Paulsell v. State

Decision Date28 December 2012
Docket NumberNo. 2012 CA 0396.,2012 CA 0396.
Citation112 So.3d 856
PartiesJuanita Christine PAULSELL, as curator of the Interdict Patricia Jolynn Paulsell–Lathrop v. STATE of Louisiana, DEPARTMENT OF TRANSPORTATION AND DEVELOPMENT, Michael A. Laviolette, ABC Helmet Distributing Company, DEF Labeling Company, GHI Helmet Manufacturing Company and XYZ Insurance Company.
CourtCourt of Appeal of Louisiana — District of US

OPINION TEXT STARTS HERE

Nelson W. Wagar, III, Sarah Ney, Metairie, LA, Michael C. Palmintier, Baton Rouge, LA, for PlaintiffAppellant, Juanita Christine Paulsell, as curator for Patricia Jolynn Paulsell–Lathrop.

James D. “Buddy” Caldwell, Attorney General, J. Elliott Baker, Irving Koch, Covington, LA, for Defendant/Appellee, State of Louisiana, through the Department of Transportation and Development.

Before CARTER, C.J., GUIDRY, and GAIDRY, JJ.

GUIDRY, J.

[1 Cir. 2]The disabled victim of a motorcycle accident, through her curator, appeals a judgment denying claims for reimbursement of certain expenses from a fund established to pay medically-necessary expenses related to her injury.
FACTS AND PROCEDURAL HISTORY

While riding as a passenger on a motorcycle on June 13, 2005, Patricia Lathrop–Paulsell was involved in an accident, which caused her to sustain traumatic brain injuries that left her in a minimally-responsive, vegetative state. As a result of the injuries she sustained, a judgment of interdiction was entered against Patricia on February 14, 2006, whereby her mother, Juanita Christine Paulsell, was appointed her curator. Following her appointment as Patricia's curator, Ms. Paulsell filed a petition for damages against various defendants, including the Louisiana Department of Transportation and Development (“DOTD”),1 but the matter proceeded to trial solely against the DOTD. During the trial, Ms. Paulsell and the DOTD reached a settlement by which Ms. Paulsell “agreed to accept the sum of one million seven hundred fifty thousand ($1,750,000.00) Dollars, in cash and one million two hundred fifty thousand ($1,250,000.00) Dollars, to be paid as incurred from the Future Medical Care Fund, in full and final settlement of all claims [Patricia] has against the defendant, [the DOTD].” The trial court signed a consent judgment incorporating the terms of the settlement agreement on April 6, 2009.

Less than two years later, on November 29, 2010, Ms. Paulsell filed a Petition to Enforce Judgment,” contending that the State of Louisiana, through the Office of Risk Management (ORM), had rejected certain expenses that she had submitted in accordance with the April 6, 2009 consent judgment. Therefore, Ms. [1 Cir. 3]Paulsell sought an order directing the ORM to disburse funds in accordance with the April 6, 2009 consent judgment. In response, the DOTD and the ORM filed an answer and exceptions pleading no cause of action, improper cumulation of actions, and prematurity. Thereafter, Ms. Paulsell filed a Motion to Enforce Consent Judgment, for Declaratory Judgment and in Opposition to [Defendants'] Exceptions of Prematurity, Improper Cumulation and/or No Cause of Action and for Attorneys Fees.” By her motion, Ms. Paulsell again sought “enforcement” of the April 6, 2009 consent judgment. She also sought a declaratory ruling defining the term “related benefits” and declaring that she had the sole and exclusive right to determine what costs and expenses are to be submitted and paid for by the Future Medical Care Fund.2

A hearing on the various exceptions filed by the DOTD and the ORM and the motion filed by Ms. Paulsell was held on October 24, 2011. The trial court rendered judgment sustaining the objections of no cause of action, improper cumulation of actions, and lack of subject matter jurisdiction raised in the exceptions filed by the DOTD and the ORM. The trial court denied Ms. Paulsell's motion to enforce consent judgment and for declaratory relief as moot. It is from this judgment that Ms. Paulsell now appeals, asserting that the trial court erred in sustaining the objections of lack of subject matter jurisdiction, no cause of action, and improper cumulation of actions to dismiss her petition to enforce judgment.

DISCUSSION

The April 6, 2009 consent decree rendered judgment against the DOTD “in the full sum of one million seven hundred fifty thousand ($1,750,000.00) Dollars, in cash and one million two hundred fifty thousand ($1,250,000.00) Dollars, to be paid as incurred from the Future Medical Care Fund with no legal and/or judicial [1 Cir. 4]interest to accrue....” In conjunction with this award, the consent judgment further orders that “the amount paid for future medical expenses ... in the amount of one million two hundred fifty thousand ($1,250,000.00) Dollars, are to be paid as incurred from the Future Medical Care Fund, as authorized by LSA–R.S. 39:1533.2, and that said funds will be paid directly to the medical provider as said expenses are incurred pursuant to LSA–R.S. 13:5106(B)(3)(c).”

The Future Medical Care Fund, as established in La. R.S. 39:1533.2, consists of “such monies transferred or appropriated to the fund for the purposes of funding medical care and related benefits that may be incurred subsequent to judgment rendered against the state or a state agency as provided by R.S. 13:5106 and as more specifically provided in R.S. 13:5106(B)(3)(c).” As for administration of the fund relative to personal injury claims against the state, La. R.S. 13:5106(B)(3)(c) provides:

In any suit for personal injury against the state or a state agency wherein the court pursuant to judgment determines that the claimant is entitled to medical care and related benefits that may be incurred subsequent to judgment, the court shall order that all medical care and related benefits incurred subsequent to judgment be paid from the Future Medical Care Fund as provided in R.S. 39:1533.2. Medical care and related benefits shall be paid directly to the provider as they are incurred. Nothing in this Subparagraph shall be construed to prevent the parties from entering into a settlement or compromise at any time whereby medical care and related benefits shall be provided but with the requirement that they shall be paid in accordance with this Subparagraph. [Emphasis added.]

The consent judgment rendered in this case complies with the provisions of La. R.S. 13:5106(B)(3)(c); therefore, Ms. Paulsell is entitled to payment for all “medical care and related benefits” incurred on behalf of Patricia. Such “medical care and related benefits” are defined under La. R.S. 13:5106(D) to mean “all reasonable medical, surgical, hospitalization, physical rehabilitation, and custodial services, and includes drugs, prosthetic devices, and other similar materials reasonably necessary in the provision of such services.” It is Ms. Paulsell's [1 Cir. 5]contention that she has submitted several claims for such “medical care and related benefits” for Patricia, 3 yet payment from the Future Medical Care Fund has not been authorized. In seeking redress for this failure, Ms. Paulsell revealed the additional issue of how and to whom should redress be sought.

In sustaining the various objections raised by the DOTD and the ORM, the trial court essentially found that Ms. Paulsell's complaints were administrative in nature, and as such, she first had to pursue administrative review prior to seeking judicial relief. Based on the record before us and the governing statutes, we disagree.

Subject Matter Jurisdiction

Jurisdiction over the subject matter is the legal power and authority of a court to hear and determine a particular class of actions or proceedings, based on the object of the demand, the amount in dispute, or the value of the right asserted. La. C.C.P. art. 2. Except as otherwise provided by the Louisiana Constitution, a district court shall have original jurisdiction of all civil and criminal matters. La. Const. art. V, § 16. The term “original jurisdiction” designates the adjudicative tribunal in which the initial adjudication is made. When the original jurisdiction allocated to the various courts is circumscribed by the Louisiana Constitution, the Legislature may not alter such jurisdiction by statute. Moore v. Roemer, 567 So.2d 75, 79 (La.1990).

Objections of failure to exhaust administrative remedies are usually premised on one of two grounds: (1) that exclusive original jurisdiction over [1 Cir. 6]certain subject matter is granted to an administrative agency 4; or (2) that the legislature, by statutory enactment, has granted primary jurisdiction over certain subject matter to an administrative agency.5 The grant of exclusive jurisdiction of certain subject matters to an agency results in the subtraction of those matters from the district court's jurisdiction. Jones v. Board of Ethics for Elected Officials, 96–2005, p. 3 (La.5/9/97), 694 So.2d 171, 172. The grant of original exclusive jurisdiction of designated subject matters to an agency can be contrasted with concurrent jurisdiction where the district court maintains original jurisdiction in certain matters at the same time that an agency or other court has been granted the same original jurisdiction. Louisiana Retailers Mutual Insurance Company v. DeRamus, 06–1427, p. 7 (La.App. 1st Cir.5/4/07), 960 So.2d 1048, 1052,writ denied,07–1189 (La.9/21/07), 964 So.2d 336. The doctrine of “primary jurisdiction” is applicable when a court and state/governmental agency have concurrent jurisdiction over a claim or a dispute leading to potential conflicts on how such disputes are resolved. In such cases, a court, at its discretion, may dismiss the claims before it and defer the matter to the agency that has been granted primary jurisdiction over the claims. M.J. Farms, Ltd. v. Exxon Mobil Corporation, 07–2371, p. 5 n. 6 (La.7/1/08), 998 So.2d 16, 22 n. 6.

The distinction between primary jurisdiction and the exhaustion rule (exclusive jurisdiction) is that primary jurisdiction applies when concurrent jurisdiction exists between the...

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