Sibley v. Board of Sup'rs of Louisiana State University

• Decision Date: 18 September 1985
• Docket Number: No. 84-C-0571,84-C-0571
• Parties: Henry A. SIBLEY, III Curator of Jane Elizabeth Sibley, Interdict v. The BOARD OF SUPERVISORS OF LOUISIANA STATE UNIVERSITY and Agricultural and Mechanical College.
• Court: Louisiana Supreme Court

Page 1094

477 So.2d 1094

Henry A. SIBLEY, III Curator of Jane Elizabeth Sibley, Interdict v. The BOARD OF SUPERVISORS OF LOUISIANA STATE UNIVERSITY and Agricultural and Mechanical College.

No. 84-C-0571.

Supreme Court of Louisiana.

Sept. 18, 1985.

Dissenting Opinion Sept. 20 and 27, 1985.

Rehearing Denied Oct. 17, 1985.

David W. Robinson, Due, Dodson, deGravelles, Robinson & Caskey, Steve Marks, Marks & Lear, Baton Rouge, for plaintiff-applicant.

Vincent P. Fornias, Kantrow, Spaht, Weaver & Blitzer, Baton Rouge, for defendants-respondents.

Robert J. Conrad, Jr., New Orleans, for Louisiana Medical Mut. Ins. Co.

Franklin D. Beahm, New Orleans, for Jefferson Soc. of Obstetricians and Gynecologists.

H. Lee Leonard, Keitha A. Leonard, Lafayette, for Lafayette Parish Medical Soc.

Philip A. LeTard, Vidalia, for Louisiana Soc. of Anethesiologists.

Gordon L. James, Monroe, for Ouachita and Calcasieu Parish Medical Societies.

Howard B. Gist, Jr., Alexandria, for Rapides Parish Medical Soc.

Donald T.W. Phelps, Baton Rouge, for Louisiana Academy of Family Physicians, Louisiana Psychiatric Ass'n and Lafourche Parish Medical Soc.

Henry B. Alsobrook, Jr., Patricia M. Hill, New Orleans, for Louisiana Section of the American College of Obstetricians and Gynecologists and the New Orleans Gynecological and Obstetrical Soc.

V. Elaine Boyle, Athena B. Piedrahita, Baton Rouge, for State of Louisiana.

Robert L. Roland, Peter T. Dazzio, Debra A. Templet, Baton Rouge, for Ass'n Ins. Trust Fund.

Ricardo M. Guevara, Baton Rouge, for Louisiana Hosp. Assn.

Roger M. Fritchie, Baton Rouge, for East Baton Rouge Medical Soc.

Sidney E. Cook, Shreveport, for Shreveport Medical Soc. and Bossier Parish Medical Soc.

Harvey J. Lewis, Russ Herman, New Orleans, for Louisiana Trial Lawyers in support of the application for rehearing on behalf of plaintiff-applicant.

D. Douglas Howard, Jr., Shawn Craddock Pedersen, Leslie A. Bonin, New Orleans, for Estate of Marlene Roubion.

Joseph W. Thomas, Ammon L. Miller, Jr., New Orleans, for Prince Williams.

Dermot S. McGlinchey, Paul M. Batiza, Eve Barrie Masinter, New Orleans, for Orleans Parish Medical Soc.

R. Gordon Kean, Jr., Pamela C. Walker, Baton Rouge, for Louisiana State Medical Soc.

Stewart E. Niles, Jr., New Orleans, Jefferson Parish Medical Soc. and Tulane Educational Fund.

[ON REHEARING]

DENNIS, Justice.

We granted rehearing to consider plaintiff's arguments that: (1) the statutory prohibition of a medical malpractice judgment exceeding 500,000 dollars does not apply to a state hospital governing board's independent liability for its own negligence, as opposed to its vicarious liability for the medical malpractice of its health care employees; (2) Jane Sibley's injuries were caused by the LSU Board's independent negligence in authorizing psychiatric treatment at LSU Medical Center by teams rather than by individual physicians, by delegating important responsibilities to medical students and inexperienced doctors, by establishing inadequate procedures for supervision and review of patient care, and by other similar acts and omissions; (3) alternatively, the malpractice judgment limitation is invalid because it conflicts with the constitutional guarantee of equal protection and the constitutional prohibition against state immunity from suit and liability for personal injury; (4) therefore, this Court should either award the full amount of Sibley's damages, or remand the case to the court of appeal to determine those damages.

We also take judicial notice of Act No. 239 of the 1985 regular session of the Legislature, which retroactively repealed the statutory limitation on liability insofar as it applied to the recovery of medical expenses.

1. Background Pertinent to Rehearing

Jane Sibley, age 19, suffered permanent, devastating mental and physical injuries in 1980 while she was a psychiatric patient at the LSU Medical Center in Shreveport, a hospital under the supervision and management of the LSU Board. The LSU Medical Center is a teaching hospital staffed primarily by physicians who teach at LSU Medical School. At the time of Sibley's injuries, the hospital employed a team system to treat psychiatric patients and train interns and residents. Each team consisted of a staff psychiatrist as its leader, along with residents, interns, nurses, social workers, and psychologists. Most of a team's health care was provided by its less experienced residents, interns and auxiliary personnel, under the supervision and review of the staff psychiatrist and senior residents. A team's diagnosis and treatment of an individual patient was not subject to review by any independent committee.

Because of lack of funds, Sibley transferred to LSU Medical Center from a private psychiatric hospital where she had been treated conservatively for depression. Her LSU Medical Center team's staff psychiatrist changed her diagnosis from depression to psychosis. Members of the team administered anti-psychotic drugs to her in increasing dosages and combinations over a period of weeks. On or about September 15, 1980, Sibley developed an anticholinergic reaction which culminated in cardio-pulmonary arrest and massive brain damage. It was proven that the team's acts of malpractice caused Sibley's mental and physical debilitation which consign her to a lifetime of institutional care, that her medical expenses exceeded $423,000 at the time of trial in January 1983, and that her total damages obviously exceed the $500,000 statutory limit by a yet undetermined amount. Because they concluded that the statutory limitation is valid and applicable, the previous courts and this Court, 462 So.2d 149, in its original opinion considered that an award limited to $500,000 was required by law.

Plaintiff argues that the evidence shows that the LSU Board was negligent in permitting psychiatric treatment and administration of drugs by teams without independent patient care review, that the Board's administrative failure caused Sibley's injury, that the Board's liability for its own negligence is independent and separate from its vicarious liability for the delicts of its agents and servants, and that, even if the Board may indirectly benefit from the statute insofar as its vicarious liability is concerned, its independent liability is unaffected because the statute is not designed to protect the state or the Board, but was instead intended to afford protection to individual health care providers acting for the state by placing a ceiling on their liability and providing for the payment of judgments against them. In the event plaintiff is not entitled to judgment against the Board based on its independent negligence, he points out that we did not address all of his arguments on original hearing that the statutory limit is unconstitutional, and asks for relief on these grounds. Before we reach these questions, however, we should deal with a change in the scope of the statutory limit on liability made during the recent legislative session.

2. Repeal of Limitation on Recovery of Medical Expenses

By Act No. 239 of 1985, the Legislature amended the limitation of liability for the acts of persons who provide health care services on behalf of the state, La.R.S. 40:1299.39, to provide that the limitation shall not apply to "all reasonable medical, surgical, hospitalization, physical rehabilitation, and custodial services, including drugs, prosthetic devices, and other similar materials reasonably necessary in the provision of such services," but not including "nonessential specialty items or devices of convenience." The Act also provides for the creation of a fund for the payment of these expenses, for the effect and means of satisfying a judgment or compromise, including an award of such expenses, and for other related matters. The provisions of the act are expressly made applicable to pending litigation and pending claims. Accordingly, even if plaintiff should fail in his attempts to avoid or invalidate the statutory limitation, plaintiff is at least entitled to an amendment of the judgment awarding medical expenses in accordance with this act.

3. Statutory Construction

Every person who causes damage to another by his fault is obliged to repair the damage. C.C. art. 2315. Every person is responsible, not only for the damage occasioned by his own act, but also for that which is caused by the act of persons for whom he is answerable. C.C. art. 2317. Every person who is a master or employer is answerable for the damage occasioned by his servants and employees in the exercise of the functions in which they are employed. C.C. art. 2320.

In accordance with Civil Code article 2315, our courts have formulated duties of care under the circumstances of individual cases to determine when a hospital's governing body is responsible for its own acts or omissions which cause injury to a patient or other person. See Hunt v. Bogalusa Community Medical Center, 303 So.2d 745 (La.1974). For example, the governing board of a hospital owes a duty to select its employees with reasonable care, Grant v. Touro Infirmary, 254 La. 204, 223 So.2d 148 (1969), a duty to furnish the hospital with reasonably adequate supplies, equipment, appliances and facilities for use in the diagnosis and treatment of patients, Snipes v. So. Baptist Hospital, 243 So.2d 298 (La.App. 4th Cir.1971); Lauro v. Travelers Ins. Co., 261 So.2d 261 (La.App. 4th Cir.1972); Hernandez v. Smith, 552 F.2d 142 (5th Cir.1977); and a duty to provide adequate procedures for the maintenance of safety and sanitation in its grounds and buildings, Head v. St. Paul Fire & Marine Ins. Co., 408 So.2d 1174 (La.App. 3d Cir.1982); Roark v. St. Paul Fire & Marine Ins. Co., 415 So.2d 295 (La.App. 2d Cir.1982). A breach of one of these duties or a similar duty of care which causes injury to a patient or other person may constitute independent negligence by a hospital's governing board, resulting in...