

private parties she initially sued. See 42 U.S.C. § 233(a); 28 U.S.C. §§ 2402, 2679(b)(1).

How can this be squared with the Seventh Amendment? Historically, the answer was

sovereign immunity. See McElrath v. United States, 102 U.S. 426, 440 (1880); Wilson v. Big

Sandy Health Care, Inc., 576 F.3d 329, 333 (6th Cir. 2009). After all, a plaintiff had no right to

sue the government. Thus, she isn’t guaranteed a jury trial when the government consents to being

sued. See Lehman v. Nakshian, 453 U.S. 156, 161 (1981). This makes sense when you have a

government agent—like a VA doctor—who is clearly from the government. But here, Profitt went

to a private hospital to see a private doctor. Absent FSHCAA’s unique statutory scheme, the

doctor wouldn’t be considered a government employee, so Profitt would have a right to try her

medical-malpractice case before a jury.

The Supreme Court recently reminded us that when it comes to the Seventh Amendment,

“what matters is the substance of the suit, not where it is brought, who brings it, or how it is

labeled.” SEC v. Jarkesy, 144 S. Ct. 2117, 2136 (2024). The Seventh Amendment applies to all

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claims that are “legal in nature.” Granfinanciera, S.A. v. Nordberg, 492 U.S. 33, 53 (1989); see

Jarkesy, 144 S. Ct. at 2128 (“The Amendment . . . embraces all suits which are not of equity or

admiralty jurisdiction.”) (quoting Parsons v. Bedford, Breedlove & Robeson, 28 U.S. 433, 447

(1830)). The cause of action’s nature and remedy determine whether a suit is legal in nature, and

thus, whether the jury trial right attaches. See Jarkesy, 144 S. Ct. at 2129. That means litigants

bringing claims that resemble common-law actions and seeking legal remedies are entitled to a

jury.

Under Jarkesy’s framework, it looks like the Seventh Amendment should apply here.

Profitt’s tort claims are the paradigmatic example of a “Suit at common law.” U.S. Const. amend.

VII. The FSHCAA and FTCA don’t create public rights—the acts don’t fashion “a new cause of

action . . . unknown to the common law.” Id. at 2137 (quoting Atlas Roofing Co., Inc. v.

Occupational Safety & Health Rev. Comm’n, 430 U.S. 442, 461 (1977)). Rather, the FTCA

expressly “borrow[s] its cause of action” from Kentucky’s medical-malpractice law. Id.; 28 U.S.C.

§ 1346(b)(1). And the founding generation litigated medical malpractice in common-law courts

before a jury. Bray, 97 F.4th at 421 (Thapar, J., concurring); see, e.g., Cross v. Guthery, 2 Root

90, 91 (Conn. Super. Ct. 1794). Moreover, Profitt seeks money damages, the “prototypical

common law remedy.” Jarkesy, 144 S. Ct. at 2129; see also Wooddell v. Int’l Bhd. of Elec.

Workers, Loc. 71, 502 U.S. 93, 98-99 (1991) (“A personal injury action is of course a prototypical

example of an action at law, to which the Seventh Amendment applies.”). Yet the FTCA denied

Profitt a jury trial.

The plaintiffs didn’t raise this issue, so we need not resolve it today. But the FSHCAA and

FTCA pose grave Seventh Amendment issues. “The Constitution deals with substance, not

shadows.” Cummings v. Missouri, 71 U.S. (4. Wall) 277, 325 (1867). And Jarkesy instructed us

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to look at the substance of the claims, not who’s on either side of the “v.,” to determine whether

the Seventh Amendment applies. Although Profitt is suing the government, the substance of her

claim is Kentucky medical-malpractice law. Future plaintiffs would be wise to raise their Seventh

Amendment rights.

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/10494390. Public record. Not legal advice.
