Davis v. Frostburg Facility Operations, LLC
Davis v. Frostburg Facility Operations, LLC
Opinion
Adkins, J.
We must decide, once again, whether claims for negligence and related claims have alleged a "medical injury" within the meaning of the Health Care Malpractice Claims Act ("Health Claims Act" or "HCA"). Md. Code (1974, 2013 Repl. Vol.), §§ 3-2A-01, et seq. of the Courts and Judicial Proceedings Article ("CJP"). Petitioners Shelia Davis and her husband Robert Davis, sued Frostburg Facility Operations, LLC ("Frostburg") for injuries Ms. Davis allegedly sustained while staying at one of Frostburg's facilities. If the plaintiffs alleged a medical injury within coverage of the Health Claims Act, they were required to file those claims in the Health Care Alternative Dispute Resolution Office ("ADR Office") as a condition precedent to their action in the Circuit Court for Allegany County. If not, the plaintiffs were free to file their claim as a non-medical negligence suit in the Circuit Court.
We issued a writ of certiorari to consider two questions, which we have rephrased for clarity: 1
1. Did the trial court err in dismissing Petitioners' claims for failure to first file in the ADR Office?
2. Did the trial court properly dismiss the remainder of the Complaint?
We hold that two of Davis's counts alleged medical injuries within the HCA, and the trial court properly dismissed those counts. The remaining negligence count did not allege a breach of a professional standard of care, and should survive. The counts sounding in Contract, Consumer Protection, and Loss of Consortium also survive dismissal.
I. BACKGROUND
Petitioners, Shelia Davis and her husband Robert Davis, filed a Complaint against Frostburg Facility Operations, LLC ("Frostburg") in the Circuit Court for Allegany County. Davis complained of injuries suffered during her stay at Frostburg's nursing care facility while recovering from back surgery. Her alleged injuries followed two separate accidents at Frostburg. First, while she slept, she fell from her bed-allegedly as a result of Frostburg's failure to properly secure her mattress to the bed frame. Davis waited on the floor approximately 45 minutes for a nurse to assist her. When she finally arrived, the nurse retrieved a mechanical lift and used that to raise Davis off the floor, intending to return her smoothly to the bed. But, in another mishap-while Davis was suspended, but not yet over her bed-the lift released and dropped her again onto the hard surface of the floor.
These events occurred on October 26, 2011. Davis 2 filed her Complaint on October 23, 2014-just three days before Maryland's general statute of limitations would have barred her claim. CJP § 5-101. 3 Frostburg responded with a Motion to Dismiss.
Frostburg argued that Davis's claims failed as a matter of law because she did not file her claims in the ADR Office pursuant to CJP § 3-2A-04(a)(1)(i). Frostburg also moved to dismiss Davis's claims for breach of contract and violation of the Maryland Consumer Protection Act ("CPA") for failure to state a claim for which relief can be granted. Before the trial court could rule on Frostburg's motion, Davis filed an Amended Complaint pursuant to Maryland Rule 2-341. Frostburg renewed its Motion to Dismiss, contending that Davis failed to remedy the deficiencies in her Complaint. Before the trial court ruled on Frostburg's motion, Davis filed a Second Amended Complaint-the subject of this appeal.
Davis amended her factual allegations to emphasize the non-medical nature of her claims. Specifically, she alleged that the Frostburg facility also served as a "residence" during her stay there. She averred that she was not receiving medical services when her mattress came loose, causing her first fall to the floor, or when she was dropped by the nurse in an effort to return Davis to the bed. Regarding the first fall, Davis alleged that she was "simply lying in bed." As to the second fall, Davis similarly alleged that her injuries resulted after the nurse "simply attempt[ed] to return [her] to her bed." Her Complaint included six Counts entitled: (1) Negligence; (2) Negligence; (3) Negligence Respondeat Superior ; (4) Breach of Contract; (5) "False Advertising/Consumer Protection;" and (6) Loss of Consortium.
Count One related solely to Davis's initial fall from her bed as she slept. She alleged that Frostburg owed her "the duty to exercise reasonable care in providing a bed to her that was safe for ordinary use." Frostburg breached this duty by "negligently and recklessly failing to properly attach Ms. Davis's mattress to the bed frame ...." Count Two related solely to her fall from the mechanical lift as the nurse attempted to return her to the bed. Davis alleged that Frostburg owed her "the duty to exercise reasonable care in providing mechanical lifts ... that were safe for ordinary use," but breached this duty by "negligently and recklessly providing a mechanical lift that malfunctioned ...." Count Three, for Negligence Respondeat Superior , also related only to Davis's fall from the mechanical lift. Davis alleged that Frostburg had a duty "to exercise reasonable care in returning her to her bed." The nurse, a Frostburg employee acting in the scope of employment, "negligently and recklessly released Ms. Davis from the mechanical lift ...." Davis also alleged-in Counts One, Two, and Three-that her injuries did not result from Frostburg's rendering or failure to render health care. Arguing that Davis's claims sounded in medical malpractice, Frostburg moved to dismiss the Second Amended Complaint because Davis failed to satisfy the "condition precedent" of filing her claims in the ADR Office according to CJP § 3-2A-04(a)(1)(i).
After the trial judge granted Frostburg's Motion to Dismiss, Davis timely appealed. In an unreported opinion, the Court of Special Appeals affirmed the trial court's decision to dismiss the entire complaint.
Davis v. Frostburg Facility Operations, LLC
, No. 540,
II. DISCUSSION
Davis makes two arguments before this Court. First, she argues that the Complaint did not set forth claims of medical negligence and, therefore, the trial court improperly dismissed her Complaint for failure to first file in the ADR Office. Second, Davis contends that the trial court also improperly dismissed the remaining counts of her Complaint for a failure to state a claim upon which relief can be granted.
The standard of review of the grant or denial of a motion to dismiss is whether the trial court was legally correct.
RRC Ne., LLC v. BAA Maryland, Inc.
,
The General Assembly adopted the Health Claims Act as a process for weeding out meritless claims and resolving disputes involving medical care. In the mid-1970s, Maryland's medical care providers faced a malpractice insurance shortage.
See, e.g.
,
St.Paul Fire & Marine Ins. Co. v. Ins. Comm'r
,
The HCA sets out several requirements for a malpractice plaintiff. A plaintiff claiming a "medical injury" committed by a "health care provider" and more than $30,000 in damages must first file their claims with the ADR Office. CJP § 3-2A-02(a)(1). The HCA defines "medical injury" as an "injury arising or resulting from the rendering or failure to render health care."
a hospital, a related institution as defined in § 19-301 5 of the Health-General Article, a medical day care center, a hospice care program, an assisted living program, a freestanding ambulatory care facility as defined in § 19-3B-01 6 of the Health-General Article, a physician, an osteopath, an optometrist, a chiropractor, a registered or licensed practical nurse, a dentist, a podiatrist, a psychologist, a licensed certified social worker-clinical, and a physical therapist, licensed or authorized to provide one or more health care services in Maryland.
Once filed in the ADR Office, the claim is subject to non-binding arbitration.
A plaintiff must also file, within 90 days of initially submitting a claim, an expert certification of the claim before unilateral waiver is permitted.
Once the expert certification is filed, either party can make a speedy exit from the ADR process. CJP § 3-2A-06B(b)(1). Indeed, most claimants elect to proceed to circuit court after satisfying compliance with the expert certification and report requirement.
7
See
A. Thomas Pedroni & Ruth F. Vadi,
Mandatory Arbitration or Mediation of Health Care Liability Claims?
, 39 Md. B. J. 54, 56 (Mar./Apr. 2006) ("The vast majority of current medical malpractice cases go directly to circuit court in this system."). Despite this unilateral waiver provision, the General Assembly, in passing the HCA, sought to maximize the number of claims submitted to binding arbitration.
We first considered the scope of the HCA, and whether a claim must be submitted to arbitration in
Cannon v. McKen
,
Specifically, Cannon alleged:
Defendant McKen had contracted for the design and construction of structural improvements to his residence to be used as a dental office. This office included a dental chair and/or x-ray equipment wall attachment, which equipment was used by plaintiff Gloria Cannon on or about October 28, 1978 in her capacity as a dental patient of defendant McKen.
[T]he condition of the dental chair and/or x-ray equipment wall attachment was not safe for use by plaintiff Gloria Cannon, on or about October 28, 1978. While the plaintiff was sitting in this dental chair, a part of the chair and/or x-ray wall attachment broke loose and fell on her, striking her on the face and head. Plaintiff also relies on the doctrine of res ipsa loquitur .
We found ambiguity in CJP § 3-2A-01(f)'s definition of "medical injury" and proceeded to set out the necessary characteristics of a medical claim covered by the HCA.
Id.
at 32,
I have defined health care as meaning once you establish the relationship of patient and health care provider; once you establish that relationship, in my judgment, does it make any difference how there is a breach. They could slip on a floor or trip over the chair, or it may be inadequate lighting, or they can drop you from the operating table or do a lot of things. Once you establish that relationship in my judgment it has to be arbitrated.
Id. at 37,
We remanded Cannon's claims for further pleading in the trial court. The pleadings were "too sparse to allow a determination whether Mrs. Cannon's injury arose because of the defendant's breach of his professional duty owed her or because of a breach of duty which he may have owed her as a premises owner or in some other non-professional capacity."
Id. at 37-38,
We again examined the scope of the HCA in
Nichols v. Wilson
,
The Court took a more expansive view of the HCA's jurisdiction in
Jewell v. Malamet
,
The plaintiff fared no better in
Goicochea v. Langworthy
,
Injury in a hospital setting does not always dictate that a claim will be covered by the HCA. In
Afamefune v. Suburban Hosp., Inc.
,
A plaintiff suing a hospital also successfully bypassed the Health Claims Office in
Swam v. Upper Chesapeake Med. Ctr., Inc.
,
These cases, in sum, instruct that for the HCA to apply, a plaintiff must allege a breach of a professional duty of care during the rendering of medical care.
See, e.g.
,
Afamefune
,
A Theory Permeating Frostburg's Argument
Permeating several of Frostburg's arguments is its theory-asserted as a matter of law-that the proper forum for filing "close" claims-that is, claims that might involve allegations of medical malpractice-is the ADR Office. Frostburg cites
Swam
to support this "rule of law." In
Swam
, the plaintiff filed her claims first in the ADR Office. After filing the certificate and report of an expert, the plaintiff elected to waive arbitration and the ADR Office transferred her case to the trial court. The defendant moved for summary judgment on the ground that the complaint before the trial court was time barred by the statute of limitations for civil actions.
Swam
,
Frostburg's "close case" theory also ignores
Cannon
, which instructs that trial courts can assess a complaint and determine whether a plaintiff should have first filed in the ADR Office. Because the complaint in
Cannon
did not clearly allege claims beyond the HCA, we remanded for further pleading. 296 Md. at 38-39,
The cases discussed above are inconsistent with Frostburg's proposed rule that all "close cases" must be submitted to the ADR Office. We conclude that a trial judge has the discretion, and the capability, to decide whether a complaint sets forth a breach of a professional standard of care such that it must be filed in the ADR Office.
Davis's Claims
Davis alleged that she was negligently injured as a result of Frostburg's negligence on two separate occasions: when she fell from her bed, and when she was dropped while staff attempted to return her to the bed. Frostburg contends that each of these injuries stem from a breach of a professional duty of care. Davis alleged three counts of negligence that we discuss in turn.
Count One-Negligence
In Count One of her Complaint, Davis alleged that she was sleeping and not receiving any medical services when the mattress on her bed detached and caused her to fall. In Maryland, a plaintiff must prove four elements to prevail in a claim of negligence: 1) the defendant owed the plaintiff a
duty
to conform to a certain standard of care; 2) the defendant
breached
this duty; 3) actual
loss or damage
to the plaintiff; and 4) the defendant's breach of the duty
proximately caused
the loss or damage.
See, e.g.
,
Schultz v. Bank of America, N.A.
,
Unlike the plaintiffs in
Jewell
and
Goicochea
, who both alleged that their injuries occurred during medical treatment or examinations, Davis alleged that she was merely asleep when she fell. The plaintiff in
Jewell
alleged an injury during a medical examination conducted by a rheumatologist.
Davis did not allege that her fall from the bed resulted from the rendering of medical care. As alleged, no medical professional was even present at the time the injury occurred. Thus, her alleged injuries differed from
Jewell
and
Goicochea
in that both of those plaintiffs' claims required a trier of fact to consider a professional standard of care. Here, though, Davis's first count does not require the fact finder to understand any professional standard of care. Claims merely for ordinary negligence fall beyond the scope of the HCA.
Swam
,
In Jewell and Goicochea , we also observed that expert testimony would be necessary to help the juries decide whether the defendants' conduct fell outside the scope of normal medical treatment. Frostburg does not explain-and we do not see-how an expert medical witness would be helpful in this case to explain why a mattress would detach itself from a bed frame.
To be sure, Davis's appeal differs in at least one respect from several of our previous cases considering the applicability of the HCA: she did not allege the commission of any intentional torts.
See
Nichols
, 296 Md. at 155 n.2,
For these reasons, the trial court and the Court of Special Appeals erred in holding that Count One of Davis's Complaint set forth a claim within the HCA.
Count Two-Negligence
In Count Two of Davis's Complaint, she alleged that Frostburg negligently and recklessly provided "a mechanical lift that malfunctioned and released [her] before [she] was over the bed, causing [her] to be dropped from the height of the bed back to the floor." Frostburg again contends that Davis has alleged a medical injury which would bring her claims under the umbrella of the HCA.
We apply the same principles discussed
supra
to determine whether Davis alleged a medical injury in Count Two. Davis
attempted to label her claims as ordinary negligence by declaring the "injuries alleged herein did not result from the Defendant's rendering of healthcare or failing to render healthcare." But in
Goicochea
, we rejected a plaintiff's attempt to characterize claims-by mere labeling-in a way that would avoided application of the HCA.
Goicochea
,
Just as the claims in Jewell and Goicochea required a detailed consideration of medical standards of care-particularly medical procedures-we conclude that Davis's claims regarding her fall from the mechanical lift also require a detailed examination of what can only be described as medical procedures. Davis's Complaint alleges that the nurse informed her that Frostburg was a "no-lift facility." Frostburg's status as a "no-lift facility," the meaning of that term, and its impact on patient care, requires an examination of professional standards of care similar to the claims in Jewell and Goicochea . Davis alleged that Frostburg "negligently and recklessly" provided a mechanical lift "that malfunctioned." Here too, an examination of medical procedures regarding the proper operation of the lift-and whether the nurse properly followed these procedures-will be necessary to decide the veracity of this claim. These circumstances are indistinguishable from Jewell and Goicochea . Therefore, Davis's claims in Count Two of her Complaint should have been filed in the ADR Office.
Count Three-Negligence Respondeat Superior
Respondeat superior is "a means of holding employers ... vicariously liable for the tortious conduct of an employee acting within the scope of his/her employment."
Serio v. Baltimore Cty.
,
Count Three can fare no better than Count Two-because proof of the employee nurse's negligence in operating the mechanical lift is a prerequisite to proving a claim for
respondeat superior
.
See, e.g.
,
Barclay v. Briscoe
,
Closely Related Claims
According to the intermediate appellate court, Davis's remaining claims-for breach of contract (Count Four), Consumer Protection Act violation (Count Five) and Loss of Consortium (Count Six)-were too closely related to the negligence claims, which that Court concluded were subject to the HCA.
Davis
,
"Did the Court of Special Appeals err in holding that Petitioners' Complaint was not sufficient on its face to survive the granting of a motion to dismiss on the remaining counts?"
But this question mischaracterizes the holding from the Court of Special Appeals. The intermediate appellate court affirmed dismissal of the entire Complaint relying solely on the grounds that the remaining claims were too closely related to those subject to the HCA. Id. at *7. We need only address, then, whether this "closely related" rationale for dismissal is valid.
We agree with the Court of Special Appeals and its conclusion that, generally, claims closely related to a claim subject to arbitration under the HCA should also be filed in the ADR Office to avoid piecemeal litigation.
See
Nichols
, 296 Md. at 158-59,
But Davis can no longer maintain her professional negligence claims in the ADR Office because her injuries occurred in 2011, and the three-year statute of limitations has expired.
See
CJP § 5-109(a) ("An action for damages for an injury arising out of the rendering of or failure to render professional services by a health care provider ... shall be filed within ... [t]hree years of the date the injury was discovered.");
Swam
,
III. CONCLUSION
In sum, we hold that Count One of Davis's Complaint did not allege a medical injury within the HCA, while Counts Two and Three did allege a medical injury. Our decision to dismiss Davis's lawsuit as it relates to the medical professional negligence-Counts Two and Three-and only revive the non-medical Counts-One, Four, Five, and Six-presents no danger of piecemeal resolution of her controversy. Her only viable negligence claim, as of our decision today, is for injuries stemming from Frostburg's ordinary negligence in failing to properly secure a mattress to a bed frame.
Accordingly, we reverse the Court of Special Appeals as to Counts One, Four, Five and Six, and hold that these Counts may proceed in Circuit Court. We affirm as to Counts Two and Three.
JUDGMENT OF THE COURT OF SPECIAL APPEALS AFFIRMED IN PART AND REVERSED IN PART; CASE REMANDED TO THAT COURT WITH DIRECTIONS TO REVERSE IN PART THE JUDGMENT OF THE CIRCUIT COURT FOR ALLEGANY COUNTY AND REMAND THE CASE TO THAT COURT FOR FURTHER PROCEEDINGS CONSISTENT WITH THIS OPINION. COSTS IN THIS COURT AND THE COURT OF SPECIAL APPEALS TO BE PAID BY PETITIONERS AND RESPONDENT EQUALLY.
Petitioner presented the following questions in her Petition for Writ of Certiorari:
1. Did the Court of Special Appeals err in holding that Petitioner was required to file in the Maryland Healthcare Dispute Resolution Office so that office could make the initial determination of whether Petitioner's injuries were the result of ordinary negligence or medical negligence?
2. Did the Court of Special Appeals err in holding that Petitioners' complaint was not sufficient on its face to survive the granting of a motion to dismiss on the remaining counts?
Although both Shelia and Robert Davis filed the Complaint for convenience we shall refer to the plaintiffs in the singular and simply as "Davis."
The statute of limitations for a claim against a health care provider also expired just three days after Davis filed her complaint.
See
Swam v. Upper Chesapeake Med. Ctr.
,
The Court of Special Appeals explained the use of this new "cleaned up" parenthetical:
"Cleaned up" is a new parenthetical intended to simplify quotations from legal sources. See Jack Metzler, Cleaning Up Quotations, J. App. Prac. & Process (forthcoming 2018), https://perma.cc/JZR7-P85A. Use of (cleaned up) signals that to improve readability but without altering the substance of the quotation, the current author has removed extraneous, non-substantive clutter such as brackets, quotation marks, ellipses, footnote signals, internal citations or made un-bracketed changes to capitalization.
Chassels v. Krepps
,
Md. Code (1982, 2015 Repl. Vol.), § 19-301( o ) of the Health-General Article ("HG") provides the following definition of a "related institution:"
(1) "Related institution" means an organized institution, environment, or home that:
(i) Maintains conditions or facilities and equipment to provide domiciliary, personal, or nursing care for 2 or more unrelated individuals who are dependent on the administrator, operator, or proprietor for nursing care or the subsistence of daily living in a safe, sanitary, and healthful environment; and
(ii) Admits or retains the individuals for overnight care.
(2) "Related institution" does not include a nursing facility or visiting nurse service that is conducted only by or for adherents of a bona fide church or religious organization, in accordance with tenets and practices that include reliance on treatment by spiritual means alone for healing.
HG 19-3B-01(c) defines a "freestanding ambulatory care facility" as "(1) [a]n ambulatory surgical facility; (2) [a] freestanding endoscopy facility; (3) [a] freestanding facility utilizing major medical equipment; (4) [a] kidney dialysis center; or (5) [a] freestanding birthing center."
If no party elects to unilaterally waive arbitration, the arbitration process continues. Cases continuing into arbitration are decided by a panel consisting of: an attorney, a health care provider, and a public member. Md. Code (1974, 2013 Repl. Vol.), § 3-2A-04(c) of the Courts and Judicial Proceedings Article. Panel members are selected at random from a listing of qualified arbitrators maintained by the Director of the ADR office.
This Court also issued a decision regarding the scope of the HCA in
Oxtoby v. McGowan
,
We qualified our holding by noting "[w]e do not mean hereby to indicate that all intentional torts of a professional nature are not covered by the [Health Claims] Act as there may well be many such acts that would be so covered."
Nichols v. Wilson
,
Presumably, the Circuit Court dismissed Count Six, Loss of Consortium, for the same reason. Because we have revived one of Davis's negligence claims, we also hold that Davis's loss of consortium claim may go forward.
See
Deems v. W. Maryland Ry. Co.
,
We do not consider the sufficiency of Davis's pleading on the claims sounding in Contract or Consumer Protection. These issues should be addressed in the trial court on remand.
Reference
- Full Case Name
- Shelia DAVIS Et Al. v. FROSTBURG FACILITY OPERATIONS, LLC D/B/A Frostburg Village
- Cited By
- 26 cases
- Status
- Published