Moore v. Mobile Infirmary Ass'n

Decision Date27 September 1991
Citation592 So.2d 156
CourtAlabama Supreme Court

Gregory B. Breedlove and Andrew T. Citrin of Cunningham, Bounds, Yance, Crowder and Brown, Mobile, for appellant.

W. Michael Atchison, W. Stancil Starnes, Laura H. Peck and A. Sybil Vogtle of Starnes & Atchison, Birmingham, for appellee.

Jack Drake of Drake, Knowles & Pierce, Tuscaloosa, for amicus curiae Alabama Trial Lawyers Ass'n.

ADAMS, Justice.

Barbara Moore appeals from a judgment reducing the amount of damages awarded to her by the jury in a medical malpractice case against Mobile Infirmary Association ("Infirmary"). We reverse.

The undisputed facts reveal that on September 8, 1988, Barbara Moore entered the Infirmary's health care facility for treatment of lower back pain. Her physician prescribed bed rest, traction, physical therapy, pain medications, muscle relaxants, and anti-inflammatory agents. As a sedative, he prescribed periodic muscular injections of "sparine."

On September 18, a nurse injected sparine into Ms. Moore's right forearm, an improper location for such an injection. The injection caused an immediate "burning sensation," followed by a loss of feeling in portions of the right hand. The numbness in her right hand persisted after her discharge from the Infirmary.

On September 21, 1988, Ms. Moore suffered third-degree burns to her little finger while cooking. Because of the absence of sensation in her hand, she was unaware of the significance of the injury until the affected area became gangrenous. The gangrenous condition eventually required amputation of the right little finger. Her right ring finger has also become permanently anesthetized and contracted, and she is expected to experience permanent pain in other areas of her right hand and arm.

Ms. Moore filed an action against the Infirmary in which she sought compensatory and punitive damages, including damages for "physical pain and mental anguish," physical impairment, and disfigurement as a result of alleged negligence or wantonness of the Infirmary's employees. At trial, the Infirmary consented to the entry of a directed verdict against it in favor of Barbara Moore on the issue of liability. The jury, after considering only the issue of damages, returned the following verdict: "We, the jury, assess the plaintiff's damages as follows: Past damages, four hundred thousand dollars; future damages, two hundred thousand dollars. It is our intention to assess total damages to the plaintiff at six hundred thousand dollars."

The trial judge, pursuant to Ala.Code 1975, § 6-5-544(b), reduced the amount of the award of noneconomic damages to $400,000 and entered a judgment against the Infirmary in the amount of $459,000. The judgment thus included the sums of $59,000, which represented economic damages for lost earnings and medical expenses, and $400,000 in damages for noneconomic loss, as defined by the statute. On appeal, the only issue presented for review is whether the statute's limitation on the amount of noneconomic damages that a jury may award offends the Constitution of Alabama of 1901.

Section 6-5-544(b) was enacted as part of the Alabama Medical Liability Act of 1987. Act. No. 87-189, § 5, 1987 Ala.Acts 261. The statute provides:

"In no action shall the amount of recovery for noneconomic losses, including punitive damages, either to the injured plaintiff, the plaintiff's spouse or other lawful dependents or any of them together exceed the sum of $400,000.00. Plaintiff shall not seek recovery in any amount greater than the amounts described herein for noneconomic losses. During the trial of any action neither the court nor any party shall advise or infer to the jury that it may not return an award for noneconomic losses in excess of an amount specified herein; in the event the jury is so advised or such inference is made, the trial court, upon motion of an opposing party, shall immediately declare a mistrial. Any verdict returned which includes an award for noneconomic losses in an amount greater than that permitted herein shall be reduced by the trial court to an amount which will include an award for noneconomic losses no greater than that permitted herein or to such lesser sums as the trial court deems appropriate in accordance with prevailing standards for reducing excessive verdicts."

Id. Section 6-5-544(a) defines "noneconomic loss" as "losses to compensate for pain, suffering, inconvenience, physical impairment, disfigurement, loss of consortium and other nonpecuniary damage."

Ms. Moore contends that § 6-5-544(b) violates various provisions of the Declaration of Rights, which composes article one of the Constitution of Alabama. In particular, she insists that the statutory ceiling on damages violates (1) the right to trial by jury as guaranteed by Ala. Const. art. I, § 11, (2) guarantees of equal protection and due process, (3) the right-of-access-to-courts provision of Ala. Const. art. I, § 13, and (4) the separation of powers provisions of Ala. Const. art. III, §§ 42, 43. Ms. Moore does not challenge the validity of § 6-5-544(b) under any provision of the United States Constitution; therefore, our analysis and conclusions regarding the constitutionality of § 6-5-544(b) are based entirely on adequate and independent state law grounds.

Our disposition of this case is facilitated by reference to the substantial body of case law that has evolved from constitutional challenges brought in the highest courts of other states to statutes imposing damages "caps" of various types. As of the date of this opinion, it appears that the majority of courts reviewing challenges under the constitutions of their respective states have invalidated limitations on damages. See, e.g., Smith v. Department of Ins., 507 So.2d 1080 (Fla.1987) (statute imposing a $450,000 cap on noneconomic damages recoverable in actions for personal injury violated open courts provision); Wright v. Central Du Page Hosp. Ass'n, 63 Ill.2d 313, 347 N.E.2d 736 (1976) ($500,000 limitation on recovery in medical malpractice actions violated equal protection guarantee); Brannigan v. Usitalo, 134 N.H. 50, 587 A.2d 1232 (1991) (statute imposing $875,000 limitation on noneconomic damages recoverable in actions for personal injury violated state constitution's equal protection guarantee); Carson v. Maurer, 120 N.H. 925, 424 A.2d 825 (1980) (statute imposing $250,000 limitation on noneconomic damages recoverable in medical malpractice actions violated state constitution's equal protection guarantee); Arneson v. Olson, 270 N.W.2d 125 (N.D.1978) (statute imposing $300,000 limit on damages recoverable in medical malpractice action violated state and federal equal protection guarantees); Morris v. Savoy, 61 Ohio St.3d 684, 576 N.E.2d 765 (1991) (statute imposing $200,000 limit on "general" damages recoverable in medical malpractice action violated state due process guarantee); Lucas v. United States, 757 S.W.2d 687 (Tex.1988) (statute limiting liability to $500,000 for damages in medical malpractice actions violated open courts provision); Condemarin v. University Hosp., 775 P.2d 348 (Utah 1989) (statute limiting medical malpractice liability of state hospital to $100,000 violated provisions of state constitution); Sofie v. Fibreboard Corp., 112 Wash.2d 636, 771 P.2d 711 (1989) (statute imposing a cap on noneconomic damages for personal injury at a rate of 0.43 X average annual wage and life expectancy violated right to jury trial under provision of state constitution); see also L. Nelson, Tort Reform in Alabama: Are Damages Restrictions Unconstitutional? 40 Ala.L.Rev. 533 (1989). Contra, Fein v. Permanente Medical Group, 38 Cal.3d 137, 211 Cal.Rptr. 368, 695 P.2d 665 (1985) (statute limiting recovery for noneconomic loss to $250,000 in action for medical malpractice did not violate equal protection or due process guarantees); Johnson v. Saint Vincent Hosp., Inc., 273 Ind. 374, 404 N.E.2d 585 (1980) (statute limiting medical malpractice liability to $500,000 did not violate right-to-remedy, jury trial, equal protection, or due process provisions of state constitution); Samsel v. Wheeler Transp. Serv., Inc., 246 Kan. 336, 789 P.2d 541 (1990) ($250,000 limitation on recovery for noneconomic loss due to personal injury did not violate right-to-remedy or jury trial provisions of state constitution where legislature had provided sufficient quid pro quo ); Etheridge v. Medical Center Hosp., 237 Va. 87, 376 S.E.2d 525 (1989) (statute limiting total recovery against a health care provider to $750,000 did not violate right to jury trial, due process, or equal protection; separation of powers provision; or special legislation prohibitions).

In reviewing the constitutionality of a statute, we "approach the question with every presumption and intendment in favor of its validity, and seek to sustain rather than strike down the enactment of a coordinate branch of the government." Alabama State Federation of Labor v. McAdory, 246 Ala. 1, 9, 18 So.2d 810, 815 (1944). Nevertheless, if it clearly appears that an act of the legislature unreasonably invades rights guaranteed by the Constitution, we have not only the power but the duty to strike it down. City of Russellville v. Vulcan Materials Co., 382 So.2d 525 (Ala.1980); Peddycoart v. City of Birmingham, 354 So.2d 808 (Ala.1978).

I. Right to Trial by Jury

The right to a jury trial in the courts of this state is guaranteed by Ala. Const. art. I, § 11. Section 11 provides in toto: "That the right of trial by jury shall remain inviolate." As we explained in Gilbreath v. Wallace, 292 Ala. 267, 292 So.2d 651 (1974), the "crucial words" found in that section are " 'shall remain inviolate.' " The clause "forbid[s] the state through the legislative, judicial, or executive department--one or all--from ever burdening, disturbing, qualifying, or tampering with this right to the...

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