McIntyre v. Ramirez

• Decision Date: 26 June 2003
• Docket Number: No. 01-1203.,01-1203.
• Citation: 109 S.W.3d 741
• Parties: Douglas K. McINTYRE M.D., Petitioner, v. Debra Marie RAMIREZ and Victor Bocanegra, Both Individually and as Next Friends of Colby Alan Ramirez, A Minor, Respondents.
• Court: Texas Supreme Court

Page 741

109 S.W.3d 741

Douglas K. McINTYRE M.D., Petitioner, v. Debra Marie RAMIREZ and Victor Bocanegra, Both Individually and as Next Friends of Colby Alan Ramirez, A Minor, Respondents.

No. 01-1203.

Supreme Court of Texas.

Argued on February 5, 2003.

Decided June 26, 2003.

James B. Ewbank, II, Maria Teresa Cantu, Ewbank & Bryam, P.C., Austin, for petitioner.

Michael Ernest Archuleta, Bill Whitehurst, Laurie Miche Higginbotham, Whitehurst Harkness Ozmun & Brees, Austin, for petitioners.

Justice WAINWRIGHT delivered the opinion of the Court.

In this medical malpractice action arising from the emergency delivery of an infant, defendant Dr. Douglas McIntyre moved for summary judgment raising the Good Samaritan statute as an affirmative defense. The Good Samaritan statute provides an affirmative defense against ordinary negligence for persons who administer emergency care, under specified circumstances. TEX. CIV. PRAC. & REM.CODE § 74.001. However, the statute does not protect from liability persons whose services were provided "for or in expectation of remuneration." Id. § 74.001(b)(1). The trial court granted the doctor's motion for summary judgment, but a divided court of appeals reversed, holding that the doctor failed to prove conclusively that he was entitled to protection from liability under the Good Samaritan statute. Specifically, the court of appeals held that the doctor failed to prove that he was not legally entitled to receive payment for the emergency services he rendered. 59 S.W.3d 821, 827.

This case presents a question of statutory construction: what must a person prove to establish that he or she did not act "for or in expectation of remuneration" within the meaning of this exception to immunity from liability in the Good Samaritan statute? TEX. CIV. REM. & PRAC. CODE § 74.001(b)(1). On this issue of first impression, we hold that the statute requires a person to prove that he or she would not ordinarily receive or ordinarily be entitled to receive payment under the circumstances in which the emergency care was provided. Because the summary judgment evidence conclusively established that Dr. McIntyre satisfied these statutory requirements, we reverse the judgment of the court of appeals and remand to that court for further proceedings consistent with this opinion.

I. Factual and Procedural Background

On April 23, 1998, St. David's Medical admitted Debra Ramirez to have labor induced, as scheduled by her obstetrician and attending physician, Dr. Patricia Gunter. Dr. Gunter visited Ramirez during the early stages of labor that day but subsequently left the labor and delivery area. As Ramirez's labor progressed and the baby's head began to crown, Dr. Gunter still had not returned. Dr. McIntyre was on the labor and delivery floor of the Medical Center visiting one his own patients when a nurse sent out page for "Dr. Stork." A "Dr. Stork" page means that a delivery is in progress without a doctor present and that a doctor needed immediately. Dr. McIntyre was not on-call for Dr. Gunter and had never treated nor seen Ramirez, but he responded to the page.

When Dr. McIntyre arrived at Ramirez's delivery room, a nurse was supporting the baby's head and told Dr. McIntyre that Ramirez was about to deliver. Ramirez had been diagnosed with gestational diabetes and the baby was macrosomic — larger than normal for his gestational age. Indications of shoulder dystocia were present. Shoulder dystocia occurs when an infant's shoulder becomes lodged against the mother's pelvic bone. Following several unsuccessful attempts to deliver the baby, Dr. McIntyre reached inside Ramirez, swept the infant's posterior arm across the baby's chest and delivered the baby's arm. Dr. McIntyre then delivered the anterior shoulder and the rest of the baby. Dr. McIntyre was in the delivery room for approximately six minutes. Dr. Gunter arrived after the delivery and resumed care of Ramirez and her baby. The baby was born with injuries to the soft tissues and nerves of his right upper extremity, neck, and shoulder, resulting in permanent neurological impairment and paralysis of his right upper extremity and shoulder girdle.

Ramirez filed suit against Dr. Gunter, Dr. McIntyre, and St. David's Medical Center for medical negligence. Dr. McIntwice tyre moved for summary judgment based on an affirmative defense provided by the Good Samaritan statute for persons who in good faith administer emergency health care without being wilfully or wantonly negligent. See TEX. CIV. PRAC. & REM.CODE ch. 74. The trial court granted Dr. McIntyre's summary judgment motion and rendered final judgment in his favor. The court of appeals reversed the trial court judgment in favor of Dr. McIntyre, concluding that an issue of fact existed as to whether his emergency medical assistance to Ramirez was excluded from the statute's protection because he acted for or in expectation of remuneration. 59 S.W.3d at 826-27.

Dr. McIntyre argues that his summary judgment evidence conclusively established the elements of the Good Samaritan defense. Specifically, he proffered his uncontroverted testimony that neither he nor any doctor in Travis County would have charged a fee to Ramirez or any other person under the circumstances of this case. This testimony, he contends, proved as a matter of law that he would not ordinarily receive or be entitled to receive remuneration for his actions within the meaning of the statute. Ramirez contends that Dr. McIntyre failed to prove that he did not fall within the statutory exception for acts performed for or in expectation of remuneration, and that doctors who provide professional services in hospitals are legally entitled to receive payment for those services as a matter of contract law. The parties' dispute highlights a practical tension between the statute's intent to encourage doctors to provide voluntary emergency medical services and the statute's requisites for the same doctors to prove that they are entitled to immunity. We granted Dr. McIntyre's petition for review to resolve this issue of statutory construction.

II. The Good Samaritan Statute

Under certain circumstances, the Good Samaritan statute exempts a person who responds to a medical emergency from liability for ordinary negligence. The statute provides in relevant part:

§ 74.001 Liability for Emergency Care

(a) A person who in good faith administers emergency care ... is not liable in civil damages for an act performed during the emergency unless the act is wilfully or wantonly negligent.

(b) This section does not apply to care administered:

(1) for or in expectation of remuneration; or

(2) by a person who was at the scene of the emergency because he or a person he represents as an agent was soliciting business or seeking to perform a service for remuneration.

(c) If the scene of an emergency is in a hospital or other health care facility or means of medical transport, a person who in good faith administers emergency care is not liable in civil damages for an act performed during the emergency unless the act is wilfully or wantonly negligent, provided that this subsection does not apply to care administered:

(1) by a person who regularly administers care in a hospital emergency room unless such person is at the scene of the emergency for reasons wholly unrelated to the person's work in administering health care; or

(2) by an admitting or attending physician of the patient or a treating physician associated by the admitting or attending physician of the patient in question.

(d) For purposes of Subsections (b)(1) and (c)(1), a person who would ordinarily receive or be entitled to receive a salary, fee, or other remuneration for administering care under such circumstances to the patient in question shall be deemed to be acting for or in expectation of remuneration even if the person waives or elects not to charge or receive remuneration on the occasion in question.

TEX. CIV. PRAC. & REM.CODE § 74.001.¹

The application of the Good Samaritan statute is divided into two scenarios defined by the physical location at which the emergency care was rendered. See id. § 74.001(a), (c). Here, the scene of the emergency was a labor and delivery room in a hospital. Accordingly, this case implicates section 74.001(c), which applies when the scene of the emergency is a hospital. See id. § 74.001(c). The parties agree that Dr. McIntyre acted in good faith and without wilful or wanton negligence. Dr. McIntyre is therefore exempt from liability under section 74.001(c), unless he is excepted by some other provision in the statute.

III. Applicable Tenets of Statutory Construction

We begin our analysis by reviewing the relevant principles of statutory construction. "In construing a statute, `our primary objective is to determine and give effect to the Legislature's intent.'" Tex. Dep't of Transp. v. Needham, 82 S.W.3d 314, 318 (Tex.2002) (quoting Nat'l Liab. & Fire Ins. Co. v. Allen, 15 S.W.3d 525, 527 (Tex.2000)). We start with the "plain and common meaning of the statute's words." State ex rel. State Dep't of Highways & Pub. Transp. v. Gonzalez, 82 S.W.3d 322, 327 (Tex.2002) (quoting Fitzgerald v. Advanced Spine Fixation Sys., Inc., 996 S.W.2d 864, 865 (Tex.1999)). If the statutory language is unambiguous, we will interpret the statute according to its plain meaning. Id. However, we will not give an undefined statutory term a meaning that is out of harmony or inconsistent with other provisions in the statute. See Needham, 82 S.W.3d at 318. We may consider other matters in ascertaining the Legislature's intent, including the objective of the law, the, legislative history, and the consequences of a particular construction. See TEX. GOV'T CODE § 311.023(1), (3), (5); Union Bankers Ins. Co. v. Shelton, 889 S.W.2d 278, 280 (Tex.1994). Finally, because statutory construction is a question of law, we review the court of appeals' opinion de novo. Gonzalez, 82...