Ala. hospital has immunity in $3.2M case

By Jessica M. Karmasek | Jan 25, 2011


MONTGOMERY, Ala. (Legal Newsline) - The Alabama Supreme Court has vacated a $3.2 million wrongful death jury award in a medical malpractice lawsuit against a Montgomery-area hospital.

The Court, in its Jan. 14 majority opinion, also found that the defendant Health Care Authority for Baptist Health was entitled to state immunity.

Baptist Health, a private nonprofit corporation, had operated several hospitals in Montgomery for many years. When it began experiencing financial difficulties, the University of Alabama Board of Trustees and its affiliate, the University of Alabama at Birmingham Health System, agreed to assist Baptist Health by managing its hospitals.

In June 2005, the board created the Health Care Authority for Baptist Health to improve the overall efficiency of clinical operations.

Months later Lauree Durden Ellison was treated in the emergency room of Baptist Medical Center East, formerly part of Baptist Health and at the time a part of the authority.

Ellison, 73, suffered from a number of chronic preexisting medical conditions, including respiratory failure, diabetes, hypertension, chronic pain, gastrointestinal bleed and stroke. The visit was for evaluation after Ellison had fallen at home.

However, while she was in the emergency room, Ellison mentioned she had a sore throat.

A doctor ordered a quick streptococcus test, which was negative. The exam and lab results indicated Ellison did not have an infection, and all other tests and X-rays were ordinary for injuries caused by the fall, so Ellison was discharged.

After she was released, the lab at the hospital grew the culture taken from the quick streptococcus test and detected the presence of methicillin-resistant staphylococcus aureus, or MRSA. Although the lab reported the results in its electronic medical records system, the results were allegedly not reported directly to Ellison's treating physician.

On Nov. 3, 2005, Ellison returned to the hospital's emergency room complaining of a cough and moderate-to-severe respiratory distress. She died five days later.

In May 2006, Kay E. Davis, as executrix of Ellison's estate, filed a complaint in Montgomery County, naming as the defendant the Health Care Authority for Baptist Health, an affiliate of UAB Health System doing business as Baptist Medical Center East.

At trial, Davis presented the testimony of expert witnesses who claimed that BMCE had breached the standard of care by not reporting its finding of MRSA directly to Ellison's doctor and that the hospital's failure to report was the proximate cause of her death.

The authority offered the testimony of its own expert witnesses, who testified that MRSA does not cause a sore throat; that, because Ellison was not suffering from a throat infection when the culture was taken, the standard of care did not require that anyone be notified of the presence of MRSA; that notifying Ellison's doctor of the MRSA would not have changed her course of treatment; and that, in any event, Ellison died of congestive heart failure unrelated to the MRSA, and not of MRSA pneumonia.

The jury returned a verdict for Davis in the amount of $3.2 million. A judgment was rendered for Davis and against the authority for that amount.

The authority then filed a postjudgment motion seeking a new trial or a reduction of the judgment from $3.2 million to $100,000. Before trial, the authority had asserted it was subject to the $100,000 statutory cap on damages against governmental entities.

The trial court denied the authority's postjudgment motion, holding that it is not entitled to have its damages capped at $100,000 pursuant to the statute, and it entered a final judgment against the authority for $3.2 million. The authority appealed.

Associate Justice Michael F. Bolin, in the Court's 36-page opinion, wrote that the "incorporating entity" for the authority is the board, which has state immunity.

The Court points to the state constitution, which holds that "public institutions created by the State purely for charitable or educational purposes are a part of the State and are not subject to be sued."

"This Court has held that the 'constitutionally guaranteed principle of sovereign immunity, acting as a jurisdictional bar, precludes a court from exercising subject-matter jurisdiction. Without jurisdiction, a court has no power to act and must dismiss the action,'" it wrote.

Accordingly, the Montgomery Circuit Court did not have subject-matter jurisdiction over this action, the Court said. Thus, its judgment is vacated, and the appeal is dismissed, it ruled.

Chief Justice Sue Bell Cobb and Associate Justice Glen Murdock dissented. In each of their opinions, they took issue with the Court's designation as the authority being a so-called "government entity" and granting it immunity.

From Legal Newsline: Reach Jessica Karmasek by e-mail at jessica@legalnewsline.com.

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