Articles Posted in Medical Malpractice

The outside limit in Florida for suing for medical negligence is seven (7) years from the date of the incident or occurrence giving rise to the action. This time limit is set forth in Florida Statute 95.11(4)(b) and is known as the Statute of Repose.

Florida’s Statute of LImitations for medical malpractice, also part of 95.11(4)(b), is 2 years from the time the malpractice “is discovered, or should have been discovered with the exercise of due diligence; however, in no event shall the action be commenced later than 4 years from the date of the incident or occurrence out of which the cause of action accrued….”
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Most people do not know that many doctors who work in hospitals are not hospital employees, but independent contractors. This is not a distinction without meaning.

The distinction can have significant legal consequences for the victims of medical negligence seeking to be fairly compensated for harm done, especially catastrophic damage.

Generally, employers are bound by the negligence of their employees. This is the concept of respondeat superior, where a passive party is liable for the negligence of another party.

The legal principle is not applicable in relationships involving independent contractors. The general rule is that entities, including hospitals, are not liable for the negligent acts of independent contractors.

Thankfully, there are exceptions to the rule, circumstances wherein an entity can be held to account for the negligent conduct of an independent contractor. In the context of hospitals, these are the exceptions:

• The medical provider is either an actual or apparent agent of the hospital. See Roessler v. Novak, 858 So.2d 1158, 1161-62 (Fla. 2d DCA 2003). Three elements must be present for apparent agency: (a) a representation by the principal; (b) reliance on that representation by a third party; and (c) a change in position on the reliance. Mobil Oil Corp. v. Bransford, 648 So.2d 119, 121 (Fla. 1995). Importantly, apparent agency does not arise from the subjective understanding of the third party. Izquierdo v. Hialeah Hosp., Inc., 709 So.2d 187, 188 (Fla. 3d DCA 1998). Rather, as indicated in the Mobil Oil case, its presence is wholly dependent on the appearance created by the principal. In Roessler, the appellate court recited the following facts as creating enough of a question on the issue of apparent agency to reverse the trial court’s order dismissing the claim against the hospital:
  

  In the present matter, evidence presented to the trial court for the purpose of the summary judgment proceeding demonstrated that Sarasota Memorial maintained a radiology department which was physically located within the hospital’s grounds. Sarasota Memorial contracted with SMH Radiology Associates, P.A., for it to be the exclusive provider of professional radiological services at the hospital. Dr. Lichtenstein was an employee of SMH Radiology on the date he interpreted Mr. Roessler’s scans. Neither Dr. Lichtenstein nor SMH Radiology had offices outside of Sarasota Memorial’s hospital grounds. The radiologists employed by SMH Radiology, including Dr. Lichtenstein, worked at Sarasota Memorial to provide all professional radiological services twenty-four hours a day, seven days a week, to Sarasota Memorial’s inpatients and outpatients.

Mr. Roessler sought the services offered by Sarasota Memorial when he went to Sarasota Memorial’s emergency department. 1163*1163 He was admitted to Sarasota Memorial as an inpatient through Sarasota Memorial’s emergency department. Once Mr. Roessler arrived at Sarasota Memorial and was admitted as an inpatient, the hospital provided him with the health care services and providers it determined to be necessary. Such services included inpatient professional radiological services, which were provided by Sarasota Memorial through its radiology department. After abdominal scans were taken in its radiology department, Sarasota Memorial assigned Dr. Lichtenstein to interpret them. Like the plaintiff in Cuker, 605 So.2d 998, Mr. Roessler did not attempt to secure a specialist on his own, but instead accepted the physician provided to him by the hospital.

• The hospital fails to exercise due care in the selection and retention of an independent contractor medical provider on the hospital staff. See Insinga v. LaBella, 543 So.2d 209, 214 (Fla. 1989). In Insigna, a patient died in the hospital from botched treatment from a phony doctor who had been granted hospital privileges. The decedent’s estate sued the hospital negligent selection and retention of the imposter. Relying on the general proposition that principals are not liable for the negligence of independent contractors, the lower court dismissed that part of the claim against the hospital. The Florida Supreme Court disagreed with the lower tribunal, finding, “as a matter of public policy, that hospitals are in a better position to protect their patients and, consequently, have an independent duty to select and retain competent independent physicians seeking staff privileges.”
• Where the duty is non-delegable. See Pope v. Winter Park Healthcare Group, Ltd., 939 So.2d 185, 187 (Fla. 5th DCA 2006). With regard to hospitals, the duty may arise out of a statute, a regulation, or a contract. Id. at 187-88. The contract concept is summarized well in a jury instruction the appellate court in Irving v. Doctor’s Hospital of Lake Worth, Inc., 415 So.2d 55 (Fla. 4th DCA 1982) decided should have been given by the trial judge: “[O]ne who undertakes by contract to do for another a given thing cannot excuse himself to the other for a faulty performance, or a failure to perform, by showing that he has engaged another to perform in his place, and that the fault or failure is that of another or independent contractor.” Irving was an action involving the liability of a hospital for alleged negligent diagnosis and treatment by an emergency room physician that resulted in serious injury to appellant’s minor daughter. The ER physician was an independent contractor, rather than an employee of the hospital. The DCA reasoned that since the hospital was under contract to render medical care to the child, it could not excuse the fault of the ER doctor because he might have been an independent contractor.
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As if the arbitrary and capricious damage caps already on the books were not enough, the 2012 Republican-controlled Florida Legislature is moving forward with legislation designed to keep those harmed by medical negligence from ever being compensated for their losses.

Senate Bill 1506 will allow doctors to get patients to waive their right to compensation for losses suffered from medical malpractice.

That’s right, not a single penny for past and future medical expenses, lost wages, or for pain and suffering!!!

How could this be, you ask. Simple. With a Governor Rick Scott and a super-majority of radical Republicans controlling both chambers of the Florida Legislature, anything is possible.

Eliminate zoning restrictions on pristine land. Done. Tax dollars to private religious schools. Done. Reduce spending for public schools. Done. Suppress voting rights. Done.

Ending the rights of malpractice victims. Almost done.
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Effective October 1, 2011, individuals seeking redress for injuries caused by medical errors face yet another obstacle placed in their path by Florida’s Republican-dominated legislature. The new legislation applies to cases that arise on or after October 1, 2011.

The new legislation, Florida Statute 766.1065, forces claimants to provide target defendants with a medical authorization form along with the notice of intent to initiate litigation. The problem is that the authorization requirements of 766.1065 appear to abrogate the privacy rights of patients under Florida Statute section 456.057(7)(a) and the Federal Health Insurance Portability and Accountability Act at 42 USC Section 201 et seq. (commonly referred to as HIPAA) and 45 CFR Section 164.512.

It is too early to tell how the conflict will be resolved. One would like to believe that privacy rights will hold sway, but the forces seeking to insulate medical providers and their malpractice insurance companies hold an inordinate amount of influence in this state, so the outcome is anything but predictable.

The consequences of failing to comply with 766.1065 could be fatal to the case, so it is best not to play with that fire. We recommend providing the required authorization form, but include a statement in the notice of intent to initiate litigation, in bold large face type, that the authorization does not abrogate or supersede the doctor-patient privacy/confidentiality rights deliniated in the aforementioned citations.

Perhaps even more problematic to the pursuit of due process than the authorization, is the further hurdle created by the new law that for physicians licensed in other states to provide expert testimony in Florida about the prevailing professional standard of care or to execute and submit presuit verified written expert medical opinions, they must obtain certain certificates. Florida Statute Sections 766.102(12) and 458.3175. This is an onerous requirement designed to make it more difficult for those harmed by malpractice to pursue just compensation.
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Medical providers (doctors, hospitals, nurses), aligned, for the most part, with Republican politicians, believing them to be covering their backs, will be surprised to learn that, in a battle between them and medical malpractice insurance companies, they have been stabbed in the back.

Florida Statute 766.1185 (2003) is a safe-harbor statute for medical mapractice insurers. It gives them 210 days after a formal Complaint is served on one of its insureds to avoid having to satisfy an excess (of the policy limits) judgment. If the insurance carrier tenders the policy limits within the 210 days, it is safe from having to pay the excess portion of any judgment.

Although the insurance carrier may be safe, the insured is not. For the carrier to benefit from the safe-harbor statute, it is the tender alone, rather than a tender and acceptance, and thus a release of liability, that matters. The statute does not make acceptance of the tender mandatory. The operative act for carrier protection is the tender.
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Not satisfied with the existing arbitrary damage caps on non-economic damages (e.g., pain & suffering) contained in Fla. Stat. 766.118 – presently under challenge in Estate of Michelle Evette McCall v. United States of America* as violating the Florida Constitution – Florida’s 2010 Republican-controlled legislature created additional barriers to the rights of individuals harmed by medical negligence.

Caps on non-economic damages for Medicaid patients. Contained in 766.118(6), Medicaid recipients harmed by medical negligence are limited to $300,000 in non-economic damages. The arbitrary cap applies regardless of the damage, including death and catastrophic injury (e.g., brain damage; paralysis).

Sovereign immunity granted to private medical schools and their employees providing services at teaching hospitals (primarily affects the University of Miami through its dealings with Jackson Memorial Hospital). The new measure is contained in F.S. 766.1115. I have blogged recently about the dangers associated with sovereign immunity – Sovereign Immunity and Florida Personal Injury Law. Sadly, the Florida Legislature has seen fit to extend the dangerous doctrine to private for-profit corporations.
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