NOT FINAL UNTIL TIME EXPIRES TO FILE REHEARING
MOTION AND, IF FILED, DETERMINED
IN THE DISTRICT COURT OF APPEAL
OF FLORIDA
SECOND DISTRICT
PORT CHARLOTTE HMA, LLC, d/b/a )
PEACE RIVER REGIONAL MEDICAL )
CENTER, a Florida corporation for profit,)
)
Appellant/Cross-Appellee, )
)
v. ) Case No. 2D15-3434
)
IALA SUAREZ, individually, and as Parent )
and Natural Guardian of K.D.P., a minor, )
)
Appellee/Cross-Appellant. )
)
Opinion filed October 26, 2016.
Appeal from the Circuit Court for Charlotte
County; Lisa S. Porter, Judge.
James E. Looper, Duane L. Cochenour,
and Denise L. Dawson of Hall Booth Smith,
P.C., Atlanta, Georgia, for
Appellant/Cross-Appellee.
Kimberly L. Boldt, Mario R. Giommoni, and
Jeffrey D. Mueller of Boldt Law Firm, P.A.,
Boca Raton; Stuart N. Ratzan and Stuart J.
Weissman of Ratzan Law Group, P.A.,
Miami, for Appellee/Cross-Appellant.
Lincoln J. Connolly of Lincoln J. Connolly
Trials & Appeals, P.A., Miami, for Amicus
Curiae Florida Justice Association.
MORRIS, Judge.
Port Charlotte HMA, LLC, doing business as Peace River Regional
Medical Center ("Peace River"), appeals a final judgment entered in favor of Iala
Suarez, individually and as the parent of K.D.P., in a medical malpractice action. Peace
River raises nine issues on appeal, and Suarez raises two issues on cross-appeal. We
find no merit in the majority of the issues raised, but we reverse the final judgment
based on the trial court's posttrial granting of a setoff on economic damages. Further,
we write to express our agreement with the Fourth District's conclusion that the statutory
cap on noneconomic damages is unconstitutional.
I. FACTS
This case arises from the alleged negligence of several health care
providers in connection with the obstetrical care and treatment of Iala Suarez during her
pregnancy with her daughter, K.D.P. Suarez presented to Peace River three times
between August 17, 2010, and August 29, 2010, with worsening symptoms of early
onset preeclampsia. Preeclampsia is a common condition of pregnancy, but it is a
progressive disease that is potentially life-threatening. Despite Suarez's worsening
symptoms and the increased risk of premature delivery, Suarez's doctors did not
promptly begin administering antenatal corticosteroids to enhance the development of
K.D.P.'s brain and lungs. Suarez's health care providers also failed to transfer her to a
Level III facility equipped to handle a premature birth of less than 33 weeks gestational
age. On August 29, 2010, K.D.P. was born at 26 weeks gestational age. K.D.P. has
severe neurological impairments that render her physically unable to do basic things;
she will be fully dependent on others for the rest of her life and will need 24-hour care.
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Suarez alleged that K.D.P.'s neurological impairments were caused by the negligence
of her physicians, Peace River, and Peace River's employees. Peace River contended
that neither it nor its employees were negligent.
Prior to trial, Suarez settled with one of the physicians, Dr. Guzman. After
a lengthy trial, the jury found that the negligence of both Peace River and another
physician, Dr. Coffey, was the legal cause of K.D.P.'s injuries. The jury attributed 30
percent of the liability to Peace River and 70 percent of the liability to Dr. Coffey.1 The
jury found that K.D.P. suffered total damages in the amount of $13,550,000, including
$1,250,000, in noneconomic damages, and that Suarez suffered total damages in the
amount of $9,637,134, including $4,000,000 in noneconomic damages.
After trial, Peace River filed a motion to reduce jury verdict pursuant to
section 766.118(3), Florida Statutes (2010), claiming that Peace River's liability for
noneconomic damages should be limited to $1.5 million. Suarez responded that the
statutory cap on noneconomic damages is unconstitutional. The trial court denied
Peace River's motion and declined to apply the statutory cap in 766.118(3).
Peace River also filed a posttrial motion for setoff based on Suarez's
pretrial settlement with Dr. Guzman. The trial court granted Peace River's motion and
set off the economic damages against Peace River in the amount of $193,395.30. After
applying the setoff to Peace River's 30 percent liability for the total damages awarded
by the jury to both Suarez and K.D.P., the trial court entered final judgment in favor of
Suarez and K.D.P. and against Peace River in the amount of $6,762,744.90.
1
Dr. Coffey was the on-call doctor during Suarez's first two visits to Peace
River, and he was also Suarez's treating obstetrician. This appeal does not involve Dr.
Coffey, who dismissed his separate appeal of his adverse judgment in 2015.
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II. ANALYSIS
A. Statutory Cap on Noneconomic Damages
In denying Peace River's request to apply the statutory cap for
noneconomic damages provided for in section 766.118(3), the trial court relied on North
Broward Hospital v. Kalitan, 174 So. 3d 403 (Fla. 4th DCA 2015), review granted, No.
SC15-1858. On appeal, Peace River contends that the statute is constitutional and that
the Fourth District in Kalitan improperly extended the supreme court's holding in Estate
of McCall v. United States, 134 So. 3d 894 (Fla. 2014), to personal injury medical
malpractice cases. Suarez responds that the trial court properly applied Kalitan, which
in turn properly extended McCall to personal injury cases. The Florida Justice
Association filed an amicus curiae brief in support of Suarez and K.D.P., arguing that
section 766.118 is unconstitutional under Florida's equal protection clause.
In McCall, the majority of the Florida Supreme Court held that the cap on
wrongful death noneconomic damages in section 766.118 violates the equal protection
clause of the Florida Constitution. 134 So. 3d at 897, 901 (plurality opinion); id. at 916
(Pariente, J., concurring). The court concluded that
[t]he statutory cap on wrongful death noneconomic damages
fails because it imposes unfair and illogical burdens on
injured parties when an act of medical negligence gives rise
to multiple claimants. In such circumstances, medical
malpractice claimants do not receive the same rights to full
compensation because of arbitrarily diminished
compensation for legally cognizable claims. Further, the
statutory cap on wrongful death noneconomic damages
does not bear a rational relationship to the stated purpose
that the cap is purported to address, the alleged medical
malpractice insurance crisis in Florida.
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Id. at 901 (plurality opinion); see id. at 919-20 (Pariente, J., concurring). The court
reasoned that the statutory cap "irrationally impacts circumstances which have multiple
claimants/survivors differently and far less favorably than circumstances in which there
is a single claimant/survivor" because "under section 766.118, the greater the number
of survivors and the more devastating their losses are, the less likely they are to be fully
compensated for those losses." Id. at 901-02 (plurality opinion); see id. at 921
(Pariente, J., concurring). The court limited its analysis to wrongful death cases, noting
that "[t]he legal analyses for personal injury damages and wrongful death damages are
not the same." Id. at 900 n.2 (plurality opinion).
However, in Kalitan, 174 So. 3d at 404, the Fourth District considered
whether, in light of McCall, "the caps on noneconomic damage awards in personal injury
medical malpractice cases are similarly unconstitutional." (Emphasis added.)
Recognizing that "section 766.118 applies to both personal injury and wrongful death
actions," the court went on to conclude that "the section 766.118 caps are
unconstitutional not only in wrongful death actions[] but also in personal injury suits as
they violate equal protection." 174 So. 3d at 411. The court reasoned that there is no
real distinction between the situation in that case—a single claimant in a personal injury
case who suffers noneconomic damages in excess of the caps—and the situation in
McCall—multiple claimants in a wrongful death case. Id. The court concluded that
under section 776.118, "injured parties with noneconomic damages in excess of the
caps are not fully compensated." Kalitan, 174 So. 3d at 411.
Turning to the instant case, the trial court properly relied on Kalitan in
denying Peace River's motion to apply the statutory cap on noneconomic damages, as
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the opinion in Kalitan was the only district court opinion on the issue and was thus
binding precedent. See Pardo v. State, 596 So. 2d 665, 666 (Fla. 1992) ("[I]n the
absence of interdistrict conflict, district court decisions bind all Florida trial courts."
(citing Weiman v. McHaffie, 470 So. 2d 682, 684 (Fla. 1985)). Further, we conclude
that the Kalitan court properly applied the McCall holding to personal injury medical
malpractice actions and we agree with the Fourth District on this issue.
B. Setoff Against Economic Damages
In granting Peace River's motion for setoff, the trial court relied on section
768.81(3), Florida Statutes (2010), and D'Angelo v. Fitzmaurice, 863 So. 2d 311 (Fla.
2003). On cross-appeal, Suarez argues that because the legislature eliminated joint
and several liability for economic damages after the D'Angelo decision, Peace River is
responsible for the damages that correspond to its percentage of fault and Peace River
is not entitled to a setoff based on a settlement Suarez reached with another defendant.
In D'Angelo, 863 So. 2d at 314, the supreme court recognized that prior to
the enactment of section 768.81, the existing setoff statutes "presuppose[d] the
existence of multiple defendants jointly and severally liable for the same damages." But
in 1997, Florida enacted section 768.81(3), which read as follows:
APPORTIONMENT OF DAMAGES.—In cases to which this
section applies, the court shall enter judgment against each
party liable on the basis of such party's percentage of fault
and not on the basis of the doctrine of joint and several
liability; provided that with respect to any party whose
percentage of fault equals or exceeds that of a particular
claimant, the court shall enter judgment with respect to
economic damages against that party on the basis of the
doctrine of joint and several liability.
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Thus, by enacting section 768.81, Florida "eliminate[d] joint and several liability for
noneconomic damages and limit[ed] joint and several liability for economic damages."
863 So. 2d at 314. The court held that based on the language of the statute,
it is appropriate to set off against the economic damages
portion of an award against one tortfeasor in a medical
malpractice action the economic damages portion of any
settlement recovered from a settling tortfeasor for the same
incident causing the injury where the settling tortfeasor was
not included on the verdict form.
Id. at 319.
However, in 2006, the Florida Legislature amended section 768.81(3) and
specifically deleted the provision applying joint and several liability to economic
damages. Ch. 2006-6 at 191, § 1, Laws of Fla. The current version of this subsection
now reads: "[T]he court shall enter judgment against each party on the basis of such
party's percentage of fault and not on the basis of the doctrine of joint and several
liability." § 768.81(3); see T & S Enters. Handicap Accessibility, Inc. v. Wink Indus.
Maintenance & Repair, Inc., 11 So. 3d 411, 412 (Fla. 2d DCA 2009) (recognizing that
joint and several liability was eliminated in section 768.81(3)). Therefore, the holding in
D'Angelo, which was based on specific language authorizing a setoff against economic
damages on the basis of joint and several liability, does not apply in this case, and the
trial court erred in applying a setoff to the economic damages awarded against Peace
River.
III. CONCLUSION
We reverse the final judgment and the order granting setoff and remand
for the trial court to reenter judgment in favor of Suarez without applying the setoff
amount of $193,395.30. In all other respects, the rulings of the trial court are affirmed.
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Affirmed in part; reversed in part; remanded.
KELLY and KHOUZAM, JJ., Concur.
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