Hospital Authority of Gwinnett County v. Jones

• Decision Date: 22 November 1989
• Docket Number: No. 46956,46956
• Citation: 259 Ga. 759,386 S.E.2d 120
• Parties: HOSPITAL AUTHORITY OF GWINNETT COUNTY et al. v. JONES, Admr. et al.
• Court: Georgia Supreme Court

Page 120

386 S.E.2d 120

259 Ga. 759

HOSPITAL AUTHORITY OF GWINNETT COUNTY et al. v. JONES, Admr. et al.

No. 46956.

Supreme Court of Georgia.

Nov. 22, 1989.

Reconsideration Denied Dec. 20, 1989.

Meade Burns, M.B. Satcher III, Glenn E. Kushel, Long, Weinberg, Ansley & Wheeler, Atlanta, for Hospital Authority of Gwinnett County et al.

James E. Butler, Jr., Columbus, Robert D. Cheeley, Butler, Wooten, Overby & Cheeley, Michael H. Schroder, Swift, Currie, McGhee & Hiers, Atlanta, for R. Stanford Jones, Admr., et al.

HUNT, Justice.

This case raises issues regarding punitive damages: whether the award is authorized under the facts of this case, whether the award is excessive, and whether punitive damages are constitutional under the excessive fines, equal protection, and due process clauses of our state and federal constitutions. ¹

On May 20, 1985, ² William Harold O'Kelley was severely burned over seventy percent of his body from a fire caused by a head-on collision between his truck and a car in Gwinnett County. Emergency personnel responding to the accident immediately called for a medivac helicopter to evacuate O'Kelley to Grady Hospital's burn unit. While still en route to the accident site, the supervisor of the Gwinnett Hospital Authority's emergency rescue unit, Metro Ambulance Services, Inc., countermanded the unanimous judgment of the emergency technicians at the scene and ordered the patient brought to Joan Glancy Hospital, one of the hospital authority's institutions, even though the helicopter was approaching as the ambulance was leaving with the patient. The helicopter was also diverted to Joan Glancy Hospital.

The Gwinnett Chief of Police, who was the dispatch officer at the time of the accident, related facts of other specific instances when an emergency patient was not taken to the nearest hospital or to a trauma center, but instead to one of the authority's institutions. He further testified that Metro's reason for this policy was to "provide more services to the county."

At the hospital emergency room the patient was stabilized, by the establishment of IV lines which the EMT had been unsuccessful in starting in the ambulance, placement of a respiratory tube in the patient's burned throat after he complained of shortness of breath about an hour after reaching the hospital, and administration of morphine. Due to the severity of his injuries, the patient's chances of survival were about 1%. About an hour and a half after arriving, O'Kelley was strapped into a stretcher and loaded onto the helicopter for evacuation to Humana Hospital in Augusta. On lift-off from the hospital parking lot, the helicopter hit a light pole and crashed. Experts testified at trial that the accident was caused by gross pilot error, not only for flying into the pole, but also because the water-alcohol tank, which may have been necessary to give added power to the helicopter engine for the ascent from such a confined space, was empty.

Incredibly, though the pilot and another occupant of the helicopter were killed, O'Kelley was only slightly injured in the helicopter crash. O'Kelley was transported by ambulance to Grady Hospital, where he died six days later as a result of his extensive burns. The bill for services from Joan Glancy Hospital was $1,216.26.

The administrator of O'Kelley's estate sued ³ the Gwinnett Hospital Authority in its own capacity and as the owner of the Gwinnett Ambulance Services doing business as Metro Ambulance Services, Inc. ⁴ , for the negligent acts of the hospital authority employees.

The jury awarded O'Kelley's estate nominal damages of $5,001.00 against the hospital authority and Metro, and punitive damages of $1,300,000.00 against the Gwinnett Hospital Authority and $5,000.00 against Metro Ambulance Services, Inc. The hospital authority appeals.

1. In its first enumeration of error, the Gwinnett Hospital Authority contends the trial court erred in failing to direct a verdict in its favor on the ground that the evidence did not authorize an award of punitive damages. The estate relied on two theories to support its demand for punitive damages: that the hospital authority, motivated by a desire to increase profits rather than by the best interests of its patients, directed emergency patients to its own institutions despite the fact that other hospitals were closer or more suited for the care required by the patient, and that the hospital authority failed to maintain proper emergency helicopter landing areas at its hospitals, specifically Joan Glancy, even though it knew the landings were unsafe and medivac helicopters would occasionally be required to use them.

OCGA § 51-12-5 provides for the award of punitive damages:

In a tort action in which there are aggravating circumstances, in either the act or the intention, the jury may give additional damages to deter the wrongdoer from repeating the trespass or as compensation for the wounded feelings of the plaintiff. ⁵

The courts have consistently required that

"[t]o authorize the imposition of punitive or exemplary damages there must be evidence of wilful misconduct, malice, fraud, wantonness, or oppression, or that entire want of care which would raise the presumption of a conscious indifference to consequences." [Cits.]

Kaplan v. Sanders, 237 Ga. 132, 134, 227 S.E.2d 38 (1976); Associated Health Systems v. Jones, 185 Ga.App. 798(2), 366 S.E.2d 147 (1988). The measure of damages, "within the enlightened conscience of a jury," appears to be judicially engrafted onto this code section. ⁶ King v. Towns, 102 Ga.App. 895, 904, 118 S.E.2d 121 (1960); Head v. John Deere Plow Co., 71 Ga.App. 276, 279, 30 S.E.2d 662 (1944). See division 5, infra.

There is some evidence in this record to support a finding of aggravated conduct and, therefore, the award of punitive damages. A policy of bypassing emergency care at a nearby hospital or diverting patients from an institution whose specialty would have been beneficial to a patient in order to utilize the authority's own hospitals supports a jury's finding a wanton disregard for the rights, and a conscious indifference to the best interests, of its injured patients. Although the evidence was, to be sure, conflicting, it authorized a determination that the authority's decision was made on an economic, rather than a medical, basis. Therefore, because the jury could decide that the patient's slight injuries in the helicopter incident would not have occurred but for the emergency care policy, the award of nominal damages was authorized and it was not inappropriate that the jury act to deter such conduct through the use of punitive damages under OCGA § 51-12-5. ⁷ Woodbury v. Whitmire, 246 Ga. 349, 351, 271 S.E.2d 491 (1980).

2. The award in this case is not, as a matter of law, excessive. See division 5, infra. That this award appears to bear no rational relationship to the extent of the injury is of no consequence. ⁸ "[Punitive damages] are not compensation for injury. Instead, they are private fines levied by civil juries to punish reprehensible conduct and to deter its future occurrence." Gertz v. Robert Welch, Inc., 418 U.S. 323, 350, 94 S.Ct. 2997, 41 L.Ed.2d 789 (1974). The concept of proportionality as a legal limitation on the amount of punitive damages applies, in Georgia, only when such damages are given to compensate for wounded feelings. A deterrence award is based on factors, for the most part, unrelated to the injury to any particular victim, and is limited only by the collective conscience of the jury. Smith v. Milikin, 247 Ga. 369(3), 276 S.E.2d 35 (1981); King v. Towns, supra, 102 Ga.App. at 904, 118 S.E.2d 121; Davis v. Glaze, 182 Ga.App. 18, 23, 354 S.E.2d 845 (1987); Lang v. Hopkins, 10 Ga. 37(3) (1851); OCGA § 51-12-12. Compare Jones v. Spindel, 122 Ga.App. 390, 394, 177 S.E.2d 187 (1970). However, while in deterrence cases there is no fixed rule regarding a relationship between the award of punitive and actual damages, a court may always consider that fact in questioning the excessiveness of the verdict. ⁹ E.g., Colonial Pipeline Co. v. Brown, 258 Ga. 115, 123, 365 S.E.2d 827 (1988) (plurality opinion).

3. There is no merit to the hospital authority's contention that an award of punitive damages violates the excessive fines clause of the Eighth Amendment to the United States Constitution. Browning-Ferris Industries of Vermont, Inc. v. Kelco, 492 U.S. 257, 109 S.Ct. 2909, 106 L.Ed.2d 219 (1989). Nor, under the facts of this case, do we find a violation of the excessive fines clause of our Georgia Constitution, Art. I, Sec. I. Par. XVII. Compare, Colonial Pipeline Co. v. Brown, supra, 258 Ga. at (4), 365 S.E.2d 827.

4. Neither the lower standard for liability, the absence of certain protections available to criminal defendants, nor the lack of a ceiling on the amount of punitive damages that can be awarded, results in a denial of equal protection to civil, as compared to criminal, defendants. Because no fundamental rights or suspect classes are involved, these classifications pass the rational basis test under minimal scrutiny. Colonial Pipeline Co. v. Brown, supra, 258 Ga. at 124, 365 S.E.2d 827 (Clarke, P.J., dissenting).

5. The hospital authority next contends that OCGA § 51-12-5, supra, violates due process in that its notice as to the proscribed conduct is unconstitutionally vague and in that its measure of damages, based solely on the "enlightened conscience of the jury," permits verdicts which may be arbitrary and oppressive and yet not subject to limitation by appropriate procedural safeguards.

a. Initially, the hospital authority argues that neither a potential defendant nor a jury can distinguish between a "lack of ordinary care" amounting to negligence and an "entire want of care" entitling a plaintiff to punitive damages. We disagree. Since, under Georgia law, a scienter element which goes beyond even gross negligence is required, e.g., BLI Construction...