Pulliam v. Coastal Emergency Services

• Decision Date: 08 January 1999
• Docket Number: Record No. 980659.
• Citation: 257 Va. 1,509 S.E.2d 307
• Parties: Karl B. PULLIAM, Executor of the Estate of Elnora R. Pulliam v. COASTAL EMERGENCY SERVICES OF RICHMOND, INC., et al.
• Court: Virginia Supreme Court

509 S.E.2d 307

257 Va. 1

Karl B. PULLIAM, Executor of the Estate of Elnora R. Pulliam v. COASTAL EMERGENCY SERVICES OF RICHMOND, INC., et al.

Record No. 980659.

Supreme Court of Virginia.

January 8, 1999.

Charles H. Cuthbert, Jr. (Margaret Cuthbert Broaddus, on briefs), Petersburg, for appellant.

E. Duncan Getchell, Jr. (William G. Broaddus; Joseph P. McMenamin; Robert L. Hodges; Katrina C. Randolph; McGuire, Woods, Battle & Boothe, on brief), Richmond, for appellees.

Amicus Curiae: The Association of Trial Lawyers of America (Mark S. Mandell; Jeffrey R. White, on brief), Washington, DC, in support of appellant.

Amici Curiae: Campaign Virginia; Brian Injury Association of Virginia (Rodney A. Smolla, on brief), Williamsburg, in support of appellant.

Amicus Curiae: The Virginia Trial Lawyers Association (John C. Jeffries, Jr., on brief), Charlottesville, in support of appellant.

Amici Curiae: The Medical "Protective Company; MMI Companies, Inc.; MCV Physicians; Eastern Virginia Medical School (Rodney K. Adams; Kelvin L. Newsome; Anne G. Scher; LeClair Ryan, on brief), Richmond, in support of appellees.

Amicus Curiae: The Medical Society of Virginia (Allen C. Goolsby, III; Robert M. Rolfe, Richmond; Marie Elena Graham, Wilmington, DE; Hunton & Williams, Richmond, on brief), in support of appellees.

Amicus Curiae: American Tort Reform Association (Sherman Joyce; Lissa Astilla, Gretna; Victor E. Schwartz; Mark A. Behrens; Crowell & Moring, Washington, DC, on brief), in support of appellees.

Amicus Curiae: Commonwealth of Virginia (Mark L. Early, Attorney General; Gregory E. Lucyk, Senior Asst. Attorney General, on brief), in support of appellees.

Amici Curiae: Virginia Hospital & Healthcare Association; Virginia Health Care Association; The Virginia Chamber of Commerce; Virginia Manufacturers Association; National Federation of Independent Business/Virginia (Julia Krebs-Markrich, Falls Church; John E. Coffey, Philadelphia, PA; Thomas W. Greeson; Hazel & Thomas, Falls Church, on brief), in support of appellees.

Amici Curiae: The Virginia Insurance Reciprocal; Doctors Insurance Reciprocal (Risk Retention Group) (Judith B. Henry; William O. Quirey, Jr.; Crews & Hancock, on brief), Richmond, in support of appellees.

Present: CARRICO, C.J., and COMPTON, HASSELL, KEENAN, KOONTZ, and KINSER, JJ., and POFF, Senior Justice.

CARRICO, Chief Justice.

In this appeal, we are called upon to consider again the constitutionality of the medical malpractice cap imposed by Code § 8.01-581.15.¹ We previously upheld the constitutionality of the cap in Etheridge v. Medical Center Hospitals, 237 Va. 87, 376 S.E.2d 525 (1989). Two other issues involving the cap become pertinent if we reaffirm Etheridge. Because we conclude that the medical malpractice cap does not violate any constitutional guarantees, we will uphold the cap's constitutionality and reaffirm Etheridge.

In a motion for judgment filed below, the plaintiff, Karl B. Pulliam, Executor of the Estate of Elnora R. Pulliam, sought damages of $2,000,000 from the defendants, Coastal Emergency Services of Richmond, Inc. (Coastal) and its agent, Dr. Thomas Anthony DiGiovanna (Dr. DiGiovanna), for his alleged negligence in the death of Mrs. Pulliam.² The jury returned a verdict in favor of the plaintiff against both defendants in the sum of $2,045,000, plus interest from the date of Mrs. Pulliam's death.

Upon motion of the defendants, the trial court reduced the verdict to $2,000,000, the amount sued for, and, applying the medical malpractice cap, further reduced the verdict to $1,000,000 and entered judgment against both defendants in that amount. Holding that prejudgment interest is subject to the cap, the trial court disallowed the jury's award of interest running from the date of Mrs. Pulliam's death. We awarded the plaintiff this appeal. The record shows that Coastal was created to provide emergency physicians to staff emergency departments in hospitals and that it contracts with hospitals for this purpose. On October 27, 1989, Coastal contracted with Southside Regional Medical Center (Southside Regional) in Petersburg to provide "at least five Physicians ... to render professional and administrative services in [Southside's Emergency] Department on a full-time basis."

Coastal recruits doctors to work in emergency departments "from a number of avenues." On October 12, 1994, Coastal contracted with Dr. DiGiovanna "to provide services on and during the days and hours scheduled by [Coastal]" and assigned him to Southside Regional.

The record shows further that about 3:55 a.m. on December 15, 1995, Mrs. Pulliam arrived at the emergency room of Southside Regional complaining of "legs aching." She had been diagnosed with influenza two days earlier in the office of her private physician. At Southside Regional, she was examined by Dr. DiGiovanna. About 5:00 a.m., Dr. DiGiovanna discharged Mrs. Pulliam after prescribing a muscle relaxant and giving her printed instructions on influenza and additional instructions concerning bed rest.

Shortly after 11:00 a.m. the same day, Mrs. Pulliam returned to the emergency room of Southside Regional complaining of general weakness, particularly in her lower extremities. Following a physical examination by Dr. Boyd Roy Wickizer, Jr., Mrs. Pulliam was started on intravenous fluids and subjected to a CT scan and a lumbar puncture.³ Thereafter, she was transferred to the intensive care unit, where her condition worsened. She was pronounced dead at 9:08 p.m. An autopsy revealed that the cause of death was bacterial pneumonia and bacteremia. She was survived by her husband, who is the executor of her estate, and a son.

A. Constitutionality of Medical Malpractice Cap.

The plaintiff's assignment of error on this point states that "[a]s a matter of law, the trial court erred in failing to conclude that the cap on medical malpractice awards is unconstitutional as applied to Coastal and to Dr. DiGiovanna."⁴ In considering this assignment of error,

we adhere to the well-settled principle that all actions of the General Assembly are presumed to be constitutional. This Court, therefore, will resolve any reasonable doubt regarding a statute's constitutionality in favor of its validity. Any judgment as to the wisdom and propriety of a statute is within the legislative prerogative, and this Court will declare the legislative judgment null and void only when the statute is plainly repugnant to some provision of the state or federal constitution.

Supinger v. Stakes, 255 Va. 198, 202, 495 S.E.2d 813, 815 (1998) (citations and interior quotation marks omitted).

In Etheridge, we rejected challenges to the constitutionality of the medical malpractice cap based upon contentions that the cap "violates the Virginia Constitution's due process guarantee, jury trial guarantee, separation of powers doctrine, prohibitions against special legislation, and equal protection guarantee, as well as certain parallel provisions of the Federal Constitution." 237 Va. at 92, 376 S.E.2d at 527. The plaintiff makes the same challenges here, but amplifies the arguments in several respects.⁵ It is clear that we cannot grant the plaintiff relief without overruling Etheridge. Immediately, therefore, the doctrine of stare decisis is implicated.

In Virginia, the doctrine of stare decisis is more than a mere cliche. That doctrine plays a significant role in the orderly administration of justice by assuring consistent, predictable, and balanced application of legal principles. And when a court of last resort has established a precedent, after full deliberation upon the issue by the court, the precedent will not be treated lightly or ignored, in the absence of flagrant error or mistake.

Selected Risks Ins. Co. v. Dean, 233 Va. 260, 265, 355 S.E.2d 579, 581 (1987) (emphasis added).

The inquiry becomes, therefore, whether flagrant error or mistake exists in the Etheridge decision. The plaintiff contends that such error does exist and, therefore, that "[t]he doctrine of stare decisis should not deter this Court from reversing Etheridge."

The plaintiff argues that the medical malpractice cap is unconstitutional on each of seven independent grounds. We will consider these grounds seriatim.

1. Right to Trial by Jury.

Article I, § 11 of the Constitution of Virginia provides "[t]hat in controversies respecting property, and in suits between man and man, trial by jury is preferable to any other, and ought to be held sacred." In Etheridge, we noted that, at the time the Constitution was adopted, the jury's sole function was to resolve disputed facts, that this continues to be a jury's sole function,⁶ and that the jury's fact-finding function extends to the assessment of damages. 237 Va. at 95-96, 376 S.E.2d at 529. We stated, however, that "[o]nce the jury has ascertained the facts and assessed the damages,... the constitutional mandate is satisfied [and thereafter], it is the duty of the court to apply the law to the facts." Id. at 96, 376 S.E.2d at 529. The medical malpractice cap, we said, does nothing more than establish the outer limits of a remedy; remedy is a matter of law and not of fact; and a trial court applies the remedy's limitation only after the jury has fulfilled its fact-finding function. Id. Hence, we concluded, the cap does not infringe upon the right to a jury trial. Id. at 97, 376 S.E.2d at 529.⁷

The plaintiff says, however, that the Court in Etheridge "erred by failing to conclude that the mandate of Article I, § 11 includes the right to receive the amount of damages awarded by a jury after a proper jury trial." In this connection, the plaintiff cites two recent Supreme Court decisions.

In Hetzel v. Prince William County, 523 U.S. 208, 118 S.Ct. 1210, 140 L.Ed.2d 336 (1998), the United States Court of Appeals for the Fourth Circuit set aside as grossly excessive a jury verdict for damages the plaintiff had been awarded in district court. The Fourth...