What Constitutes an “Occurrence” of Medical Malpractice for Damage Caps’ Purposes?

August 23, 2013

Kinney–Lindstrom  v. Medical Care Availability and Reduction of Error Fund, — A.3d —, 2013 WL 4410996 (Pa. 2013)

This decision of the Pennsylvania Supreme Court determined the meaning of “occurrence” for purposes of statutory caps on malpractice damages. In the case at bar, the Medical Care Availability and Reduction of Error Act of 2002 limited an aggrieved patient recovery to $1,000,000 per “occurrence” of medical malpractice. This limit was set for payments coming from the government’s fund that supplements the primary insurance coverage of participating healthcare providers.

The plaintiff was a mother of twins who suffered serious injuries as a result of a doctor’s prenatal neglect: failure to diagnose and treat the plaintiff’s infection while she was pregnant with the twins. The fund conceded that the doctor was negligent but argued that this negligence amounted to a single occurrence, which should cap the plaintiff’s compensation at $1,000,000.  The plaintiff, for her part, argued that she and her twins had suffered from two occurrences of medical malpractice; and so she should recover $2,000,000 (following the jurors’ assessment of the twins’ injuries at $13,150,000).

The Court rejected the plaintiff’s effect-based interpretation of “occurrence” along with the claim that “occurrence” should be construed broadly in order to expand an aggrieved patient’s entitlement to compensation. Based on the legislative language and history, the Court adopted the cause-based interpretation under which a single act of malpractice constitutes one “occurrence” even when it injures multiple victims.

In the case at bar, the plaintiff argued that she and her twins are entitled to a $2,000,000 compensation even under the “cause” approach. Specifically, she claimed that her evidence demonstrated that the “twins were subjected to different infectious organisms at different times, which the doctor discretely failed to diagnose and treat.” According to the plaintiff, there were two separate occurrences of medical malpractice that caused distinct damages to each twin.

The Court remanded the case with instructions to adjudicate the plaintiff’s claim under the “cause” approach.