Roebuck v. Mayo Clinic
Not reported in official reporter; filed 9-19-2023 (2023)
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Rule of Law:
A.R.S. section 12-516, which grants healthcare providers immunity from liability for ordinary negligence in providing COVID-19 related medical treatment and requires proof of willful misconduct or gross negligence, violates the anti-abrogation clause (Article 18, Section 6) of the Arizona Constitution because it entirely abolishes a common law right of action rather than merely regulating it.
Facts:
- Robin Roebuck received a heart transplant in 1993, and a second heart transplant and kidney transplant at Mayo Clinic in 2017.
- Mayo Clinic continued to provide Roebuck’s follow-up care after his 2017 transplants.
- In April 2020, Roebuck was hospitalized at Mayo Clinic after presenting with COVID-19 symptoms and was placed under the care of Mayo Clinic's congestive heart failure team due to his medical history.
- On April 23, 2020, a chest x-ray revealed Roebuck had developed pneumonia and an echocardiogram showed his heart was functioning well, so his doctors focused on managing his COVID-19.
- On April 24, 2020, Dr. Hasan Ashraf ordered an arterial blood gas (ABG) test because Roebuck was progressively hypoxic and suffering from metabolic acidosis due to COVID-19, and to provide information to support giving him the COVID-19 treatment tocilizumab.
- The ABG test results showed very low oxygen content, leading to Roebuck being given tocilizumab.
- The next day, Roebuck developed compartment syndrome, a complication from the ABG test, and underwent emergency surgery on his right hand, forearm, and wrist, resulting in diminished strength and use of his right hand and arm and significant scarring.
Procedural Posture:
- In January 2021, Robin Roebuck filed a medical negligence suit against the Mayo Clinic defendants in the Superior Court in Maricopa County (state trial court), alleging negligent performance of an ABG test.
- In March 2021, the Mayo Clinic defendants removed the action to the United States District Court for the District of Arizona, asserting federal question jurisdiction under the PREP Act.
- The District Court remanded the case to the state trial court, finding it did not raise a federal question.
- In May 2021, Roebuck filed an amended complaint in the state trial court.
- The Mayo Clinic defendants moved to dismiss the amended complaint, which the state trial court denied.
- The Mayo Clinic defendants subsequently moved for summary judgment, which the state trial court granted, dismissing Roebuck's claims but stating he was not barred from filing an amended complaint asserting willful misconduct or gross negligence.
- After the state trial court entered partial final judgment, Robin Roebuck (Plaintiff/Appellant) timely appealed to the Arizona Court of Appeals, Division One.
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Issue:
Does A.R.S. § 12-516, which shields healthcare providers from liability for ordinary negligence in providing COVID-19 related medical care, violate the anti-abrogation clause of the Arizona Constitution (Article 18, Section 6) by abrogating a common law right to recover damages for ordinary negligence?
Opinions:
Majority - Presiding Judge Maria Elena Cruz
Yes, A.R.S. § 12-516 violates the anti-abrogation clause of the Arizona Constitution because it completely abolishes the common law right to sue for ordinary negligence in COVID-related medical treatment, rather than merely regulating it. Article 18, Section 6 of the Arizona Constitution protects common law actions for negligence, including medical malpractice, from abrogation. While the legislature may regulate these actions, it cannot 'completely abolish' the right to sue. The court applies the 'reasonable election test,' which requires that a claimant be left with 'reasonable alternatives or choices' to bring an action. Section 12-516 goes beyond merely raising the burden of proof by barring all claims for ordinary negligence arising out of COVID-related medical treatment, instead requiring proof of gross negligence or willful misconduct. The court found that the availability of relief for gross negligence is not a 'reasonable alternative' to a claim for ordinary negligence, as they are distinct theories of liability requiring different showings, citing Walls v. Ariz. Dep’t of Pub. Safety and Noriega v. Town of Miami. The court cited precedents like Hazine v. Montgomery Elevator Co. and Rubino v. De Fretias, which held that preserving alternative causes of action does not save a statute that abrogates a distinct common law claim. Similarly, statutes that create an absolute bar to recovery for a subcategory of plaintiffs or claims, as seen in City of Tucson v. Fahringer, Little v. All Phoenix S. Cmty. Mental Health Ctr., Inc., and Young Through Young v. DFW Corp., have been found unconstitutional. Therefore, denying recovery to a subcategory of medical negligence plaintiffs (those whose treatment was COVID-related) who would otherwise be entitled to assert a claim violates Article 18, Section 6. The court also affirmed that the federal Public Readiness and Emergency Preparedness (PREP) Act did not bar Roebuck's state law claims, because the ABG procedure is not a 'qualified pandemic or epidemic product,' a 'drug,' a 'biological product,' or a 'device' as defined by the Act, and no declaration was issued for it under subsection (b).
Analysis:
This case significantly reinforces the robust protection offered by Arizona's anti-abrogation clause, demonstrating that the legislature cannot extinguish an entire category of common law claims, even under the perceived exigencies of a public health emergency. It clarifies that merely preserving a higher-standard claim, such as gross negligence, does not constitute a 'reasonable alternative' to an ordinary negligence claim if the underlying legal theories are distinct. This ruling will likely serve as a crucial precedent, limiting future legislative attempts to severely restrict common law tort rights in Arizona and underscoring the judiciary's role in safeguarding constitutional protections for injured plaintiffs.
