Boyd v. Bulala

Decision Date05 November 1986
Docket NumberCiv. A. No. 83-0557-A-C.
PartiesHelen C. BOYD, et al., Plaintiffs, v. R.A. BULALA, M.D., Defendant.
CourtU.S. District Court — Western District of Virginia

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William O. Snead, III, Fairfax, Va., Rosemarie Annunziata, Mclean, Va., J. Randolph Parker, Charlottesville, Va., for plaintiff.

Ronald D. Hodges, Roy W. Ferguson, Jr., Harrisonburg, Va., for defendant.

MEMORANDUM OPINION

MICHAEL, District Judge.

Plaintiffs Helen and Roger Boyd filed this medical malpractice suit on behalf of themselves and their infant daughter, Veronica Lynn Boyd, who suffered a perinatal injury which left her with profound physical and mental handicaps. The Boyds alleged that the defendant negligently failed to provide adequate medical care during labor and delivery. At trial, plaintiffs presented evidence that Dr. Bulala, then at his home several miles away, had ordered the delivery room nurses to call him to the hospital only after crowning, and that consequently, he was absent when the emergency began and for the actual delivery. As a result, plaintiffs alleged, Mrs. Boyd was attended during labor and delivery only by nurses who were untrained in emergency measures which would have prevented the injury. The case was tried before a seven-member jury, which returned six verdicts against the defendant and for the various plaintiffs totalling $8,300,000. The verdicts were as follows: (1) compensatory damages for Veronica Boyd—$1,850,000; (2) compensatory damages for Helen Boyd—$1,575,000; (3) compensatory damages for Roger Boyd— $1,175,000; (4) compensatory damages for Helen Boyd and Roger Boyd, jointly, for past and future medical costs until Veronica Boyd reaches 18 years of age—$1,700,000; (5) punitive damages for Veronica Boyd—$1,000,000; and (6) punitive damages for Helen Boyd—$1,000,000. Defendants moved that the verdicts be set aside on several grounds and for judgment notwithstanding the verdicts, and also moved that the amount recovered be reduced to conform to Va.Code § 8.01-581.15. Plaintiffs, in turn, moved to amend the complaint to conform to evidence produced at trial.

Six weeks after the trial, before the court had ruled on any post-trial motions, Veronica Lynn Boyd died. Following the death of the infant plaintiff, the defendant moved to amend the action to an action for wrongful death under Va.Code §§ 8.01-50 and 8.01-56. The defendant also moved that the record be opened to present evidence of death and that the court set aside the two verdicts returned for Veronica and the verdict returned jointly for her parents to compensate them for her medical expenses. The case is now before the court upon both the original post-trial motions and the motions made following the death of Veronica Lynn Boyd.

I. Original Post-trial Motions

Following the trial, the defendant moved the court to reduce the amount of the verdict to conform with the requirements of Va.Code § 8.01-581.15; to set aside the verdicts for Roger Boyd and Veronica Boyd and enter judgment notwithstanding the verdicts; and to set aside all of the verdicts as excessive and because of alleged errors in the jury instructions concerning agency and damages and because of alleged prejudice resulting from the court's failure to inquire on voir dire whether any of the veniremen had a child who suffered birth-related injuries. The plaintiffs moved to amend the complaint to conform to the evidence at trial, specifically to increase the prayer for punitive damages in the ad damnum of the complaint from $800,000 to $2,000,000.

A. Constitutionality of Va.Code § 8.01-581.15

Defendant moves this court to reduce the total amount recovered by the plaintiffs in accordance with Va.Code § 8.01-581.15, which at the time of trial provided as follows:

In any verdict returned against a health care provider in an action for malpractice where the act or acts of malpractice occurred on or after April one, nineteen hundred and seventy-seven, which is tried by a jury or in any judgment entered against a health care provider in such an action which is tried without a jury, the total amount recoverable for any injury to, or death of, a patient shall not exceed $750,0001.

Plaintiffs challenge the constitutionality of this statutory limitation on recovery, arguing that § 8.01-581.15 violates constitutional rights to due process of law, equal protection of the laws, and the right to a jury trial. Plaintiffs further argue that the statute violates the separation of powers clause and the prohibitions against special legislation in the Virginia Constitution.

A search of the statute and case law across the country dealing with the cap question reveals first, that the statutes vary considerably, and second, that the case law is split on the constitutionality of medical malpractice cap legislation.2 On the equal protection question, some courts have exercised more stringent scrutiny than that normally accorded to economic regulation, basing this heightened scrutiny on independent state constitutional grounds, see, e.g., Carson v. Maurer, 424 A.2d 825, 831 (N.H.1980), or on the argument that the statutes failed to provide an adequate quid pro quo to the class of plaintiffs who are disadvantaged by the limitation on recovery. See, e.g., Baptist Hospital of Southeast Texas, Inc. v. Baber, 672 S.W.2d 296, 298 (Tex.Civ.App. 1984).

In the present case, however, the court finds no basis in the Virginia Constitution for a heightened standard of review. The Virginia Constitution contains no equal protection clause as such; equal protection rights are guaranteed by the antidiscrimination clause in article 1, section 11, and the prohibitions against special legislation in article 4, section 14. Neither clause provides stronger protection than the equal protection clause of the fourteenth amendment to the United States Constitution. The Virginia Supreme Court has specifically held that article 1, section 11, which is limited by its terms to classifications based on religion, race, color, sex, or national origin, is no broader than the equal protection clause. Archer v. Mayes, 213 Va. 633, 638, 194 S.E.2d 707, 711, (1973). Likewise, in interpreting article 4, section 14, the court has applied a reasonable basis standard which is equivalent to weak equal protection review. E.g., Bray v. County Board of Arlington County, 195 Va. 31, 37, 77 S.E.2d 479, 483 (1953).

Further, the lack of a quid pro quo provides no basis for stringent scrutiny of the statute. The United States Supreme Court has never clearly established the quid pro quo requirement as a constitutional doctrine and this court declines to do so. Duke Power Co. v. Carolina Environmental Study Group, Inc., 438 U.S. 59, 88, 98 S.Ct. 2620, 2638, 57 L.Ed.2d 595 (1978).3

As the Supreme Court noted in Duke Power, 438 U.S. at 83, 98 S.Ct. at 2635, a statutory limitation on recovery is a classic economic regulation, and as such is entitled to judicial deference. Absent the use of a suspect classification or the infringement of a fundamental right, the statute must be upheld if it is reasonably related to a valid legislative purpose.

The Virginia medical malpractice cap legislation clearly does not create a suspect classification.4 Certainly, the law treats victims of medical malpractice differently from the victims of other torts, and within the class of medical malpractice plaintiffs, the law further discriminates between those whose losses exceed the cap and those whose losses do not. Such classifications, while facially unfair, do not violate the equal protection clause according to current interpretation. In Duke Power, 438 U.S. at 93, 98 S.Ct. at 2640, the Supreme Court stated, "The general rationality of the Price-Anderson Act liability limitations—particularly with reference to the important Congressional purpose of encouraging private participation in the exploitment of nuclear energy—is ample justification for the difference of treatment between those injured in nuclear accidents and those whose injuries are derived from other causes." Likewise, the purpose of Va.Code § 8.01-581.15, to maintain an adequate level of health care services in the Commonwealth by ensuring that health care providers can obtain affordable insurance, 1976 Va. Acts c. 611, is sufficient justification under the Constitution for treating those injured through medical malpractice differently from those injured in other torts.

Further, the rationality of the statute justifies the distinction it draws between medical malpractice plaintiffs whose damages are less than the cap amount, who may be completely compensated for their injuries, and those whose damages exceed the cap, who will not be completely compensated. In Dandridge v. Williams, 397 U.S. 471, 90 S.Ct. 1153, 25 L.Ed.2d 491 (1970), the Supreme Court upheld the State of Maryland's administration of the Federal Aid to Families With Dependent Children program (AFDC), a need-based program under which Maryland limited the total amount a family could receive, thereby burdening larger families. The medical malpractice cap, which similarly burdens those whose losses are greatest, must certainly pass constitutional muster under the rule of Dandridge. As the Indiana Supreme Court noted in Johnson v. Saint Vincent Hospital, Inc., 273 Ind. at 398, 404 N.E.2d at 600, "While the interest of the severely injured patient in full recovery rather than partial recovery ... is great for the purpose of selecting the appropriate equal protection test, it is not greater than that of the children needing but being denied subsistence level support in Dandridge...." Clearly, the classifications created by the statute do not violate the equal protection clause.

Even in the absence of a suspect classification, however, a statute is subject to strict scrutiny under both equal protection and due process analyses if it infringes upon a...

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