Rose v. Doctors Hosp. Facilities

• Decision Date: 09 February 1987
• Docket Number: No. 05-86-00009-CV,05-86-00009-CV
• Citation: 735 S.W.2d 244
• Parties: Lisa Beth ROSE, Alton Rose and Frances Rose, Appellants, v. DOCTORS HOSPITAL FACILITIES d/b/a Doctors Hospital, and National Medical Enterprises, NME Hospitals, Inc. d/b/a Doctors Hospital, Appellees.
• Court: Texas Court of Appeals

Page 244

735 S.W.2d 244

Lisa Beth ROSE, Alton Rose and Frances Rose, Appellants, v. DOCTORS HOSPITAL FACILITIES d/b/a Doctors Hospital, and National Medical Enterprises, NME Hospitals, Inc. d/b/a Doctors Hospital, Appellees.

No. 05-86-00009-CV.

Court of Appeals of Texas,

Dallas.

Feb. 9, 1987.

Rehearing Denied May 1, 1987.

W. James Kronzer, Houston, Douglas D. Mulder, John H. Hagler, Dallas, Ronald D. Krist, Houston, for appellants.

Robert A. Gwinn, Kenneth C. Stone, Michael W. Huddleston, R. Brent Cooper, Dallas, for appellees.

Before GUITTARD, C.J., and HOWELL and SCALES ¹, JJ.

R.T. SCALES, Justice, retired.

Lisa Beth Rose, Alton Rose, and Frances Rose appeal from a judgment notwithstanding the verdict rendered in this claim for wrongful death pursuant to the Medical Liability and Insurance Improvement Act, TEX.REV.CIV.STAT.ANN. art. 4590i (Vernon Supp.1986). The jury awarded $815,000 each to Alton Rose and Frances Rose, parents of the deceased, and $2,825,000 to Lisa Rose, wife of the deceased. In an accompanying opinion, which is unpublished pursuant to rule 90 of the Texas Rules of Appellate Procedure, we hold that there is some evidence, and that the evidence is sufficient, to support the jury's verdict that the hospital caused the decedent's death. Accordingly, we reverse the judgment of the trial court and render judgment on the jury verdict, subject to suggested remittiturs by Alton Rose of $230,000, by Frances Rose of $315,000, and Lisa Rose of $500,000.

By cross-point of error, however, Doctors Hospital Facilities d/b/a Doctors Hospital, and National Medical Enterprises, NME Hospitals, Inc. d/b/a Doctors Hospital (collectively, the hospital) contend that recovery of each of the Roses should be limited in accordance with section 11.02(a) of the Texas Medical Liability and Insurance Improvement Act. ² ("the Medical Liability Act"). The hospital alternatively contends that recovery of each of the Roses for non-pecuniary losses should be limited in accordance with section 11.03 of the Medical Liability Act.

The Roses argue that the Medical Liability Act is unconstitutional, citing Detar Hospital, Inc. v. Estrada, 694 S.W.2d 359 (Tex.App.--Corpus Christi 1985, no writ); Malone & Hyde, Inc. v. Hobrecht, 685 S.W.2d 739 (Tex.App.--San Antonio 1985, writ dism'd by agr.); and Baptist Hospital of Southeast Texas, Inc. v. Baber, 672 S.W.2d 296 (Tex.App.--Beaumont 1984), writ ref'd n.r.e. per curiam, 714 S.W.2d 310 (Tex.1986) (amount of judgment did not exceed statutory limits of liability, thus constitutionality was not reached). We hold that section 11.02(a) of the Medical Liability Act is constitutional; thus, we render judgment subject to the limits contained in the Medical Liability Act. Section 11.02(a) of the Medical Liability Act provides:

In an action on a health care liability claim where final judgment is rendered against a physician or health care provider, the limit of civil liability for damages of the physician or health care provider shall be limited to an amount not to exceed $500,000.

In reviewing the constitutionality of a statute, there is a presumption of the validity of the statute. Spring Branch I.S.D. v. Stamos, 695 S.W.2d 556, 558 (Tex.1985); McCulloch v. Fox & Jacobs, Inc., 696 S.W.2d 918, 923 (Tex.App.--Dallas 1985, writ ref'd n.r.e.). We must presume that the legislature has not acted unreasonably or arbitrarily and a mere difference of opinion, where reasonable minds could differ, is not a sufficient basis to strike down legislation as being arbitrary or unreasonable. Smith v. Davis, 426 S.W.2d 827, 831 (Tex.1968); Detar, 694 S.W.2d at 365.

Courts in eight other states have addressed the constitutionality of damage limits in medical malpractice claims. The supreme courts of California, Indiana, and Nebraska have upheld such limits against constitutional attack, Fein v. Permanente Medical Group, 38 Cal.3d 137, 211 Cal.Rptr. 368, 695 P.2d 665 (1985) ($250,000 limit on "noneconomic" damages), appeal dismissed, 474 U.S. 892, 106 S.Ct. 214, 88 L.Ed.2d 215 (1985); Johnson v. St. Vincent Hospital, Inc., 273 Ind. 374, 404 N.E.2d 585 (1980) ($500,000 limit on total recovery); Prendergast v. Nelson, 199 Neb. 97, 256 N.W.2d 657 (1977) ($500,000 limit on total recovery unless patient elects not to come within provisions of act), while courts in other states have held such limits unconstitutional on differing grounds. See Carson v. Maurer, 120 N.H. 925, 424 A.2d 825 (1980) ($250,000 limit on "noneconomic" damages violates equal protection provision of New Hampshire constitution); Arneson v. Olson, 270 N.W.2d 125 (N.D.1978) ($300,000 limit on all damages violates equal protection clauses of state and federal constitutions); Wright v. Central DuPage Hospital Ass'n, 63 Ill.2d 313, 347 N.E.2d 736 (1976) ($500,000 limit on all damages is unconstitutional as a special privilege prohibited by the Illinois constitution); Simon v. St. Elizabeth Medical Center, 355 N.E.2d 903 (Ohio Com.Pls.1976) ($200,000 limit on "general" damages violates equal protection clauses of the state and federal constitution); see also Jones v. State Board of Medicine, 97 Idaho 859, 555 P.2d 399 (1976) (in challenge of constitutionality of ceiling on "recoverable" damages based on due process and equal protection grounds, court remanded for factual determination on whether medical malpractice insurance crisis actually existed in Idaho).

In addition, three courts of appeals in Texas have addressed the constitutionality of the damage limits contained in the Medical Liability Act. In Detar Hospital, Inc. v. Estrada, 694 S.W.2d 359 (Tex.App.--Corpus Christi 1985, no writ), the Corpus Christi court of appeals held that sections 11.01-11.05 "are unconstitutional." Id. at 366. In that case, the plaintiff attacked the constitutionality of the Medical Liability Act on equal protection grounds under the state and federal constitutions. Detar, 694 S.W.2d at 365. The court applied the "rational basis" test set forth in McGowan v. Maryland, 366 U.S. 420, 81 S.Ct. 1101, 6 L.Ed.2d 393 (1961); however, the court also discussed the presence or absence of a quid pro quo, a concept applicable to due process analysis under the federal constitution, see Duke Power Co. v. Carolina Environmental Study Group, 438 U.S. 59, 98 S.Ct. 2620, 57 L.Ed.2d 595 (1978), and applicable to analysis under the open courts provision of the Texas constitution, TEX.CONST. art. I § 13. See Lebohm v. City of Galveston, 154 Tex. 192, 275 S.W.2d 951 (1955). In Malone & Hyde, Inc. v. Hobrecht, 685 S.W.2d 739 (Tex.App.--San Antonio 1985, writ dism'd by agr.), the San Antonio court of appeals held section 11.02 of the Medical Liability Act unconstitutional without specifying the grounds. Finally, in Baptist Hospital of Southeast Texas, Inc. v. Baber, 672 S.W.2d 296 (Tex.App.-- Beaumont 1984),writ ref'd n.r.e., per curiam, 714 S.W.2d 310 (Tex.1986), the Beaumont court of appeals held that section 11.02(a) of the Medical Liability Act violates equal protection. That court also discussed the presence or absence of a quid pro quo as a factor in determining constitutionality.

DUE PROCESS ³/OPEN COURTS DOCTRINE

The fourteenth amendment to the United States Constitution provides that no state shall deprive any person of life, liberty, or property without due process of law. U.S. CONST. amend. XIV, § 1. Similarly, the Texas constitution provides that no citizen shall be deprived of life, liberty, property, privileges or immunities except by due course of law. TEX.CONST. art. I, § 19. In addition, the Texas constitution provides that "all courts shall be open, and every person for injury done him, in his lands, goods, person or reputation, shall have remedy by due course of law." TEX.CONST. art. I, § 13. The open courts provision is a facet of due process, Sax v. Votteler, 648 S.W.2d 661, 663-64 (Tex.1983); McCulloch, 696 S.W.2d at 923, and it insures that Texas citizens bringing common law causes of action will not unreasonably be denied the right to redress of injuries. Hanks v. City of Port Arthur, 121 Tex. 202, 209-16, 48 S.W.2d 944, 946-50 (1932).

The question of whether due process under the federal constitution requires an adequate quid pro quo when the legislature acts to restrict or abolish a right of recovery has been left open by the United States Supreme Court. Fein v. Permanente Medical Group, 474 U.S. 892, 106 S.Ct. 214, 215-16, 88 L.Ed.2d 215 (1985) (White, J., dissenting on dismissal for want of substantial federal question), quoting Duke Power Co. v. Carolina Environmental Study Group, 438 U.S. 59, 88, 98 S.Ct. 2620, 2638, 57 L.Ed.2d 595 (1978) ("it is not at all clear that the Due Process clause in fact requires that a legislatively enacted scheme either duplicate the recovery at common law or provide a reasonable substitute remedy. However, we need not resolve this question here").

A state, however, in interpreting its own constitution, is free to provide additional rights for its citizens. See, e.g., Pruneyard Shopping Center v. Robins, 447 U.S. 74, 100 S.Ct. 2035, 64 L.Ed.2d 741 (1980); Sax, 648 S.W.2d at 664. In Texas, the supreme court has done so, adopting the requirement of a quid pro quo as part of the open courts aspect of due process. Lebohm v. City of Galveston, 154 Tex. 192, 275 S.W.2d 951 (1955). In Lebohm, the court stated:

[Section 13] prohibit[s] legislative bodies from arbitrarily withdrawing all legal remedies from one having a cause of action well established and well defined at common law.... Legislative action withdrawing common law remedies ... for injuries is sustained only when it is reasonable in substituting other remedies....

Lebohm, 154 Tex. at 197, 275 S.W.2d at 954. Recently, the Texas supreme court reaffirmed the interpretation in Lebohm of article I, section 13 of the Texas constitution. Sax, 648 S.W.2d at 665. In Sax, the court held that, absent a showing that the legislative basis for the statute outweighs the...