North Broward Hospital District v. Kalitan

174 So. 3d 403, 2015 Fla. App. LEXIS 9969, 2015 WL 3973075
District Court of Appeal of Florida·Decided July 1, 2015·No. Nos. 4D11-4806, 4D11-4833, 4D11-4834·Published·Cited by 14 cases

Opinion

FORST, J.

In Estate of McCall v. United States, 134 So.3d 894 (Fla.2014), the Florida Supreme Court determined that the caps on noneconomic damages awards in wrongful death cases, imposed by section 766.118, Florida Statutes (2005), violated the equal protection clause of the Florida Constitution. Art. I, § 2, Fla. Const. The instant case consolidates three appeals from, a single medical malpractice incident with a final judgment finding Appellants, defendants below (“Defendants”), liable for the injuries and damages suffered by Appellee Susan Kalitan (“Plaintiff’). ’ Plaintiffs jury-awarded damages were limited by the trial court’s application of section 766.118, and Plaintiffs cross-appeal challenges the constitutionality of those caps.

Accordingly, this appeal presents an issue of first impression in the post-McCall legal environment — whether the opinion (or, more accurately, opinions) of the Florida Supreme Court in McCall dictates our holding that the caps on noneconomic damage awards in personal injury medical malpractice cases are similarly unconstitutional. Although Defendants attempt to distinguish the caps in wrongful death cases from those in personal injury cases, and there are clear distinctions, McCall mandates a finding that the caps in section 766.118 personal injury cases are similarly unconstitutional. - To conclude otherwise would be disingenuous. Consequently, we reverse the trial court’s decision below insofar as it reduced the jury’s award of noneconomic damages based on the caps in section 766.118.

Introduction

In addition to Plaintiffs cross-appeal challenge to the constitutionality of the noneconomic damages caps, this case also involves Defendants’ challenges to the apportionment of liability amongst the six defendants, as well as the determination that the noneconomic damages, were caused by a “catastrophic injury.” Our holding on the constitutionality of the caps renders several of the issues' raised by Defendants on appeal moot. As for the one ruling still at issue, we reverse the final judgment with respect to its finding defendant Barry University (“University”) vicariously liable for the conduct of defendant Edward Punzalan, CRNA (“the Nurse”).

Our opinion will first present the events that led to Plaintiffs medical malpractice lawsuit. Second, we. will review the trial court proceedings and decision. Third, we will discuss McCall, which addressed the constitutionality of noneconomic damages caps limiting awards in wrongful death actions. Fourth, we will apply McCall’s holding to the instant appeal. Fifth,-we will address the University’s liability for the Nurse’s actions.

I. Background

In 2007, Plaintiff went to defendant North Broward Hospital District (“the [406]*406Hospital”) for outpatient surgery to treat carpal tunnel syndrome in her wrist. The surgery required Plaintiff to be placed under general anesthesia. Defendant Dr. Robert Alexander (“the Anesthesiologist”) was the anesthesiologist of record providing anesthesia care to Plaintiff during her surgery. The Anesthesiologist’s team included the Nurse, as well as defendant Eleidy Miedes, a student nurse anesthetist from the University (“the Student”). All three individuals were present through the coordination of defendant Anesco North Broward, LLC (“Anesco”), a company that contracted with the Hospital to staff it with anesthesiologists and nurse anesthetists. Anesco also contracted with the University to facilitate the clinical training of the University’s student registered nurse anesthetists (“SRNAs”) at Anesco’s affiliates, including the Hospital. At the time of the surgery, the Nurse was an employee of Anesco as a certified registered nurse anesthetist and an employee of the University as its clinical coordinator for the SRNA program.

During intubation, as part of the administration of anesthesia for Plaintiffs surgery, one of the tubes perforated Plaintiffs esophagus. Prior to the surgery and intubation, Plaintiff had no problems with her esophagus, nor did she complain of any bodily pain unassociated with her carpal tunnel. Plaintiffs hospital records do not indicate which member of the team actually intubated Plaintiff, but the Anesthesiologist testified that it was he, not the Nurse nor the Student, who performed the intu-bation.

When Plaintiff awoke in recovery, she complained of excruciating pain in her chest and back. The Anesthesiologist was notified, and, unaware of the perforated esophagus, he ordered the administration of a drag for the chest pain and concluded that there was no issue with Plaintiffs heart. Plaintiff was discharged from the hospital later that afternoon. Plaintiffs neighbor picked her up and drove her home.

The neighbor returned the next day to check on Plaintiff. Plaintiff was unresponsive, so the neighbor took her to the emergency room of a nearby hospital. Upon diagnosis of the problem, Plaintiff was rushed into lifesaving surgery to repair her esophagus. Plaintiffs next memory was waking up in the intensive care unit after being in a drug-induced coma for several weeks. Plaintiff had additional surgeries and underwent intensive therapy to begin eating again and regain mobility. She testified that she continues to suffer from pain throughout the upper half of her body and from serious mental disorders as a result of the traumatic incident and the loss of independence because of her body’s physical limitations following this incident.

II. Plaintiffs Medical Malpractice Lawsuit

Plaintiff filed a medical negligence action against Defendants. The issues at trial encompassed personal liability and vicarious liability for Plaintiffs injuries, as well as the extent of the injuries and whether they amounted to “catastrophic injury” under section 766.118(l)(a). At the end of Plaintiffs case, all parties moved for directed verdict on various grounds. Primarily, Defendants contended that Plaintiff failed to meet the threshold for a determination of catastrophic injury. Plaintiff moved for directed verdict as to the University’s liability for the Nurse’s actions, but the University objected, arguing that Plaintiff never had alleged such a claim in the case.

Ultimately, the trial court decided to submit these two highly contested issues to the jury as questions on the verdict form. With respect to the University’s [407]*407vicarious liability for the Nurse, the jury was asked whether the Nurse was acting as the University’s agent or employee when he was supervising the Student during the administration of the anesthesia to Plaintiff. With regard to catastrophic injury, the jury was asked to determine whether Plaintiff suffered a “permanent impairment constituted by either ... [sjpi-nal cord injury involving severe paralysis of an arm, a leg, or the trunk ... [or] [sjevere brain or closed-head injury evidenced by a severe episodic neurological disorder.”

The jury found in Plaintiffs favor and apportioned liability as directed on the verdict form. The jury also found that the Nurse was acting as the University’s agent or employee when supervising the Student during the administration of anesthesia to Plaintiff. Finally, the jury determined that Plaintiff suffered catastrophic injury in the form of a “[sjevere brain or closed-head injury evidenced by a severe episodic neurological disorder” and awarded Plaintiff $4,718,011 in total damages. The non-economic damage awards were $2 million for past pain and suffering and $2 million for future pain and suffering.

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North Broward Hospital District v. Kalitan, 174 So. 3d 403, 2015 Fla. App. LEXIS 9969, 2015 WL 3973075 (Fla. Ct. App. 2015).

174 So. 3d 403 (North Broward Hospital District v. Kalitan) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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