When Damages May Exceed the Statutory Med Mal Cap

Dr. Steven Nathanson is the defendant in a medical malpractice case involving the death of a patient.  On June 24 the court rejected his motion for summary judgment on his claim that punitive damages are barred by West Virginia’s medical malpractice act, which puts a $500,000 limit on damage awards for care of an emergency condition in a state-designated trauma center.  Maybe even worse, the court said that the plaintiff’s allegations, if proved to a jury, could make the limit altogether inapplicable.

The executrix of patient Joel Dew’s estate brought the malpractice suit.  When Dew was involved in an auto accident on September 6, EMS and law enforcement officers found him in an altered mental state, which EMS attributed to the influence of some substance.  In contrast, the plaintiff offered evidence that Dew’s mental state was the result of a massive underlying infection.

Dr. Nathanson and others treated Dew in the Raleigh General Hospital ER.  Nathanson discharged him with a set of standard instructions for patients involved in auto accidents.  At the time of discharge, blood test results weren’t yet available.  The parties disagree on whether Nathanson had reviewed urine test results.  The plaintiff alleges that when the blood test results arrived, they showed symptoms that satisfy the criteria for systemic inflammatory response syndrome.

On September 8 Dew was transported back to Raleigh General in severe pain.  Dr. Nathanson transferred him to a Charleston hospital, where he suffered cardiopulmonary arrest and died.  An autopsy showed systemic sepsis in the brain, myocardium and coronary arteries, lungs, liver, spleen, pancreas, and kidneys.

The plaintiff sued Dr. Nathanson for malpractice, seeking punitive as well as actual damages.

Citing the limits of the state medical malpractice statute, Dr. Nathanson sought summary judgment barring punitive damages.  In denying the motion, the federal court for the Southern District of West Virginia noted that the statute contains no express prohibition on punitive damages.  What’s more, the court observed, the evidence, when viewed most favorably to the plaintiff, could trigger the act’s exception for medical care rendered “in willful and wanton or reckless disregard of a risk of harm to the patient.”  W.Va. Code Sec. 55-7B-9c(f)(1).

The case is Mandeville v. Nathanson, No. 5:14-cv-25013 (S.D. W.Va., June 24, 2016).

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