Oliver v. Magnolia Clinic

• Decision Date: 13 March 2012
• Docket Number: Nos. 2011–C–2132,2011–C–2142.,2011–C–2139,s. 2011–C–2132
• Citation: 85 So.3d 39
• Parties: Joe OLIVER, et al. v. MAGNOLIA CLINIC, et al.
• Court: Louisiana Supreme Court

85 So.3d 39

Joe OLIVER, et al.

v.MAGNOLIA CLINIC, et al.

Nos. 2011–C–2132

2011–C–2139

2011–C–2142.

Supreme Court of Louisiana.

March 13, 2012.

Raggio, Cappel, Chozen & Berniard, L. Paul Foreman, Lake Charles, LA, for Applicant (No. 2011–C–2132).

James D. Caldwell, Attorney General, John Elliott Baker, Irving Hirsch Koch, Special Assistant Attorneys General, Jones, Walker, Waechter, Poitevent, Carrere & Denegre, Nadia Marie de la Houssaye, Lafayette, LA, The Townsley Law Firm, Marcus Paul LaCombe, Todd A. Townsley, David L. Sigler & Associates, LLC, Lake Charles, LA, Cade Richard Cole, for Respondent (No. 2011–C–2132).

James D. Caldwell, Attorney General, Irving Hirsch Koch, John Elliott Baker, Special Assistant Attorneys General, for Applicant (No. 2011–C–2139).

Jones, Walker, Waechter, Poitevent, Carrere & Denegre, Nadia Marie de la Houssaye, Lafayette, LA, Raggio, Cappel, Chozen & Berniard, L. Paul Foreman, The Townsley Law Firm, Marcus Paul LaCombe, Todd A. Townsley, David L. Sigler & Associates, LLC, Lake Charles, LA, Cade Richard Cole, for Respondent (No. 2011–C–2139).

Jones, Walker, Waechter, Poitevent, Carrere & Denegre, Nadia Marie de la Houssaye, Lafayette, LA, for Applicant (No. 2011–C–2142).

James D. Caldwell, Attorney General, Irving Hirsch Koch, John Elliott Baker, Special Assistant Attorneys General, Raggio, Cappel, Chozen & Berniard, L. Paul Foreman, The Townsley Law Firm, Todd A. Townsley, Marcus Paul LaCombe, David L. Sigler & Associates, LLC, Lake Charles, LA, Cade Richard Cole, for Respondent (No. 2011–C–2142).

CLARK, Justice.

We granted these consolidated writ applications to address the majority opinion of the court of appeal which held the medical malpractice cap enunciated in La.R.S. 40:1299.42(B) is unconstitutional "to the extent it includes nurse practitioners within its ambit." We reiterate our holding in Butler v. Flint Goodrich Hospital of Dillard University, 607 So.2d 517 (La.1992), cert. denied, 508 U.S. 909, 113 S.Ct. 2338, 124 L.Ed.2d 249 (1993), decreeing the cap constitutional. Finding the cap to be applicable to all qualified healthcare providers under the Medical Malpractice Act, including nurse practitioners, we reverse the judgment of the court of appeal in this respect. Additionally, we address two other assignments of error asserted by the Louisiana Patients' Compensation Fund and affirm these portions of the court of appeal judgment. The effect of our holding is to reinstate the trial court judgment in full.

FACTS AND PROCEDURAL HISTORY

This case involves a malpractice judgment in favor of Taylor, Joe, and Helena Oliver against a nurse practitioner, Nurse Susan Duhon, her insurer, St. Paul Fire and Marine Insurance Company, the clinic she owned and operated, The Magnolia Clinic, and the Louisiana Patients' Compensation Fund ("PCF").

Facts in Malpractice Case

The underlying facts of the case are as follows: Taylor Oliver was born to Joe and Helena Oliver on September 5, 2000. Shortly after birth, she was brought to The Magnolia Clinic and treated by Nurse Duhon exclusively. Over the next year, Taylor visited Nurse Duhon thirty-two times, presenting with symptoms including nausea, vomiting, diarrhea, bruising, and infections. Ultimately, her condition was later diagnosed by other physicians as neuroblastoma, a form of cancer that develops from nerve cells. Taylor now suffers from severe bone loss and muscle deterioration, loss of sight, and severe cognitive disabilities.

The Olivers sued Nurse Duhon for malpractice, alleging Taylor's delayed diagnosis and treatment caused the severity of her injuries.¹ On June 8, 2007, a jury heard the matter and returned a verdict in favor of the Olivers in the amount of approximately ten million dollars.² On June 29, 2007, the Olivers filed a Motion to Stay Judgment and a Petition for Declaratory Judgment, contending the provision of the Louisiana Medical Malpractice Act ("MMA") that limits the recovery of medical malpractice damages, La.R.S. 40:1299.42(B), is unconstitutional.³ On July 30, 2007, the State of Louisiana intervened to defend the statute being challenged. A hearing on the constitutional issue took place on December 4 and 5, 2007.

Trial Court

The trial court rejected each of the Olivers' challenges to the cap's constitutionality; however, it found the MMA was "overly broad due to its inclusion of nurse practitioners." On that basis, the trial court found the cap unconstitutional as it applies in this case. Nurse Duhon/St. Paul Fire and Marine Insurance Company, the PCF, and the State filed a Motion for New Trial/Reconsideration. They asserted the Olivers never challenged the inclusion of nurse practitioners within the listing of qualified healthcare providers; thus the issue was not properly before the trial court.

The trial court granted the Motion for New Trial/Reconsideration and signed a judgment reducing the jury's award to comply with the MMA. Specifically, the judgment reduced the general damages award from the $6 million to $500,000.00 pursuant to the statutory cap, ordered the PCF to pay past medical expenses in the amount of $629,728.24 plus judicial interest, and declared Taylor to be a patient in need of future medical care and related benefits, entitling her to past, present, and future medical services and benefits.

The Olivers appealed to the Louisiana Third Circuit Court of Appeal, challenging the constitutionality ruling by the trial court. The PCF also appealed, assigning two additional errors regarding the underlying tort judgment. First, the PCF argued the trial court erred in awarding the amount for past medical and related benefits beyond those awarded by the jury. Second, the PCF averred the trial court erred in awarding the judicial interest on the past medical expenses to the Olivers when the interest is owed instead to the Louisiana Department of Health and Hospitals ("DHH").⁴

Court of Appeal

A five-judge panel of the court of appeal reversed the trial court's holding that the cap is constitutional and reinstated the full jury award. The two assignments of error by the PCF were found to lack merit. Oliver v. Magnolia Clinic, 09–439 (La.App. 3 Cir. 11/17/10), 51 So.3d 874. Two judges ruled that the cap is unconstitutional as applied to nurse practitioners, while two other judges ruled that a nurse practitioner did not meet the statutory definition of a health care provider under the MMA pursuant to La.R.S. 40:1299.41, thus rendering the cap inapplicable in this case. Lastly, one judge dissented finding the cap to be constitutional in general and as applied to nurse practitioners.

Nurse Duhon/her insurer, the State, and the PCF filed separate writ applications with this court on March 22, 2011. Finding a violation of Article V, § 8(B)⁵ of the Louisiana Constitution, we remanded the matter to the court of appeal for an en banc hearing so that a majority vote could be rendered on the issues. Oliver v. Magnolia Clinic, 10–2766, 10–2782, 10–2785 (La.3/25/11), 57 So.3d 307, 308.

Court of Appeal (En Banc)

On remand, a majority of the court of appeal "voted to adopt the original opinion released in this case with additional reasons." Oliver v. Magnolia Clinic, 09–439, p. 1 (La.App. 3 Cir. 8/31/11), 71 So.3d 1170, 1173. Specifically, the court of appeal added to its previous opinion which held that the enforcement of the MMA's cap violated the Olivers' equal protection rights by also ruling the cap limited the Oliver's right to an adequate remedy in violation of La. Const. Art. I, § 22. The court of appeal found it unnecessary to address the separation of powers doctrine. The majority's opinion presented inconsistent grounds for its holding insofar as the reasoning belied the outcome.⁶ Nevertheless, the opinion seemingly held the cap on damages as applied to nurse practitioners violates the equal protection and adequate remedy guarantees of the Louisiana Constitution.

Judge Saunders concurred, finding the MMA did not apply in this case but for different reasons than those enunciated by the majority. He concluded the constitutionality of the cap need not be addressed because, in his view, nurse practitioners were not covered at the time of the malpractice (prior to the 2009 amendment to La.R.S. 40:1299.41 which specifically listed nurse practitioners as qualified health care providers.) Judge Saunders rejected the argument that nurse practitioners are afforded coverage under the MMA because they are registered nurses and registered nurses were covered at the time of the incident. Instead, he explained that the two professions have differing duties and, therefore, require separate statutory listings.

Judge Painter concurred in the result for the reasons assigned by Judge Saunders.

Judge Amy dissented from the majority opinion, finding an affirmation of the trial court's judgment was appropriate. He relied on this court's holding in Butler, which upheld the constitutionality of the cap on damages in malpractice cases.

Judge Gremillion also dissented, reiterating the controlling precedent set by this court in Butler as discussed in Judge Amy's dissent. Additionally, he addressed the majority's decree which attempts to limit the holding only to nurse practitioners. First, Judge Gremillion challenged the majority's consideration of the cap's application to nurse practitioners at all in light of the Olivers' failure to assign the alleged over-inclusion as error. Second, while he expressed his belief that nurse practitioners are covered by the MMA, he addressed the underlying fallacy and inconsistency in the court of appeal's logic by noting that the majority's reasoning is applicable to all health care providers, not just nurse practitioners. Thus, if the majority found the cap unconstitutional as it applied to nurse practitioners, its reasoning necessarily requires a decree of unconstitutionality of the cap in general. Finally, Judge Gremillion opined that the dollar amount of the cap is a consideration best left to the...