Boyd v. Bulala

• Decision Date: 12 November 1987
• Docket Number: Civ. A. No. 83-0557-A-C.
• Court: U.S. District Court — Western District of Virginia
• Parties: Helen C. BOYD, et al., Plaintiffs, v. R.A. BULALA, M.D., Defendant.

672 F. Supp. 915

Helen C. BOYD, et al., Plaintiffs, v. R.A. BULALA, M.D., Defendant.

Civ. A. No. 83-0557-A-C.

United States District Court, W.D. Virginia, Charlottesville Division.

November 12, 1987.

J. Randolph Parker, Charlottesville, Va., Rosemarie Annunziata, McLean, Va., William O. Snead, III, Fairfax, Va., for plaintiffs.

Phillip C. Stone, Ronald D. Hodges, Harrisonburg, Va., for defendant.

Mary Sue Terry, Atty. Gen. of Va., William L. Thurston, Gregory E. Lucyk, Asst. Attys. Gen., Richmond, Va., for intervenor.

Joanne I. Schwartz, Trial Atty., Torts Branch, Civ. Div., U.S. Dept. of Justice, Washington, D.C., for amicus.

MICHAEL, District Judge.

This matter comes before the court upon the motion by the defendant for post-judgment relief and upon the motion by the Commonwealth of Virginia, intervenor in this action, to reconsider the court's earlier ruling on the constitutionality of section 8.01-581.15 of the Code of Virginia.

The plaintiffs, Helen and Roger Boyd, and their infant daughter, Veronica Lynn, charged Dr. R.A. Bulala with breaching the standard of care for obstetricians in Virginia. The Boyds alleged that Dr. Bulala failed to assess Mrs. Boyd's labor after he was notified of her admission to the hospital, and that he made a deliberate decision not to monitor her progress during the early morning hours immediately following that admission. They further alleged that Dr. Bulala's usual practice was to come to the hospital only after the infant crowned, even though he knew his conduct endangered both mother and infant. Because of this negligent practice, the Boyds charged, Dr. Bulala failed to attend Mrs. Boyd during labor and delivery, causing severe injuries to the infant.

The evidence at trial was largely uncontroverted, especially as to the critical facts and as to the standard of care appropriate to this case. It showed that shortly after 4:00 a.m. on January 31, 1982, Dr. Bulala was notified that Mrs. Boyd had been admitted to the Clinch Valley Community Hospital in active labor. Dr. Bulala knew that Mrs. Boyd was three weeks before term and that she had delivered before, and he consequently should have realized that she might deliver quickly. He nevertheless elected to remain at home, some twenty minutes or so away, after receiving the call from the hospital.

In his brief conversation with the nurse who called to advise him of Mrs. Boyd's admission, Dr. Bulala did not obtain the information necessary to assess the progress of Mrs. Boyd's labor. He specifically did not ascertain the station of the fetus in the birth canal or the duration and strength of contractions. Dr. Bulala knew that he alone was responsible for assessing labor. He knew that the nurses did not possess the necessary knowledge or training to perform such an assessment. He was also aware that the hospital was short-staffed at night, and that the nurses had failed to monitor patients properly in the past. Nonetheless, Dr. Bulala relied on the nurses to monitor Mrs. Boyd's labor and to discern any signs of trouble. According to the hospital chart, Mrs. Boyd was not checked regularly following her admission.

At 7:00 a.m., Mrs. Boyd's cervix was fully dilated, signaling the start of the second stage of labor. The nurses did not call Dr. Bulala, however, because he had ordered them not to summon him for off-hours deliveries until the baby actually crowned, that is, when the baby's head reached the vaginal opening. This order ensured that Dr. Bulala would be absent for everything but the final stage of labor, and posed the risk that he would arrive after delivery.

Sometime after Mrs. Boyd was admitted to the hospital, the fetus suffered acute distress. At 7:45 a.m., a nurse discovered that the fetal heart rate had dropped to 84, well below the normal range of 120-140 beats per minute. Unprepared for such an emergency, the nurses notified Dr. Bulala. Shortly afterward, Mrs. Boyd's membranes ruptured, and she was rushed to the delivery room. The baby was born, blue and limp, before Dr. Bulala arrived at the hospital. When Dr. Bulala at last entered the delivery room, he saw Mrs. Boyd and demanded, "Couldn't you wait?" This remark caused Mrs. Boyd a great deal of pain, both at the time and later, as the extent of the infant's injuries became apparent.

In depositions and trial testimony, Dr. Bulala admitted that he had lowered his standard of care when he moved to Tazewell County in southwestern Virginia. He also acknowledged that in ordering the night nurses to summon him at crowning, he ran the risk that he would not arrive before delivery, endangering both mother and infant. When queried about why he did not come to the hospital in a timely fashion, his answer was that doctors also needed their sleep. Dr. Bulala went on to acknowledge that he failed to assess Helen Boyd's labor when she was admitted to the hospital.

Expert testimony clearly established that Dr. Bulala's conduct fell well below the standard of care in Virginia. Dr. Guy M. Harbert, Jr., Professor of Obstetrics and Gynecology at the University of Virginia Medical School, testified that an obstetrician is responsible for assessing the progress of labor and attending the patient accordingly. He testified that with a full-term patient who has delivered before, most obstetricians attend when the patient is in active labor and her cervix is dilated 7-8 centimeters. In Mrs. Boyd's case, Dr. Harbert stated, earlier attendance was clearly required by the facts available when she was admitted. Dr. Scott D. Vogel, an obstetrician in private practice in Charlottesville, testified that Dr. Bulala's policy inevitably shifted responsibility for diagnosis and treatment to the nurses, setting the stage for the events which ensued. Dr. Harbert compared Dr. Bulala's order to be called at crowning to Russian roulette, and Dr. Bulala's own expert witness, Dr. James V. Moore, Jr., agreed that such a practice was egregious. Expert testimony also showed that Dr. Bulala might well have prevented Veronica Boyd's injuries if he had been present to assess and manage Mrs. Boyd's labor.

Because of the ischemic encephalopathy — brain injury caused by deprivation of oxygen — she suffered before birth, Veronica Boyd was afflicted with severe cerebral palsy, profound mental retardation, and a seizure disorder. These conditions gave rise to other problems, including feeding difficulties, recurrent pneumonia, and a danger of bone deformation. Uncontroverted testimony at trial established that Veronica would never walk, that she could possibly develop mentally to the level of a one-year-old child, and that she would require institutional care for the rest of her life. Similarly uncontroverted was the expert testimony on the infant's life expectancy, costs of the necessary intensive institutional care, and on the other costs associated with maintaining and caring for the infant.

Based on this evidence, the jury returned verdicts totaling $8,300,000 against the defendant and for the various plaintiffs, allocated as follows: (1) $1,850,000 in compensatory damages for Veronica Boyd; (2) $1,575,000 in compensatory damages for Helen Boyd; (3) $1,175,000 in compensatory damages for Roger Boyd; (4) $1,700,000 in compensatory damages for Helen Boyd and Roger Boyd, jointly, for Veronica's past medical costs and future medical costs until her eighteenth birthday; (5) $1,000,000 in punitive damages for Veronica Boyd; and (6) $1,000,000 in punitive damages for Helen Boyd. The defendant then moved to reduce the judgment to conform with the limit on damages imposed by Va.Code § 8.01-581.15. This court denied the motion, holding that the statute was void because it violated the separation of powers and infringed upon the right to a civil jury trial guaranteed by the United States Constitution and the Virginia Constitution. Boyd v. Bulala, 647 F.Supp. 781 (W.D.Va. 1986).

Shortly after the court issued its opinion, the Attorney General of the Commonwealth of Virginia moved to intervene, requesting the opportunity to argue in defense of the statute. The court granted the motion to intervene and took under advisement the Commonwealth's motion to reconsider under Rule 59(e) of the Federal Rules of Civil Procedure, thereby suspending the running of the appeal period. App. Rules 4(a)(4); 16 C. Wright, A. Miller, E. Cooper & E. Gressman, Federal Practice & Procedure, § 3950 at 364 (1977). Because the court's earlier ruling upheld the statute as to equal protection and due process requirements, the court declined to hear reargument on those issues. See Boyd v. Bulala, 647 F.Supp. at 786-88. The court limited the motion to reconsider to the question of whether the statute violated the right to trial by jury guaranteed by the seventh amendment of the United States Constitution and article I, section 11 of the Virginia Constitution. By leave of the court, the United States filed a brief and argued at the hearing as an amicus curiae.

Following argument, the court took the matter under advisement. The court has scrutinized the submissions of the parties and carefully considered the questions of the case. For the reasons stated below, the court will deny the Commonwealth's motion to reconsider and deny defendant's motion for post-judgment relief.

The Constitutionality of Virginia Code § 8.01-581.15

The seventh amendment to the United States Constitution guarantees the right to a jury trial in a civil case brought under diversity jurisdiction in federal court.¹ Byrd v. Blue Ridge Rural Electric Co-op., Inc., 356 U.S. 525, 78 S.Ct. 893, 2 L.Ed.2d 953 (1958). The amendment provides,

In Suits at common law, where the value in controversy shall exceed twenty dollars, the right of trial by jury shall be preserved, and no fact tried by a jury, shall be otherwise reexamined in any Court of the United States, than according to the rules of common law.

Too often neglected in modern times, the seventh amendment is...