Johnson v. St. Vincent Hospital, Inc.
Decision Date | 16 May 1980 |
Docket Number | Nos. 1078,s. 1078 |
Citation | 404 N.E.2d 585,273 Ind. 374 |
Parties | William JOHNSON and Connie Johnson, Appellants, v. ST. VINCENT HOSPITAL, INC., St. Vincent Emergency Physicians, Inc., Stephen Watson, Robert A. Blackburn, and H. Pete Hudson, Commissioner of Insurance of the State of Indiana, Appellees. Sharon S. BOVA and Joseph A. Bova, Husband and Wife, Appellants, v. Chester KMAK, M. D., Robert Goldstone, M. D., and Broadway Methodist Hospital, Inc., A Corporation, Appellees. Abed MANSUR, Appellant, v. Donald J. CARPENTER, M. D., Indiana Department of Insurance, and H. P. Hudson, As Commissioner of Insurance, Appellees. Carl W. HINES and Andrew J. Fetsch, As Special Administrators of the Estate of Paula J. Hines, Carl W. Hines, Individually, and Karen Kay Hines, Sandra Carol Hines and William Walter Hines by Carl W. Hines, Their Mutual Guardian and Best Friend, Appellants, v. ELKHART GENERAL HOSPITAL and E. L. Fosbrink, M. D., Appellees. S 216, 779 S 178, 379 S 79, and 1179 S 315. |
Court | Indiana Supreme Court |
Forrest Bowman, Jr., Indianapolis, for appellants Johnson.
Karl J. Stipher, James H. Ham, III, Indianapolis, for amicus curiae Indiana State Medical Association.
James J. Stewart, Edward Squier Neal, Indianapolis, for appellee Robert Blackburn.
Geoffrey Segar, Ralph A. Cohen, Indianapolis, for appellee St. Vincent Hospital, Inc.
Aribert L. Young, Donald L. Dawson, Peter G. Tamulonis, Indianapolis, for appellees St. Vincent Emergency Physicians Inc. and Stephen Watson.
Theodore L. Sendak, Atty. Gen., Robert J. Black, Deputy Atty. Gen., Indianapolis, for appellee H. P. Hudson, Commissioner of Insurance of the State of Indiana.
Timothy S. Schafer, Merrillville, for appellants Bova.
David C. Jensen, Hammond, for appellee Robert Goldstone.
Lester F. Murphy, East Chicago, for appellee Chester Kmak.
Jon F. Schmoll, James D. McQuillan, Gary, for appellee Broadway Methodist Hospital.
Theodore L. Sendak, Atty. Gen., Dan S. LaRue, Deputy Atty. Gen., Indianapolis, for Attorney General.
John J. Dillon, William T. Rosenbaum, Indianapolis, for amicus curiae Rockwood Insurance Company and Independent Insurance Agents of Indiana.
Mark W. Gray, Indianapolis, for amicus curiae Indiana Hospital Association.
Saul I. Ruman, Hammond, for amicus curiae Indiana Trial Lawyers Association.
J. B. Smith, Timothy F. Kelly, Randall J. Nye, Hammond, for appellants Hines and Fetsch.
Vernon J. Petri, John J. Fuhs, Spencer, Leon D. Cline, William H. Stone, Columbus, for appellant Mansur.
Geoffrey Segar, Indianapolis, for amicus curiae Indiana Medical federation.
Karl J. Stipher, James H. Ham, III, Indianapolis, for amicus curiae Indiana State Medical Association.
Arthur A. May, Thomas J. Hall, South Bend, for appellees Elkhart General Hospital and E. L. Fosbrink.
James J. Stewart, Edward Squier Neal, Indianapolis, for appellee Donald Carpenter.
In these cases we consider the constitutionality of aspects of the Indiana Medical Malpractice Act. Ind. Code §§ 16-9.5-1-1 through 16-9.5-10-5. Appellants Johnson brought their medical malpractice claim for death of a minor child occurring in the aftermath of a tonsillectomy in the trial court without first submitting it to a medical review panel for an opinion as required by the Act. Ind.Code § 16-9.5-9-2. The complaint included a separate paragraph seeking a declaratory judgment upon the constitutionality of the statute. Upon their summary judgment motion the trial court determined that the statute governed the claim, upheld the statute, and then dismissed their complaint upon motion of appellees.
Appellants Bova brought their claim for medical malpractice in the trial court for wrongful injury to the ureter and kidney of Mrs. Bova occurring as a consequence of a hysterectomy. This complaint was also filed in the trial court without first submitting it to a review panel as required by the Act, and included a paragraph of complaint for declaratory judgment upon the constitutionality of the statute. The trial court found the Act governing, the Act consistent with the Constitution, and the motion of appellees for summary judgment for non-compliance with the Act well taken.
Appellant Mansur brought his claim for wrongful injury and loss of vision to his right eye resulting from the negligence of a physician in examining, treating, and diagnosing him. He also challenged the Act in a paragraph of his complaint on constitutional grounds. The trial court determined that the claim was subject to the Act, that the Act was constitutional, and that the malpractice claim should be dismissed because claimant had not complied with the provisions of the Act.
The Hines case involves a claim seeking damages for the wrongful death of Paula J. Hines on behalf of her husband and dependent children, such death being attributed to the negligence of her physician and the hospital in providing her with treatment and care. The trial court dismissed the complaint, finding that the Act was constitutional, and that appellant had failed to comply with its requirements. This case was previously filed in the Federal District Court and was dismissed for failure to comply with the Indiana Act. That court found the Act constitutional. Hines v. Elkhart General Hospital et al.., (N.D.Ind. South Bend Div., 1979) 465 F.Supp. 421. The district court's judgment was affirmed on August 3, 1979.
Pursuant to Ind.R.App.P. 4(A)(10) we have permitted transfer to this Court. These appeals were heretofore consolidated for the purposes of argument and are now consolidated for opinion.
In the Mansur case a great deal of proof descriptive of the conditions in the health care and insurance industries which gave rise to the Act was brought forth and developed at a trial for constitutional purposes. Immediately prior to its enactment seven of the ten insurance companies writing the majority of medical malpractice insurance policies in the State ceased or limited writing such insurance because of unprofitability or an inability to calculate an adequate premium. Premiums had already increased as much as 1200 percent over a period of fifteen years because of the increase in the number and size of claims. Physicians practicing high risk specialties such as anesthesiology were hard pressed or totally unable to purchase insurance coverage. In some rural areas surgery was reported cancelled. Emergency services were discontinued at some hospitals. Health care providers had become fearful of the exposure to malpractice claims and at the same time were unable to obtain adequate malpractice insurance coverage at reasonable prices.
According to the Legislature's appraisal, these conditions implicated the vital interests of the community in the availability of the professional services of physicians and other health care providers. The Legislature responded with this Act in an effort to preserve those services and thereby to protect the public health and wellbeing of the community. It reflects a specific legislative judgment that a causal relationship existed at the time between the settlement and prosecution of malpractice claims against health care providers and the actual and threatened diminuation of health care services. The exceptionally high cost and even unavailability of malpractice insurance were major links in the relational chain. They in turn were connected through the large settlements and judgments being paid to patients. To the extent that these sums were excessive or unjustifiable, they had become so large because the processes by which evidence of negligent conduct was being gathered, evaluated, and used were faulty. Subsidiarily, these sums were being unnecessarily increased because the habitually negligent health care providers were not being identified and dealt with, very large attorney fees were being charged, and the time limitations upon bringing malpractice actions were too long.
With these judgments as its basis the Act created voluntary state-sponsored liability insurance for doctors and other health care providers, created a patient compensation fund, took measures to prevent injuries to patients through the negligence of health care providers, and subjected negligence claims against health care providers to special controls limiting patient remedies.
The issue in this appeal is whether those special controls and limitations are consistent with the guarantees of the Indiana and Federal Constitutions. Appellants complain of the following features of the Act:
(I) Before filing suit in court, plaintiffs must submit their complaints to the Commissioner for consideration by a medical review panel. The panel renders an opinion which is admissible at trial. Appellants contend these and related provisions violate the (A) jury trial provisions of Art. I, § 20, of the Indiana Constitution; (B) due process and (C) equal protection clauses of the Fourteenth Amendment, and the Indiana Constitution, the rights and privileges clause of Art. I, § 23, of the Indiana Constitution; and (D) the separation of powers doctrine of Art. III, § 1, of the Indiana Constitution.
(II) Recovery in malpractice cases is limited to $500,000 when health care provider has elected to come under the Act. Appellants challenge this limitation relying upon the due process and equal protection clauses of the Fourteenth Amendment and the Indiana Constitution, the rights and privileges clause of Art. I, § 23, of the Indiana Constitution, the right to trial by jury guaranteed by Art. I, § 20, of the Indiana Constitution.
(III) Attorney fees to be paid plaintiff's attorney are limited by the Act. This limitation is challenged as contrary to the due process and equal protection clauses of the Fourteenth Amendment and the Indiana Constitution.
(IV) The time in which a malpractice action may be brought is severely limited by the Act. This limitation is challenged as contrary to the guarantee of the due process and equal...
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