Abate v. Healthcare Intern., Inc.

560 So. 2d 812, 1990 WL 55834
CourtSupreme Court of Louisiana
DecidedApril 30, 1990
Docket89-CC-2737, 89-CC-2748
StatusPublished
Cited by21 cases

This text of 560 So. 2d 812 (Abate v. Healthcare Intern., Inc.) is published on Counsel Stack Legal Research, covering Supreme Court of Louisiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Abate v. Healthcare Intern., Inc., 560 So. 2d 812, 1990 WL 55834 (La. 1990).

Opinion

560 So.2d 812 (1990)

Kathy B. Abate, Wife of/and Charles V. ABATE, Jr.
v.
HEALTHCARE INTERNATIONAL, INC., Alpha Stress Care, Inc., and Ali A. Salehi, M.D.
Joe REED, Husband of/and Dorothy Reed
v.
ST. CHARLES GENERAL HOSPITAL, the Blood Center for Southeast Louisiana, Inc. and Drs. Treuting, Simpson, and the Pathology Laboratory.

Nos. 89-CC-2737, 89-CC-2748.

Supreme Court of Louisiana.

April 30, 1990.
Rehearing Denied May 24, 1990.

C. Scott Carter, New Orleans, for applicants Kathy and Charles Abate.

Albert H. Hanemann, Jr., Susan C. Northrop, Lemle & Kelleher, Kurt Blankenship, Lanny Zatzkis, New Orleans, William J. Guste, Jr., Atty. Gen., for respondents Healthcare Intern., Inc., Alpha Stress Care, Inc., and Ali Salehi.

Russ Herman, Mark R. Wolfe, Herman Herman Katz & Cotlar, New Orleans, for applicants Joe and Dorothy Reed.

Edward Rodrigue, Jr., Terry Deffes, Boggs, Loehn & Rodrigue, New Orleans, Leo R. Hemelt, II, Windhorst, Gaudry, Talley & Ransom, Harvey, Robert Young, Jr., Young, Richaud, Theard & Myers, New Orleans, for respondents St. Charles Gen. Hosp., the Blood Center for Southeast La., Inc., and Drs. Treuting, Simpson and the Pathology Lab.

*813 COLE, Justice.[*]

The issue is whether a health care provider must "qualify" under the provisions of the Medical Malpractice Act, LSA-R.S. 40:1299.41 et seq., prior to the commission of the alleged tortious conduct in order for the conduct to be covered by the Act.

The defendants in the two cases consolidated for our review were not enrolled in the Patient Compensation Fund (PCF) when their alleged acts or omissions of medical malpractice occurred. However, defendants "qualified" as health care providers (QHCP) under the provisions of the Medical Malpractice Act (Act) prior to the dates plaintiffs filed their respective suits 1) by filing proof of their financial responsibility with the Commissioner of Insurance and 2) by payment of the surcharge assessed by the PCF. LSA-R.S. 40:1299.42(A), (E).[1] The insurance policies defendants filed to establish their financial responsibility were "claims-made" policies with coverage which retroactively encompassed the dates of defendants' alleged tortious acts or omissions.

Both sets of plaintiffs filed their suits against the QHCPs without first presenting their claims to medical review panels as required by the Act. LSA-R.S. 40:1299.47. As a consequence, defendants filed dilatory exceptions objecting to the prematurity of the suits. Interpreting Act 435 of 1984, which amended LSA-R.S. 40:1299.42(E),[2] as providing QHCPs with PCF coverage which is coextensive with their primary policies of malpractice liability insurance, both trial courts considered defendants' alleged tortious acts or omissions covered by the provisions of the Act. Defendants' dilatory exceptions were, therefore, maintained and plaintiffs' suits dismissed. The courts of appeal denied both plaintiffs' applications for supervisory relief. We granted writ to examine whether defendants' exceptions were properly maintained. Finding the Act does not provide coverage to health care providers who fail to qualify prior to the commission of the tortious conduct, we reverse and remand.

POSTURE OF THE CASE

A. The Abates

Kathy B. and Charles V. Abate, Jr., filed suit on April 16, 1987, naming as defendants Bonnabel Hospital; Alpha Stress Care, Inc. and Dr. Ali A. Salehi, M.D., a specialist in radiology. Amending and supplemental petitions added as defendants Philip V. Bellina, Jr., M.D. (a professional medical corporation) and defendants' insurers.[3] The original and amending petitions claim defendants are solidarily and jointly liable for "negligently and/or carelessly fail[ing] to properly care for, treat, supervise, test and monitor Mrs. Abate while she was hospitalized in Bonnabel Hospital" from February 16, 1986 until April 4, 1986. The petitions further allege the defendants' "failure to recognize and properly treat Mrs. Abate's ailment or condition allowed significant spread of infection, destruction of tissues, and medical complications." As a result of these alleged acts of negligence, plaintiffs claim Mrs. Abate has undergone fifteen to twenty surgical procedures and has amassed medical bills totaling approximately $1.5 million dollars.

In response, on September 19, 1988, Dr. Salehi filed a dilatory exception objecting to the prematurity of the suit. He claims that at all times pertinent to the lawsuit he has been a QHCP pursuant to the provisions of the Medical Malpractice Act, LSA-R.S. 40:1299.41 et seq. Accordingly, he asserts his entitlement to having plaintiffs' claim submitted to a medical review panel as a condition precedent to suit. LSA-R.S. 40:1299.47. He claims the rights and privileges afforded to QHCP because 1) his surcharge was paid to the PCF on July 28, *814 1986, before plaintiffs' filed their claim, and 2) his proof of financial responsibility is established by a "claims-made" malpractice liability insurance policy with a policy term effective August 15, 1986, expiring on August 15, 1987, but with retroactive coverage to August 15, 1985. Dr. Salehi asserts that according to Act 435 of 1984, "qualification" under the Medical Malpractice Act takes effect, covers the same time and provides identical coverage to the QHCP's primary policy of malpractice liability insurance.[4]

As Dr. Salehi was not "qualified" as a health care provider when the alleged tortious conduct occurred, the Abates' opposition to the exception declares the Act does not cover their claim. LSA-R.S. 40:1299.41(D).[5] The Abates contend "qualification" under the Act requires filing proof of financial responsibility and payment of the surcharge levied by the PCF prior to the commission of the tort. LSA-R.S. 40:1299.42(A); 40:1299.41(D). To support their position, the Abates cite Williams v. St. Paul Ins. Co., 419 So.2d 1302 (La.App. 4th Cir. 1982), writ den., 423 So.2d 1182 (La.1982), and Mehalik v. Morvant, 451 So.2d 1321 (La.App. 1st Cir. 1984), as dispositively holding, for the tortious conduct to be covered by the Act, the initial surcharge had to be paid by the health care provider before the tortious conduct occurred. LSA-R.S. 40:1299.42(A).

The Abates also produced Dr. Salehi's deposition testimony which reveals he specifically rejected PCF coverage for the policy period of August, 1985 through August, 1986, the period in which Mrs. Abate was hospitalized at Bonnabel Hospital. Their supplemental memoranda and exhibits reveal Dr. Salehi's insurance agents confirm he rejected the PCF coverage for the effective period covering Mrs. Abate's hospital stay, with full knowledge that, without the PCF endorsement, malpractice claims against him would not be limited to $500,000 and he would not be entitled to PCF privileges such as preliminary review of claims against him by a panel of his peers.[6]

To refute this opposition, Dr. Salehi cites James Keating, M.D. v. Sherman Bernard, Commissioner of Insurance and Administrator of the Louisiana Patient's Compensation Fund, No. 315-915, 24th J.D.C. and Timothy Rochester, et al. v. St. Paul Fire and Marine Insurance Company, No. 311,547, 19th J.D.C., as holding Williams and Mehalik had been legislatively overruled by LSA-R.S. 40:1299.42(E), as amended by Act 435 of 1984. Dr. Salehi claims the Keating and Rochester

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Bluebook (online)
560 So. 2d 812, 1990 WL 55834, Counsel Stack Legal Research, https://law.counselstack.com/opinion/abate-v-healthcare-intern-inc-la-1990.