Smith v. Schulte

• Decision Date: 18 August 1995
• Parties: Woodrow SMITH, as Administrator of the Estate of Annie Jo Smith, Deceased v. William J. SCHULTE, M.D., et al. William J. SCHULTE, M.D., and Pulmonary Associates of Mobile, P.A. v. Woodrow SMITH, as Administrator of the Estate of Annie Jo Smith, Deceased. 1930362, 1930459.
• Court: Alabama Supreme Court

Page 1334

671 So.2d 1334

Woodrow SMITH, as Administrator of the Estate of Annie Jo Smith, Deceased v. William J. SCHULTE, M.D., et al.

William J. SCHULTE, M.D., and Pulmonary Associates of Mobile, P.A. v. Woodrow SMITH, as Administrator of the Estate of Annie Jo Smith, Deceased.

1930362, 1930459.

Supreme Court of Alabama.

Aug. 18, 1995.

Rehearing Overruled Dec. 15, 1995.

Certiorari Denied May 28, 1996.

See 116 S.Ct. 1849.

Andrew T. Citrin; John T. Crowder, Jr.; Michael A. Worel, and David G. Wirtes, Jr., of Cunningham, Bounds, Yance, Crowder and Brown, Mobile, for appellant/cross appellee Smith.

Jerry A. McDowell of Hand, Arendall, Bedsole, Greaves & Johnston, Mobile, for William J. Schulte, M.D.

W. Boyd Reeves, Robert J. Mullican, and Tara T. Bostick of Armbrecht, Jackson, DeMouy, Crowe, Holmes & Reeves, Mobile, for William J. Schulte, M.D., and Pulmonary Associates of Mobile, P.A.

Patrick H. Sims of Cabaniss, Johnston, Gardner, Dumas & O'Neal, Mobile, for Pulmonary Associates of Mobile, P.A.

Thomas H. Keene and Amy C. Vibbart, Montgomery, amicus curiae Medical Association of the State of Alabama.

PER CURIAM.

Woodrow Smith, as administrator of his deceased wife's estate, appeals from a judgment reducing to $1,276,873 a jury's $4,500,000 punitive damages award in his wrongful death action against William J. Schulte, M.D., and Pulmonary Associates of Mobile, P.A. ("PAM"). Schulte and PAM cross appeal from that judgment.

On September 28, 1989, Annie Jo Smith was involved in an automobile accident in which she suffered contusions to the upper body and multiple fractures, including fractures of the ribs and hip. She was admitted to Knollwood Park Hospital in Mobile, where she was surgically treated for the fractured hip and was placed in the intensive care unit. Because she was breathing with difficulty, she was given supplemental oxygen externally, specifically, by an oxygen "mask," at a volume of 40%.

Throughout the night and the next day, her breathing difficulties increased progressively, and "pulmonologists" with PAM were summoned to consult and participate in her treatment. By 7:30 a.m., September 30, when she was first attended by Dr. Schulte, Mrs. Smith's breathing difficulties had not lessened, despite the fact that her supplemental oxygen supply had been increased to a concentration of 100%. Moreover, test results suggested that she had begun suffering from "adult respiratory distress syndrome" ("ARDS"), pneumonia, and one or more additional infections.

Dr. Schulte concluded that her respiratory condition required mechanical oxygenation--an internally inserted "endotracheal tube" connected to a mechanical "ventilator." Between 9:05 a.m. and 9:15 a.m., he inserted an endotracheal tube through a passageway in her throat. As she was being "intubated" in this manner, Mrs. Smith became "combative." Doctor Schulte then ordered the administration of Pavulon, a drug that, within 30 seconds of administration, paralyzes striated muscles and renders all voluntary muscular activity--including breathing--impossible.

Coincident with the cessation of her voluntary movement, Mrs. Smith's blood pressure began falling; it continued to fall until 9:15 a.m., by which time she had lost all blood pressure and experienced a "cardiac arrest." After Dr. Schulte and accompanying medical personnel had initiated cardiopulmonary rescusitation and other measures calculated to revive her, Dr. Schulte noticed "gastric contents in the tube"; that fact revealed that the endotracheal tube had, in fact, passed through Mrs. Smith's esophagus into her stomach instead of into her lungs. Subsequently, a new endotracheal tube was properly inserted; however, Mrs. Smith, who had by that time lost consciousness, never revived.

She died four days later, October 4, 1989. An autopsy revealed that the "immediate cause of death" was "anoxic encephalopathy, cerebral edema with brain stem herniation." More colloquially stated, Mrs. Smith had suffered a period of oxygen deprivation that caused her brain to swell out of its cavity and force its way "down into the spinal canal."

On April 19, 1990, Woodrow Smith, as administrator of his wife's estate, sued Dr. Schulte and PAM. The complaint alleged that Dr. Schulte had "passed the [endotracheal] tube into the esophagus, [and had left the] tube for a period of time so that it produced brain death and cardiac arrest," followed by "the wrongful, premature" death of Mrs. Smith. The cause was tried to a jury, which, on April 6, 1993, returned a verdict for Mr. Smith in the amount of $4,500,000.

On April 23, 1993, Dr. Schulte and PAM filed a motion requesting reduction of the verdict to $1,000,000, with consumer-price-index adjustments, the amount of the damages limitation set forth in Ala.Code 1975, § 6-5-547. On November 5, 1993, the trial court conducted a post-verdict review of the damages award, as required by Hammond v. City of Gadsden, 493 So.2d 1374 (Ala.1986), and Green Oil Co. v. Hornsby, 539 So.2d 218 (Ala.1989). At this hearing, Smith renewed an argument he had made before trial, namely, that § 6-5-547 violates rights guaranteed him by the Constitution of Alabama.

Following this hearing, the trial court concluded that the verdict was supported by the evidence and was not excessive. It also rejected Smith's constitutional challenges, however, and applied the damages limitation set forth in the statute. Consequently, it entered a judgment for Smith in the amount of $1,276,873. From that judgment, all the parties appealed. In case number 1930362, Smith challenges the constitutionality of § 6-5-547, and, consequently, the reduction of the verdict. In case number 1930459, Dr. Schulte and PAM challenge the judgment, contending that the verdict on which it was based was excessive.

I. Case Number 1930362

Smith challenges on two grounds the constitutionality of § 6-5-547, which provides in pertinent part:

"In any action commenced pursuant to Section 6-5-391 or Section 6-5-410, against a health care provider whether in contract or in tort based on a breach of the standard of care the amount of any judgment entered in favor of the plaintiff shall not exceed the sum of $1,000,000. Any verdict returned in any such action which exceeds $1,000,000 shall be reduced to $1,000,000 by the trial court or such lesser sum as the trial court deems appropriate in accordance with prevailing standards for reducing excessive verdicts.... The maximum amount payable under this section, $1,000,000, shall be adjusted on April fifteenth of each year to reflect any increase or decrease during the preceding calendar year in the consumer price index of the United States Department of Commerce. Said adjustment shall equal the percentage change in the consumer price index during the preceding calendar year."

(Emphasis added.) He contends (1) that § 6-5-547 violates the constitutional provisions guaranteeing the equal protection of the laws, and (2) that it violates the constitutional provision guaranteeing the right to a trial by jury. We shall address those contentions in that order. Moreover, because Smith does not challenge § 6-5-547 under any provision of the United States Constitution, our analyses and conclusions are based entirely on adequate and independent state law grounds.

A. Equal Protection

Smith bases his equal protection argument on Moore v. Mobile Infirmary Association, 592 So.2d 156 (Ala.1991), in which four Justices of this Court concluded that Ala.Code 1975, § 6-5-544(b), ¹ violated the equal protection guarantee arising under the Alabama Constitution. More specifically, the plurality concluded that the statute represented unreasonable " 'class legislation arbitrarily discriminatory against some and favoring others in like circumstances.' " 592 So.2d at 165 (quoting Opinion of the Justices, 252 Ala. 527, 530, 41 So.2d 775, 777 (1949)) (plurality opinion). One Justice declined to "express [an] opinion" on the equal protection question, because he had already joined with four other Justices in the preceding section of Moore, holding that § 6-5-544(b) violated the right to a trial by jury. 592 So.2d at 178 (Almon, J., concurring specially). We now hold that § 6-5-547 represents a similar form of "class legislation" that is unreasonable, and, therefore, violates the equal protection guarantee of the Constitution of Alabama.

In reaching its conclusion, the plurality reiterated a previously established principle, namely, that the analysis of a claim alleging a violation of the equal protection afforded by our state constitution does not parallel, or necessarily produce the same result as, an analysis based on the Equal Protection Clause of the Fourteenth Amendment to the United States Constitution. Moore, 592 So.2d at 170. The Alabama constitution allows the legislature to classify citizens in order to effect some "public interest," the plurality explained, only insofar as the resultant burden on individual rights or liberties does not outweigh the benefits effected by the statute. Id. at 166. In other words, "whether the classifications created under [the challenged statute] represent a reasonable exercise of legislative power depends on whether they are reasonably related to the stated objective, and on whether the benefit sought to be bestowed upon society outweighs the detriment to private rights occasioned by the statute." Id. (emphasis added). ² One factor to be weighed in this determination is the relative importance of the private right or interest burdened by the statute.

While conceding that the Moore plurality applied a more rigorous standard of review than the Fourteenth Amendment would, arguably, have required, Dr. Schulte and PAM dispute the correctness of the Moore plurality's conclusion. Moreover, they attempt to distinguish § 6-5-547 from the statute reviewed in Moore, on the basis of the species of damages affected; whereas Moore involved a limitation on compensatory damages, ...