Pulliam v. Coastal Emergency Services of Richmond, Inc.
509 S.E.2d 307, 257 Va. 1, 1999 Va. LEXIS 3 (1999)
Rule of Law:
The Virginia medical malpractice cap, Code § 8.01-581.15, limiting the total amount recoverable for injury or death of a patient, is constitutional and does not violate guarantees of jury trial, prohibitions against special legislation, taking of property clauses, due process, equal protection, or separation of powers; additionally, prejudgment interest is considered part of the actual damages and is therefore subject to the cap.
Facts:
- On October 27, 1989, Coastal Emergency Services of Richmond, Inc. (Coastal) contracted with Southside Regional Medical Center in Petersburg to provide emergency physicians to staff its emergency department.
- On October 12, 1994, Coastal contracted with Dr. Thomas Anthony DiGiovanna to provide services and assigned him to Southside Regional.
- About 3:55 a.m. on December 15, 1995, Elnora R. Pulliam arrived at the emergency room of Southside Regional complaining of “legs aching.”
- Dr. DiGiovanna examined Mrs. Pulliam and discharged her around 5:00 a.m. after prescribing a muscle relaxant and providing instructions for influenza and bed rest.
- Shortly after 11:00 a.m. the same day, Mrs. Pulliam returned to the emergency room of Southside Regional, complaining of general weakness, particularly in her lower extremities.
- Following an examination by Dr. Boyd Roy Wickizer, Jr., Mrs. Pulliam was transferred to the intensive care unit, where her condition worsened.
- Mrs. Pulliam was pronounced dead at 9:08 p.m., and an autopsy revealed the cause of death was bacterial pneumonia and bacteremia.
- Mrs. Pulliam was survived by her husband, Karl B. Pulliam, who is the executor of her estate, and a son.
Procedural Posture:
- Karl B. Pulliam, Executor of the Estate of Elnora R. Pulliam, filed a motion for judgment in a trial court, seeking $2,000,000 in damages from Coastal Emergency Services of Richmond, Inc. and Dr. Thomas Anthony DiGiovanna for alleged negligence in Mrs. Pulliam's death.
- A jury returned a verdict in favor of Pulliam against both defendants in the sum of $2,045,000, plus interest from the date of Mrs. Pulliam’s death.
- Upon motion of the defendants, the trial court reduced the verdict to $2,000,000 (the amount sued for) and, applying the medical malpractice cap, further reduced the verdict to $1,000,000.
- The trial court entered judgment against both defendants for $1,000,000 and disallowed the jury’s award of prejudgment interest, holding that it was subject to the cap.
- Pulliam, as appellant, was awarded an appeal by the Supreme Court of Virginia.
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Issue:
Does Code § 8.01-581.15, which imposes a statutory cap on medical malpractice awards, violate the Virginia Constitution’s guarantees of due process, jury trial, separation of powers, prohibitions against special legislation, and equal protection, or the federal and state constitutional prohibitions against the taking of private property, as applied to a corporate entity employing physicians and to prejudgment interest?
Opinions:
Majority - Chief Justice Carrico
No, Code § 8.01-581.15, which imposes a statutory cap on medical malpractice awards, does not violate constitutional guarantees, and Coastal Emergency Services of Richmond, Inc. is a health care provider to which the cap applies, and prejudgment interest is subject to the cap. The Court reaffirms its prior decision in Etheridge v. Medical Center Hospitals, 237 Va. 87, 376 S.E.2d 525 (1989), which upheld the cap's constitutionality, finding no "flagrant error or mistake" sufficient to overturn stare decisis. The Court holds that the medical malpractice cap does not infringe upon the right to a jury trial because a jury's function is to ascertain facts and assess damages, after which the court applies the law, including statutory limits on remedies; the common law never recognized a right to full recovery in tort, and legislatures may limit or abolish causes of action. The cap does not constitute special legislation because the classification of health care providers is reasonable and bears a substantial relation to the legislative objective of ensuring the availability of affordable medical malpractice insurance and, consequently, health care services. The 1994 amendment expanding the definition of "health care provider" to include corporate entities like Coastal also serves this purpose. There is no unconstitutional taking of property, as a cause of action that has not accrued is not a vested property right. Applying the rational basis test for due process and equal protection challenges, the Court finds the cap reasonably related to a legitimate state purpose. Finally, the Court reaffirms that the General Assembly has the power to define court jurisdiction and modify remedies without violating the separation of powers doctrine or invading the province of the judiciary, as the Supreme Court's rule-making authority is subordinate to general laws established by the General Assembly. Coastal is determined to be a "health care provider" under Code § 8.01-581.1(vi) because it primarily renders health care services through its employed physicians and contractual obligations. Prejudgment interest is held to be part of the actual damages sought and thus subject to the total amount recoverable under the medical malpractice cap.
Concurring - Justice Hassell
Yes, the medical malpractice cap is constitutional, but this conclusion is compelled primarily by the absence of a sufficient record presented by the plaintiff to rebut the presumption of legislative reasonableness. The plaintiff, Karl B. Pulliam, did not present evidence demonstrating that the legislative classification limiting damages was unreasonable or unsupported by any reasonably conceivable state of facts at the time the statute was enacted. Therefore, the standard required to declare the statute constitutionally impermissible under the special laws prohibition (Art. IV, § 14 and § 15 of the Virginia Constitution) was not met. Justice Hassell agrees with the majority's resolution of the remaining issues.
Concurring - Justice Kinser
Yes, the medical malpractice recovery cap contained in Code § 8.01-581.15 does not violate any provision of either the Constitution of the United States or the Constitution of Virginia. Justice Kinser also agrees with the majority's decision that Coastal Emergency Services of Richmond, Inc., is a “health care provider” and that prejudgment interest is subject to the medical malpractice cap. Justice Kinser reaches this conclusion without considering the role that stare decisis should play in this case. She writes separately to express her belief that, while legally sound, the medical malpractice cap creates an "unwarranted injustice" in certain situations, particularly for those individuals most severely injured by the negligence of health care providers. She hopes that the General Assembly will adopt a more equitable method to ensure the availability of health care in the Commonwealth.
Analysis:
This case significantly reinforces the power of the Virginia General Assembly to enact statutory limitations on damages in tort actions, particularly medical malpractice, against various constitutional challenges. By strongly reaffirming Etheridge through the doctrine of stare decisis, the Court solidifies the precedent that statutory caps on damages do not infringe upon the right to a jury trial, property rights, or violate principles of due process, equal protection, or separation of powers in Virginia. The expansion of the "health care provider" definition to include corporate entities like Coastal broadens the cap's applicability, further limiting potential recoveries in medical negligence cases involving such entities. The ruling also clarifies that prejudgment interest is treated as part of the total damages subject to the cap, which impacts the overall financial recovery for plaintiffs.
