Luther v. Iom Co.

130 So. 3d 817, 2013 WL 5788759, 2013 La. LEXIS 2234
Supreme Court of Louisiana·Decided October 15, 2013·No. No. 2013-C-0353·Published·Cited by 55 cases

Opinion

HUGHES, J.

BWe granted certiorari in this case to review an appellate court reversal of a district court ruling that the defendants, a medical diagnostic monitoring company and its employee/physician, were not “qualified health care providers” (“QHCPs”) under the Louisiana Medical Malpractice Act, LSA-R.S. 40:1299.41 et seq. (“MMA”), for purposes of alleged acts of medical malpractice. For the reasons that follow, we reverse the appellate court, reinstate the district court judgment, and remand.

FACTS AND PROCEDURAL HISTORY

On October 30th and November 1st of 2007, George Luther underwent two successive surgical procedures on his back at a Monroe hospital, which resulted in neurological damage, including partial paralysis. During the October surgery, Intra-Op Monitoring Services, LLC (“Intra-Op”) provided electro-diagnostic monitoring services to the operating surgeon, by means of an on-site technician (John Partridge) and remote monitoring by Dr. Dan W. Joachim, who was located in Intra-Op’s Covington office. Allegedly, Dr. Joachim and Mr. Partridge 12negligently failed to apprise Mr. Luther’s surgeon, during the October surgery, of “significant loss of function to critical neurological structures,” reporting, instead, functioning within normal limits. The incorrect monitoring reports purportedly deprived the surgeon of the opportunity to take appropriate action, which could have prevented the permanent loss of motor function that Mr. Luther suffered.1

Subsequent to these events, Intra-Op was purchased by IOM Company, LLC [820] (“IOM”), in September of 2008. In October of 2008, Mr. Luther requested a medical review panel to evaluate the asserted medical malpractice of his surgeon and the hospital.2 This request was later amended, in June of 2009, to assert the negligence of IOM, its employees, and medical staff, particularly Dr. Joachim and Mr. Partridge, for their failure to notify Mr. Luther’s surgeon of “salient medical facts which would or could have altered the surgical result of 80 October 2007.”

On July 7, 2009, the Louisiana Patient’s Compensation Fund (“PCF”) forwarded a letter to Mr. Luther’s attorney, stating that “[b]ased on the documents and information in possession of this office as of this date, ... [Intra-Op and Dr. Joachim] are being reported as qualified for acts of medical malpractice under the provisions of [the MMA], for the above referenced claim.” The PCF letter further stated that “[t]he Oversight Board reserves the right to revise its qualification and coverage determination upon receipt of additional information.”

Subsequently, on or about August 11, 2010, Mr. Luther and IOM agreed to settle the matter, with IOM agreeing to pay $100,000 to Mr. Luther in exchange for a release of liability, subject to court approval; Mr. Luther would retain the right to proceed against the PCF. In connection with the petition for approval of the settlement agreement, filed with the 4th Judicial District Court, the Patient’s | sCompensation Fund Oversight Board (“Board”) was served with the petition and given formal notice of the terms of the settlement agreement. Thereafter, the PCF staff reviewed its earlier letter that the defendants were qualified for acts of medical malpractice under the MMA, for Mr. Luther’s claim, and discovered that, at the time of Mr. Luther’s October 2007 surgery, the defendants were not QHCPs under the provisions of the MMA.3 On August 17, 2010, the PCF notified Mr. Luther’s attorney that its July 7, 2009 letter “incorrectly listed [Intra-Op and Dr. Joachim] as qualified health care providers for the referenced [Medical Review Panel].” The August 17, 2010 PCF letter further stated that “our records reflect that [Intra-Op and Dr. Joachim] are considered not qualified for the acts of medical malpractice under the [MMA].” (Emphasis original.) Letters were also sent on August 17, 2010 to Intra-Op .and Dr. Joa-chim, by the PCF, advising them that the PCF records reflected that they were not members of the fund and were not qualified for panel review, for purposes of Mr. Luther’s claim.

On October 15, 2010, Mr. Luther and his wife filed suit against IOM, Dr. Joachim, Mr. Partridge,4 and Admiral Insurance Company (IOM’s liability insurer), seeking damages arising out of alleged acts of neg[821] ligence during Mr. Luther’s October 30, 2007 surgery. IOM and Dr. Joachim filed a third party demand against the PCF and the Board for a declaration by the court that they were QHCPs under the MMA. Thereafter, the PCF and the Board filed a motion for summary judgment, contending that because the defendants had not enrolled with the PCF prior to the date of the alleged tort in this case, but, rather, enrolled after |4the date of Mr. Luther’s October 30, 2007 surgery, they were not QHCPs with respect to the alleged October 30, 2007 malpractice. The defendants responded with a cross motion for summary judgment, asserting that they detrimentally relied on the PCF’s July 7, 2009 letter stating they were QHCPs, and the PCF should be estopped from revoking that “certification.” The district court denied the defendants’ motion for summary judgment and granted the PCF’s motion for summary judgment, finding that the defendants were not QHCPs; the defendants’ third party demand was dismissed.

The defendants then sought review from the appellate court, which reversed the district court’s grant of summary judgment in favor of the PCF and rendered summary judgment in favor of the defendants, prohibiting the PCF from withdrawing its certification that the defendants were QHCPs for this claim. In so ruling, the appellate court reasoned that the defendants “were certified by the PCF as QHCPs” and that the defendants “relied upon this certification in entering into a settlement with the plaintiffs.” See Luther v. IOM Company LLC, 47,667 (La. App. 2 Cir. 1/16/13), 109 So.3d 467. Thereafter, this court granted the PCF’s application for review. See Luther v. IOM Company LLC, 2013-0353 (La.4/19/13), 111 So.3d 1022.

The PCF presents the following assignments of error to this court for review: (1) the appellate court improperly considered the PCF as the defendants’ insurer; (2) the appellate court improperly and erroneously interpreted critical and significant PCF rules and regulations establishing requirements for qualified healthcare provider status for a particular malpractice claim; (3) the appellate court made erroneous factual findings that all conditions and requirements of the PCF’s rules and regulations regarding enrollment were satisfied on October 30, 2007, when there was no evidence to support such a finding; (4) the appellate court improperly applied LSA-C.C. art. 1967 and/or the doctrine of equitable estoppel | Bunder the facts at bar, as there was no evidence that the defendants were reasonable in relying upon representations or were harmed; (5) the appellate court improperly found that the defendants met their burden of establishing a LSA-C.C. art. 1967 and/or equitable estop-pel claim against the PCF; and (6) the appellate court’s application of LSA-C.C. art. 1967 and/or equitable estoppel in these circumstances impermissibly resulted in de facto amendments of the PCF’s rules and regulations, properly and duly enacted pursuant to Louisiana Legislation.

LAW AND ANALYSIS

Motion for Summary Judgment

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Luther v. Iom Co., 130 So. 3d 817, 2013 WL 5788759, 2013 La. LEXIS 2234 (La. 2013).

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