Roebuck v. Mayo Clinic

• Docket Number: 1 CA-CV 22-0508
• Decision Date: 19 September 2023
• Citation: Roebuck v. Mayo Clinic, 105 Arizona Cases Digest 38, 536 P.3d 289 (Ariz. App. 2023)
• Parties: Robin ROEBUCK, Plaintiff/Appellant, v. MAYO CLINIC, et al., Defendants/Appellees.
• Court: Arizona Court of Appeals

105 Arizona Cases Digest 38

536 P.3d 289

Robin ROEBUCK, Plaintiff/Appellant,

v.MAYO CLINIC, et al., Defendants/Appellees.

No. 1 CA-CV 22-0508

Court of Appeals of Arizona, Division 1.

Filed September 19, 2023

Law Office of Robert M. Gregory, P.C., Gilbert, By Robert M. Gregory, Counsel for Plaintiff/Appellant

Quintairos, Prieto, Wood & Boyer, P.A., Scottsdale, By Vincent J. Montell, Rita J. Bustos, Samantha L. Butler, Counsel for Defendants/Appellees

Presiding Judge Maria Elena Cruz delivered the opinion of the Court, in which Judge James B. Morse Jr. and Judge Daniel J. Kiley joined.

CRUZ, Judge:

¶1 Robin Roebuck appeals the superior court's grant of summary judgment to Mayo Clinic, Mayo Clinic Arizona, Nicole Secrest, N.P., and Robert Scott, M.D. (collectively, "the Mayo Clinic defendants"). Because Arizona Revised Statutes ("A.R.S.") section 12-516 does away with a patient's right to recover damages for ordinary negligence we hold that it violates the anti-abrogation clause of the Arizona Constitution. Accordingly, we reverse and remand.

FACTUAL AND PROCEDURAL HISTORY

¶2 Roebuck had a heart transplant in 1993, and a second heart transplant and kidney transplant at Mayo Clinic in 2017. Thereafter, Mayo Clinic provided Roebuck's follow-up care. Roebuck was healthy until he contracted COVID-19 in 2020.

¶3 Roebuck was hospitalized on April 20, 2020, at Mayo Clinic after presenting with COVID-19 symptoms. Because he had previously received a heart transplant, Roebuck was placed under the care of Mayo Clinic's congestive heart failure team, standard Mayo Clinic procedure for admitted heart transplant patients regardless of the reason for their admission.

¶4 On April 23, 2020, a chest x-ray revealed Roebuck had developed pneumonia, and he had to be given supplemental oxygen. That same day, Dr. Hasan Ashraf, a cardiologist, ordered an echocardiogram to assess Roebuck's heart. The echocardiogram confirmed that Roebuck's heart was "doing pretty well" and that he was not having primary cardiac issues or signs of rejection. In light of Roebuck's positive COVID-19 test and the results of the echocardiogram, his doctors "proceeded with regards to the management of COVID" rather than "any cardiac kind of management."

¶5 The next day, Dr. Ashraf ordered an arterial blood gas ("ABG") test. The test, which is drawn from a patient's radial artery, measures the oxygen in the patient's arterial blood and provides doctors with more accurate information than a pulse oximeter. Dr. Ashraf ordered the ABG test because Roebuck had COVID-19 and was "becoming progressively hypoxic," and because he was suffering from metabolic acidosis as a result of his diarrhea from COVID-19. In addition, Dr. Ashraf had consulted with Mayo Clinic's infectious disease doctors who were considering giving Roebuck a monoclonal antibody, tocilizumab, to treat his COVID-19, and ABG test results would provide necessary "additional information that would ... support giving the tocilizumab." The results of the ABG test revealed that Roebuck had very low oxygen content in his blood, warranting treatment with tocilizumab, which he was given shortly thereafter.

¶6 The next day, Roebuck developed complications from the ABG test, was diagnosed with compartment syndrome, and underwent emergency surgery on his right hand, forearm, and wrist. Roebuck was left with diminished strength and use of his right hand and arm and significant scarring.

¶7 In January 2021, Roebuck filed a medical negligence suit against the Mayo Clinic defendants alleging the ABG test was negligently performed. He did not allege the Mayo Clinic defendants were grossly negligent. In March 2021, the Mayo Clinic defendants removed the action to the United States District Court for the District of Arizona, asserting federal question jurisdiction under 28 U.S.C. § 1331 based on their immunity defense under the Public Readiness and Emergency Preparedness ("PREP") Act, 42 U.S.C. §§ 247d-6d, 247d-6e. Roebuck moved to remand to state court. The district court remanded to the superior court after finding the case did not raise a federal question because it did not involve a state law claim arising under federal law or a state law claim completely preempted by a federal statute.

¶8 In May 2021, Roebuck filed an amended complaint and additionally alleged that Dr. Ashraf had ordered the ABG test to evaluate his heart disease. The Mayo Clinic defendants moved to dismiss the complaint, and the superior court denied the motion. The court ordered that the scope of discovery would "initially" be limited "to the issues of the purpose of the [ABG] blood draw."

¶9 The parties deposed Roebuck, Dr. Ashraf, and Mayo Clinic doctor Robert Scott, M.D. The Mayo Clinic defendants moved for summary judgment, and after briefing and oral argument, the superior court granted the motion. Although it dismissed Roebuck's claims, the court expressly stated that Roebuck was "not barred from filing an amended complaint asserting willful conduct or gross negligence [if] such claims can satisfy the requirements of Rule 11 of the Arizona Rules of Civil Procedure." Roebuck did not file an amended complaint.

¶10 After the court entered partial final judgment under Ariz. R. Civ. P. 54(b), Roebuck timely appealed. We have jurisdiction pursuant to A.R.S. §§ 12-120.21(A)(1), -2101(A)(1).

DISCUSSION

¶11 We review a grant of summary judgment de novo, viewing the evidence and reasonable inferences in the light most favorable to Roebuck as the non-moving party. See Wells Fargo Bank v. Ariz. Laborers, Teamsters & Cement Masons Loc. No. 395 Pension Tr. Fund , 201 Ariz. 474, 482, ¶ 13, 38 P.3d 12, 20 (2002). "Summary judgment is appropriate only if no genuine issues of material fact exist and the moving party is entitled to judgment as a matter of law." Id. at ¶ 14 (citing Ariz. R. Civ. P. 56(a) ; Orme Sch. v. Reeves , 166 Ariz. 301, 309, 802 P.2d 1000, 1008 (1990) ). We review de novo the superior court's interpretation of statutes and constitutional issues. Hohokam Irrigation & Drainage Dist. v. Ariz. Pub. Serv. Co. , 204 Ariz. 394, 397, ¶ 5, 64 P.3d 836, 839 (2003). "Legislation ... is entitled to a strong presumption of constitutionality, and we construe a statute to give it, if possible, a reasonable and lawful meaning." Governale v. Lieberman , 226 Ariz. 443, 447, ¶ 7, 250 P.3d 220, 224 (App. 2011). "[C]onstitutional provisions are interpreted in view of the history behind the enactment, the purpose sought to be accomplished by its enactment and the evil sought to be remedied." Ruth v. Indus. Comm'n , 107 Ariz. 572, 575, 490 P.2d 828, 831 (1971).

I. No Issues of Material Fact

¶12 Roebuck first argues there was a genuine issue of material fact about the purpose of the ABG procedure that should have precluded summary judgment. We disagree. The deposition testimony of Drs. Ashraf and Scott unequivocally established that the ABG test was performed to assess and treat Roebuck for COVID-19. Although Roebuck complains of a purported "incongruity" in Dr. Ashraf's explanation of the reason for the ABG test, we find no such incongruity. The fact that Roebuck had undergone an ABG test in 2017 for non-COVID-19 related reasons does not negate the uncontroverted testimony of Drs. Ashraf and Scott that Dr. Ashraf ordered the ABG test in 2020 as part of Roebuck's treatment for COVID-19.

II. Ambiguity

¶13 Roebuck next argues A.R.S. § 12-516 is ambiguous. "If a statute's language is clear and unambiguous, we apply it without resorting to other methods of statutory interpretation. Ambiguity exists if there is uncertainty about the meaning or interpretation of a statute's terms." Hayes v. Cont'l Ins. Co. , 178 Ariz. 264, 268, 872 P.2d 668, 672 (1994) (citations omitted). The statute provides, in relevant part:

A. If the governor declares a state of emergency for a public health pandemic¹ pursuant to title 26, chapter 2, a health care professional or health care institution that acts in good faith is not liable for damages in any civil action for an injury or death that is alleged to be caused by the health professional's or health care institution's action or omission while providing health care services in support of this state's response to the state of emergency declared by the governor unless it is proven by clear and convincing evidence that the health professional or health care institution failed to act or acted and the failure to act or action was due to that health professional's or health care institution's wilful misconduct or gross negligence.

B. Subsection A of this section applies to any action or omission that is alleged to have occurred during a person's screening, assessment, diagnosis or treatment and that is related to the public health pandemic that is the subject of the state of emergency ....

....

E. This section applies to all claims that are filed before or after September 29, 2021 for an act or omission by a person that occurred on or after March 11, 2020 and that relates to a public health pandemic that is the subject of the state of emergency declared by the governor.

Roebuck argues subsections A and B of the statute are ambiguous because "[i]t is unclear if this language suggests that any medical care rendered during a pandemic extends immunity to the healthcare provider, or does the medical care in question have to be exclusively done in treatment of a pandemic-related condition, or does immunity arise when the assessment, diagnosis or treatment is via a medical procedure that was developed specifically for the pandemic-related condition?"

¶14 We disagree. The language in subsection A stating "while providing health care services in support of this state's response to the state of emergency declared by the governor," is clear and unambiguous, as is the language in subsection B stating that the statute applies "to any action or omission that is alleged to have occurred during a person's screening, assessment, diagnosis or treatment and that is related to the...