Health Law Daily Wrap Up, HIPAA—N.D. Tex.: Court rejects hospital’s request for stay in dispute over subpoena seeking records of gender-affirming care, (May 12, 2026)

By Sheila Lynch-Afryl, J.D., M.A.

Rhode Island Hospital argued that venue is improper and the court’s refusal to give the hospital an opportunity to respond was reversible error.

A federal court refused to stay pending appeal its order enforcing an administrative subpoena served on Rhode Island Hospital that sought records related to youth gender-affirming care. The court found that the hospital did not make a strong showing of likely success on the merits, despite issuing the order without a response from the hospital, because over the previous 10 months the hospital “proffered no reason for its noncompliance with the subpoena.” However, the Fifth Circuit is almost certain to quickly weigh in, as the May 14 compliance date only days away and the hospital also requested a stay pending appeal from that court (In the Matter of Administrative Subpoena 25-1431-032, No. 4:26-MC-0006-O (N.D. Tex. May 10, 2026)).

On April 30, the Department of Justice (DOJ) filed a motion for enforcement of subpoena served on Rhode Island Hospital. The motion alleged that the hospital had not complied with a HIPAA administrative subpoena served July 3, 2025, with a return date of August 7, that sought to investigate potential “misbranding” of drugs under the Food, Drug, & Cosmetic Act—specifically, the use of certain drugs to treat gender dysphoria when the FDA did not approve them for such uses. The same day, the Northern District of Texas ordered Rhode Island Hospital to comply with the subpoena by May 14.

Rhode Island Hospital filed an emergency motion for stay pending appeal on May 6 arguing that: (1) the court’s refusal to give the hospital an opportunity to respond was reversible error; (2) venue is improper because “neither the Government’s petition nor its accompanying exhibits identify any nexus between its investigation” and the Northern District of Texas; and (3) the “government lacks authority to regulate the practice of medicine, including a physician’s off-label prescription of drugs.”

The district court, denying the motion, concluded that the hospital failed to demonstrate a strong likelihood of success on the merits. A response to the petition would not have affected the outcome due to the hospital’s “long-term non-compliance with the subpoena and the arguments in opposition that have been made to other district courts.” As for irreparable harm, “the subpoena requires production of nonprivileged, pre-existing business records of a large, closely regulated healthcare provider.” In addition, the hospital failed to show that the disclosure of patient records would irreparably harm the hospital’s patients and its relationship with its patients since the patients are third parties.

The hospital appealed the April 30 order to the Fifth Circuit (No. 26-10431). On May 9, the hospital filed a motion for stay pending appeal arguing that it “cannot fully comply” with the subpoena by May 14, “nor should it have to, when the subpoena is faulty and the Order likely to be overturned on appeal.” The Fifth Circuit ordered the DOJ to respond by noon on May 12.

The case is No. 4:26-MC-0006-O.

Attorneys: Patrick Raymond Runkle, U.S. Department of Justice, for the U.S. Mindy Sauter (McGuireWoods LLP) for Rhode Island Hospital.

Companies: Rhode Island Hospital

MainStory: CaseDecisions FDCActNews DrugBiologicNews EHRNews GCNNews GeneralNews HealthReformNews HIPAANews PrescriptionDrugNews ReproductiveHealthCareNews RhodeIslandNews TexasNews