More on Suit Categorization: Medical Malpractice or Fraud?

CHRISTUS Health Gulf Coast v. Carswell, — S.W.3d — (Tex. 2016), 2016 WL 2979718

This decision involved cover-up allegations brought by the widow of a patient who died in a hospital. The widow attributed to the hospital post-mortem fraud. She claimed that the hospital concealed information showing that her husband received deficient care. She also alleged that the hospital failed to notify the local Medical Examiner about the death incident and rushed to perform an autopsy at an affiliated medical facility. After finding these allegations meritorious, the jury awarded the widow compensation that included $1,000,000 in exemplary damages. Pursuant to the statutory cap on exemplary damages for medical malpractice, the trial court reduced this award to $750,000. The court of appeals upheld this decision and the Texas Supreme Court gave it its affirmation as well.

The Court categorized the widow’s allegations as a complaint about medical malpractice. Specifically, it held that these allegations constitute a “health care liability claim,” defined in Tex. Civ. Prac. & Rem. Code § 74.001(a)(13) as including “professional or administrative services directly related to health care.” Post-mortem fraud accusations, it explained, are about professional or administrative services directly related to health care. The Court also clarified that “Even if persons can no longer be patients after they die …. the inquiry does not end there. As to a claim based on professional or administrative services, the statute does not require that the person alleging injury was a patient during the relevant period. Neither does it require that the alleged injury must have occurred during or contemporaneously with health care, nor that the alleged injury was caused by health care.”

The Court made this decision without asking itself whether a caregiver’s intentional wrongdoing against a patient or her family can ever be properly categorized as “medical malpractice.” Arguably, such wrongdoings do not deserve the special protections given to defendants in medical malpractice cases. Cf. Manor Care, Inc. v. Douglas, 763 S.E.2d 73 (W. Va. 2014).