Eileen Hernandez, M.D. v. Lualhati Crespo
41 Fla. L. Weekly Supp. 625, 2016 WL 7406537, 211 So.3d 19 (2016)
Rule of Law:
A medical malpractice arbitration agreement is void as against public policy if it purports to incorporate Florida's Medical Malpractice Act (MMA) but selectively excludes provisions that create a balanced scheme of incentives for both claimants and defendants, thereby contravening legislative intent and being injurious to the public good.
Facts:
- On August 17, 2011, Mrs. Crespo, 39 weeks pregnant, was turned away from her doctor’s appointment for being a few minutes late, and her appointment was rescheduled.
- On August 20, 2011, Mrs. Crespo delivered her stillborn son, Joseph Crespo.
- Mr. and Mrs. Crespo provided Dr. Eileen Hernandez and Women’s Care Florida with a notice to initiate litigation regarding the medical treatment that led to Joseph's stillbirth.
- Dr. Eileen Hernandez and Women’s Care Florida denied the Crespos’ claim.
- Mrs. Crespo had signed an undated arbitration agreement with Women’s Care Florida, which mandated binding arbitration for all claims, waived the right to a jury trial, required all claims to be arbitrated together, and stipulated that expenses would be shared equally by the parties.
- The arbitration agreement incorporated Chapter 766 of the Florida Statutes (MMA) but provided that if there was no mutual agreement to arbitrate under §§ 766.106 or 766.207 after the pre-suit screening period, claims would be resolved through the agreement’s terms.
- Mr. Crespo did not sign the arbitration agreement.
- Mr. and Mrs. Crespo requested binding arbitration under section 766.207, Florida Statutes, which Dr. Hernandez and Women’s Care Florida rejected, insisting on the terms of the signed arbitration agreement.
Procedural Posture:
- Mr. and Mrs. Crespo filed a complaint against Dr. Eileen Hernandez and Women’s Care Florida.
- Petitioners (Dr. Hernandez and Women’s Care Florida) filed a motion to stay proceedings and compel binding arbitration, based on the agreement signed by Mrs. Crespo.
- The Fifth District Court of Appeal in Crespo v. Hernandez ruled on the arbitration agreement.
- The Fifth District Court of Appeal certified that its decision was in direct conflict with the Second District Court of Appeal’s decision in Santiago v. Baker.
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Issue:
Is a medical malpractice arbitration agreement void as against public policy when it includes statutory terms only favorable to the healthcare provider and excludes required, balanced provisions of Florida's Medical Malpractice Act?
Opinions:
Majority - Quince, J.
Yes, a medical malpractice arbitration agreement is void as against public policy when it includes statutory terms only favorable to the healthcare provider and excludes required, balanced provisions of Florida's Medical Malpractice Act. The Court found that the agreement between Mrs. Crespo and the Petitioners was void because it unilaterally altered the arbitration provisions of the MMA, thereby contravening legislative intent and being injurious to the public good. The MMA was created to remedy a medical malpractice insurance crisis by providing substantial incentives for both claimants and defendants to submit cases to binding arbitration, aiming to reduce attorney’s fees, litigation costs, and delay. The agreement in this case severely limited the benefits provided to patients in exchange for waiving their right to a jury trial, mirroring the statute only in providing for three arbitrators but allowing Petitioners to avoid statutory arbitration. Specifically, the agreement diverged from the MMA by not conceding liability, not guaranteeing independent arbitrators or an administrative law judge, requiring equal sharing of costs (instead of the provider assuming most costs), not providing for payment of interest on damages, not requiring joint and several liability, and dispensing with the right to appeal. These deviations disrupted the carefully crafted balance of incentives in the MMA, making the agreement unenforceable.
Concurring - Pariente, J.
Yes, a medical malpractice arbitration agreement that alters the balance of the Medical Malpractice Act's provisions is void as against public policy. Justice Pariente concurred with the majority, clarifying that the current case, unlike Estate of McCall v. United States, does not involve the constitutionality of the medical malpractice statute itself or caps on damages, where the existence of a medical malpractice crisis would be relevant. Instead, this case concerns whether an arbitration agreement violates public policy by undermining the legislative 'quid pro quo' (something for something) established in the MMA. The MMA's structure provides patients with certain benefits, such as the defendant admitting liability, in exchange for giving up a jury trial and facing limitations on damages. The arbitration agreement in question here eviscerated these statutory rights and benefits for the patient, without providing the counterbalancing incentives the Legislature intended, thus undermining the public policy of reducing costs and delays in medical malpractice litigation.
Dissenting - Canady, J.
No, a medical malpractice arbitration agreement that voluntarily limits litigation costs should not be considered void as against public policy, even if it deviates from some statutory provisions. Justice Canady dissented, adhering to his prior dissenting view in Franks v. Bowers. He argued that voluntary pre-dispute agreements designed to limit litigation costs and claims are consistent with the Medical Malpractice Act's (MMA) purpose, rather than thwarting it. He criticized the majority's reliance on the idea of a 'medical malpractice crisis' as the foundation for its public policy argument, pointing out that a majority of the Court in Estate of McCall v. United States had since concluded that such a crisis had subsided or was nonexistent. Therefore, he argued, the majority's decision condemns a voluntary agreement designed to achieve the same cost-limiting goals as the statute, based on a now-rejected premise.
Analysis:
This case significantly reinforces the principle that parties cannot selectively adopt portions of a statutory scheme while rejecting others, especially when the statute establishes a delicate balance of incentives, as seen in Florida's Medical Malpractice Act. It confirms that the freedom to contract is not absolute and must yield to public policy when contractual terms contravene legislative intent in a manner injurious to the public good. Future medical malpractice arbitration agreements in Florida will need to meticulously adhere to the comprehensive framework of the MMA, ensuring that patients receive the intended benefits and protections if they are to be enforceable. This decision may lead to increased scrutiny of pre-dispute arbitration clauses in healthcare contracts.
