Kaplan v. Mayo Clinic

District Court, D. Minnesota
947 F.Supp.2d 1001 (2013)

ELI5:

Rule of Law:

Under Minnesota law, damages recoverable for a breach of contract, including a contract between a physician and a patient, are limited to pecuniary losses that naturally flow from the breach and do not include non-pecuniary, extra-contractual damages such as pain, suffering, or emotional distress unless the breach is accompanied by an independent, willful tort.

Facts:

In July 2003, Elliot Kaplan was diagnosed with pancreatic cancer following a needle biopsy in Missouri.
In August 2003, Kaplan sought a second opinion from Mayo Clinic, where Dr. Burgart, a Mayo pathologist, reviewed the Missouri pathology slides and confirmed the diagnosis of pancreatic cancer.
Dr. Nagorney, a Mayo surgeon, recommended Kaplan undergo a pancreatoduodenectomy, or 'Whipple' procedure.
Concerned about the diagnosis's validity, Kaplan discussed it with Dr. Nagorney, who allegedly promised to perform an intraoperative biopsy to confirm the cancer before completing the full Whipple procedure.
On August 14, 2003, Dr. Nagorney performed the Whipple procedure on Kaplan.
Dr. Nagorney did not perform the promised intraoperative biopsy before completing the surgery.
A post-operative examination of the removed pancreatic tissue revealed that Kaplan did not have pancreatic cancer.

Procedural Posture:

Elliot and Jeanne Kaplan filed a complaint in U.S. District Court against Mayo Clinic, Dr. Nagorney, and Dr. Burgart, alleging medical malpractice and breach of contract.
The District Court granted summary judgment in favor of Dr. Nagorney, dismissing him from the case.
The case proceeded to a jury trial against Mayo and Dr. Burgart, where the court granted judgment as a matter of law for the defendants on the breach of contract claim.
The jury returned a verdict for Mayo and Dr. Burgart on the negligent misdiagnosis claim.
The Kaplans (appellants) appealed to the U.S. Court of Appeals for the Eighth Circuit.
The Eighth Circuit affirmed the jury verdict on the negligence claim but reversed the judgment as a matter of law on the breach of contract claim against Mayo.
The Eighth Circuit remanded the breach of contract claim against Mayo back to the District Court for further proceedings.
On remand, Mayo filed motions in limine in the District Court to preclude the Kaplans from presenting evidence of non-pecuniary damages at the upcoming trial.

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Issue:

Under Minnesota law, may a plaintiff in a breach of contract action against a physician recover damages for pain, suffering, and emotional distress, or a derivative claim for loss of consortium?

Opinions:

Majority - John R. Tunheim

No. Damages for pain, suffering, emotional distress, and loss of consortium are not recoverable in a breach of contract action against a physician under Minnesota law. Minnesota law strictly limits damages in contract actions to pecuniary losses that are capable of measurement by a definite standard of compensation. The law maintains a clear distinction between contract and tort, and non-pecuniary damages like pain and suffering are considered extra-contractual and recoverable only in tort actions where there is an accompanying independent and willful tort. The court predicted the Minnesota Supreme Court would follow this restrictive approach rather than allowing damages based on the personal nature of the physician-patient contract. Because the jury had already found no underlying tort (negligence), the Kaplans are precluded from recovering tort-like damages through their contract claim. Similarly, a loss of consortium claim is derivative of a tort action and cannot be maintained based on a breach of contract claim.

Analysis:

This decision reinforces the traditional, strict demarcation between contract and tort remedies under Minnesota law, particularly in the context of medical services. It establishes that a plaintiff cannot use a breach of contract claim as an alternative path to recover non-economic damages typically associated with medical malpractice tort claims. The ruling prevents the blurring of legal theories and ensures that claims for pain and suffering remain grounded in tort law, which has its own distinct elements and evidentiary requirements, such as expert testimony on the standard of care. This precedent significantly limits the scope of recovery for patients who sue for a breach of a specific promise by a healthcare provider, confining their potential damages to tangible, economic losses.

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