The Florida Supreme Court heard oral arguments in February, 2012 in a case that may determine the constitutionality of Florida’s cap on non-economic damages in medical malpractice cases that was enacted in 2003 (the cap is $500,000 or $1 million under certain circumstances, depending on the number of claimants). The appeal involves the May 27, 2011 decision of the United States Court of Appeals for the Eleventh Circuit (“Appeals Court”) that affirmed the lower federal court’s application of Florida’s statutory cap on noneconomic damages, finding that the cap comports with the Equal Protection and Takings Clauses of the United States Constitution and does not constitute a taking in violation of the Takings Clause of the Florida Constitution.
Nonetheless, the Appeals Court certified the following questions to the Florida Supreme Court for its determination:
(1) Does the statutory cap on noneconomic damages, Fla. Stat. § 766.118, violate the right to equal protection under Article I, Section 2 of the Florida Constitution?
(2) Does the statutory cap on noneconomic damages, Fla. Stat. § 766.118, violate the right of access to the courts under Article I, Section 21 of the Florida Constitution?
(3) Does the statutory cap on noneconomic damages, Fla. Stat. § 766.118, violate the right to trial by jury under Article I, Section 22 of the Florida Constitution?
(4) Does the statutory cap on noneconomic damages, Fla. Stat. § 766.118, violate the separation of powers guaranteed by Article II, Section 3 and Article V, Section 1 of the Florida Constitution?
The Underlying Facts Of The Case
During June 2005, a pregnant woman received prenatal medical care at a United States Air Force clinic as an Air Force dependent. She opted for the Air Force’s family practice department to provide primary prenatal care and delivery services throughout her pregnancy. She had a healthy and normal pregnancy until the last trimester. On February 21, 2006, test results revealed that her blood pressure was high and that she was suffering from severe preeclampsia. Her serious condition required that labor be induced immediately.
Instead of transferring the pregnant woman to the OB/GYN department, the family practice department continued to provide medical care. The Air Force hospital was temporarily unavailable for obstetric and delivery services, so members of the family practice department transferred her to the Fort Walton Beach Medical Center instead. There, Air Force family practice doctors treated her for hypertension and induced labor. When she dilated to five centimeters, her contractions slowed and became weaker. The Air Force family practice doctors treating the woman called an Air Force obstetrician and asked if he could perform a cesarean section. The obstetrician reported that he was performing another surgery and would not be available to perform a cesarean section on the woman until after he finished that surgery. The Air Force family practice doctors prepared the woman for a cesarean section but did not call other obstetricians to determine if one was available to provide immediate medical care.
On February 22, 2006, the obstetrician finally arrived to perform the cesarean section, but the woman’s contractions had resumed and the Air Force family practice doctors decided to allow her to deliver vaginally, so the obstetrician left the Fort Walton Beach Medical Center. On February 23, 2006 at 1:25 a.m., the woman delivered a healthy baby boy. Family members who visited the woman after the delivery expressed concerns about the amount of blood she had lost during delivery. Medical personnel assured the family members that the woman was stable.
Thirty-five minutes later, when the placenta had not delivered as expected, two family practice doctors from the family practice department tried without success to manually extract the placenta. An Air Force nurse anesthetist administered additional epidural pain relief and gave the woman two separate doses of Morphine intravenously. Around 2:35 a.m., the family practice department doctors called the obstetrician for assistance when they could not remove the placenta manually.
The woman’s blood pressure began to drop rapidly and remained dangerously low over the next two and a half hours. The Air Force nurse anesthetist monitoring the woman’s vital signs did not notify the family practice doctors of the drop in her blood pressure. The obstetrician arrived at 2:45 a.m. and removed the placenta within five minutes. The family practice department doctors informed the obstetrician that the woman had not lost much blood during delivery. The obstetrician, however, noticed severe vaginal lacerations and worked to repair them over the next hour. During that time, the Air Force nurse anesthetist monitored the woman’s vital signs, reported to the obstetrician that they were stable, and failed to inform him that the woman’s blood pressure was dangerously low and continuing to drop. The obstetrician never checked the vital signs himself and relied exclusively on the nurse to inform him of any blood pressure changes or problems.
At 3:50 a.m. when the obstetrician finished his work, he requested an immediate blood count and, if needed, a transfusion to compensate for the blood the woman lost during the procedure. Forty minutes later, the family practice department physician ordered the blood count test. Forty minutes after that, and over an hour after the obstetrician had requested immediate blood work, a nurse attempted to draw blood from the woman but she was unresponsive. She had gone into shock and cardiac arrest as a result of severe blood loss. It is not clear how long the woman had been in this state, since no one had monitored her or checked her status for the hour following the obstetrician’s procedure. The woman never regained consciousness and was removed from life support on February 27, 2006.
The medical malpractice plaintiffs sued the United States under the Federal Tort Claims Act (“FTCA”), 28 U.S.C. §§ 1346(b), 2671–80. After a two-day bench trial, the District Court found the United States liable under the FTCA because the negligence of its employees proximately caused the woman’s death. The District Court found that Plaintiffs’ economic damages amounted to $980,462.40. The District Court found that Plaintiffs’ noneconomic damages totaled $2 million, including $500,000 for the woman’s son and $750,000 for each of her parents. The District Court applied Florida’s statutory cap on noneconomic damages for medical malpractice claims and limited Plaintiffs’ recovery of noneconomic damages to $1 million.
The Plaintiffs appealed the District Court’s decision to the Appeals Court, challenging the District Court’s rulings on both the application and constitutionality of Florida’s cap on noneconomic damages for medical malpractice claims.
We await the Florida Supreme Court’s decision in this matter.
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