Court Opinion

ID: 9946281
Source: CourtListenerOpinion
Date Created: 2024-02-29 17:00:44.951674+00
Date Added: 2024-06-11T14:25:38.539797
License: Public Domain

FOR PUBLICATION

   UNITED STATES COURT OF APPEALS
        FOR THE NINTH CIRCUIT

MARK MCDONALD; JEFF BARKE,              No. 22-56220

              Plaintiffs-Appellants,       D.C. No.
                                        8:22-cv-01805-
 v.                                       FWS-ADS

KRISTINA D. LAWSON, in her
official capacity as President of the     OPINION
Medical Board of California; RANDY
W. HAWKINS, in his official capacity
as Vice President of the Medical
Board of California; LAURIE ROSE
LUBIANO, in her official capacity as
Secretary of the Medical Board of
California; MICHELLE ANNE
BHOLAT; DAVID E. RYU; RYAN
BROOKS; JAMES M. HEALZER;
ASIF MAHMOOD; NICOLE A.
JEONG; RICHARD E. THORP;
VELING TSAI; ESERICK
WATKINS, in their official capacities
as members of the Medical Board of
California; ROB BONTA, in his
official capacity at Attorney General
of California,

              Defendants-Appellees.
2                    MCDONALD V. LAWSON

         Appeal from the United States District Court
             for the Central District of California
         Fred W. Slaughter, District Judge, Presiding

MICHAEL COURIS; MICHAEL                      No. 23-55069
FITZGIBBONS,
                                                D.C. No.
                Plaintiffs-Appellants,       3:22-cv-01922-
                                                RSH-JLB
    v.

KRISTINA D. LAWSON, in her
official capacity as President of the
Medical Board of California;
WILLIAM J. PRASIFKA, in his
official capacity as Executive Director
of the Medical Board of California;
ROB BONTA, in his official capacity
as Attorney General of California,

                Defendants-Appellees.

         Appeal from the United States District Court
            for the Southern District of California
         Robert Steven Huie, District Judge, Presiding

             Argued and Submitted July 17, 2023
                    Pasadena, California

                   Filed February 29, 2024
                       MCDONALD V. LAWSON                           3

     Before: A. Wallace Tashima and Danielle J. Forrest,
     Circuit Judges, and Kathleen Cardone,* District Judge.

                    Opinion by Judge Forrest

                          SUMMARY**

                     COVID-19 /Mootness

    The panel vacated the district court’s judgment and
remanded with instructions to dismiss as moot two cases
brought by doctors who challenged California’s now
repealed Assembly Bill 2098, which made it “unprofessional
conduct” for a doctor to provide COVID-19-related
“disinformation” or “misinformation” to patients.
    The panel held that California’s repeal of AB 2098
triggers the presumption of mootness. Plaintiffs did not
contend that “there is a reasonable expectation” that
California will reenact AB 2098 or similar legislation, nor
did plaintiffs point to anything in the record so indicating.
AB 2098 was enacted in response to the COVID-19
pandemic, which is not a routine occurrence that is
reasonably likely to reoccur. While it may be reasonably
likely, as a general matter, that future pandemics may occur,

*
 The Honorable Kathleen Cardone, United States District Judge for the
Western District of Texas, sitting by designation.
**
  This summary constitutes no part of the opinion of the court. It has
been prepared by court staff for the convenience of the reader.
4                   MCDONALD V. LAWSON

this alone is insufficient to overcome the presumption of
mootness.
    Because there is no indication that California is
reasonably likely to reenact AB 2098 or anything
substantially similar to it, and because the possibility of
California enforcing AB 2098 following its repeal is at best
“remote,” there was no longer an ongoing case or
controversy to resolve. Accordingly, the panel vacated the
district court’s judgment and remanded with instructions for
the district court to dismiss the two cases as moot.

                        COUNSEL

Adam E. Schulman (argued) and Theodore H. Frank,
Hamilton Lincoln Law Institute, Washington, D.C.; Neville
Hedley, Hamilton Lincoln Law Institute, Chicago, Illinois;
Jacob H. Huebert (argued), Daniel R. Suhr, and Reilly
Stephens, Liberty Justice Center, Chicago, Illinois; Mariah
Gondeiro, Julianne E. Fleischer, and Robert H. Tyler,
Advocates for Faith & Freedom, Murrieta, California; for
Plaintiffs-Appellants.
Kristin Liska (argued) and Christina S. Goot, Deputy
Attorneys General; Edward Kim and Anya M. Binsacca,
Supervising Deputy Attorneys General; Gloria L. Castro and
Thomas S. Patterson, Senior Assistant Attorneys General;
Rob Bonta, Attorney General of California; Office of the
Attorney General, San Francisco, California; for
Defendants-Appellees.
Paul M. Sherman, Institute for Justice, Arlington, Virginia;
Paul Avelar, Institute for Justice, Tempe, Arizona; for Amici
Curiae Institute for Justice.
                     MCDONALD V. LAWSON                       5

John Kappos, O’Melveny & Meyers LLP, Dallas, Texas;
Laura K. Kaufmann, O’Melveny & Meyers LLP, Los
Angeles, California; Kevin Díaz, Compassion & Choices,
Portland, Oregon; for Amici Curiae Compassion & Choices.
Hannah M. Kieschnick, Shilpi Agarwal, Angélica Salceda,
and Chessie Thacher, American Civil Liberties Union
Foundation of Northern California, San Francisco,
California; Peter Eliasberg and Melissa Goodman, American
Civil Liberties Union Foundation of Southern California,
Los Angeles, California; for Amici Curiae ACLU of
Northern California and ACLU of Southern California.
Jenin Younes, Gregory Dolin MD, and Mark Chenoweth,
New Civil Liberties Alliance, Washington, D.C.; for Amici
Curiae New Civil Liberties Alliance.

                          OPINION

FORREST, Circuit Judge:

    In the wake of the COVID-19 pandemic, California
enacted Assembly Bill 2098 (AB 2098).1 AB 2098 made it
“unprofessional conduct” for a doctor to provide COVID-
19-related “disinformation” or “misinformation” to patients.
Several doctors challenged the law as an unconstitutional
restriction of speech and unconstitutionally vague, including
the plaintiffs in these consolidated appeals.
  In McDonald v. Lawson, No. 22-56220, Mark
McDonald, M.D. and Jeff Barke, M.D. sued numerous

1
 AB 2098 was codified as Cal. Bus. & Prof. Code § 2270 (repealed
2024).
6                    MCDONALD V. LAWSON

California officials and sought to enjoin AB 2098. The
district court denied a preliminary injunction, holding that
AB 2098 was neither an unconstitutional restraint on speech
nor impermissibly vague. Drs. McDonald and Barke timely
appealed. In Couris v. Lawson, No. 22-55069, Michael
Couris, M.D. and Michael Fitzgibbons, M.D. separately
sued various California officials and also sought an
injunction, but the district court stayed their case pending our
decision in McDonald. Drs. Couris and Fitzgibbons timely
appealed, and we consolidated the two appeals.
    Because California repealed AB 2098 while these
appeals were pending and presented evidence that it would
not enforce any violations that occurred when AB 2098 was
in effect, we vacate the judgments below and remand with
instructions to dismiss the cases as moot. United States v.
Munsingwear, Inc., 340 U.S. 36, 39 (1950).
                    I. BACKGROUND
                      A. The Plaintiffs
    Dr. McDonald is a licensed psychiatrist practicing in Los
Angeles, California who has counseled patients on a range
of mental health issues stemming from COVID-19. His
patients have asked him about various COVID-19 related
topics such as masking, vaccines, and government
shutdowns. Responding to these questions, Dr. McDonald
has shared information that “undermines the government’s
preferred position,” such as questioning the efficacy of
masks, expressing disagreement with shut-down policies,
and sharing information critical of the COVID-19 vaccines.
Dr. McDonald is concerned that his medical license is in
jeopardy because of AB 2098’s vague restrictions.
                    MCDONALD V. LAWSON                     7

    Dr. Barke is a licensed physician who operates a
concierge practice in Newport Beach, California. He has
treated hundreds of patients with COVID-19 using a wide
range of treatment protocols. He has also provided
information to patients questioning the efficacy of masking
and has discussed natural immunity as an alternative to
COVID-19 vaccines and booster shots. Dr. Barke is
concerned about AB 2098’s vague standard and fears that
the law jeopardizes his medical license because “the medical
advice [he] give[s] has been contrary to the government’s
version of the scientific consensus.”
    Dr. Couris is an ophthalmologist based in San Diego,
California. Many of his patients have asked him about
COVID-19, and he has provided advice to those patients. He
typically advises that older patients and those with risk
factors such as obesity, diabetes, or asthma should get
vaccinated, but that in doing so they should opt for the
Novavax vaccine. He also generally advises patients that
young children should not get the mRNA vaccines. Dr.
Couris is concerned that this type of advice and counsel
could cause him to be disciplined under AB 2098.
    Dr. Fitzgibbons is a board-certified physician practicing
in Santa Ana, California. Between 2020 and 2022, he
personally treated around 1,000 patients diagnosed with
COVID-19. In doing so, he informed patients about his
beliefs regarding the origin of the COVID-19 virus and has
advised      patients     regarding      (and     prescribed)
hydroxychloroquine, azithromycin, and ivermectin. He also
advises patients regarding vaccination for COVID-19. While
he advises some patients to get vaccinated, he counsels
others—such as children and those that have previously
contracted COVID-19—against the shots. Dr. Fitzgibbons
8                   MCDONALD V. LAWSON

fears that he will be disciplined under AB 2098 for
continuing to provide similar advice.
    Although Drs. McDonald, Barke, Couris, and
Fitzgibbons (Plaintiffs) all express concern about the
possibility of professional discipline, they have not been
subject to disciplinary action by the Medical Board of
California (Medical Board) for violating AB 2098.
                        B. AB 2098
    The Medical Board, headed by defendant Kristina
Lawson, supervises the medical profession in California by
issuing licenses, reviewing the quality of medical practice
carried out by physicians and surgeons, approving medical-
evaluation programs, and administering the continuing-
medical-education program. See Cal. Bus. & Prof. Code
§ 2234. As part of this responsibility, the Medical Board has
a duty to “take action against any licensee who is charged
with unprofessional conduct,” which includes gross
negligence, repeated negligent acts, incompetence,
dishonesty, and corruption. See Cal. Bus. & Prof. Code
§ 2234. California’s Business and Professions Code
identifies a wide array of activities that the California
legislature has determined constitute unprofessional conduct
and can lead to professional discipline. See Cal. Bus. & Prof.
Code § 2243.
   Frustrated by what it saw as an “amplification of
misinformation and disinformation related to the COVID-19
pandemic” by licensed medical providers who hold a high
degree of public trust, the California Medical Association
sponsored a bill aimed at ensuring medical professionals
were “held accountable for the information they spread.”
The California Assembly’s Business and Professions
Committee report on this legislative proposal noted that an
                    MCDONALD V. LAWSON                     9

“extreme minority” of health professionals’ “legitimiz[ation
of] false information during the COVID-19 pandemic has
presented serious implications for public safety.” Notably,
the report identified a licensed physician who had publicly
promoted hydroxychloroquine as a COVID-19 treatment
and engaged in public campaigns “stok[ing] public distrust
in COVID-19 vaccines” as “an illustrative example of the
type of behavior that the author of this bill” wanted to
address.
    In the Fall of 2022, after some revisions narrowing its
scope, the legislature passed, and Governor Newsom signed
into law, AB 2098. As codified, the law provided, in relevant
part:

       (a) It shall constitute unprofessional conduct
       for a physician and surgeon to disseminate
       misinformation or disinformation related to
       COVID-19, including false or misleading
       information regarding the nature and risks of
       the virus, its prevention and treatment; and
       the development, safety, and effectiveness of
       COVID-19 vaccines.
       (b) For purposes of this section, the following
       definitions shall apply:
       ...
               (2)     “Disinformation”      means
       misinformation that the licensee deliberately
       disseminated with malicious intent or an
       intent to mislead.
             (3) “Disseminate” means the
       conveyance of information from the licensee
10                    MCDONALD V. LAWSON

        to a patient under the licensee’s case in the
        form of treatment or advice.
                (4) “Misinformation” means false
        information that is contradicted by
        contemporary scientific consensus contrary
        to the standard of care.

Cal. Bus. & Prof. Code § 2270 (repealed 2024) (emphases
added). The legislative findings in the bill noted: the severe
loss of life caused by COVID-19; the increased risk of death
associated with COVID-19 for those who are not fully
vaccinated; the safety and efficacy of COVID-19 vaccines
that were developed; that misinformation about these
vaccines had weakened public confidence and placed lives
at risk; and that media had reported that some of the most
dangerous propagators of inaccurate information regarding
COVID-19 vaccines are licensed health-care professionals.
See A.B. 2098 2021–2022 Reg. Sess. § 1(a)–(e) (Cal. 2022).
                           C. SB 815
    In September 2023, the California Legislature passed
Senate Bill 815, enacted as 2023 Cal. Stat., ch. 294 (SB 815),
which repeals AB 2098. See S.B. 815 2023 –2024 Reg. Sess.
§ 19 (Cal. 2023). Governor Newsom signed SB 815 on
September 30, 2023, and it took effect on January 1, 2024.
See Cal. Const. art. IV, § 8(c)(1).
                       II. DISCUSSION
    We requested supplemental briefing from the parties on
the impact of SB 815 on this appeal.2 After considering the
parties’ arguments, we conclude that “there is no longer a

2
 SB 815 was enacted and became effective after oral argument in this
case.
                     MCDONALD V. LAWSON                      11

possibility that [Plaintiffs] can obtain relief for [their]
claim[s]” and their claims are, therefore, moot. MetroPCS
Cal., LLC v. Picker, 970 F.3d 1106, 1116 (9th Cir. 2020)
(quoting Foster v. Carson, 347 F.3d 742, 745 (9th Cir.
2003)).
    We have a duty to determine our jurisdiction at all stages
of a case. See Moore v. Harper, 600 U.S. 1, 14 (2023); see
also Native Vill. of Nuiqsut v. Bureau of Land Mgmt., 9 F.4th
1201, 1210 (9th Cir. 2021) (“[O]ur duty to examine
mootness is an ongoing obligation.”). We “have no
jurisdiction to hear a case that is moot.” MetroPCS, 970 F.3d
at 1115–16 (citation omitted). “[C]hanging circumstances”
can render a case moot. ACLU of Nev. v. Lomax, 471 F.3d
1010, 1016 (9th Cir. 2006) (quoting Clark v. City of
Lakewood, 259 F.3d 996, 1006 (9th Cir. 2001)). Relevant
here, a “repeal, amendment, or expiration of legislation”
gives rise to “a presumption that the action is moot, unless
there is a reasonable expectation that the legislative body is
likely to enact the same or substantially similar legislation in
the future.” Bd. of Trs. of Glazing Health & Welfare Tr. v.
Chambers, 941 F.3d 1195, 1197 (9th Cir. 2019) (en banc);
see also New York State Rifle & Pistol Ass’n v. City of New
York, 140 S. Ct. 1525, 1526 (2020) (per curiam) (holding
that claims seeking “declaratory and injunctive relief against
enforcement” of New York City rule were moot after the rule
was amended); Bunker Ltd. P’ship v. United States, 820 F.2d
308, 312 (9th Cir. 1987) (“Where new legislation represents
a complete substitution for the law as it existed at the time
of a district court’s decision, arguments based upon the
superseded part are moot.”). A reasonable expectation of the
same or similar legislation being re-adopted “must be
founded in the record.” Glazing Health, 941 F.3d at 1199.
12                   MCDONALD V. LAWSON

    While a private party’s voluntary cessation of challenged
conduct “ordinarily does not suffice to moot a case” because
the defendant may be “free to return to his old ways” and
resume the conduct, see Friends of the Earth, Inc. v. Laidlaw
Env't Servs. (TOC), Inc., 528 U.S. 167, 174, 189 (2000)
(citation omitted), “we treat the voluntary cessation of
challenged conduct by government officials ‘with more
solicitude.’” Glazing Health, 941 F.3d at 1198 (quoting Am.
Cargo Transp., Inc. v. United States, 625 F.3d 1176, 1180
(9th Cir. 2010)); see also Southcentral Found. v. Alaska
Native Tribal Health Consortium, 983 F.3d 411, 419 (9th
Cir. 2020) (“[T]he voluntary cessation of challenged acts by
a private party is not entitled to the presumption of good faith
enjoyed by legislative bodies when they repeal or amend a
challenged legislative provision.”).
    Here, California’s repeal of AB 2098 triggers the
presumption of mootness. Plaintiffs do not contend that
“there is a reasonable expectation” that California “will
reenact [AB 2098] or [legislation] similar to it,” nor do they
point to anything in the record so indicating. Glazing Health,
941 F.3d at 1199. SB 815 passed with overwhelming
support. And AB 2098 was enacted in response to the
COVID-19 pandemic, which is not a routine occurrence that
we can assume is reasonably likely to reoccur. While it may
be reasonably likely, as a general matter, that future
pandemics may occur, this alone is insufficient to overcome
the presumption of mootness.
    Plaintiffs argue that this appeal is not moot because they
face the possibility of being disciplined for violations that
occurred while AB 2098 was in effect. If true, this could
defeat a finding of mootness. See MetroPCS, 970 F.3d at
1117 (concluding the “possibility that the [government
entity] will bring an enforcement action against
                     MCDONALD V. LAWSON                       13

[Plaintiffs] . . . means there is still a live controversy”). But
evidence submitted by California undermines Plaintiffs’
argument.
    We can, and, in some cases, must consider extra-record
evidence “when developments render a controversy moot
and thus divest us of jurisdiction.” Lowry v. Barnhart, 329
F.3d 1019, 1024 (9th Cir. 2003); see also Fellowship of
Christian Athletes v. San Jose Unified Sch. Dist. Bd. of
Educ., 82 F.4th 664, 681 (9th Cir. 2023) (en banc) (“Due to
the nature of the mootness inquiry, unlike standing, we must
consider factual developments that occurred after the suit
was filed.”). As part of California’s response addressing the
impact of SB 815, the Executive Director of the Medical
Board stated under penalty of perjury that, due to the
legislative repeal, the Medical Board’s “employees and
agents, including investigators . . . have been instructed not
to enforce [AB 2098]” through the repeal effective date and
that after AB 2098 is no longer in effect, “the Medical Board
will have no legal authority to enforce [AB 2098].”
    There is nothing in the record that contradicts the
Executive Director’s statement or otherwise indicates that it
was made in bad faith. See Am. Cargo Transp., 625 F.3d at
1180. Moreover, the Executive Director’s sworn statement
was made in the context of litigation, and, consequently, the
Medical Board may be judicially estopped from assuming a
contradictory position on enforcement or pursuing legal
action against Plaintiffs at a later date. See Bock v.
Washington, 33 F.4th 1139, 1145 (9th Cir. 2022) (citing New
Hampshire v. Maine, 532 U.S. 742, 749 (2001)); see also
Hamilton v. State Farm Fire & Cas. Co., 270 F.3d 778, 783
(9th Cir. 2001) (“The application of judicial estoppel is not
limited to bar the assertion of inconsistent positions in the
14                   MCDONALD V. LAWSON

same litigation, but is also appropriate to bar litigants from
making incompatible statements in two different cases.”).
                           *****
    Because there is no indication that California is
reasonably likely to reenact AB 2098 or anything
substantially similar to it, and because the possibility of
California enforcing AB 2098 following its repeal is at best
“remote,” Decker v. Nw. Envt’l Def. Ctr., 568 U.S. 597, 610
(2013), there is no longer an ongoing case or controversy for
us to resolve. See City & County of San Francisco v.
Garland, 42 F.4th 1078, 1087 (9th Cir. 2022); see also Pitts
v. Terrible Herbst, Inc., 653 F.3d 1081, 1086–87 (9th Cir.
2011). Accordingly, we vacate the district court’s judgment
and remand with instructions for the district court to dismiss
Case Nos. 8:22-cv-01085 FWS-ADS and 3:22-cv-01922
RSH-JLB as moot. Munsingwear, 340 U.S. at 39.
     VACATED AND REMANDED.
     Each party shall bear its own costs on appeal.