Case Title: Nathan Mizrahi v. North Miami Medical Center, Ltd

Citation: 

Docket Number: 

State: florida

Court: Florida Supreme Court

Date: 2000-04-20T00:00:00Z

Document:
Supreme Court of Florida
  
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Nos. SC93649 & SC93650
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NATHAN MIZRAHI, et al.,
Petitioners,
vs.
NORTH MIAMI MEDICAL CENTER, LTD., etc., et al.,
Respondents.
and
LYNN GARBER, etc.,
Petitioner,
vs.
LAWRENCE SNETMAN, M.D., et al.,
Respondents.
[April 20, 2000]
CORRECTED OPINION
PER CURIAM.
We have for review two decisions that pass upon the following question
certified to be of great public importance:
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DOES SECTION 768.21(8), FLORIDA STATUTES
(1995), WHICH IS PART OF FLORIDA'S WRONGFUL
DEATH ACT, VIOLATE THE EQUAL PROTECTION
CLAUSE OF THE FLORIDA AND FEDERAL
CONSTITUTIONS, IN THAT IT PRECLUDES
RECOVERY OF NONPECUNIARY DAMAGES BY A
DECEDENT'S ADULT CHILDREN WHERE THE
CAUSE OF DEATH WAS MEDICAL MALPRACTICE
WHILE ALLOWING SUCH CHILDREN TO
RECOVER WHERE THE DEATH WAS CAUSED BY
OTHER FORMS OF NEGLIGENCE? 
Mizrahi v. North Miami Med. Ctr., Ltd., 712 So. 2d 826 (Fla. 3d DCA 1998);
Garber v. Snetman, 712 So. 2d 481 (Fla. 3d DCA 1998).  We have jurisdiction.  See
art. V, § 3(b)(4), Fla. Const.  We answer the certified question in the negative.
In Mizrahi, the undisputed facts and the trial court's ruling are as follows:
The appellants are the surviving adult children of
Morris Mizrahi, who died in May 1993, allegedly as a
result of the medical malpractice of one or more of the
appellees.  The appellants brought a wrongful death suit
against the appellees--North Miami Medical Center and
various physicians who had treated the decedent.  The
trial court granted summary judgment for the hospital and
physicians, based on section 768.21, Florida Statutes
(1995)--part of Florida's Wrongful Death Act[.]
712 So. 2d at 827.  Petitioners appealed and the Third District Court of Appeal held
that "the statute's disparate treatment of medical malpractice wrongful deaths does
bear a rational relationship to the legitimate state interest of ensuring the
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accessibility of medical care to Florida residents by curtailing the skyrocketing
medical malpractice insurance premiums in Florida."  Id. at 828.  In so holding, the
Third District recognized that "escalating insurance costs adversely impact not only
physicians but also, ultimately, their patients through the resultant increased cost of
medical care."  Id. 
The undisputed facts as found by the trial court in the companion case,
Garber v. Snetman, are as follows: 
Plaintiff instituted this action against several
physicians and a hospital seeking recovery for intentional
infliction of emotional distress and for mental pain and
suffering.  On March 26, 1994, Frances Golub was
admitted to Mount Sinai Medical Center for treatment
following a suspected stroke.  On April 13, 1994, Mrs.
Golub underwent surgery to remove a suspected
cancerous tumor from her pelvis.  She died on May 8,
1994.
Mrs. Golub was seventy years old at the time of her
death.  She had never worked outside the home, did not
have a spouse, and was survived only by Lynn Garber,
her thirty-three-year-old daughter, the plaintiff in this
action.
The claims for which Ms. Garber seeks recovery
are governed by Chapters 768 and 766 of the Florida
Statutes.  She seeks damages for mental pain and
suffering and for loss of support and services in her
individual capacity, and for the net accumulations on
behalf of her mother's estate.
Based on these facts, the trial court entered summary judgment for the respondents
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pursuant to section 768.21(8).  On appeal, the Third District affirmed the trial
court's order and certified the same question of great public importance as certified
in Mizrahi. 
The First District Court of Appeal recently addressed the same issue in
Stewart v. Price, 718 So. 2d 205 (Fla. 1st DCA 1998), wherein the court rejected
the argument that section 768.21(8) denies the federal and state constitutional
guarantee of equal protection under the law.  The First District analyzed the issue as
follows:    
[U]nder the common law an adult, who has not been
dependent on a parent, was not entitled to recover
damages for the wrongful death of a parent.  U.S. v.
Durrance, 101 F.2d 109 (5th Cir.1939); Louisville & N.R.
Co. v. Jones, 45 Fla. 407, 34 So. 246 (1903).  Prior to the
enactment of chapter 90-14, Laws of Florida, under
section 768.21(3) only minor children could recover
damages for their pain and suffering upon the wrongful
death of a parent.  See Weimer v. Wolf, 641 So.2d 480
(Fla. 2d DCA 1994).  In chapter 90-14, the legislature
amended section 768.21(3), among other things, to
expand the definition of "survivors" who may recover for
the wrongful death of a parent.  Thus, in addition to minor
children, chapter 90-14 authorized all children of the
decedent to recover for lost parental companionship,
instruction and guidance and for mental pain or suffering,
when there is no surviving spouse.  At the same time,
however, in chapter 90-14 the legislature precluded the
application of this expanded "survivors" definition to adult
children where the cause of the wrongful death is the
result of medical malpractice.  Thus, chapter 90-14 treated
1  As adopted in 1988, section 766.201(1), Florida Statutes (1995), provides 
in pertinent part: 
(1) The Legislature makes the following findings: 
(a) Medical malpractice liability insurance premiums have
increased dramatically in recent years, resulting in increased costs
for most patients and functional unavailability of malpractice
insurance for some physicians.
(b) The primary cause of increased medical malpractice
liability insurance premiums has been the substantial increase in loss
payments to claimants caused by tremendous increases in the
amounts of paid claims.
 . . . .  
(d) The high cost of medical malpractice claims in the state
can be substantially alleviated . . . by imposing reasonable
limitations on damages . . . .
2  The court correctly observed that "Chapter 90-14 closed no courthouse doors.  Rather,
it opened, albeit only for some, those doors by creating a limited right of recovery where no
recovery had previously existed at all."  Id.
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adult children of a person who dies as a result of medical
malpractice differently than adult children whose parent
dies as a result of a cause other than medical malpractice.
Id. at 209.  The First District then concluded that the "legislature's choice to exclude
from such right adult children of persons who wrongfully died as a result of medical
malpractice bears a rational relationship to the legitimate state interests of limiting
increases in medical insurance costs.  See § 766.201(1), Fla. Stat. (1995)."1  Id. at
210.2
In support of this rationale, the Legislature referred to and discussed the
medical malpractice crisis and its adverse impact on the accessibility of health care
3  This Court acknowledged the existence of the medical malpractice crisis as a legitimate
state interest in University of Miami v. Echarte, 618 So. 2d 189, 196-97 (Fla. 1993).
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during the passage of section 768.21.3  Legislators expressly linked the exclusion of
adult children of medical malpractice decedents contained in section 768.21(8) to
the health care crisis rationale expressed in section 766.201.  See Act Relating to
Wrongful Death:  Hearings on S. 324 Before Fla. Senate, Fla. Senate, 1990 Session
(Apr. 17, 1990); Hearings on H. 709 Before Fla. House Judiciary-Civil Comm., Fla.
House, 1990 Session (Apr. 16, 1990); Mizrahi, 712 So. 2d at 829.  Clearly, limiting
claims that may be advanced by some claimants would proportionally limit claims
made overall and would directly affect the cost of providing health care by making it
less expensive and more accessible. 
Accordingly, the instant statute which created a right of action for many while
excluding a specific class from such action, and which exclusion is rationally related
to controlling healthcare costs and accessibility, does not violate  the equal
protection guarantees of either the United States or Florida Constitutions.  We
therefore answer the certified question in the negative and approve the district
court's decisions below.
It is so ordered.
HARDING, C.J., and SHAW, WELLS and ANSTEAD, JJ., concur.
LEWIS, J., concurs in result only.
4See, e.g., University of Miami v. Echarte, 618 So.2d 189 (Fla. 1993) (discussing the
medical malpractice crisis and the related findings of the Academic Task Force for Review of the
Insurance and Tort Systems).
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PARIENTE, J., dissents with an opinion in which QUINCE, J., concurs.
NOT FINAL UNTIL TIME EXPIRES TO FILE REHEARING MOTION, AND IF
FILED, DETERMINED.
PARIENTE, J. dissenting.
I dissent.  There is no indication that the past medical malpractice crisis4
continues into the present.  If the medical malpractice crisis does not continue into
the present, I fail to see how a past crisis can justify the permanent exclusion of an
entire class of victims from seeking compensation for pain and suffering damages
due to the wrongful death of their parents as a result of medical malpractice.  
Indeed, it is a “settled principle of constitutional law” that although a statute
is constitutionally valid when enacted, that statute may become constitutionally
invalid due to changes in the conditions to which the statute applies.  See Conner v.
Cone, 235 So. 2d 492, 498 (Fla. 1970); see also Georgia S. & Fla. Ry. Co. v.
Seven-Up Bottling Co., 175 So. 2d 39, 40 (Fla. 1965).  Accordingly, while it is not
our role to reexamine legislative fact-finding, we also need not blindly accept the
Legislature’s conclusions, especially when such conclusions may no longer be valid
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due to changed conditions.  See Seagram-Distillers Corp. v. Ben Greene, Inc., 54
So. 2d 235, 236 (Fla. 1951); see also Conner, 235 So. 2d at 498.
Further, there is the additional question of whether there is a reasonable
relationship between the outright denial of the right to recover damages by an entire
class of adult children whose parents died as a result of medical malpractice and the
legitimate state interest of ensuring accessibility to medical care.  See Pinillos v.
Cedars of Lebanon Hosp. Corp., 403 So. 2d 365,  367 (Fla. 1981).  “The rational
basis test requires that a statute bear a reasonable relationship to a legitimate state
interest, and the burden is on the challenger to prove that a statute does not rest on
any reasonable basis or that it is arbitrary.”  Id.
All other adult children who lose their parents as a result of other negligent
conduct have the right to recover pain and suffering damages if their parent died
without a spouse.  See §768.21(8), Fla. Stat. (1999).  However, in the case of adult
children of medical malpractice victims, the Legislature has denied compensation
for mental pain and suffering not because the claims of the adult children are
meritless, but because of the adult children's age and because their parents died as a
result of medical malpractice.  As to the reasonableness of the distinction drawn by
the Legislature, I agree with the reasoning of Judge Schwartz in his concurring
opinion in Garber v. Snetman, 712 So. 2d 481, 482 (Fla. 3d DCA 1998):
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I believe that it is contrary to the requirements of
substantive due process and equal protection to
discriminate between survivors of the victim of a wrongful
death on the basis of their age only to accomplish the
stated purpose of making medical malpractice insurance
somewhat less expensive.  To my mind, it is no less
"unreasonable, arbitrary, capricious, discriminatory [and]
oppressive", 10 Fla.Jur.2d Constitutional Law § 427, at
740 (1997), and cases cited, to restrict the right to recover
on this basis than it would be for the legislature to do so
as to survivors with blue eyes or--heaven forfend!--of less
than a certain height.
In sum, there is no indication that the distinction drawn by the statute bears a
reasonable relationship to a legitimate state interest associated with ensuring
accessible health care.  Further, there is no indication that the medical malpractice
crisis that formed the basis for treating this class of survivors differently than all
other adult children even continues to this day.  I therefore believe that the
challengers of this statute have met their burden and have demonstrated that the
distinction drawn by the Legislature is arbitrary. 
Finally, regardless of the constitutional question, I urge the Legislature to
reconsider this exclusion and provide to adult children of parents who die as a result
of medical malpractice the same rights afforded to the victims of every  other tort
action. 
QUINCE, J., concurs.
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Two Cases Consolidated:
Applications for Review of the Decision of the District Court of Appeal - Certified
Great Public Importance
Third District - Case Nos.  3D97-353 and 3D97-1109
(Dade County)
Arnold R. Ginsberg of Ginsberg & Schwartz, Miami, Florida; Gaebe, Murphy, Mullen
& Antonelli, Coral Gables, Florida, and Spector, Levine & Zimmerman, Miami,
Florida,
for Petitioner
Janis Brustares Keyser of Gay, Ramsey & Warren, P.A., West Palm Beach, Florida;
Hinda Klein of Conroy, Simberg & Ganon, P.A., Hollywood, Florida;  John D. Kelner
of the Law Offices of Kelner & King, LLP, Hollywood, Florida; Esther E. Galicia of
George, Hartz, Lundeen, Flagg & Fulmer, Fort Lauderdale, Florida; and W. Sam
Holland of Hinshaw & Culbertson, Miami, Florida,
for Respondents
Harriet Rae Freeman, West Palm Beach, Florida, and Barbara Scheffer, Palm Beach
Gardens, Florida,
for Association for Responsible Medicine, Amicus Curiae
Douglas M. McIntosh, and Jack Heda of McIntosh, Sawran & Craven, P.A., Fort
Lauderdale, Florida,
for Florida League of Healthsystems, Florida Hospital Association, Florida Medical
Association, and The Association of Community Hospitals and Health Systems of
Florida, Amicus Curiae