Guzman v. Jones

• Decision Date: 22 October 2015
• Docket Number: No. 15–40007,15–40007
• Citation: Guzman v. Jones, 804 F.3d 707 (5th Cir. 2015)
• Parties: Jaime GUZMAN ; Derrick Lambert, Plaintiffs–Appellees, v. Melvin JONES; Celadon Trucking Services, Incorporated, Defendants–Appellants.
• Court: U.S. Court of Appeals — Fifth Circuit

804 F.3d 707

Jaime GUZMAN ; Derrick Lambert, Plaintiffs–Appellees

v.Melvin JONES; Celadon Trucking Services, Incorporated, Defendants–Appellants.

No. 15–40007

United States Court of Appeals, Fifth Circuit.

Oct. 22, 2015.

Ryan Grant Anderson, Law Offices of Ryan G. Anderson, P.L.L.C., San Antonio, TX, Gene Stuart Hagood, Hagood, Neumann & Huckeba, L.L.P., Alvin, TX, for Plaintiff–AppelleeJaime Guzman.

Gene Stuart Hagood, Hagood, Neumann & Huckeba, L.L.P., Alvin, TX, for Plaintiff–AppelleeDerrick Lambert.

David Lawrence Plaut, Esq., Eric Scott Peabody, Attorney, Hanna & Plaut, L.L.P., Austin, TX, Baldemar Garcia, Jr., Person, Whitworth, Borchers & Morales, L.L.P., Laredo, TX, for Defendants–Appellants.

Peter M. Kelly, Attorney, Law Office of Peter M. Kelly, P.C., Houston, TX, Bryan O. Blevins, Jr., Esq., Trial Attorney, Provost Umphrey Law Firm, L.L.P., Beaumont, TX, Judy Kostura, Judge, Kostura & Putman, P.C., Austin, TX, for Amicus Curiae.

Appeal from the United States District Court for the Southern District of Texas.

Before HIGGINBOTHAM, ELROD, and SOUTHWICK, Circuit Judges.

Opinion

JENNIFER WALKER ELROD, Circuit Judge:

Melvin Jones and Celadon Trucking Services appeal the district court's denial of their motion for new trial.They argue that the district court erred by admitting evidence of Jaime Guzman's medical expenses and refusing to provide an adverse jury instruction in their favor based on spoliation of evidence after Guzman underwent back surgery prior to a requested medical examination.Because the district court did not abuse its discretion in admitting evidence of the medical bills and in refusing spoliation sanctions, we AFFIRM.

I.

This law suit arises from a motor vehicle accident between a truck driven by Jones and owned by Celadon and another vehicle driven by Jaime Guzman.All parties agree that Jones was at fault for the accident and that Celadon is vicariously liable because the accident occurred in the scope of Jones' employment.A trial took place solely to determine the amount of damages.The jury returned an award of $1,314,000 to Guzman, of which $104,000 reflected past medical expenses.An additional $20,500 was awarded to co-plaintiffDerrick Lambert.Appellants do not contest that award.

During trial the district court allowed Guzman to present evidence of his medical bills.These bills showed the amounts charged to Guzman by his various medical providers.Although one bill indicates that Guzman may have been eligible for workers' compensation, no bill shows any reduction in charges provided as part of insurance coverage.The parties agree that, at the time of the accident, Guzman was not actually a Medicaid participant and received no benefits from the program toward his medical expenses, nor did he receive any workers' compensation payments.

Prior to trial, Appellants moved to exclude the bills, arguing that Guzman was eligible for Medicaid and workers' compensation based on his employment status and his income levels.The district court denied Appellants' motion.

During discovery, on May 9, 2011, Appellants sent Guzman's counsel an e-mail indicating that they wanted Guzman to undergo an independent medical examination¹ to support Appellants' contention that his injuries were not a result of the accident.Guzman's counsel provided Appellants' counsel with a draft order agreeing to the examination.The draft order was unsigned and had blank spaces in which Appellants' counsel could enter the examining physician and date of examination.On May 27, Guzman disclosed to Appellants during his deposition that he intended to undergo back surgery.On June 21, Appellants' counsel sent Guzman's counsel a signed proposed order for an independent medical examination.On June 23, Guzman scheduled his surgery, which then took place on June 27.On June 29, Guzman's counsel signed and returned the proposed order, which was never filed with the court.Guzman underwent the examination on July 26.Guzman's medical records, including scans taken prior to his surgery, were provided to Appellants' examiner.Following the examination, Appellants moved for sanctions against Guzman, alleging that his surgery constituted spoliation of evidence, and they requested a jury instruction of an adverse inference in their favor.The district court denied both motions.

II.

We review district court rulings on the admissibility of evidence for abuse of discretion.Arthur J. Gallagher & Co. v. Babcock,703 F.3d 284, 293(5th Cir.2012).When the question of admissibility first involves a legal determination, this court begins by reviewing the underlying legal analysis de novo.Global Petrotech, Inc. v. Engelhard Corp.,58 F.3d 198, 201(5th Cir.1995).

In 2003, Texas enacted an omnibus tort reform bill and approved, through voter referendum, a state constitutional amendment to alter the state's treatment of tort liability in a broad range of areas.Act of June 2, 2003, 78th Leg. R.S., ch. 204, 2003 Tex. Sess.LawServ. Ch. 204 (H.B. 4)(West);Tex. Const. art. III, § 66.As part of that reform, the legislature passed and the governor signed into law a provision that “[i]n addition to any other limitation under law, recovery of medical or health care expenses incurred is limited to the amount actually paid or incurred by or on behalf of the claimant.”Tex. Civ. Prac. and Rem.Code § 41.0105(West).The precise meaning of § 41.0105 has been the topic of considerable debate.²

The Supreme Court of Texas addressed § 41.0105 directly in Haygood v. De Escabedo,356 S.W.3d 390(Tex.2012).Aaron Haygood was injured in a car accident caused by Margarita de Escabedo.Haygood,356 S.W.3d at 392.During his trial, Haygood introduced several medical bills totaling $110,069.12.Id.These bills, however, were an inaccurate reflection of his actual personal liabilities because he was a participant in Medicare Part B. Id.As the Supreme Court of Texas explained:

Charges for health care, once based on the provider's costs and profit margin, have more recently been driven by government regulation and negotiations with private insurers.A two-tiered structure has evolved: “list” or “full” rates sometimes charged to uninsured patients, but frequently uncollected, and reimbursement rates for patients covered by government and private insurance....[F]ew patients today ever pay a hospital's full charges, due to the prevalence of Medicare, Medicaid, HMOs, and private insurers who pay discounted rates.Hospitals, like health care providers in general, feel financial pressure to set their full charges as high as possible, because the higher the full charge the greater the reimbursement amount the hospital receives since reimbursement rates are often set as a percentage of the hospital's full charge....Providers commonly bill insured patients at list rates, with reductions to reimbursement rates shown separately as adjustments or credits.Portions of bills showing only list charges are admitted in evidence, with proof of reasonableness coming from testimony by the provider, or more often, by affidavit of the provider....

Id. at 393–94(footnotes, alteration, and internal quotation marks omitted).In Haygood,the plaintiff entered into evidence bills showing the list prices of the treatments he had received even though the amounts actually paid by Medicare and Haygood were only one-fourth of that amount.Id. at 392, 394.Because of the reimbursement rates mandated by law through Medicare, the various providers treating Haygood were only entitled to a maximum of $27,739.43.Id. at 392.In response, Haygood argued that the reduction in his bill fell under the collateral source rule, the common law principle that precludes any reduction in a tortfeasor's liability because of benefits received by the plaintiff from a third party.Id. at 392, 394–96.The Supreme Court of Texas, however, concluded that the text of § 41.0105“limits a claimant's recovery of medical expenses to those which have been or must be paid by or for the claimant.”Id. at 398.Because neither Haygood nor Medicare was under any obligation to pay the amounts entered into evidence, the court reversed the award and capped his damages at the total amount owed by Haygood and Medicare.Id. at 399–400.

The present case raises a different question than that answered in Haygood: whether an uninsured plaintiff who may have been eligible for insurance benefits but did not have insurance at the time of his injury or treatment is barred from presenting evidence of the list prices he was charged by the hospital and is obligated to pay.

Appellants argue here that Guzman's debt to his medical providers is not “actually incurred” because Guzman may have been charged a different rate had he participated in an insurance program.That argument is unconvincing; here, Guzman has actually incurred his billed obligations because he received the medical care, was billed for it, has provided no payments to cover it, and could be subject to suit for non-payment in the full amount billed.The amount he might have owed under different circumstances has no bearing on what Guzman actually owes now.Appellants' reliance on Haygood is misplaced.The decision in Haygood prohibits a plaintiff from introducing evidence of, or recovering damages in excess of, the reduced rate negotiated between his insurer and his medical provider because that is the most the medical provider can take from the plaintiff.Haygood,356 S.W.3d at 395, 399(“[W]e hold that only evidence of recoverable medical expenses is admissible at trial.”).Haygood gives no indication, however, that such a limitation is required by § 41.0105 when the plaintiff does not benefit from a reduced rate but merely may be eligible for insurance or public benefits that would have reduced his rates.

The Supreme Court of Texas has not yet considered the precise issue raised in this case.In such a situation, which calls for an “Erie guess,”seeKrieser v. Hobbs,166 F.3d 736,...