The District Court of Appeal of the State of Florida Fifth District (“Florida Appellate Court”) stated in its opinion dated May 29, 2020, “The issue presented by these consolidated petitions is whether a claim arising out of the alleged failure to complete a medically necessary transfer, as part of a scheme to increase admission rates for strictly financial reasons, sounds in medical malpractice. Because the claim raised here directly relates to medical care or services, which require the use of professional judgment or skill, we hold the trial court departed from the essential requirements of law when it determined the medical negligence standard of care is not implicated.”
The Underlying Facts
On February 20, 2012, Shannon C. Lawley (“Lawley”) arrived at the emergency room (“ER”) at Rockledge HMA, LLC, d/b/a Wuesthoff Medical Center Rockledge (“Wuesthoff”). The emergency medicine physician diagnosed Lawley with several medical issues and determined that she required intensive care unit (“ICU”) treatment. At the time the determination was made, the defendants allegedly knew that Wuesthoff had no available ICU beds and that six other patients in the ER were also awaiting ICU beds. However, other hospitals in the immediate vicinity of the ER allegedly had ICU beds available and could treat Lawley. Instead of transferring Lawley, she was admitted and was placed in a hallway in the Wuesthoff ER for over seven hours, where she ultimately became unresponsive and died.
The subsequent lawsuit alleged that Lawley’s admission was for “the sole purpose of generating hospital and/or physician revenue.” The lawsuit alleged that the decision to admit rather than transfer Lawley led to her being treated by an ER physician who caused her death. The Complaint was filed prior to the plaintiff initiating the pre-suit investigation process, which is required by Chapter 766, Florida Statutes (2014).
The Fifth Amended Complaint reasserted that the defendants failed to transfer Lawley as a result of the scheme to increase admission rates for strictly financial reasons (the plaintiff attached a non-prosecution agreement reached with the federal government in which Health Management Associates, Inc. of Delaware (“HMAD”) was prohibited from denying that it “executed a formal and aggressive plan to improperly increase overall emergency department inpatient admission rates at all HMA Hospitals”).
The trial court determined that the wrongful acts complained of were not “directly related to improper application of medical services” and did not require the use of professional judgment or skill. The trial court therefore reasoned that the claim did not arise out of the rendering of or failure to render medical care because the decision not to transfer Lawley constituted a non-medical decision. In light of this determination, the trial court found that neither the pre-suit requirements of Chapter 766 nor the statute of limitations applicable to medical malpractice claims served to bar the Complaint. The defendants appealed.
Florida Appellate Court Opinion
The Florida Appellate Court stated, “Here, the act from which Respondents’ claim arises also concerns a lack of treatment: Dr. Hill’s decision to admit the decedent to receive critical care management, as opposed to transferring her to another facility’s ICU. In order to establish damages, Respondents will need to show the decision was improper. In other words, Respondents will be required to show that Dr. Hill improperly exercised medical judgment, in contradiction of the prevailing professional standard of care, through the testimony of a qualified medical expert … Respondents allege that the reason for the improper decision was economic interest. Even so, the damages Respondents seek are inescapably linked to the alleged failure to provide appropriate medical care. Consequently, the claim is one “arising out of the rendering of, or failure to render, medical care or services.” § 766.106(1)(a), Fla. Stat. (2014).”
The Florida Appellate Court held: “The trial court’s contrary determination constituted a departure from the essential requirements of law,” concluding that “[b]ecause Respondents’ claims sound in medical negligence, we grant the petitions, quash the orders on review, and remand for additional proceedings consistent with this opinion.”
Source Rockledge HMA, LLC v. Lawley, Case No. 5D19-1223, 5D 19-1919, 5D19-1225, 5D19-1957.
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