A Medical Malpractice Opinion
McCall v. United States, No. SC11-1148 (Fla. March 13, 2014).
On February 21, 2006, Michelle McCall, who was six months pregnant, was diagnosed with preeclampsia. Her doctor’s, who were all U.S. Air Force employees, determined that it would be best to immediately induce labor in order to save the child. On February 23, Ms. McCall delivered a healthy baby boy, however during the delivery she had lost a lot of blood. In a follow-up operation on Ms. McCall to repair some damage that had been done during delivery, her medical staff failed to properly monitor her blood pressure and when they tried to revive her after the operation, she never regained consciousness and passed away a few days later.
Ms. McCall’s family filed a claim against the United States in the United States district court for the Northern District of Florida under the Federal Tort Claims Act (FTCA) citing medical malpractice. After a bench trial, the judge agreed with the McCalls and found that the U.S. was guilty of malpractice and liable under the FTCA. The judge specifically found that the negligence of the U.S. Air Force hospital employees was the proximate cause of death. The judge awarded the McCalls US $ 980,462.40 for financial losses and awarded non-economic damages in the amount of US $ 2 million. However, the judge applied a Florida State regulation to the award of non-economic damages in medical malpractice cases that limited any award amount to US $ 1 million.
The McCalls appealed the district court’s decision to the Federal Appeals Court for the llth Circuit. The McCall’s appeal argued that the district court erred in applying the Florida state cap on non-economic damages. In addition, they argued that the cap was unconstitutional under both the U.S. and Florida State constitution. The 11th Circuit Appeals Court found that the district court had not erred in applying the cap and that the cap was constitutional under the U.S. Constitution’s Equal Protection Clause and Takings Clause as well the Florida Constitution’s Takings Clause.
However, because Florida law was not clear on the questions of whether the cap violated the Florida Constitution in regards to its: Equal Protection Clause; right to have access to the courts; right to a trial by jury and the separation of powers, the Court of Appeals sent the case to the Florida Supreme Court to make a determination under Florida state law whether the cap was constitutional as to those four specific aspects of the McCall’s argument. The Florida State Supreme Court agreed to hear the case and rendered its decision on March 13, 2014.
In a 5 to 2 decision, the Florida Supreme Court found that the cap violated the Equal Protection Clause of the Florida Constitution. The Court declined to consider the remaining three questions because they were determined to be unnecessary in answering the specific issues of the McCall’s case.
Justice Lewis wrote the majority opinion with Justice Labarga concurring and Justices Pariente, Quince and Perry concurring in part and opposing in part. The majority’s opinion focused on two elements. First the Court found that the cap was not rationally related to a legitimate purpose. According to the Court, the purpose of the cap was to address the state’s medical malpractice crisis. The Court defined the crisis as the increasing malpractice insurance rates that were supposedly driving doctor’s to decline providing affordable and needed treatments to patients as a method of “escaping” paying for the insurance. However, the Court’s research into the “crisis” revealed that contrary to reports, even with high insurance rates, doctors were not only providing services but increasing the amounts of services given in city and rural areas. Moreover, the Court found that application of caps had little or no impact on decreasing insurance rates as illustrated by the fact that a higher percentage of states without caps had experienced stable or declining malpractice premium rates.
Second, the Court found the cap unfair. According to the Court application of the cap could result in unequal awards. For instance, if Ms. McCall only had one relative, an application of the cap would result in him receiving 100% of any non-economic damage award. But since Ms. McCall had three relatives, the application of the cap resulted in division of the award by three. The Court found that this unfairly discriminated against them based on circumstances beyond their control.
Chief Justice Polston dissented in an opinion with which Justice Canady concurred. In his dissent, Chief Justice Polston argued that the cap was rationally related to the legitimate concern of the Florida Legislature to address the state’s medical malpractice situation. According to Polston, the majority failed to present convincing evidence that the caps had not worked at decreasing insurance rates and increasing the “affordability and availability of health care.” (Mcall, 2014, p.56).
Although the case was recently decided, judging from the amount of briefs in filed in support for or against the McCall’s arguments before the decision was made, it is clear that it has attracted much attention among the malpractice bar. Its effect may be that similar challenges will be made to non-economic damage awards in other states if they are similar in design and application to the Florida cap. Moreover, the ruling looks to bring a number of challenges in courts with arguments with data and analysis showing that rationale for caps (they will stop catastrophic raises in medical malpractice insurance and guarantee the availability of affordable health care services).
Engstrom, N.F., Rabin, R.L. (2013, August 13). Raise the Cap on Malpractice Awards. LATIMES.com. Retrieved on June 29, 2014, from http://articles.latimes.com/2013/aug/13/opinion/la-oe-engstrom-malpractice-damage-caps-20130813
Figley, P.F. (2009, Sping/Summer). Understanding the Federal Tort Claims Act: A Different Metaphor. Tort Trial & Insurance Practice Journal, 44 (3-4), 1105-1138.
Florida State Constitution, Article 1, Section 2. Retrieved on June 29, 2014, from http://www.leg.state.fl.us/Statutes/Index.cfm?Mode=Constitution&Submenu=3&Tab=statutes
McCall v. United States, No. SC11-1148 (Fla. March 13, 2014). Retrieved on June 29, 2014, from http://www.floridasupremecourt.org/decisions/2014/sc11-1148.pdf
McCall v. United States, 642 F.3d 944 (11th Cir. 2011). Retrieved on June 29, 2014, from http://casetext.com/case/estate-of-mccall-ex-rel-mccall-v-us
Sugarman, S.D. (). Tort Damages for Non-economic Losses. Retrieved on June 29, 2014, from http://www.law.berkeley.edu/files/journals/Sugarman_Non_economic_loss_ReformattedFinal.pdf