Spradling v. SSM HEALTH CARE ST. LOUIS
| Decision Date | 29 June 2010 |
| Docket Number | No. SC 90613.,SC 90613. |
| Citation | 313 S.W.3d 683 |
| Parties | Ann SPRADLING, et al., Appellants, v. SSM HEALTH CARE ST. LOUIS, et al., Respondents. |
| Court | Missouri Supreme Court |
COPYRIGHT MATERIAL OMITTED
Joan M. Lockwood, Stephen R. Woodley of Gray, Ritter & Graham PC, St. Louis, for the Spradlings.
Jeffery T. McPherson, Thomas B. Weaver, Timothy J. Gearin, Anna T. Selby of Armstrong Teasdale LLP, Kenneth W. Bean, Jaime L. Sitton of Sandberg, Phoenix & von Gontard PC, St. Louis, for health care defendants.
Stephen G. Reuter of Lashley & Baer PC, Anne Garcia of St. Louis University Medical Center, St. Louis, for Saint Louis University.
The issue in this medical negligence case is whether the health care affidavit filed pursuant to section 538.225.21 was based upon an opinion by a "legally qualified health care provider" who actively practiced "substantially the same specialty" as the defendant. This Court finds that the phrase "substantially the same specialty" used in section 538.225.2 does not require that a "legally qualified health care provider" have the same board certification as the defendant. While the legislature did not define "substantially the same specialty," one who repeatedly performs the same procedure as that allegedly performed negligently qualifies as one who actively practices "substantially the same specialty" as the defendant. The legally qualified health care provider here meets this standard. The judgment is reversed, and the case is remanded.
Ann and Gene Spradling filed the underlying medical negligence lawsuit against SSM Health Care St. Louis d/b/a SSM St. Mary's Health Center and SSM Medical Group, Inc. (collectively "Defendants"). Their petition alleged that Ann, who had been admitted to St. Mary's Health Center after suffering a fall, was diagnosed with compression fractures in her lower back. The next month, Ann returned to St. Mary's, where Dr. William Sprich, a neurosurgeon, performed a vertebroplasty.2 Following the vertebroplasty, she complained of pain and paralysis in her lower extremities. When St. Mary's discharged Ann, she did not have the use of her lower extremities and was admitted to a nursing home where she continues to reside.
After filing a medical negligence lawsuit, plaintiffs are required to comply with the health care affidavit statute, section 538.225.1, which states:
In any action against a health care provider for damages for personal injury or death on account of the rendering of or failure to render health care services, the plaintiff or the plaintiff's attorney shall file an affidavit with the court stating that he or she has obtained the written opinion of a legally qualified health care provider which states that the defendant health care provider failed to use such care as a reasonably prudent and careful health care provider would have under similar circumstances and that such failure to use such reasonable care directly caused or directly contributed to cause the damages claimed in the petition.
The Spradlings' attorney filed an affidavit stating that they had obtained a written opinion of Dr. John M. Mathis, finding that Dr. Sprich failed to use reasonable care in his treatment of Ann. The affidavit also stated that Dr. Mathis was certified in both diagnostic radiology and nuclear medicine radiology.
After the filing of the affidavit, Defendants moved to dismiss the complaint under section 538.225.6, which requires the trial court to dismiss the action without prejudice "if the plaintiff or his attorney fails to file such affidavit." Defendants contended that the affidavit filed by the Spradlings' attorney failed to comply with the requirements of section 538.225.1 in that the written opinion must be of a "legally qualified health care provider." Defendants asserted that because Dr. Mathis was a radiologist, he did not practice "substantially the same specialty" as Dr. Sprich, a neurosurgeon.
The trial court dismissed the Spradlings' suit without prejudice, finding that pursuant to section 538.225.2, Dr. Mathis, a radiologist, was not a "legally qualified health care provider" because he did not actively practice "substantially the same specialty" as the defendant, a neurosurgeon.3 The Spradlings appealed.4 Because the Spradlings' challenge includes the validity of section 538.225, this Court has exclusive jurisdiction over the appeal. MO. CONST. art. V, sec. 3.
Statutory interpretation is an issue of law that this Court reviews de novo. S. Metro. Fire Prot. Dist. v. City of Lee's Summit, 278 S.W.3d 659, 666 (Mo. banc 2009). This Court's task in statutory interpretation is to discern the intent of the legislature from the language used. Id. In doing so, this Court considers the language's plain meaning. Id.
The health care affidavit statute, section 538.225, first was promulgated in 1986. At its inception, section 538.225, RSMo 1986, provided that a plaintiff filing an action against a health care provider for damages for personal injury must file a health care affidavit. The affidavit must state that the plaintiff has obtained the written opinion of a "legally qualified health care provider" that the defendant "failed to use such care as a reasonably prudent and careful health care provider would have under similar circumstances and that such failure to use reasonable care directly caused or directly contributed to cause the damages claimed in the petition." Id.
This Court has recognized that the statute was a "legislative response to the public concern over the increased cost of health care and the continued integrity of that system of essential services." Mahoney, 807 S.W.2d at 507. Mahoney instructed that the legislature intended section 538.225 to dismiss medical negligence lawsuits that lack "even color of merit" and "to protect the public and litigants from the cost of ungrounded medical malpractice claims." Id.
Although section 538.225, RSMo 1986, did not define "legally qualified health care provider,"5 in 2005, the legislature passed House Bill 393, which did include a definition:
As used in this section, the term "legally qualified health care provider" shall mean a health care provider licensed in this state or any other state in the same profession as the defendant and either actively practicing or within five years of retirement from actively practicing substantially the same specialty as the defendant.
The issue presented by this case is whether the trial court correctly interpreted section 538.225.2 in dismissing the action because Dr. Mathis was not a "legally qualified health care provider" as defined by the statute. This issue requires the resolution of two questions. First, this Court must determine whether the phrase "substantially the same specialty" applies to those health care providers actively practicing and those who are retired. Second, because the legislature did not define "substantially the same specialty," this Court must ascertain the meaning of the phrase.
In interpreting section 538.225.2, the first question posed is which phrase or phrases "substantially the same specialty" modifies. The Spradlings contend that "substantially the same specialty" modifies "within five years of retirement from actively practicing," so that the health care provider only must have practiced substantially the same specialty as the defendant if he or she is retired. Defendants claim, however, that it also modifies "actively practicing," so that whether the health care provider actively practices or is retired, he or she must have "substantially the same specialty" as the defendant.
This Court was faced with another situation involving the applicability of a modifier in Norberg v. Montgomery, 351 Mo. 180, 173 S.W.2d 387 (1943). At issue in Norberg was the following statutory language:
Wherever in this act the term "accounting officer" shall appear, it shall be deemed to mean the county clerk, county comptroller, county auditor, accountant or other officer or employee keeping the principal records of the county.
Section 10934, RSMo 1939.
The parties' dispute in Norberg centered on which words "keeping the principal records of the county" modified: "other officer or employee" or all of the positions named. Norberg, 173 S.W.2d at 389. This Court took a two-step approach in its interpretation of the statute. Id. at 389, 390. First, it considered all sections of the county budget law and harmonized them to give effect to the legislature's intent. Id. at 389. From its review of the county budget law, this Court determined that the legislature's intent was that "keeping the principal records of the county" modified all the positions named. Id. at 390. It found that the "accounting officer" must "keep the principal records of the county," but depending on the county, that person may be the county clerk, county comptroller, county auditor, accountant, or other officer or employee. Id.
Next the Court determined that the grammatical construction of the statute supported its interpretation. Id. Under the last antecedent rule, relative and qualitative words are to be applied only to the words or phrases preceding them. Id. The relative and qualitative words "are not to be construed as extending to or including others more remote." Id. In reaching its holding that the phrase "keeping the principal records of the county" modified all of the officers named, the Court found that the last antecedent rule is not always mandatory in statutory interpretation. Id. It is "merely an aid to construction and will not be adhered to where extension to a more remote antecedent is clearly required by consideration of the entire act." Id. "Where several words are followed by a clause as much applicable to the first and other words as to the last, the clause should be read...
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