Clements v. Dr. John Alvan Stewart, P.C.

• Court: Alabama Supreme Court
• Writing for the Court: HOUSTON; PER CURIAM; ALMON; HORNSBY; HORNSBY; HOUSTON
• Citation: Clements v. Dr. John Alvan Stewart, P.C., 595 So.2d 858 (Ala. 1992)
• Decision Date: 28 February 1992
• Parties: William CLEMENTS v. DR. JOHN ALVAN STEWART, P.C., and Dermatology Clinic. 1900887.

Page 858

595 So.2d 858

William CLEMENTS v. DR. JOHN ALVAN STEWART, P.C., and Dermatology Clinic.

1900887.

Supreme Court of Alabama.

Feb. 28, 1992.

Tom Dutton of Pittman, Hooks, Marsh, Dutton & Hollis, P.C., Birmingham, for appellant.

Michael A. Florie, Walter W. Bates and A. Sybil Vogtle of Starnes & Atchison, Birmingham, for appellees.

[Reporter of Decisions' Note: The first part of this opinion, addressing issues I and II, was written by Justice Houston. The last part, addressing issue III, is a per curiam opinion.]

HOUSTON, Justice.

William Clements brought this action in the Circuit Court of Lee County, Alabama, under the Alabama Medical Liability Act of 1987, against Dr. John Alvan Stewart, P.C., and Dermatology Clinic. (Our references hereinafter will be only to Dr. Stewart as the defendant.) The plaintiff contended that "1) The defendant negligently failed to perform further excision of a cancerous lesion and to submit same for pathological analysis immediately following his receipt of the pathologist's report on the tissue removed at the time of the initial excision procedure;

"2) As [a] result of such negligence, there was an approximately ten-month delay in adequate excision of the cancerous lesion and concomitantly, a substantial decrease in plaintiff's chances of surviving his cancer. More specifically, said negligence has resulted in a decrease in plaintiff's life ... expectanc[y], and has and will in the future cause him to suffer mental anguish and emotional distress."

The defendant denied any negligence and contended that his treatment of the plaintiff met or exceeded the applicable standard of care (Ala.Code 1975, § 6-5-542(2)). The case was tried to a jury, which returned a verdict in favor of the defendant. The plaintiff appealed, arguing three issues for our review.

I.

Whether Ala. Code 1975, § 6-5-542(5), violates Article IV, § 104(9), of the Constitution of Alabama of 1901.

Alabama Code 1975, § 12-21-12, provides, in pertinent part:

"(a) In all civil actions brought in any court of the state of Alabama, proof by substantial evidence shall be required to submit an issue of fact to the trier of the facts....

"....

"(d) Substantial evidence shall mean evidence of such quality and weight that reasonable and fair-minded persons in the exercise of impartial judgment might reach different conclusions as to the existence of the fact sought to be proven...."

(Emphasis added.)

Subsequent to the enactment of § 12-21-12, the Alabama Medical Liability Act of 1987, Ala.Code 1975, §§ 6-5-540 through 6-5-552, was enacted. Section 6-5-542 provided, in pertinent part:

"For the purposes of [the Alabama Medical Liability Act of 1987] the following terms shall have the meanings respectively ascribed to them by this section:

"....

"(5) SUBSTANTIAL EVIDENCE. Substantial evidence is that character of admissible evidence which would convince an unprejudiced thinking mind of the truth of the fact to which the evidence is directed."

The plaintiff contends that because the definition of "substantial evidence" applicable in actions under the Alabama Medical Liability Act of 1987 is different from the definition of "substantial evidence" in all other civil actions, § 6-5-542(5) violates Article IV, § 104, of the Constitution. Article IV, § 104, provides, in pertinent part:

"The legislature shall not pass a special, private, or local law in any of the following cases.

"....

"(9) Exempting any individual, private corporation, or association from the operation of any general law;

"....

"The legislature shall pass general laws for the cases enumerated in this section...."

(Emphasis added.)

The word "exempt" is defined in Black's Law Dictionary 571 (6th ed.1990) as follows:

"To release, discharge, waive, relieve from liability. To relieve, excuse, or set free from a duty or service imposed upon the general class to which the individual exempted belongs; as to exempt from military service."

It is not clear how health care providers are exempted from a general law by the enactment of § 6-5-542(5). The wording of the statements of the quality and weight of the evidence necessary to submit an issue of fact to the trier of fact differs. However, with the judicial interpretation of § 12-21-12(d) in West v. Founders Life Assurance Co. of Florida, 547 So.2d 870 871 (Ala.1989) ("substantial evidence" was there defined as "evidence of such weight and quality that fair-minded persons in the exercise of impartial judgment can reasonably infer the existence of the fact sought to be proved"), we cannot find that plaintiffs in actions against health care providers have a higher burden of proof under § 6-5-542 (which defines "substantial evidence" as "admissible evidence which would convince an unprejudiced thinking mind of the truth of the fact to which the evidence is directed") than under § 12-21-12(d), which the plaintiff describes as the "general law." This is a difference without a distinction.

Likewise, a "health care provider," as defined by § 6-5-542(1) ("A medical practitioner, dental practitioner, medical institution, physician, dentist, hospital," and those other health care providers described in § 6-5-481 and Ala.Code 1975, § 22-21-20), is not an individual or corporation.

"Association" is defined in Black's Law Dictionary 121 (6th ed.1990) as "[a]n unincorporated society; a body of persons united and acting together without a charter, but upon the methods and forms used by incorporated bodies for the prosecution of some common enterprise." "Association" is defined in The American Dictionary of the English Language 80 (1969) as "[a]n organized body of people who have some interest, activity, or purpose in common; a society; league." Health care providers are not united or acting together; they are a diverse group who provide health care in a number of different ways to a number of different individuals with a number of different health care needs. Health care providers would not be an "association," as that word is used in § 104 of the Constitution.

Likewise, § 104 of the Constitution does not prohibit the legislature from "[e]xempting any individual, private corporation, or association from the operation of any general law," if the legislature does this by a general law. It could be argued that the last paragraph of § 104 expressly empowers the legislature to exempt an individual, private corporation, or association from the operation of any general law by enacting a general law; but certainly there is no prohibition against it.

"[G]eneral law," "local law," and "special or private law" are defined in Article IV, § 110, Constitution, as:

"A general law within the meaning of this article is a law which applies to the whole state; a local law is a law which applies to any political subdivision or subdivisions of the state less than the whole; a special or private law within the meaning of this article is one which applies to an individual, association, or corporation."

So a "special or private" law that cannot exempt any individual, private corporation, or association is a law that applies only to an individual, association, or corporation.

In Reese v. Rankin Fite Memorial Hospital, 403 So.2d 158, 162 (Ala.1981), the Alabama Medical Liability Act of 1975 was challenged as violating § 104 of the Constitution. This Court held:

"The last argument made is that the [Alabama Medical Liability Act of 1975] violates § 104 ... of the state constitution. Again, we disagree. [This] constitutional provision[ ] den[ies] to the legislature power to enact special, private, or local laws. Such laws are defined in § 110 of the Constitution. The Alabama Medical Liability Act does not fall within the constitutional definition of special, private, or local laws. Rather, it is a general law as defined by that section: 'A general law within the meaning of this article is a law which applies to the whole state....' It operates throughout the state alike on all the people or all the people of a class. Holt v. Mayor of Birmingham, 111 Ala. 369, 19 So. 735 (1896)."

(Emphasis added.)

Reese v. Rankin Fite Memorial Hospital, supra, held that, despite the fact that the Alabama Medical Liability Act of 1975 dealt only with actions against health care providers, it applied uniformly to an entire class and was statewide in application and therefore, was a general law rather than a special or private law.

There is no difference in the scope of the Alabama Medical Liability Act of 1987 and the scope of the Alabama Medical Liability Act of 1975. Both deal only with actions against health care providers, both apply uniformly to an entire class, and both are statewide in application. Both apply to a shifting class of both medical malpractice plaintiffs and medical malpractice defendants. The Alabama Medical Liability Act of 1987 is statewide and comprehensive in its application to all causes of action against health care providers that accrue after June 11, 1987; therefore, "[i]t operates throughout the state alike on ... all the people of a class." Reese v. Rankin Fite Memorial Hospital, supra; Holt v. Mayor of Birmingham, 111 Ala. 369, 19 So. 735 (1896).

We have considered the authorities cited in the plaintiff's initial brief on this issue. Although the arguments are impressive, we are reluctant at this time to overturn a line of cases both predating the present Constitution (Holt v. Mayor of Birmingham, supra) and as recent as 1981 (Reese, supra), and holding that a "general law," as defined in § 104 of the Constitution and its predecessor in the Constitution of 1875, is a law that operates throughout the state alike on all the people or on all the people of a class.

II.

Whether the plaintiff was prejudiced when he was not permitted to question the defendant as to statements contained in a medical text that was not admitted into evidence.

In the pretrial order in this case, the trial court required that ...