Butler v. Flint Goodrich Hosp. of Dillard University

• Decision Date: 19 October 1992
• Docket Number: No. 92,92
• Citation: 607 So.2d 517
• Parties: Cleo Allen BUTLER, Individually and for and on Behalf of the Minor, Michelle Butler and Arlene Major as Custodian of the Minor, Michelle Butler, v. FLINT GOODRICH HOSPITAL OF DILLARD UNIVERSITY, Jerome T. Medley, Warren P. McKenna, Jr., M.D., Sandra Viglia, Joseph Braud, M.D. and Sherman Bernard in his Capacity as Commissioner of Insurance, et al. CC 0559.
• Court: Louisiana Supreme Court

Page 517

607 So.2d 517

61 USLW 2284

Cleo Allen BUTLER, Individually and for and on Behalf of the Minor, Michelle Butler and Arlene Major as Custodian of the Minor, Michelle Butler, v. FLINT GOODRICH HOSPITAL OF DILLARD UNIVERSITY, Jerome T Medley, Warren P. McKenna, Jr., M.D., Sandra Viglia, Joseph Braud, M.D. and Sherman Bernard in his Capacity as Commissioner of Insurance, et al.

No. 92 CC 0559.

Supreme Court of Louisiana.

Oct. 19, 1992.

Dissenting Opinion by Justice Dennis,

Nov. 10, 1992.

Rehearing Denied Nov. 25, 1992.

Darleen M. Jacobs, Brian C. Beckwith, James L. Yates, New Orleans, for applicants.

Franklin D. Beahm, Katherine B. Muslow, Thomas, Hayes & Beahm, Lawrence L. McNamara, Philip O. Bergeron, Robert J. Conrad, Jr., Adams & Reese, New Orleans, C.T. Williams, Jr., J. Elliott Baker, Blue, Williams & Buckley, Metairie, for respondents.

Joseph W. Thomas, New Orleans, for Norward Sutton, Sr., amicus curiae.

Robert G. Pugh, Jr., Lamar P. Pugh, Pugh, Pugh & Pugh, Shreveport, for Louisiana Medical Mut. Ins. Co., amicus curiae.

Lawrence S. Kullman, New Orleans, David W. Robertson, Baton Rouge, for Louisiana Trial Lawyers Ass'n, amicus curiae.

George E. Cain, Bryan Misshore, Kelley A. Robichaux, Lemle & Kelleher, New Orleans, for Ins. Corp. of America, amicus curiae.

Richard P. Ieyoub, Atty. Gen., Athena B. Peidrahita, Asst. Atty. Gen., for State, amicus curiae.

Charles A. Boggs, Boggs, Loehn & Rodrigue, New Orleans, for Dr. Susan Jeanfreau, amicus curiae.

Robert L. Roland, Peter T. Dazzio, P. Scott Jolly, Baton Rouge, for Louisiana Hosp. Ass'n and Louisiana Hosp. Ass'n Ins. Trust Fund, amicus curiae.

H. Evans Scobee, Durrett, Hardin, Hunter, Dameron & Fritchie, Baton Rouge, for East Baton Rouge Parish Medical Soc., amicus curiae.

Larry M. Roedel, Roedel Parsons Forrester & Koch, Baton Rouge, for Louisiana Dental Ass'n, amicus curiae.

Marc W. Judice, Juneau, Judice, Hill & Adley, Lafayette, for The Ninth Dist. of Louisiana State Medical Soc., amicus curiae.

Cynthia C. Anderson, Gregg A. Wilkes, Cook, Yancey, King & Galloway, Shreveport, for Shreveport Medical Soc., The North Cent. Parishes Medical Soc., The Delta Medical Soc., and the Morehouse Parish Medical Soc., amicus curiae.

Jesse D. McDonald, Hudson, Potts & Bernstein, Monroe, for Louisiana State Medical Soc. and Ouachita Parish Medical Soc., amicus curiae.

Donna D. Fraiche, Michael M. Meunier, Elaine W. Selle, Locke Purnell Rain Harrell, New Orleans, for Orleans Parish Medical Soc. and The Jefferson Parish Medical Soc., amicus curiae.

WATSON, Justice.

The issue presented is the constitutionality of Louisiana's $500,000 cap on general damages in a medical malpractice victim's suit against multiple defendants. LSA-R.S. 40:1299.42(B)(1).

FACTS

In May of 1976, a three year old child, Michelle Butler, had complications following eye surgery. After suffering cardiac arrest, she was rendered blind, paralyzed and retarded. Michelle's maternal grandmother, Arlene Major, was appointed tutrix. She and the minor's attorney released the Flint-Goodrich Hospital, a division of Dillard University, and its employee, Sandra Viglia Williams, a nurse-anesthetist, for $100,000. The minor's rights against other parties, including the Louisiana Patient's Compensation Fund, Dr. Jerome Medley, Dr. Warren McKenna, and Dr. Joseph Braud, were reserved. It is alleged that there is excess coverage on some or all of the other health care providers, but plaintiff's discovery was prohibited.

The trial court gave judgment against the Louisiana Patient's Compensation Fund for $400,000 and ordered the Fund to pay Michelle Butler's medical care and related expenses from April 27, 1990. Plaintiff was awarded $244,275 for past care. After tender of its $400,000 was refused, the Fund deposited that sum in the court registry.

Drs. Medley, McKenna and Braud filed a motion for summary judgment because Michelle had received the maximum $500,000 recovery allowed by LSA-R.S. 40:1299.42(B)(1). The trial court denied the motion. The court of appeal granted a writ and ordered that summary judgment be entered. This court granted a writ to review the ruling of the court of appeal.

LAW

The Louisiana Constitution mandates equal protection of the laws. Art. I, Sec. 3. It prohibits arbitrary, capricious or unreasonable discrimination because of physical condition. Art. I, Secs. 3 and 12. Open courts must provide an adequate remedy, administered without partiality, for injury to persons and property. Art. I, Sec. 22.

Imperfections in legislation are not grounds for judicial intervention unless they result in denial of constitutional rights. James v. Strange, 407 U.S. 128, 92 S.Ct. 2027, 32 L.Ed.2d 600 (1972); Everett v. Goldman, 359 So.2d 1256 (La.1978). Consistent with most other state supreme courts, Everett held that medical malpractice legislation does not infringe upon fundamental rights. See, for example, Condemarin v. University Hosp., 775 P.2d 348 (Utah 1989). Also see Tull v. United States, 481 U.S. 412, 107 S.Ct. 1831, 95 L.Ed.2d 365 (1987) and Boyd v. Bulala, 877 F.2d 1191 (4th Cir.1989). Two provisions of the Louisiana Act were approved in Everett- : medical review panels and no demand for a dollar amount. Compare Hoem v. State, 756 P.2d 780 (Wyo.1988), which held that medical review panels deny equal protection.

Sibley I, Sibley v. Board of Sup'rs of Louisiana, 462 So.2d 149 (La.1985), held that limiting medical malpractice awards to $500,000 per patient does not violate the equal protection and due process guarantees of the state and federal constitutions or the state constitutional guarantee of access to courts. A rehearing was granted and those issues were given further scrutiny in Sibley II, Sibley v. Board of Sup'rs of Louisiana, 477 So.2d 1094 (La.1985), which rejected the federal three-tier system of scrutiny. Sibley II decided that the physical condition discrimination in Louisiana's medical malpractice act, between those more and less severely injured, must further a legitimate state interest. Sibley II remanded, ordering that the state's interests be balanced against the discrimination to determine if the legislative classifications were arbitrary, capricious and unreasonable. The case was settled.

After a Sibley II analysis, the fourth circuit found the cap valid in Williams v. Kushner, 524 So.2d 191 (La.App. 4th Cir.1988). The evidence included testimony that some health care providers were "bare" of malpractice insurance before the passage of Act 817 of 1975. Williams v. Kushner, 549 So.2d 294 (La.1989), amended and affirmed the court of appeal opinion without a definitive holding on the constitutional issue. Williams confirmed the validity of the $400,000 cap on general damages from the Fund but pretermitted the question of limiting payment by an individual health care provider to $100,000.

Plaintiff's withdrawal of a doctor's $100,000 deposit in a court registry settled plaintiff's claim against the doctor. Ewing v. Aubert, 566 So.2d 616 (La.1990). Payment of $100,000 by one qualified health care provider triggers the Fund's liability for excess damages. Stuka v. Fleming, 561 So.2d 1371 (La.1990) cert. denied, 498 U.S. ----, 111 S.Ct. 513, 112 L.Ed.2d 525 (1990). The Fund cannot contest liability when there is a settlement for $100,000 by a health care provider before or after trial. Koslowski v. Sanchez, 576 So.2d 470 (La.1991).

The fourth circuit again found the cap constitutional in LaMark v. NME Hospitals, Inc., 542 So.2d 753 (La.App. 4th Cir.1989) writ denied, 551 So.2d 1334 (La.1989). Despite the lack of an express decision from this court, the United States Fifth Circuit inferred that the cap meets Louisiana's constitutional requirements. Owen v. U.S., 935 F.2d 734 (5th Cir.1991) cert. denied, --- U.S. ----, 112 S.Ct. 870, 116 L.Ed.2d 775 (1992).

Under Louisiana's medical malpractice act, liability of multiple health care providers, to an aggregate exceeding $100,000, does not inure to the victim but reduces the excess due from the Fund. LSA-R.S. 40:1299.42(B)(3)(a). The total amount paid from multiple health care providers shall not exceed $500,000. LSA-R.S. 40:1299(B)(1) and (3)(b).

Since the Louisiana Act does not affect fundamental rights, the constitutional test is whether its provisions are reasonably related to furthering general social interests. Sibley II; Bazley v. Tortorich, 397 So.2d 475 (La.1981).

Other state courts of last resort have addressed these constitutional issues.

Lucas v. United States, 757 S.W.2d 687 (Tex.1988), answering a certified question from the United States Fifth Circuit, concluded that a $500,000 limitation on medical malpractice damages unconstitutionally limited open access to the Texas courts. The legislation failed to provide an adequate substitute, a societal quid pro quo. Moreover, reducing recovery of persons catastrophically injured by medical negligence was arbitrary, because it had no rational relationship to the state's interests.

Smith v. Department of Insurance, 507 So.2d 1080 (Fla.1987), invalidated a $450,000 ceiling on noneconomic damages as an arbitrary cap denying constitutional access to the courts and the right to a jury trial.

Rose v. Doctors Hosp., 801 S.W.2d 841 (Tex.1990), decided that the $500,000 Texas cap on damages for wrongful death, a statutory remedy, was valid. The wrongful death cap was distinguished and severed from the common law remedy for malpractice. However, the statutory cap on wrongful death damages was interpreted to allow excess damages to a plaintiff recovering against more than one defendant.

Alabama's $400,000 limit on noneconomic damages recoverable against physicians violates the constitutional guarantee of equal protection. Moore v. Mobile Infirmary Ass'n, 592 So.2d 156 (Ala.1991). Balancing the direct burden on catastrophically injured victims of medical malpractice against the indirect and speculative benefit to society, Moore found that any...