Martinez v. Maruszczak
168 P.3d 720, 123 Nev. 433, 123 Nev. Adv. Rep. 43 (2007)
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Rule of Law:
Under Nevada law, the discretionary-function exception to the waiver of sovereign immunity protects a state employee's actions only if they (1) involve an element of judgment or choice, and (2) are based on considerations of social, economic, or political policy. Medical treatment decisions, while involving professional discretion, are generally not based on public policy and thus are not shielded from liability, though the state employee remains protected by a statutory damages cap.
Facts:
- Dr. John Martinez was employed as a full-time faculty member by the University of Nevada, School of Medicine (UNSOM), a state agency.
- As a condition of his employment, Dr. Martinez was required to join MedAssociates, a non-profit medical practice plan that handled administrative services for UNSOM physicians.
- UNSOM determined Dr. Martinez's salary, issued his paychecks, and provided him with state retirement and other benefits.
- Dr. Martinez was prohibited from providing private patient care outside the scope of his work with MedAssociates without written approval from his UNSOM department chairman.
- Robert Maruszczak died from accidental injuries while under the medical care of Dr. Martinez at University Medical Center.
Procedural Posture:
- The estate of Robert Maruszczak filed a wrongful death action for medical malpractice against Dr. John Martinez in a Nevada state district court.
- By stipulation of the parties, the district court converted the case into an action for declaratory relief to determine the applicability of sovereign immunity.
- The district court issued a declaratory judgment, concluding that Dr. Martinez was not entitled to sovereign immunity.
- Dr. Martinez, as the appellant, appealed the district court's judgment to the Supreme Court of Nevada.
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Issue:
Does the discretionary-function exception to Nevada's waiver of sovereign immunity shield a state-employed physician from liability for medical malpractice when their treatment decisions involve professional judgment but not public policy considerations?
Opinions:
Majority - Maupin, C. J.
No. The discretionary-function exception to sovereign immunity does not shield a state-employed physician from liability for medical malpractice because ordinary medical treatment decisions are not based on public policy considerations. The court adopts the two-part Berkovitz-Gaubert test from federal jurisprudence to determine the applicability of the discretionary-function exception. For immunity to apply, an act must (1) involve an element of judgment or choice, and (2) be based on considerations of social, economic, or political policy. While a physician’s diagnostic and treatment decisions satisfy the first prong, they generally fail the second because they are grounded in professional standards of care, not governmental policy. The court explicitly rejects its prior inconsistent frameworks, such as the planning-versus-operational and governmental-versus-proprietary tests. Although Dr. Martinez is not immune from suit, the court holds that he is a state employee acting within the scope of his employment and is therefore protected by the state's statutory cap on damages.
Analysis:
This decision significantly clarifies Nevada's sovereign immunity doctrine by formally adopting the federal Berkovitz-Gaubert test and discarding previous, inconsistent analytical frameworks. It establishes the critical precedent that professional judgment, such as that exercised by state-employed doctors, is distinct from the policy-based discretion that sovereign immunity is designed to protect. Consequently, state professionals can be held liable for malpractice, ensuring a remedy for injured parties. However, by affirming their status as state employees entitled to the statutory damages cap, the court balances accountability with the state's interest in protecting public funds and encouraging qualified professionals to enter public service.
