In its Opinion filed on July 31, 2024, the Supreme Court of Maryland held that the Appellate Court of Maryland properly applied Virginia substantive law in accordance with the doctrine of lex loci delicti. Pursuant to that doctrine, which requires the application of the substantive law of the state where the last element required to complete a tort occurs, the Maryland Supreme Court held that there was sufficient evidence that Respondent, Shelly Blackston, suffered a cognizable injury during a surgery that a jury determined had been negligently performed by Dr. Alva Roy Heron, Jr. Accordingly, Virginia law applied with respect to the damages recoverable.
Lex Loci Delicti
Pursuant to Maryland’s choice of law rule, lex loci delicti, the substantive law of the place of the wrong is applied. For a tort, that is the place where the final element of the cause of action occurs. In the negligence context, that is generally where the first harm or injury occurs.
In the case the Maryland Supreme Court was deciding, Plaintiff Shelly Blackston had a liposuction procedure performed by Dr. Alva Roy Heron, Jr. at his office in Alexandria, Virginia. During the procedure, Ms. Blackston experienced excruciating pain, which Dr. Heron treated with additional injections of the local anesthesia he had administered prior to beginning the procedure. After the procedure, Ms. Blackston returned to her home in Maryland, where the pain continued. Within a few days, an infection manifested, and she required hospitalization and underwent five separate procedures and several rounds of antibiotics to treat that MRSA infection. As a result of the liposuction procedure, Ms. Blackston suffers from permanent physical and emotional injuries.
In September 2018, Ms. Blackston filed a Maryland medical malpractice complaint alleging medical malpractice and failure to obtain informed consent in the Circuit Court for Prince George’s County, Maryland. After a five-day trial, a jury found in her favor on both claims. The jury awarded Ms. Blackston damages of $2,300,900, which included non-economic damages of $2,000,000, economic damages of $60,000, and medical expenses of $240,900. The jury was not asked to determine where Ms. Blackston was first injured.
The circuit court reduced the non-economic damages to $755,000, consistent with Maryland’s statutory cap on non-economic damages. At the relevant time, Virginia law placed a cap of $2,150,000 on the total award for medical malpractice claims. Va. Code Ann. § 801-581.15. Ms. Blackston appealed, challenging the circuit court’s reduction of the noneconomic damages award based on Maryland’s cap on noneconomic damages in Maryland medical malpractice cases.
The Maryland Supreme Court stated, “Where the sustainability of all or part of a jury’s damages award depends on a factual determination of where the last act giving rise to the tort occurred, the better practice is to submit that factual question to the jury. Here, that issue was not submitted to the jury, neither party requested that it be submitted to the jury, and neither party objected to it not being submitted to the jury.”
“In resolving that issue, our focus must remain exclusively on the evidence presented to the jury and whether there was any evidence, however slight, sufficient to sustain the jury’s verdict. In addressing that question, we do not weigh that evidence ourselves or look to outside sources or independent knowledge to assess the veracity or persuasiveness of the evidence.”
“Based on the expert medical testimony admitted at trial, we hold that there was sufficient evidence for the jury to conclude that Ms. Blackston sustained an injury in the form of an infection in Dr. Heron’s Virginia office, where the
procedure was performed … the question before us is whether evidence admitted at trial can sustain the jury’s verdict, not whether that evidence was correct or scientifically valid. As discussed, the evidence was sufficient. Therefore, viewed in the light most favorable to Ms. Blackston, we hold that the Appellate Court correctly determined that Virginia substantive law applied to her claim and, therefore, that Virginia’s medical malpractice damages cap, rather than Maryland’s cap on non-economic damages, applies to the damages award.”
The Maryland Supreme Court concluded: “We hold that the circuit court erred in applying the Maryland cap on non-economic damages to the damages that the jury awarded to Ms. Blackston. Lex loci delicti requires the application of the substantive law of the state where the last element required to complete a tort occurs. Here, two different expert witnesses testified that the infection Ms. Blackston sustained started or was introduced during the procedure in Virginia. The jury was entitled to believe that testimony. Therefore, we agree with the Appellate Court that Ms. Blackston sustained a legally cognizable injury during the surgery in Virginia. Accordingly, viewing the evidence in the light most favorable to her as the prevailing party at trial, the evidence is sufficient to sustain the part of the jury’s verdict that is dependent on the location of her injury. Therefore, the cap on damages under Virginia law, not
Maryland law, is applicable to the damages awarded by the jury.”
Source Doctor’s Weight Loss Centers, Inc., et al. v. Shelly Blackston, No. 17, September Term, 2023.
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