PRESENT: All the Justices
BENNIE G. ALCOY, JR., ADMINISTRATOR
OF THE ESTATE OF DELFINA G. ALCOY, DECEASED
v. Record No. 051701 OPINION BY JUSTICE BARBARA MILANO KEENAN
June 8, 2006
VALLEY NURSING HOMES, INC.
FROM THE CIRCUIT COURT OF THE CITY OF ALEXANDRIA
Lisa B. Kemler, Judge
In this appeal, we consider whether causes of action for
negligence and sexual assault and battery, based on the failure
of nursing home personnel to ensure the safety of one of their
residents, are subject to the provisions of the Medical
Malpractice Act, Code §§ 8.01-581.1 through –581.20:1 (the Act).
In 2002, Delfina G. Alcoy was 79 years old when she
suffered a stroke that rendered her physically helpless, unable
to communicate verbally, and incapable of making decisions.
After treatment at a local hospital, Alcoy was admitted to
Woodbine Rehabilitation and Healthcare Center (Woodbine), a
nursing home facility operated by Valley Nursing Homes, Inc.
(Valley) in Alexandria.
Four days after being admitted to Woodbine, Alcoy was
sexually assaulted. Among other injuries, she suffered vaginal
bleeding and tearing. Her assailant was never identified.
Alcoy died about eight months after the assault.
In 2004, Bennie G. Alcoy, Jr., who served as administrator
of Alcoy’s estate (the administrator), filed an amended motion
for judgment in the circuit court against Valley alleging, among
other things, negligence, sexual assault, and battery. In his
pleadings, the administrator sought both compensatory and
punitive damages.
Valley filed a motion in limine, contending that the
administrator’s claims were governed by the Act. Valley argued
that any torts that may have been committed against Alcoy during
her confinement at Woodbine constituted “malpractice,” as
defined in Code § 8.01-581.1. On this basis, Valley asked that
the evidence in the case be limited to the issue whether Valley
“committed malpractice defined as a breach of the standard of
care, which proximately caused damages to Mrs. Alcoy.”
The administrator responded that the Act’s provisions did
not apply because Valley’s duty to Alcoy arose from her status
as a resident at the Woodbine facility, not from any medical
treatment or care she received or should have received at
Woodbine. The administrator contended that Valley’s failure to
protect Alcoy from sexual assault was not a medical omission
within the Act but was the result of simple negligence.
The circuit court granted Valley’s motion in limine,
holding that the administrator’s claims were within the scope of
the Act. Because the administrator’s witnesses were not
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qualified to give expert medical testimony on the standard of
care as required by Code § 8.01-581.20 in the Act, Valley moved
for summary judgment. The circuit court granted the motion for
summary judgment, and this appeal followed.
The administrator argues that his claims arose from
Valley’s failure to protect Alcoy from physical harm and were
unrelated to her medical care. He contends that the circuit
court’s interpretations of the Act’s terms “health care” and
“malpractice” are overbroad and would encompass numerous torts
not involving medical care, leading to absurd results. Noting
that Code § 8.01-581.20 addresses the “clinical practice” of
witnesses providing expert testimony in cases subject to the
Act, the administrator asserts that the General Assembly
intended that the Act cover only medical acts and omissions, not
torts involving building security or hiring practices.
In response, Valley argues that any duty it had to protect
Alcoy arose from the patient-health care provider relationship
and therefore is subject to the provisions of the Act. Valley
asserts that all torts committed by health care providers on
their premises are covered by the Act because Code § 8.01-581.1
addresses “professional services” as well as “health care.”
Valley also contends that the General Assembly has endorsed an
expansive definition of medical malpractice, as shown by a
recent statutory amendment to Code § 8.01-581.1 that added
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breach of contract claims for personal injury and wrongful death
to the statutory definition of “malpractice.” We disagree with
Valley’s arguments.
The issue before us involves a question of law. Therefore,
we review the record de novo on appeal. Wilby v. Gostel, 265
Va. 437, 440, 578 S.E.2d 796, 798 (2003); Transcontinental Ins.
Co. v. RBMW, Inc., 262 Va. 502, 514, 551 S.E.2d 313, 319 (2001).
Under basic rules of statutory construction, we consider
the language of a statute to determine the General Assembly’s
intent from the plain and natural meaning of the words used.
Britt Constr., Inc. v. Magazzine Clean, LLC, 271 Va. 58, 62, 623
S.E.2d 886, 888 (2006); West Lewinsville Heights Citizens Ass’n
v. Board of Supervisors, 270 Va. 259, 265, 618 S.E.2d 311, 314
(2005); Mozley v. Prestwould Bd. of Dirs., 264 Va. 549, 554, 570
S.E.2d 817, 820 (2002). When the language of a statute is
unambiguous, we are bound by the plain meaning of that language.
Williams v. Commonwealth, 265 Va. 268, 271, 576 S.E.2d 468, 470
(2003); Woods v. Mendez, 265 Va. 68, 74-75, 574 S.E.2d 263, 266
(2003); Industrial Dev. Auth. v. Board of Supervisors, 263 Va.
349, 353, 559 S.E.2d 621, 623 (2002). Thus, when the General
Assembly has used words of a plain and definite import, courts
cannot assign them a construction that would amount to holding
that the General Assembly meant something other than that which
it actually expressed. Britt Constr., Inc., 271 Va. at 62-63,
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623 S.E.2d at 888; Alliance to Save the Mattaponi v.
Commonwealth, 270 Va. 423, 439, 621 S.E.2d 78, 87 (2005);
Williams, 265 Va. at 271, 576 S.E.2d at 470.
The statutory language at issue is clear and unambiguous.
Therefore, as in previous decisions involving the scope of the
Act, we will apply the plain meaning of the Act’s language to
the facts presented. See Hagan v. Antonio, 240 Va. 347, 350,
397 S.E.2d 810, 811 (1990); Gonzales v. Fairfax Hosp. Sys., 239
Va. 307, 310, 389 S.E.2d 458, 459 (1990); Glisson v. Loxley, 235
Va. 62, 67, 366 S.E.2d 68, 71 (1988).
The portions of the Act defining the terms “malpractice”
and “health care” are central to the issue before us. The term
“malpractice” is defined in Code § 8.01-581.1 as “any tort
action or breach of contract action for personal injuries or
wrongful death, based on health care or professional services
rendered, or which should have been rendered, by a health care
provider, to a patient.”
The term “health care,” also defined in Code § 8.01-581.1,
“means any act, or treatment performed or furnished, or which
should have been performed or furnished, by any health care
provider for, to, or on behalf of a patient during the patient's
medical diagnosis, care, treatment or confinement.” The Act
does not define the term “professional services.”
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Initially, we observe that the allegations in the present
case do not involve a tort committed during the course of a
medical procedure or treatment administered on a patient’s
behalf during the course of patient care. Therefore, the facts
here are different from several prior decisions in which we held
that the torts alleged were subject to the provisions of the
Act. See e.g., Hagan, 240 Va. at 351, 397 S.E.2d at 812
(alleged battery involving improper touching of breast occurring
during physical examination is within definition of
“malpractice” under Act); Gonzalez, 239 Va. at 309-10, 389
S.E.2d at 459-60 (laceration of patient’s toe in hospital during
physical therapy session prescribed for patient’s vascular
condition is “malpractice” under Act); Glisson, 235 Va. at 69,
366 S.E.2d at 72 (performing arthroscopic surgery without
consent is “malpractice” under Act).
We also recognize that the factual context of a tort
alleged to have occurred in a nursing home facility presents
certain unique circumstances for our consideration. In agreeing
to care for its residents, a nursing facility such as Woodbine
engages in many professional services related to patient care
that do not occur during the course of a medical procedure or
treatment designed to address a particular medical condition.
Thus, the provision of health care and professional services at
facilities of this nature may, depending on the particular facts
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of a case, include additional services beyond those
traditionally rendered in a medical office or hospital setting.
With these considerations in mind, the issue we must
resolve is whether the administrator’s allegations, as a matter
of law, describe tortious conduct on Valley’s part “based on
health care or professional services rendered, or which should
have been rendered,” within the meaning of the Act. The essence
of the administrator’s claims is that Alcoy was sexually
assaulted because of Valley’s failure to ensure her safety by
providing adequate and proper personnel, visitor screening, and
security systems for the Woodbine facility.
We conclude that these alleged omissions do not involve the
provision of health care or professional services as
contemplated by the Act. Instead, the alleged omissions involve
administrative, personnel, and security decisions related to the
operation of the Woodbine facility, rather than to the care of
any particular patient. The plain language of the definitions
of “malpractice” and “health care” in the Act underscores this
distinction.
By their terms, the definitions of “malpractice” and
“health care” apply to patients on an individual basis, rather
than to the staffing and security of any medical facility in
which the patients are located. As defined in Code § 8.01-
581.1, “health care” relates to acts or omissions “on behalf of
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a patient.” Likewise, under the same definitional statute,
“malpractice” involves health care or professional services that
are rendered or should have been rendered “to a patient.” The
factual allegations of the administrator’s pleadings address
conduct unrelated to any health care or professional service
that Valley should have rendered to Alcoy individually.
Instead, as stated above, the administrator’s allegations
involve failures relating to proper staffing and security
measures for the facility.
The contrary conclusion advanced by Valley is also
untenable because it cannot be harmonized with the provisions of
Code § 8.01-581.20(A), which specify the requirements for expert
testimony on the standard of care in cases subject to the Act.
This section provides:
A witness shall be qualified to testify as an expert
on the standard of care if he demonstrates expert
knowledge of the standards of the defendant’s
specialty and of what conduct conforms or fails to
conform to those standards and if he has had active
clinical practice in either the defendant’s specialty
or a related field of medicine within one year of the
date of the alleged act or omission forming the basis
of the action.
(Emphasis added.)
This statutory language illustrates the General Assembly’s
intent that the Act apply only to omissions and actions related
to medical treatment and care of an individual patient, rather
than to any tort committed against a patient on the premises of
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a medical care facility. The specific statutory requirement
that an expert have had an active clinical practice plainly
indicates a legislative intent that expert testimony in cases
subject to the Act address medical standards of care, rather
than standards concerning building security or employment
protocols. Therefore, we conclude that the circuit court erred
in holding that the administrator’s claims were subject to the
provisions of the Act.
For these reasons, we will reverse the circuit court’s
judgment and remand the case for further proceedings consistent
with the principles expressed in this opinion.
Reversed and remanded.
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