Hoffman v. U.S.

• Decision Date: 26 July 1985
• Docket Number: No. 84-5572,84-5572
• Citation: 767 F.2d 1431
• Parties: Scott J. HOFFMAN, an incompetent person, by Harriet Hoffman, the Conservator of his person and estate, Plaintiff-Appellee, v. UNITED STATES of America, Defendant-Appellant.
• Court: U.S. Court of Appeals — Ninth Circuit

Page 1431

767 F.2d 1431

54 USLW 2116

Scott J. HOFFMAN, an incompetent person, by Harriet Hoffman, the Conservator of his person and estate, Plaintiff-Appellee, v. UNITED STATES of America, Defendant-Appellant.

No. 84-5572.

United States Court of Appeals, Ninth Circuit.

Argued Dec. 6, 1984.

Submitted July 26, 1985 ^*.

Decided Aug. 9, 1985.

Arthur E. Schwimmer, Los Angeles, Cal., for plaintiff-appellee.

Stephen E. O'Neil, Asst. U.S. Atty., Los Angeles, Cal., S. Thomas Todd, Encino, Cal., for defendant-appellant.

Appeal from the United States District Court for the Central District of California.

Before BOOCHEVER and HALL, Circuit Judges, and JAMESON ^**, District Judge.

JAMESON, District Judge:

The United States has appealed from a judgment of the district court holding unconstitutional section 3333.2 of the California Civil Code, which limits recovery for noneconomic losses in medical malpractice suits to $250,000. We reverse.

I. Facts and Proceedings Below

The appellee, Scott J. Hoffman, on May 12, 1981, went to the Veterans Administration Hospital, Wadsworth, Los Angeles, California, for treatment of a lacerated tendon in his right middle finger. As a result of the negligent administration of a general anesthetic during the finger surgery, Hoffman suffered an anoxic brain injury. Hoffman is confined permanently to a bed and a wheelchair. He experiences recurrent and painful body spasms and his ability to communicate verbally is impaired.

Hoffman, through Harriet Hoffman, the conservator of his person and estate, brought this action against the United States under the Federal Tort Claims Act. 28 U.S.C. Secs. 1346(b), 2671 et seq. The United States admitted liability. In a non-jury trial on the issue of damages the court entered a total judgment against the United States of $4,179,100--$3,179,100 for economic damages and $1,000,000 for noneconomic damages.

Under the Federal Tort Claims Act the federal courts apply the law of the state where the claim against the United States arose. 28 U.S.C. Sec. 1346(b). Section 3333.2 of the California Civil Code limits noneconomic losses in professional negligence suits against health care providers to $250,000. In allowing the $1,000,000 award for noneconomic damages, the court concluded that section 3333.2 "is unconstitutional in that it violates equal protection." ¹ The court found that section 3333.2 violated equal protection because it "discriminates between medical malpractice victims with noneconomic losses that exceed $250,000 and all other tort victims with noneconomic losses, including medical malpractice victims with smaller losses." The court found, relying on Carson v. Maurer, 120 N.H. 925, 424 A.2d 825, 836 (1980) and Jones v. State Board of Medicine, 97 Idaho 859, 874-75, 555 P.2d 399, 414-15 (1976), cert. denied, 431 U.S. 914, 97 S.Ct. 2173, 53 L.Ed.2d 223 (1977), that the "necessary correspondence between the special treatment of medical malpractice victims, with noneconomic losses that exceed $250,000 and the legislative goal of lowering medical malpractice premiums is lacking because paid out damages constitutes only a small part of total insurance premium costs and few individuals suffer noneconomic damages in excess of $250,000."

II. Issue on Appeal

The sole remaining issue on appeal is whether section 3333.2 of the California Code violates the Equal Protection Clause of the Fourteenth Amendment to the United States Constitution. ² U.S. Const. amend. XIV, Sec. 1.

III. California Civil Code Sec. 3333.2

In May 1975, the Governor of California convened a special session of the California Legislature because of problems resulting from the rapid increase in medical malpractice insurance premiums. Many doctors had decided to limit their practice to specific areas of medicine. Others were practicing with no insurance. In response to this perceived emergency, the Legislature enacted the Medical Injury Compensation Reform Act of 1975 (MICRA). The general provisions of the act are described by the California Supreme Court:

In broad outline, the act (1) attempted to reduce the incidence and severity of medical malpractice injuries by strengthening governmental oversight of the education, licensing and discipline of physicians and health care providers, (2) sought to curtail unwarranted insurance premium increases by authorizing alternative insurance coverage programs and by establishing new procedures to review substantial rate increases, and (3) attempted to reduce the cost and increase the efficiency of medical malpractice litigation by revising a number of legal rules applicable to such litigation.

American Bank & Trust Co. v. Community Hosp. of Los Gatos-Saratoga, Inc., 204 Cal.Rptr. 671, 673, 36 Cal.3d 359, 683 P.2d 670, 672 (1984).

Section 3333.2, a part of MICRA, provides in relevant part:

(a) In any [medical malpractice] action ... the injured plaintiff shall be entitled to recover noneconomic losses to compensate for pain, suffering, inconvenience, physical impairment, disfigurement and other nonpecuniary damage.

(b) In no action shall the amount of damages for noneconomic losses exceed two hundred fifty thousand dollars ($250,000).

In Fein the California Supreme Court held that in the light of its discussion of the legislative history and purposes of MICRA in American Bank, supra, and other prior cases, ³ "it is clear that section 3333.2 is rationally related to legitimate state interests." 211 Cal.Rptr. at 383, 695 P.2d at 680. The court noted that it had explained in those decisions that "in enacting MICRA the Legislature was acting in a situation in which it had found that the rising cost of medical malpractice insurance was posing serious problems for the health care system in California, threatening to curtail the availability of medical care in some parts of the state and creating the very real possibility that many doctors would practice without insurance, leaving patients who might be injured by such doctors with the prospect of uncollectible judgments." ⁴ Id.

IV. Equal Protection

A. Standards Applied

Traditionally two standards have been applied where a state statute has been challenged on equal protection grounds--strict scrutiny and rational basis.

Strict scrutiny is applied when the classification involves a suspect classification, i.e., race, McLaughlin v. Florida, 379 U.S. 184, 191-92, 85 S.Ct. 283, 288, 13 L.Ed.2d 222 (1964); ancestry, Oyama v. California, 332 U.S. 633, 644-46, 68 S.Ct. 269, 274-75, 92 L.Ed. 249 (1948); and alienage, Graham v. Richardson, 403 U.S. 365, 372, 91 S.Ct. 1848, 1852, 29 L.Ed.2d 534 (1971); or categorizations impinging upon a fundamental right, i.e., privacy, Roe v Wade, 410 U.S. 113, 154-64, 93 S.Ct. 705, 727-32, 35 L.Ed.2d 147 (1973); marriage, Zablocki v. Redhail, 434 U.S. 374, 383-87, 98 S.Ct. 673, 679-81, 54 L.Ed.2d 618 (1978); voting, Bullock v. Carter, 405 U.S. 134, 144, 92 S.Ct. 849, 856, 31 L.Ed.2d 92 (1972); travel, Shapiro v. Thompson, 394 U.S. 618, 627, 89 S.Ct. 1322, 1327, 22 L.Ed.2d 600 (1969); and freedom of association, NAACP v. Alabama, 357 U.S. 449, 460-62, 78 S.Ct. 1163, 1170-72, 2 L.Ed.2d 1488 (1958). To withstand strict scrutiny a statute must be precisely tailored to serve a compelling state interest. Plyler v. DOE, 457 U.S. 202, 216, 217, 102 S.Ct. 2382, 2394, 2395, 72 L.Ed.2d 786 (1982). ⁵

In cases not involving a suspect classification or a fundamental right, the state statutes have been tested under the rational basis standard. See, e.g., McGowan v. Maryland, 366 U.S. 420, 425-26, 81 S.Ct. 1101, 1104-05, 6 L.Ed.2d 393 (1961), where the Court said:

The constitutional safeguard [of equal protection] is offended only if the classification rests on grounds wholly irrelevant to the achievement of the State's objective. State legislatures are presumed to have acted within their constitutional power despite the fact that, in practice, their laws result in some inequality. A statutory discrimination will not be set aside if any statement of facts reasonably may be conceived to justify it.

In recent years an intermediate level of scrutiny has begun to develop. See Gunther, Forward: In Search of Evolving Doctrine on a Changing Court: A Model for a Newer Equal Protection, 86 Harv.L.Rev. 1, 20-24 (1972). Under this standard, a statutory classification is validated if it substantially furthers a purported legislative purpose. Although the reviewing court does not question the legitimacy of the legislative rationale, a state must give greater justification for a statute classification than is required for rational basis analysis. 591 F.2d 1164 at 1172-73 (5th Cir.1979). The Supreme Court has applied this intermediate level of scrutiny only to gender based classifications, see, e.g., Craig v. Boren, 429 U.S. 190, 199-204, 97 S.Ct. 451, 458-60, 50 L.Ed.2d 397 (1976); and to categorizations premised on legitimacy. See, e.g., Trimble v. Gordon, 430 U.S. 762, 767-68, 97 S.Ct. 1459, 1463-64, 52 L.Ed.2d 31 (1977).

B. Proper Standard for this Case--Rational Basis

In Brandwein v. Cal. Bd. of Osteopathic Examiners, 708 F.2d 1466, 1470 (9th Cir.1983), we expressly recognized that, "Strict scrutiny is the proper test of a legislative classification only when the classification impermissibly interferes with the exercise of a fundamental right or operates to the peculiar disadvantage of a suspect class." Since malpractice victims with noneconomic losses that exceed $250,000 do not constitute a suspect class and the right to recovery of tort damages is not a fundamental right, strict scrutiny is not appropriate in this case. We need then only determine whether the intermediate level of scrutiny or the rational basis test is appropriate.

In In re Paris Air Crash, 622 F.2d 1315, 1320 (9th Cir.), cert. denied, 449 U.S. 976, 101 S.Ct. 387, 66 L.Ed.2d 237 (1980), we applied the rational basis test in upholding the constitutionality of a California statute disallowing punitive damages in...