Iodice v. U.S.

• Decision Date: 02 May 2002
• Docket Number: Docket No. 01-1651.,Docket No. 01-1654.,No. 01-1640.,01-1640.
• Citation: 289 F.3d 270
• Parties: Aline Joan IODICE; James Iodice; Mary J. Iodice, Plaintiffs-Appellants, v. UNITED STATES of America; Department of Veterans Affairs, an agency of the United States of America, Defendants-Appellees. Barbara Hansen, Administratrix of the Estate of Julie Marie Hansen, Plaintiff-Appellant, v. The Department of Veterans Affairs, Defendant-Appellee. R. Kenneth Babb, Ancillary Public Administrator of the Estate of Maia Cory Witzl, Plaintiff-Appellant, v. Department Of Veterans Affairs, Defendant-Appellee.
• Court: U.S. Court of Appeals — Fourth Circuit

289 F.3d 270

Aline Joan IODICE; James Iodice; Mary J. Iodice, Plaintiffs-Appellants, v. UNITED STATES of America; Department of Veterans Affairs, an agency of the United States of America, Defendants-Appellees.

Barbara Hansen, Administratrix of the Estate of Julie Marie Hansen, Plaintiff-Appellant, v. The Department of Veterans Affairs, Defendant-Appellee.

R. Kenneth Babb, Ancillary Public Administrator of the Estate of Maia Cory Witzl, Plaintiff-Appellant, v. Department Of Veterans Affairs, Defendant-Appellee.

No. 01-1640.

Docket No. 01-1651.

Docket No. 01-1654.

United States Court of Appeals, Fourth Circuit.

Argued February 27, 2002.

Decided May 2, 2002.

COPYRIGHT MATERIAL OMITTED

ARGUED: David D. Daggett, Lewis & Daggett, Winston-Salem, North Carolina; Robert Mauldin Elliot, Elliot, Pishko, Gelbin & Morgan, P.A., Winston-Salem, North Carolina, for Plaintiffs-Appellants. Gill Paul Beck, Assistant United States Attorney, Greensboro, North Carolina, for Defendants-Appellees.

ON BRIEF: Rodney A. Guthrie, Bennett & Guthrie, P.L.L.C., Winston-Salem, North Carolina, for Plaintiffs-Appellants. Benjamin H. White, Jr., United States Attorney, Greensboro, North Carolina, for Defendants-Appellees.

Before WILKINS, MICHAEL, and MOTZ, Circuit Judges.

Affirmed by published opinion. Judge MOTZ wrote the opinion, in which Judge WILKINS and Judge MICHAEL joined.

OPINION

DIANA GRIBBON MOTZ, Circuit Judge.

On September 4, 1996, Richard Thomas Jones, when driving his car while severely impaired by alcohol and prescription drugs, crashed into a car carrying several college students. The accident seriously injured Aline Joan Iodice, and killed two other students, Julie Marie Hansen and Maia Cory Witzl. Iodice and the administrators of Hansen's and Witzl's estates (collectively "the students") brought these consolidated actions, pursuant to the Federal Tort Claims Act, 28 U.S.C.A. §§ 2671-2680 (1994), against the United States.¹ They allege that employees of the Department of Veterans Affairs (VA) committed numerous negligent acts — including negligently dispensing narcotics to Jones and failing to institute, enforce, and monitor adequate policies concerning the dispensation of narcotics — that proximately and foreseeably caused their injuries. We affirm the district court's dismissal of their complaints, albeit on somewhat different grounds than those on which the district court relied.

I.

In reviewing a dismissal for failure to state a claim under Federal Rule of Civil Procedure 12(b)(6), we accept the facts as alleged by the plaintiffs and construe them in the light most favorable to the plaintiffs, but consider legal issues de novo. See Flood v. New Hanover County, 125 F.3d 249, 251 (4th Cir.1997). The factual account below is drawn from the three amended complaints.

For more than fifteen years before the 1996 accident at the core of this case, doctors at VA facilities in Asheville, North Carolina, and Salisbury, North Carolina, treated Jones (a veteran) for a number of painful physical problems (including amputation of a leg and surgeries on his back) and administered necessary pain medications to him. Jones became dependent on both prescription drugs and alcohol. For example, according to his medical history, in the eighteen months before the accident, Jones took 30-40 Percocet pills a day.

The VA included Jones in a "drug registry" of addicts that it maintained at its Asheville facility. Jones developed a "history of requesting and receiving early refills of his prescriptions," and his wife urged VA employees to treat her husband for drug addiction and to limit his prescriptions. Nonetheless, the VA continued to prescribe narcotics to Jones and permitted him to receive prescription refills through the mail.

On three occasions, VA facilities admitted Jones as an inpatient for alcohol or alcohol and drug detoxification; the last admission began on August 3, 1996. During that admission, Jones was reported to be drunk and under the influence of narcotics, and to have left the campus twice to drink. Throughout the admission, Jones demonstrated effects of alcohol and narcotics abuse including belligerent behavior, an unsteady gait, slurred speech, and a strong odor of alcohol. Later in August, Jones left the inpatient program without completing detoxification.

On August 30, 1996, after Jones had ceased to be an inpatient, a VA doctor prescribed narcotics for Jones in doses even greater than his usual heavy dose. On September 3, 1996, a VA employee, either a doctor or a staff member, permitted Jones to refill his prescription early. The next evening, driving under the influence of alcohol and narcotics, Jones caused the fatal accident. In sum, the students allege that "veteran Jones was being prescribed excessive narcotic drugs and other medications which, at the time of the collision, impaired his ability and judgment, and proximately caused said collision, and resulting injuries and damages" to them.²

The students sued the United States, alleging that the accident was proximately and foreseeably caused by breaches of a number of duties that the VA purportedly owed to Jones and to the public. A magistrate judge recommended that the complaints be dismissed for failure to state a claim. Apparently concluding that all claims asserted in the complaints constituted claims of medical malpractice, the magistrate judge ruled that the complaints should be dismissed because North Carolina law does not "recognize a cause of action for medical malpractice brought by [unrelated third party] victims of a patient who commits the type of crimes committed by Jones in these cases." The district court rejected the students' timely objections, accepted the magistrate judge's recommendation, and dismissed all three cases. These appeals followed.

In this federal tort claims action, arising out of events occurring in North Carolina, the law of that state controls. See FDIC v. Meyer, 510 U.S. 471, 478, 114 S.Ct. 996, 127 L.Ed.2d 308 (1994). We must rule as the North Carolina courts would, treating decisions of the Supreme Court of North Carolina as binding, and "depart[ing] from an intermediate court's fully reasoned holding as to state law only if `convinced' that the state's highest court would not follow that holding." See Assicurazioni Generali, S.p.A. v. Neil, 160 F.3d 997, 1003 (4th Cir.1998). The students contend that they have alleged not one, but two, kinds of claims against Jones's health care providers — medical malpractice claims and ordinary negligence claims — and that North Carolina law permits them to bring both kinds of claims. We consider their arguments with respect to each kind of claim in turn.

II.

By statute, North Carolina defines a "medical malpractice action" as "a civil action for damages for personal injury or death arising out of the furnishing or failure to furnish professional services in the performance of medical, dental, or other health care by a health care provider," including a doctor, a pharmacist, or a hospital. N.C. Gen.Stat. § 90-21.11 (1999). Unquestionably, some of the students' claims, specifically those attacking the quality of the medical care the VA provided to Jones in terms that track the statutory medical malpractice standard, constitute claims for medical malpractice. See N.C. Gen.Stat. § 90-21.12 (1999). Thus, it is clear that the students have alleged medical malpractice claims against Jones's health care providers. However, it is equally clear that North Carolina does not allow such claims. Rather, the Supreme Court of North Carolina has unequivocally held that "the relationship of physician to patient must be established as a prerequisite to an actionable claim for medical malpractice." Easter v. Lexington Mem'l Hosp., 303 N.C. 303, 278 S.E.2d 253, 255 (N.C.1981) (citation omitted).

Nevertheless, the students insist that North Carolina law permits them, Jones's victims, to bring medical malpractice claims against Jones's health care providers. They rely on Pangburn v. Saad, 73 N.C.App. 336, 326 S.E.2d 365 (N.C.Ct.App. 1985), and Mozingo v. Pitt County Memorial Hospital, 101 N.C.App. 578, 400 S.E.2d 747 (N.C.Ct.App.1991). Neither case assists them.

Pangburn simply holds that third party victims of a wrongly released mental patient may sue the patient's health care providers for negligent release. Pangburn, 326 S.E.2d at 367. A claim for negligent release is not a claim for medical malpractice. In Mozingo, although the North Carolina Court of Appeals did permit a plaintiff to pursue a medical malpractice claim against a doctor with whom he had no personal doctor-patient relationship, the plaintiff himself was a patient allegedly afforded inadequate medical care, not the victim of a patient afforded inadequate medical care. See Mozingo, 400 S.E.2d at 751-53; see also Webb v. Nash Hosps., Inc., 133 N.C.App. 636, 516 S.E.2d 191, 194 (N.C.Ct.App.1999) (considering, but finding no facts to support, a Mozingo claim in a suit by a patient).

Thus, the students have not cited, and we have not found, a single North Carolina case permitting unrelated third party victims of a patient to sue the patient's health care providers for medical malpractice, or even suggesting that such claims are possible.³ Instead, North Carolina courts have emphasized the policy reasons counseling rejection of such suits; "`doctors should owe their duty to their patient and not to anyone else' so as not to compromise this primary duty." Russell v. Adams, 125 N.C.App. 637, 482 S.E.2d 30, 33 (N.C.Ct.App.1997) (rejecting a third party claim of harm based on the care provided by a medical provider to a patient) (citations omitted); see also Childers v. Frye, 201 N.C. 42, 158 S.E. 744, 746 (N.C.1931) (holding that doctors do not have to accept patients); Nash v. Royster, 189 N.C. 408, 127 S.E. 356, 359 (N.C.1925) (holding that doctors may limit the extent of their responsibility to patients by narrowing the scope of...