Taylor v. Christiana Care Health Servs., Inc.
| Decision Date | 27 February 2012 |
| Docket Number | C.A. No.: 10C-02-068 FSS |
| Parties | ROBERTA TAYLOR, individually and as Personal Representative of the Estate of DORIS BOWERS, Decedent, JEANNA BOWERS, and GAIL BOWERS, Plaintiffs, v. CHRISTIANA CARE HEALTH SERVICES, INC., a/k/a CHRISTIANA CARE HEALTH SYSTEM, INC., KENNETH NUKUNA, M.D., QING LIU, M.D., and CHRISTIANA MEDICAL GROUP, P.A., Defendants. |
| Court | Delaware Superior Court |
(E-FILED)
This is a medical negligence case stemming from a hospital's alleged patient neglect. Almost two years into the litigation, Plaintiffs have moved to amend their complaint to seek punitive damages. They want to allege that when the hospital's physicians-in-training, its medical residents, neglected the patient, the doctors acted "recklessly and/or intentionally." Plaintiffs do not, however, seek to prove that the medical residents' supervision was recklessly or intentionally derelict. Thus, Plaintiffs want the hospital to be punished vicariously for its employees' misconduct
While Plaintiffs' allegations are serious and they have some evidence supporting their new claim, it is unlikely Plaintiffs can show that the residents acted in a "managerial capacity." Where, as here, Plaintiffs are asking to hold the hospital vicariously liable not only for all injury its employees caused, but also demand that the hospital be punished, Plaintiffs must prove the wrongdoers acted in a managerial capacity.
As discussed below, it is likely the hospital's medical residents, including its "chief" resident, are merely temporary employees, in-training. They are not part of the hospital's management. And so, it would be neither efficient nor productive to allow the amendment now. Allowing the amendment will drastically refocus, expand and delay the litigation. Denying the motion, on the other hand, willhave no impact on Plaintiffs' opportunity to receive full compensation.
On January 20, 2011, Plaintiffs filed their motion to amend to allege punitive damages against Defendant Christiana Care Health Services. On February 11, 2011, the court denied Plaintiffs' motion without prejudice, but allowed additional discovery to determine whether the chief resident acted in a "managerial capacity."1 On October 7, 2011, after additional discovery concluded, Plaintiffs again moved to add punitive damages against Christiana Care. On October 13, 2011, Christiana Care responded. On October 28, 2011, the court heard oral argument and allowed the parties to submit "managerial capacity" cases. On November 7, 2011, they complied. Trial is April 2, 2012, little more than a month from now.
Under Superior Court Civil Rule 15(a), a party may amend its pleading when "justice so requires."2 Plaintiffs move to add punitive damages against Christiana Care "based upon the reckless and/or intentional behavior of theemployees and residents of [Christiana Care], which was unknown to [Plaintiffs] until after recent fact discovery was taken." The court assumes without deciding that Plaintiffs' "reckless and/or intentional behavior" is tantamount to the wilful or wanton conduct mentioned in 18 Del. C. § 6855.3 Plaintiffs would allege Dr. Ray Green, chief surgical resident at the time Doris Bowers died, acted in a "managerial capacity" when he allegedly refused to treat her, and his refusal should be imputed to Christiana Care so that the hospital is punished for the resident's decision.
Ordinarily, amendment is permitted because the court prefers to give parties the opportunity to be heard. That preference, however, is tempered somewhat if there is delay in presentation or the amendment: is broad, adds to the trial's complexity, substantially changes a cause of action or defense, or is legally insufficient.4 The idea behind punitive damages is to punish the wrongdoer as a deterrent, not just to make the injured party whole again. Moreover:
[A] claim of . . . punitive damages can indeed add to the evidentiary burden both on discovery and at trial. There can be added evidence designed to paint the defendant as a large, bad corporate person. Even on liability, the degree of inquiry, and particularly thedegree of defense, are seldom the same as in simple negligence claims. Allowing amendments to the complaint which add a . . . claim for punitive damages would inject new issues requiring additional discovery.5
The proposed amendment broadens the case considerably, adds to its complexity, changes the action and defenses, and, as discussed at length below, is legally insufficient.
In a medical negligence case, punitive damages may be imposed if "the injury complained of . . . was the result of wilful or wanton misconduct by the health care provider."6 Dr. Green is a "health care provider," as is Christiana Care.7 Under Restatement (Second) of Torts, however, a hospital may only be subject to punitive damages if its negligent employees "act in a managerial capacity and within the scope of employment."8
Thus, assuming Dr. Green made a bad decision that was wilful or wanton, Plaintiffs must also prove he acted in a managerial capacity. For presentpurposes only, it is conceded that Dr. Green acted wilfully or wantonly.9 Nevertheless, Christiana Care challenges punitive damages on the ground that Dr. Green did not act in a managerial capacity.
Plaintiffs cited four "managerial capacity" cases: two linking managerial capacity to Title VII discrimination,10 and two linking managerial capacity to employees' intentional and gross negligence torts.11 Title VII does not apply here and Plaintiffs do not cite a case linking managerial capacity to a health care provider's wilful or wanton misconduct in a medical negligence case.
Christiana Care provided four cases holding "managerial capacity" was not present: three Title VII cases12 and one maritime case.13 As stated above, Title VII does not apply. Maritime law also does not apply. Christiana Care fails to citea medical negligence case holding a health care provider did not have managerial capacity. Thus, the parties have little precedent on which to rely.14
Kolstad v. American Dental Association,15 however, helps define "managerial capacity." "Managerial capacity" depends on the "type of authority that the employer has given to the employee, [and] the amount of discretion that the employee has in what is done and how it is accomplished."16 As discussed below, it may be that Dr. Green, as chief resident, had some temporary authority over other residents, but he was still subordinate to the hospital's full-time, attending physicians.
Plaintiffs allege three newly discovered pieces of evidence show chief resident Dr. Green acted in a managerial capacity, which justify allowing amendment. First, Plaintiffs cite Christiana Care's Surgical Resident Policy and Procedure Manual. The manual requires "senior" residents "[p]rovide[] direct and indirect supervision of "junior" residents' activities." The manual also states, "[I]f anyquestion should arise about the management of a patient, residents should call the senior resident or the attending surgeon." The snippets from the manual provided by Plaintiffs do not speak to the chief resident's authority, so the court sees the chief resident as the most senior of all residents. The chief, however, is neither a permanent employee nor an attending.
Plaintiffs misconstrue"management" by equating it with "managerial capacity." Christiana Care's manual discusses management in a patient-care context. Simply put, the fact that a chief resident is responsible for managing a patient's care does not make him or her part of the hospital's management. Similarly, the fact that he was the most senior resident does not, by that alone, make him a hospital manager. A chief resident, like a junior resident, is still a physician-in-training and, as to the hospital, just passing through. All residents, including the "chief," answer to the hospital's permanent, attending physicians.17 Dr. Green's chief residency meant he was further along in his studies and superior to the hospital's other physicians-in-training.18 It did not make him a hospital administrator or manager.19
Second, Plaintiffs cite Dr. James Larson's deposition. Dr. Larson wasa junior resident at Christiana Care when Ms. Bowers died. Dr. Larson testified, 20 As discussed above, the fact that the chief resident helps supervise junior residents on the front-line does not make the chief part of the hospital's management. Dr. Green testified a chief resident's job was to "educate and assist patient management for the younger residents."21 He also testified he did not have authority to set hospital policy.22 Even after discovery, that is undisputed.
Last, Christiana Care's attorney invoked attorney-client privilege during Dr. Green's deposition. Plaintiffs allege invoking the privilege "concede[s] that Dr. Green was employed in a managerial capacity" because attorney-client privilege applies only to employees "having a managerial responsibility on behalf of the organization."23 It does not.
Plaintiffs' reliance on Showell v. Mountaire Farms for that propositionis misguided. Showell does not address attorney-client privilege.24 Showell only discusses Delaware Rule of Professional Conduct 4.2 and its application to employees acting in a "managerial capacity."25
Dr. Green was a hospital employee. Christiana Care's attorney was present at the deposition to defend his client. Thus, Christiana Care's attorney could attempt to invoke attorney-client privilege...
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