Acosta v. Healthspring of Fla., Inc.

• Decision Date: 17 July 2013
• Docket Number: No. 3D12–1340.,3D12–1340.
• Citation: 118 So.3d 246
• Parties: Angel ACOSTA, et al., Appellants, v. HEALTHSPRING OF FLORIDA, INC., etc., et al., Appellees.
• Court: Florida District Court of Appeals

118 So.3d 246

Angel ACOSTA, et al., Appellants,

v.HEALTHSPRING OF FLORIDA, INC., etc., et al., Appellees.

No. 3D12–1340.

District Court of Appeal of Florida, Third District.

July 17, 2013.

Ralph George Patino, Coral Gables, and Jose Menendez; Ralph O. Anderson, for appellants.

Holland & Knight, and Christopher N. Bellows, Marie Lefere, and Joshua R. Levenson, for appellees.

Before SUAREZ, ROTHENBERG and SALTER, JJ.

SALTER, J.

Angel and Maria Acosta appeal a summary final judgment entered in favor of HealthSpring of Florida, Inc. (doing business as “Leon Medical Centers Health Plans, Inc.”), in a circuit court lawsuit relating to a stroke suffered by Mr. Acosta in May 2009. The issue presented is whether the Acostas' claims against HealthSpring are subject to Florida's medical malpractice statute and, if so, whether their claims were barred by the two-year statute of limitations and their failure to provide a timely statutory presuit notice to HealthSpring. We reverse, concluding that (1) the Acostas' claims against HealthSpring were not “claims for medical malpractice” as defined in section 766.106(1)(a), Florida Statutes (2009), and (2) even if the claims are characterized as a matter of law as claims for medical malpractice, the claims related back to the first amended complaint (which had a filing date within the applicable statute of limitations), and HealthSpring waived the statutory presuit notice requirement in its response to that pleading.

Background and Procedural History

Mr. Acosta suffered his stroke in May 2009 and was initially seen at North Shore Medical Center. HealthSpring provided Medicare health insurance benefits to Mr. Acosta. The Acostas' initial circuit court complaint in 2010 alleged that HealthSpring breached its contract with Mr. Acosta (Count I) and negligently performed that contract (Count II). Count III was Ms. Acosta's claim for loss of consortium. HealthSpring moved to dismiss the complaint for a failure to attach exhibits, and it removed the case to federal court. There the Acostas filed an amended complaint attaching the pertinent exhibits. HealthSpring filed an answer and affirmative defenses that did not include any specific allegation that the Acostas were required to provide, or had failed to provide, a statutory medical malpractice presuit notice. The federal court then remanded the case to the circuit court in 2011, finding that the Acostas' state law claims “raise no substantial federal question.”

The Acostas then filed a second amended complaint in which they joined as additional defendants the North Shore Medical Center (where Mr. Acosta was first seen for the stroke) and Dr. Rehan Naqui, a physician who reviewed Mr. Acosta's case while he was at North Shore. The new counts against North Shore and Dr. Naqui were medical malpractice claims. The Acostas served statutory presuit notices as to North Shore and Dr. Naqui, and they included an allegation to that effect in the second amended complaint. HealthSpring's answer and affirmative defenses to the second amended complaint alleged that the Acostas “failed to comply with Section 766 et seq., by failing to provide [HealthSpring] with a notice of intent to initiate medical malpractice within the two (2) year statute of limitations for HealthSpring's alleged failure to render medical care and services to Angel Acosta.”

HealthSpring moved for a summary final judgment regarding the Acostas' failure to serve a presuit notice and the expiration of the two-year limitations period for medical malpractice claims. The Acostas filed a response that included pleadings and deposition testimony. The trial court granted HealthSpring's motion, and this appeal followed.

Analysis

“We review the summary judgment de novo to determine whether, after viewing every inference in favor of [the non-movant], there is any genuine issue of material fact. If not, we must determine whether [the movant] is entitled to judgment as a matter of law.” Bldg. Educ. Corp. v. Ocean Bank, 982 So.2d 37, 40 (Fla. 3d DCA 2008) (citing Volusia Cnty. v. Aberdeen at Ormond Beach, L.P., 760 So.2d 126, 130 (Fla.2000)).

Because the presuit requirements of Florida's Medical Malpractice Act limit claimants' constitutional rights of access to the courts, we narrowly construe the presuit notice requirements in favor of such access. Pierrot v. Osceola Mental Health, Inc., 106 So.3d 491, 493 (Fla. 5th DCA 2013).

I. “Medical Malpractice” versus “Ordinary Negligence”

The allegations relating to HealthSpring in the Acostas' second amended complaint did not address traditional medical assessments, professional judgment, and medical services. The Acostas alleged that HealthSpring's administrative personnel—not medical staff—failed to provide contractual authorization for Mr. Acosta to be transported promptly to the University of Miami hospital for an urgent carotid endarterectomy to prevent a second major stroke. Dr. Naqui and North Shore allegedly provided diagnosis and initial care—but HealthSpring's administrative delay in authorizing Mr. Acosta's transfer allegedly resulted in his second stroke four days after the first. The Acostas alleged that one or more administrative employees at HealthSpring belatedly authorized transfer to Mercy Hospital instead of the University of Miami Hospital because HealthSpring enjoyed a lower “preferred provider” rate at Mercy Hospital for the services in question.

The central issue, therefore, was whether the Acostas' claims against HealthSpring required evidence that HealthSpring's acts and omissions deviated from accepted standards of medical care. Mere delay, albeit ultimately-critical delay, in arranging transportation to a different hospital to save money, may have involved negligence by clerical personnel of HealthSpring, not medical personnel. In its motion for summary judgment, HealthSpring candidly acknowledged that the distinction between...