Theresa McKenney, Shirley Patterson, and the National Federation of the Blind, Inc. v. Exact Care Pharmacy, LLC

CourtDistrict Court, N.D. Ohio
DecidedNovember 26, 2025
Docket1:23-cv-02360
StatusUnknown

This text of Theresa McKenney, Shirley Patterson, and the National Federation of the Blind, Inc. v. Exact Care Pharmacy, LLC (Theresa McKenney, Shirley Patterson, and the National Federation of the Blind, Inc. v. Exact Care Pharmacy, LLC) is published on Counsel Stack Legal Research, covering District Court, N.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Theresa McKenney, Shirley Patterson, and the National Federation of the Blind, Inc. v. Exact Care Pharmacy, LLC, (N.D. Ohio 2025).

Opinion

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF OHIO EASTERN DIVISION

THERESA MCKENNEY, et al., ) Case No. 1:23-cv-2360 ) Plaintiffs, ) Judge J. Philip Calabrese ) v. ) Magistrate Judge ) Jonathan D. Greenberg EXACT CARE PHARMACY, LLC, ) ) Defendant. ) )

OPINION AND ORDER Plaintiffs Theresa McKenney, Shirley Patterson, and the National Federation of the Blind, Inc., bring this action against Exact Care Pharmacy, LLC, which ships prescription medications to patient’s homes, for allegedly denying blind individuals an equal opportunity to access its services, in violation of the Rehabilitation Act, the Patient Protection and Affordable Care Act, and State law. Since the outset of the case, the Court has questioned whether the National Federation of the Blind has standing. The parties have briefed that issue and provided supplemental briefs in response to a recent Sixth Circuit decision. In their briefs, the parties go beyond the standing of the National Federation of the Blind. In this ruling, the Court addresses each standing issue that the parties raise. STATEMENT OF RELEVANT FACTS At this stage of the proceedings, where the parties are engaged in ongoing discovery, the record contains the following facts. A. Exact Care Pharmacy Exact Care Pharmacy is a mail-order pharmacy that claims to offer patients a more convenient and safer way to access their medication, particularly those that

take multiple medications a day and have multiple providers. (ECF No. 30, ¶ 13, PageID #306.) Exact Care takes all the medications a patient is prescribed and packages them in what it calls the “ExactPack.” (Id.) The ExactPack is a 30-day supply of a patient’s medication sorted into individual, tear-away packets based on the day and time for a patient to take the medications as prescribed. (Id.) The tear-away packets are then connected on a roll to allow the patient to tear off the packet when they need to take their medication. (Id.) The individual packets of

medicine contain all pertinent information, including: [T]he name, strength, and dosage for each medication in the packet, the day and time the medicine should be consumed (e.g., ‘Friday Morning’), the number of each type of pull in the packet, description of each medication (which may include the color, shape, and what is printed on the pill), and the number of packets for this day and time of day (i.e., whether that packet is ‘1/1’ or ‘1/2’ for ‘Friday Morning’). (Id., ¶ 14, PageID #306.) B. Plaintiffs Theresa McKenney and Shirley Patterson Plaintiffs Theresa McKenney and Shirley Patterson are both older blind women who previously used Exact Care to receive their medications. (ECF No. 30, ¶¶ 8–9, PageID #304.) Ms. McKenney was an Exact Care patient until April 2023 (id., ¶ 8, PageID #304), and Ms. Patterson was a patient until 2022 at the latest (id., ¶ 9, PageID #304). Ms. McKenney and Ms. Patterson chose to use Exact Care over traditional brick-and-mortar pharmacies because they believed that it would be more convenient. (Id., ¶¶ 21–22, 57 & 60, PageID #308 & 315–16.) They did so after meeting with an Exact Care representative who assured them Exact Care would be just as reliable as traditional pharmacies but more convenient. (Id., ¶¶ 20–21, 57 &

60, PageID #307–08 & 315–16.) Ms. McKenney and Ms. Patterson preferred Exact Care because they would no longer have to rely on family members to help get their medications from the pharmacy and could receive them by mail instead. (Id.) After switching to Exact Care, Ms. McKenney and Ms. Patterson began encountering difficulties obtaining information about their medications in an alternative format to normal, standard print documents. (Id., ¶¶ 24–40 & 62–68,

PageID #308–12 & 316–317.) They requested alternative formats for information on their medications due to their visual impairments and blindness. (Id.) Ms. McKenney requested that Exact Care put “ScripTalk” labels on her medication which read aloud a blind patient’s medicine information when scanned on the patient’s home “station reader.” (Id., ¶¶ 26–28, PageID #309–10.) Ms. Patterson also requested “ScripTalk” or a similar technology be provided with her medicine information in a large print. (Id., ¶¶ 63–64, PageID #316–17.) Exact Care never

provided Ms. McKenney or Ms. Patterson with the requested or similar accommodations. (Id., ¶¶ 24–40 & 62–68, PageID #308–10 & 316–17.) As a result of not having access to the information about their medication, Ms. McKenney and Ms. Patterson each allegedly suffered injury. (Id.) The second amended complaint alleges that Ms. McKenney took double her prescribed dose of medication for months that resulted in kidney damage and nerve damage in her feet (id., ¶¶ 35–37, PageID #311–12), and Ms. Patterson suffered from congestive heart failure, shortness of breath, leg swelling, and hair loss (id., ¶¶ 69–72, PageID #317–19).

C. National Federation of the Blind Throughout their time with Exact Care and to this day, Ms. McKenney and Ms. Patterson have been members of the National Federation of the Blind. NFB is the “oldest and largest national organization of blind persons.” (Id., ¶10, PageID #304.) Currently, NFB has approximately 50,000 members. (Id.) Many of whom, including Ms. McKenney and Ms. Patterson, rely on Exact Care for their pharmaceutical needs and often require access to their medical information in an

alternative format. (Id., ¶11, PageID #305.) NFB’s “ultimate purpose” is the “complete integration of the blind into society on a basis of equality.” (Id.) NFB does this by working “to ensure that the blind have an equal opportunity to access information related to their health care” and that blind patients are provided access through the use of applicable technology. (Id.) STATEMENT OF THE CASE

In the second amended complaint, Plaintiffs bring three claims. In Count I, Ms. McKenney and NFB allege a violation of Section 504 of the Rehabilitation Act. (Id., PageID #321.) In Count II, all three Plaintiffs allege a violation of Section 1557 of the Patient Protection and Affordable Care Act. (Id., PageID #324.) Ms. McKenney and Ms. Patterson bring a negligence claim against Exact Care in Count III. (Id., PageID #328.) At the initial case management conference, the Court questioned whether the National Federation of the Blind has standing. At the time, the complaint brought the negligence claim in Count III on behalf of NFB as well. (See ECF No. 1, PageID

#27.) But the core of the Court’s concern and the parties’ discussion at that time involved associational standing more broadly. Eventually, the Court ordered briefing on NFB’s standing. (ECF No. 19.) That order led to the filing of the second amended complaint, which amended the parties bringing Count III, the negligence claim. After the decision in Dayton Area Chamber of Commerce v. Kennedy, 147 F.4th 626 (6th Cir. 2025), the Court ordered supplemental briefing on the question of

standing. (ECF No. 33; ECF No. 48.) That briefing addresses the standing of the National Federation of the Blind. In addition, Defendant argues that Ms. McKenney and Ms. Patterson do not have standing to seek injunctive and declaratory relief, necessitating a determination that NFB lacks standing as well. (ECF No. 53, PageID #506–11.) Accordingly, the Court addresses the individual standing of Ms. McKenney and Ms. Patterson to pursue injunctive relief before turning to the issue of NFB’s associational standing.

ANALYSIS Standing presents a “threshold determinant[] of the propriety of judicial intervention.” Warth v. Seldin, 422 U.S. 490, 517–18 (1975). “Standing is an essential and unchanging part of the case-or-controversy requirement of Article III.” Lujan v. Defenders of Wildlife, 504 U.S. 555

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Theresa McKenney, Shirley Patterson, and the National Federation of the Blind, Inc. v. Exact Care Pharmacy, LLC, Counsel Stack Legal Research, https://law.counselstack.com/opinion/theresa-mckenney-shirley-patterson-and-the-national-federation-of-the-ohnd-2025.