Title: Susan Czapinski v. St. Francis Hospital, Inc.

State: wisconsin

Issuer: Wisconsin Supreme Court

Document:

2000 WI 80 
 
SUPREME COURT OF WISCONSIN 
 
 
Case No.: 
98-2437 
 
 
Complete Title 
of Case: 
 
Susan Czapinski and Gary Czapinski,  
 
Plaintiffs-Appellants, 
 
v. 
St. Francis Hospital, Inc., American  
Continental Insurance Company and  
Wisconsin Patients Compensation Fund,  
 
Defendants-Respondents.  
 
 
ON CERTIFICATION FROM THE COURT OF APPEALS 
 
 
Opinion Filed: 
July 6, 2000 
Submitted on Briefs: 
      
Oral Argument: 
April 5, 2000 
 
 
Source of APPEAL 
 
COURT: 
Circuit 
 
COUNTY: 
Milwaukee 
 
JUDGE: 
Louis J. Ceci 
 
 
JUSTICES: 
 
Concurred: 
      
 
Dissented: 
      
 
Not Participating:       
 
 
ATTORNEYS: 
For the plaintiffs-appellants there were briefs 
(in the court of appeals) by Ted M. Warshafsky, Edward E. 
Robinson and Warshafsky, Rotter, Tarnoff, Reinhardt & Bloch, 
S.C., Milwaukee, and oral argument by Gerald J. Bloch. 
 
 
For the defendants-respondents there was a brief 
by John A. Nelson, Timothy W. Feeley and von Briesen, Purtell & 
Roper, S.C., Milwaukee, and oral argument by John A. Nelson. 
 
 
2 
 
 
An amicus curiae brief was filed by Mark L. 
Thomsen and Cannon & Dunphy, S.C., Brookfield, on behalf of the 
Wisconsin Academy of Trial Lawyers. 
 
2000 WI 80 
 
NOTICE 
This opinion is subject to further editing and 
modification.  The final version will appear 
in the bound volume of the official reports. 
 
 
No. 98-2437 
 
STATE OF WISCONSIN                    :  
  IN SUPREME COURT 
 
 
Susan Czapinski and Gary Czapinski,  
 
          Plaintiffs-Appellants, 
 
     v. 
 
St. Francis Hospital, Inc., American  
Continental Insurance Company and  
Wisconsin Patients Compensation Fund,  
 
          Defendants-Respondents. 
 
 
APPEAL from a judgment of the Circuit Court for Milwaukee 
County, Honorable Louis J. Ceci, Circuit Court Judge.  Affirmed. 
 
¶1 
N. PATRICK CROOKS, J.   This case comes before the 
court on certification from District I of the court of appeals. 
 Petitioners, Susan and Gary Czapinski, seek review of a circuit 
court decision that dismissed their medical malpractice claim on 
the grounds that they failed to state a claim upon which relief 
could be granted.  Petitioners had sought damages for the loss 
of their mother's society and companionship following her death 
during a routine hip replacement surgery.  The circuit court 
FILED 
 
JUL 6, 2000 
 
Cornelia G. Clark 
Clerk of Supreme Court 
Madison, WI 
 
 
 
 
 
No. 
98-2437 
 
 
2 
held that under Wis. Stat. § 893.55(4)(f) (1995-96),1 adult 
children lack standing to recover for the wrongful death of a 
parent caused by medical malpractice. 
¶2 
We affirm.  First, we hold that the language of Wis. 
Stat. § 893.55(4)(f) makes applicable to medical malpractice 
death cases only the limit on damages, and does not incorporate 
the wrongful death classification of claimants entitled to bring 
such an action.  The classification of claimants entitled to 
bring a wrongful death suit for medical malpractice is limited 
to those enumerated in Wis. Stat. § 655.007.  Legislative 
history shows that adult children were not intended to be 
included within this classification.  Second, we hold that 
§ 893.55(4)(f) does not violate the equal protection clause of 
the Wisconsin Constitution. 
I. 
¶3 
On October 19, 1995, seventy-eight-year-old Helen 
Czapinski was admitted to St. Francis Hospital to undergo 
routine hip replacement surgery.  During the surgery, doctors 
had trouble intubating her,2 and by late evening, after the 
surgery, she was having difficulty breathing.  Her respiratory 
                     
1 All subsequent references to the Wisconsin Statutes are to 
the 1995-96 text unless otherwise noted.  1995 Wisconsin Act 10 
created Wis. Stat. § 893.55(4)(f), which became effective on May 
25, 1995.  Section 893.55(4)(f) sets forth the damages for loss 
of society and companionship recoverable for a wrongful death 
resulting from medical malpractice.  
2 An endotracheal tube was inserted during Helen Czapinski's 
surgery.  The Petitioners contend that this tube punctured her 
trachea and esophagus.  
No. 
98-2437 
 
 
3 
distress intensified throughout the night and measures were 
taken by hospital staff in an attempt to resolve the problem.  
The 
respiratory 
difficulty 
continued 
and 
an 
emergency 
tracheostomy was eventually performed; this too failed in 
solving the respiratory crisis.3  Helen Czapinski went into 
cardiac arrest and was pronounced dead at 8:29 a.m. on October 
20, 1995.  A post mortem examination showed that her esophagus 
had been lacerated, apparently allowing air to escape into her 
neck, a potential cause of the respiratory obstruction.4 
¶4 
At the time of her death, Helen Czapinski was not 
survived by a spouse.  As a result, her two adult children, 
Susan and Gary Czapinski, filed a medical malpractice claim 
under Wis. Stat. ch. 655 on November 12, 1997.  They alleged 
that St. Francis Hospital, Inc., "acting through its employees, 
agents and others for whom it is responsible in respondeat 
superior," negligently caused their mother "to sustain injuries, 
severe pain and suffering, and ultimately to die."  (R. at 1:5.) 
 The Czapinskis sought damages for loss of their mother's 
society and companionship. 
¶5 
The 
defendant, 
St. 
Francis 
Hospital, 
along 
with 
American Continental Insurance Company, and Wisconsin Patients 
Compensation Fund (hereinafter, St. Francis) filed a motion for 
                     
3 A tracheostomy is the construction of an artificial 
opening through the neck into the trachea, usually done to help 
difficulty in breathing. 
4 It is not clear in the record when the laceration of the 
esophagus occurred; the Petitioners alleged that the laceration 
occurred during the intubation done during surgery. 
No. 
98-2437 
 
 
4 
judgment on the pleadings pursuant to Wis. Stat. § 802.06(3).  
St. Francis claimed that the Czapinskis failed to state a claim 
upon which relief could be granted because Wis. Stat. ch. 655 
precludes adult children from recovering for wrongful death 
resulting from medical malpractice. 
¶6 
The Czapinskis responded to this motion by claiming 
that Wis. Stat. § 893.55(4)(f) supersedes Wis. Stat. § 655.007 
in terms of who may bring a cause of action in medical 
malpractice death cases, and it makes the classification of 
claimants entitled to bring wrongful death actions under Wis. 
Stat. § 895.04(4)5 applicable to claims for loss of society and 
companionship in medical malpractice actions.  The Czapinskis 
argued that this classification would include adult children's 
claims for such loss. 
¶7 
The circuit court, the Honorable Louis J. Ceci 
presiding, granted St. Francis' motion and dismissed the 
complaint with prejudice.  The circuit court held that adult 
children lack standing to recover for loss of society and 
companionship in the wrongful death of a parent caused by 
medical malpractice, because Wis. Stat. § 893.55(4) makes 
applicable to medical malpractice death cases only the limit on 
                     
5 Wisconsin 
Stat. 
§ 895.04(4) 
sets 
forth 
the 
damages 
available for loss of society and companionship in a wrongful 
death action.  
No. 
98-2437 
 
 
5 
damages 
and 
does 
not 
incorporate 
the 
wrongful 
death 
classification of claimants entitled to bring such an action.  
The circuit court held that the classification of claimants 
entitled to bring claims for loss of society and companionship 
in wrongful death actions for medical malpractice are limited to 
those enumerated in Wis. Stat. § 655.007.   
¶8 
The Czapinskis appeal on two grounds.6  First, they 
claim that as of May 25, 1995, Wis. Stat. § 893.55(4)(f) 
incorporated adult children in the classification of claimants 
that may bring claims for loss of society and companionship in 
wrongful death actions in medical malpractice cases.  In support 
of their claim, they point to the terminology of § 893.55(4)(f), 
which provides in part, "damages recoverable against health care 
providers and an employee of a health care provider . . . for 
wrongful death are subject to the limit under s. 895.04(4)."  
Wisconsin Stat. § 895.04(4), in turn, provides that in wrongful 
death actions, "[a]dditional damages not to exceed $150,000 for 
loss of society and companionship may be awarded to the spouse, 
children or parents of the deceased."7 
                     
6 An amicus curiae brief was filed on behalf of the 
Czapinskis by the Wisconsin Academy of Trial Lawyers.  
7 The parties in this action dispute whether "children" in 
Wis. Stat. § 895.04(4) refers to both adult and minor children. 
No. 
98-2437 
 
 
6 
¶9 
Second, the Czapinskis argue that if Wis. Stat. 
§ 893.55(4)(f) is construed to incorporate only the wrongful 
death limitation on damages, and not the classification of 
wrongful death claimants entitled to bring such actions, then 
the statute should be struck down as unconstitutional for 
violating the equal protection provision in art. I, § 1 of the 
Wisconsin Constitution.8  Under the current statute, physicians 
whose negligence causes death while acting in a medical capacity 
are treated differently than physicians whose negligence causes 
death while acting in a non-medical capacity.  Furthermore, 
adult children would not have the same protections under the law 
as minor children.  The Czapinskis claim that this inequitable 
treatment of both tortfeasors and tort victims violates equal 
protection.  
¶10 St. Francis seeks an affirmation of the circuit court 
decision, which would prevent adult children from recovering for 
loss of society and companionship in medical malpractice cases. 
 They 
argue 
that 
because 
Wis. 
Stat. 
§ 893.55(4)(f) 
only 
incorporates the amount of damages a claimant may recover in 
medical malpractice suits, the classification of claimants 
                     
8 Petitioners claim that following our interpretation of 
Wis. Stat. § 893.55(4)(f), the statute would also violate the 
due process provision of the Wisconsin Constitution.  However, 
Petitioners failed to present any further arguments pertaining 
to due process in either their brief or at oral argument, and 
thus, we do not address the due process issue.  
No. 
98-2437 
 
 
7 
entitled to bring such a claim under medical malpractice is 
limited to those enumerated in Wis. Stat. § 655.007.  St. 
Francis argues that the Czapinskis could not meet the heavy 
burden 
to 
show 
that 
Wis. 
Stat. 
§ 893.55(4)(f) 
is 
unconstitutional. 
¶11 The court of appeals certified the appeal to this 
court for its determination.  We are presented with two issues 
for review.  First, does Wis. Stat. § 893.55(4)(f) expand the 
classification of claimants entitled to collect damages for loss 
of society and companionship in medical malpractice claims to 
include adult children who have lost a parent as a result of 
medical malpractice?9  Second, if § 893.55(4)(f) is construed not 
to incorporate adult children who have lost a parent in the 
classification of claimants that can collect damages resulting 
from loss of society and companionship in medical malpractice 
cases, does this statute then violate the equal protection 
provision of the Wisconsin Constitution? 
II. 
¶12 We first address whether Wis. Stat. § 893.55(4)(f) 
includes adult children in the class of claimants that can 
                     
9 Wisconsin Stat. § 893.55(4)(f) provides in pertinent part, 
"Notwithstanding the limits on noneconomic damages under this 
subsection, damages recoverable against health care providers . 
. . acting within the scope of his or her employment and 
providing health care services, for wrongful death are subject 
to the limit under s. 895.04(4)." 
No. 
98-2437 
 
 
8 
recover for loss of society and companionship in a medical 
malpractice suit.  The interpretation of a statute is a question 
of law that is reviewed de novo.  Burks v. St. Joseph's Hosp., 
227 Wis. 2d 811, 824, 596 N.W.2d 391 (1999).  Likewise, the 
constitutionality of a statute is also a question of law that is 
reviewed de novo.  Riccitelli v. Broekhuizen, 227 Wis. 2d 100, 
119, 595 N.W.2d 392 (1999). 
¶13 We conclude that Wis. Stat. § 893.55(4)(f) does not 
expand the classification of claimants entitled to recover for 
loss of society and companionship in the wrongful death of a 
parent caused by medical malpractice to include adult children. 
 Statutory language along with legislative history and precedent 
lead us to hold that the intent of the legislature was to make 
applicable to medical malpractice death cases only the Wis. 
Stat. § 895.04(4) limit on damages,10 and not to incorporate the 
wrongful death classification of claimants entitled to bring 
such an action. 
 
¶14 We begin by outlining the statutory provisions at 
issue in this case.  Wisconsin Stat. ch. 655 provides medical 
patients a recourse for health care liability and establishes 
                     
10 Wisconsin Stat. § 895.04(4) now reads "Judgment for 
damages for pecuniary injury from wrongful death may be awarded 
to any person entitled to bring a wrongful death action.  
Additional damages not to exceed * * * $500,000 per occurrence 
in the case of a deceased minor, or $350,000 per occurrence in 
the case of a deceased adult, for loss of society and 
companionship may be awarded to the spouse, children or parents 
of the deceased, or to the siblings of the deceased, if the 
siblings were minors at the time of the death.  Wis. Stat. Ann. 
§ 895.04(4) (West Supp. 1999). 
No. 
98-2437 
 
 
9 
the Patients Compensation Fund.  Chapter 655 was created in 1975 
as a response to what the legislature perceived as a "social and 
economic crisis."  State ex rel. Strykowski v. Wilkie, 81 Wis. 
2d 491, 509, 261 N.W.2d 434 (1978).  It "established an 
exclusive procedure for the prosecution of malpractice claims 
against a health care provider . . . ."  Strykowski, 81 Wis. 2d 
at 499.  The legislative rationale behind creating Chapter 655 
was stated in Strykowski, 81 Wis. 2d at 508, in which the court 
noted: 
 
The legislature cited a sudden increase in 
the number of malpractice suits, in the size 
of awards, and in malpractice insurance 
premiums, and identified several impending 
dangers: increased health care costs, the 
prescription 
of 
elaborate 
"defensive" 
medical procedures, the unavailability of 
certain 
hazardous 
services 
and 
the 
possibility that physicians would curtail 
their practices. 
 
However, 
soon 
after 
the 
enactment 
of 
Chapter 
655, 
the 
legislature passed Wis. Stat. § 893.55, in part, to limit the 
damages a claimant could recover under medical malpractice 
claims.   
¶15 Before the enactment of Wis. Stat. § 893.55(4)(f) in 
1995, Wis. Stat. § 893.55(4)(b) and (d) provided that the limit 
on total noneconomic damages would be $1 million for actions 
filed or after June 14, 1986 and before January 1, 1991.  During 
this same time period, damages for loss of society and 
companionship in all other wrongful death cases were limited 
under Wis. Stat. § 895.04(4) to $50,000.  Rineck v. Johnson, 155 
No. 
98-2437 
 
 
10
Wis. 2d 659, 665-66, 456 N.W.2d 336 (1990), rev'd on other 
grounds, Chang v. State Farm Mut. Auto. Ins. Co., 182 Wis. 2d 
549, 514 N.W.2d 399 (1994).    
¶16 In 1990, this court held that the larger $1 million 
limitation under Wis. Stat. ch. 655 superseded the smaller 
limitation in the general wrongful death statute.  Rineck, 155 
Wis. 2d at 661.  Furthermore, this court also held in Jelinek v. 
St. Paul Fire and Casualty Insurance Co., 182 Wis. 2d 1, 9, 512 
N.W.2d 764 (1994), that after January 1, 1991, recovery for loss 
of society and companionship in medical malpractice cases was 
unlimited.  Possibly as a response to our decisions in these 
cases, the legislature passed 1995 Wisconsin Act 10, which among 
other things, created Wis. Stat. § 893.55(4)(f).11  Prior to the 
enactment of § 893.55(4)(f), the classification of claimants 
entitled to bring a claim for loss of society and companionship 
as a result of medical malpractice was limited to those 
enumerated in Wis. Stat. § 655.007.  Ziulkowski v. Nierengarten, 
210 Wis. 2d 98, 103, 565 N.W.2d 164 (1997).  Section 
893.55(4)(f) made applicable to medical malpractice cases the 
                     
11 Wisconsin Stat. § 893.55 Medical malpractice; limitation 
of actions; limitation of damages; itemization of damages.  
(4)(f) Notwithstanding the limits on noneconomic damages under 
this 
subsection, 
damages 
recoverable 
against 
health 
care 
providers and an employe of a health care provider, acting 
within the scope of his or her employment and providing health 
care services, for wrongful death are subject to the limit under 
s. 895.04(4).  If damages in excess of the limit under s. 
895.04(4) are found, the court shall make any reduction required 
under s. 895.045 and shall award the lesser of the reduced 
amount or the limit under s. 895.04(4).  
No. 
98-2437 
 
 
11
limit on damages for loss of society and companionship that was 
established in Wis. Stat. § 895.04(4),12 the wrongful death 
statute.  
¶17 The 
statutory 
construction 
of 
Wis. 
Stat. 
§ 893.55(4)(f) supports our interpretation of only incorporating 
the damage limitations of Wis. Stat. § 895.04(4), and not the 
class of claimants entitled to bring such an action under that 
same section.  A court will not ordinarily engage in statutory 
construction unless a statute is ambiguous.  Harris v. Kelley, 
70 Wis. 2d 242, 249, 243 N.W.2d 628 (1975).  "[W]hen a statute 
is plain and unambiguous, interpretation is unnecessary and 
intentions cannot be imputed to the legislature except those to 
be gathered from the terms of the statute itself."  Id.  A 
statute is ambiguous if "reasonable minds could differ" over the 
meaning of the statute.  Harnischfeger Corp. v. LIRC, 196 Wis. 
2d 650, 662, 539 N.W.2d 98 (1995).  If a statute's language is 
ambiguous, a court may discern legislative intent by examining 
the "history, scope, context, subject matter, and object of the 
statute."  State v. Kirch, 222 Wis. 2d 598, 602, 587 N.W.2d 919 
(Ct. App. 1998) (citing Lake City Corp. v. City of Mequon, 207 
Wis. 2d 155, 164, 558 N.W.2d 100, 103 (1997)).  Section 
893.55(4)(f) is ambiguous as to what limitation from the 
                     
12 Wisconsin 
Stat. 
§ 895.04(4) 
pertains 
to 
limits 
on 
wrongful death awards and states, in part, "Additional damages 
not to exceed $150,000 for loss of society and companionship may 
be awarded to the spouse, children or parents of the deceased."  
No. 
98-2437 
 
 
12
wrongful 
death statute, 
§ 895.04(4), 
it incorporates 
into 
medical malpractice suits.   
¶18 In Rineck, 155 Wis. 2d at 661, we recognized that Wis. 
Stat. ch. 655 controls all claims for death or injury resulting 
from medical malpractice.  We have also held that Chapter 655 
incorporates by specific reference an exclusive list of those 
extrinsic statutory provisions that the legislature intended to 
apply in medical malpractice actions, and extrinsic statutes 
must be specifically incorporated into Chapter 655 to be applied 
to medical malpractice actions.  Id. at 666-67.  Wisconsin Stat. 
§ 895.04(2) is the statute that lays out the class of claimants 
that may recover in wrongful death actions.13  Had the 
legislature wanted to incorporate § 895.04(2) into Chapter 655 
and medical malpractice actions, it would have been referred to, 
or included in Wis. Stat. § 893.55(4)(f), which applied wrongful 
death limitations to medical malpractice suits.  Instead, the 
only 
wrongful 
death 
limit 
expressly 
applied 
to 
medical 
malpractice suits is the limitation on noneconomic damage awards 
for 
loss 
of 
society 
and 
companionship 
under 
Wis. 
Stat. 
§ 895.04(4).   
¶19 This statutory construction is also supported by 
specific language in Wis. Stat. § 893.55(4)(f).  First, the 
legislature chose to use the term "limit" to expand medical 
malpractice cases to incorporate only the wrongful death 
                     
13 Wisconsin Stat. § 895.04(2) includes adult children in 
the class of claimants that can recover for wrongful death.   
No. 
98-2437 
 
 
13
recovery limitation for loss of society and companionship.  The 
word "limit" in its singular form suggests that the legislature 
did not 
want 
the 
entire 
second 
sentence 
of 
Wis. 
Stat. 
§ 895.04(4) to be incorporated into § 893.55(4)(f).  Had the 
legislature wanted also to incorporate the class of claimants 
entitled to recover for loss of society and companionship in 
wrongful death suits to medical malpractice suits, they could 
have easily done so by changing Wis. Stat. § 655.007, or by 
expressly stating this intention in § 893.55(4)(f), when the 
wrongful death limit on noneconomic damage awards was also 
incorporated. 
¶20 Further, 
the 
final 
sentence 
in 
Wis. 
Stat. 
§ 893.55(4)(f) clarifies that the legislature intended to equate 
"limit" with monetary damages, not a class of claimants.  The 
sentence states that "if damages in excess of the limit under s. 
895.04(4) are found, the court shall make any reduction required 
under s. 895.045 and shall award the lesser of the reduced 
amount or the limit under s. 895.04(4)."  § 893.55(4)(f).  The 
repeated references to § 895.04(4) connect "limit" to damages, 
but there is no reference that connects "limit" to a class of 
claimants. 
¶21 Second, Wis. Stat. § 893.55(4)(f) uses the language, 
"damages recoverable . . . are subject to the limit under s. 
895.04(4)." (emphasis added).  This shows that the legislature 
intended to extend to medical malpractice suits the wrongful 
No. 
98-2437 
 
 
14
death limit on damages, not the class of claimants entitled to 
bring such a suit.  Again, had the legislature been attempting 
to incorporate the wrongful death class of claimants to medical 
malpractice claims, they could have used terminology such as, 
"damages recoverable and class of claimants entitled to bring a 
suit . . . are subject to the limits under s. 895.04(4)."  This 
type of statutory language would have decidedly incorporated the 
wrongful death class of claimants that could recover damages for 
loss of society and companionship into medical malpractice 
cases.  But, the legislature did not use such terminology. 
¶22 "When interpreting a statute, our primary objective is 
to ascertain and give effect to the intent of the legislature . 
. . and the legislature is presumed to act with knowledge of the 
existing case law."  Ziulkowski, 210 Wis. 2d at 104 (citations 
omitted).  Therefore, a statute's construction will stand unless 
the legislature explicitly changes the law.  State ex rel. 
Campbell v. Township of Delavan, 210 Wis. 2d 239, 256, 565 
N.W.2d 209 (Ct. App. 1997).   
¶23 Numerous Wisconsin courts, including this one, have 
held that adult children lack standing to recover for loss of 
society 
and 
companionship 
in 
medical 
malpractice 
cases. 
Ziulkowski, 210 Wis. 2d at 100; In re Wells v. Mt. Sinai Med. 
Ctr., 183 Wis. 2d 667, 677, 515 N.W.2d 705 (1994); Dziadosz v. 
Zirneski, 177 Wis. 2d 59, 61, 501 N.W.2d 828 (Ct. App. 1993).  
No. 
98-2437 
 
 
15
Petitioners argue that these cases predate the enactment of Wis. 
Stat. § 893.55(4)(f), and therefore have no bearing on the 
statute, which supersedes the interpretations found in the case 
law.  However, because § 893.55(4)(f) did not explicitly modify 
the interpretations found in previous case law, adult children 
still cannot recover for loss of society and companionship in 
medical malpractice cases.  Furthermore, in 1999, the court of 
appeals reaffirmed that adult children lack standing to recover 
for the loss of society and companionship of a parent in medical 
malpractice cases.  Conant v. Physicians Plus Med. Group, Inc., 
229 Wis. 2d 271, 277, 600 N.W.2d 21 (Ct. App. 1999).  The 
interpretation of who may recover for loss of society and 
companionship in medical malpractice cases arose after the 
enactment of Wis. Stat. § 893.55(4)(f).  We agree with that 
interpretation.   
¶24 Our construction of Wis. Stat. § 893.55(4) is also 
supported by legislative history, which is properly subject to 
judicial notice. Strykowski, 81 Wis. 2d at 504-05 (citing 
Nekoosa-Edwards Paper Co. v. Public Serv. Comm., 8 Wis. 2d 582, 
590, 591, 99 N.W.2d 821 (1959)).  1995 Wis. Act 10, the act 
creating Wis. Stat. § 893.55(4)(f), established the maximum 
amount a claimant may recover for noneconomic damages in a 
medical malpractice case.  Furthermore, the introduction to the 
act stated that the statutory changes and enactments made by 
No. 
98-2437 
 
 
16
1995 Wis. Act 10 related to "limiting medical malpractice 
noneconomic damage awards . . . ."  Introduction to 1995 Wis. 
Act 10.  There was no evidence in the drafting record that 
points to a legislative intent to broaden the classification of 
claimants entitled to recover for the loss of society and 
companionship in medical malpractice cases.  This classification 
has been governed solely by Wis. Stat. § 655.007.  Because the 
legislature did not make any changes to § 655.007,14 and because 
the legislature is presumed to know that Wisconsin courts have 
established that adult children cannot recover for loss of 
society and companionship in medical malpractice cases, see 
Ziulkowski, 210 Wis. 2d at 104, we find that the legislative 
intent in creating Wis. Stat. § 893.55(4)(f) was to limit 
noneconomic damage awards in medical malpractice suits.  There 
is no evidence of any legislative intent to broaden the 
                     
14 Senate Substitute Amendment 1 to 1997 Senate Bill 148, 
which was rejected, proposed that Wis. Stat. § 655.007 be 
amended to state, in part, that "any patient or the patient's 
representative having a claim or any spouse, parent, sibling or 
child of the patient having a derivative claim for injury or 
death on account of malpractice is subject to this chapter.  In 
this section, "child" means an adult or minor child."  The 
amendment of § 655.007 that passed both houses and was signed 
into law stated, in pertinent part, that "any patient or the 
patient's representative having a claim or any spouse, parent, 
minor sibling or child of the patient having a derivative claim 
for injury or death on account of malpractice is subject to this 
chapter."  Wis. Stat. § 655.007 (1997-1998).  This is at least 
some evidence that the legislature specifically declined to 
include adult children in the class of claimants that could 
recover for medical malpractice. 
No. 
98-2437 
 
 
17
classification of claimants entitled to recover in such suits to 
include adult children. 
¶25 Petitioners argue that the real purpose in enacting 
Wis. Stat. § 893.55(4)(f) was to make the treatment of medical 
malpractice claims and other tort actions uniform.  They support 
this proposition by citing several prepared statements from 
members of the medical and insurance communities who testified 
in favor of amending Wis. Stat. ch. 655 to create a system that 
would treat medical malpractice death cases the same as actions 
under the wrongful death act.  The Petitioners, however, fail to 
discuss the context in which such testimony was presented.  When 
examining a particular phrase in a statute, a court must look at 
the phrase in light of the entire statute.  Elliott v. Employers 
Mut. Cas. Co., 176 Wis. 2d 410, 414, 500 N.W.2d 397 (Ct. App. 
1993).  Likewise, it only follows that a particular statement in 
prepared testimony should be examined in light of the entire 
prepared statement.  When the prepared statements cited by the 
Petitioners are viewed in their entirety, it is clear that 
support for the bill from the medical and insurance communities 
arose because the language of the bill was going to clearly 
reduce the maximum award of noneconomic damages allowed in 
medical malpractice cases.  Those members of the medical and 
insurance communities that were cited by Petitioners deemed the 
reduction of noneconomic awards in medical malpractice cases 
No. 
98-2437 
 
 
18
necessary in order to reduce malpractice premiums and to improve 
access to health care services across the state.  To interpret 
Wis. Stat. § 893.55(4)(f) as broadening the class of claimants 
entitled to bring claims for damages in medical malpractice 
cases would only increase the burden on the medical and 
insurance communities, an outcome that they likely would not 
support. 
III. 
¶26 The second issue raised by Petitioners is based on the 
Equal Protection Clause of the Wisconsin Constitution.  They 
argue that if this court would find Wis. Stat. § 893.55(4)(f) 
not to include adult children in the classification of claimants 
that could recover for loss of society and companionship in 
medical malpractice death cases, then the statute would be in 
violation of art. I, § 1 of the Wisconsin Constitutionthe equal 
protection provision.  We conclude that this claim has no merit. 
 Although § 893.55(4)(f) creates separate classifications for 
both tortfeasors and tort victims, these classifications do not 
violate equal protection. 
¶27 This court starts with the presumption that a statute 
is constitutional and will continue to preserve a statute's 
constitutionality if there is a reasonable basis for the 
exercise of legislative power.  Miller v. Kretz, 191 Wis. 2d 
573, 578, 531 N.W.2d 93 (Ct. App. 1995).  This court will 
"uphold a statute under an equal protection analysis '[i]f a 
No. 
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19
rational basis exists to support the classification, unless the 
statute 
impinges 
on 
a 
fundamental 
right 
or 
creates 
a 
classification based on a suspect criterion.'"  Id. at 579.  The 
Petitioners must prove that the statute is unconstitutional 
beyond a reasonable doubt.  Id. at 578. 
¶28 We have previously held that Wis. Stat. ch. 655 does 
not deny any fundamental right.  Strykowski, 81 Wis. 2d at 507. 
 We presently find no reason to overturn this determination.  
Similarly, a suspect class is one that involves "immutable 
personal 
characteristics 
or 
historical 
patterns 
of 
discrimination 
and 
political 
powerlessness."15 
 
Id. 
 
The 
different classes of tortfeasors and tort victims that would be 
created under our interpretation of § 893.55(4)(f) consist of 
medical personnel who would be immune from the higher damage 
awards recoverable under other tort actions, creating a non-
favored class of non-medical personnel, and a non-favored class 
of adult children that could not recover for loss of society and 
companionship when a parent dies as a result of medical 
malpractice.  We find that these non-favored classes do not have 
immutable personal characteristics and have not experienced a 
historical 
pattern 
of 
discrimination 
and 
political 
powerlessness.  Therefore, § 893.55(4)(f) does not create a 
classification that would be based on suspect criterion.  
Because § 893.55(4)(f) is not based on a fundamental right and 
                     
15 Examples of suspect criterion include race, alienage, or 
nationality.  Miller v. Kretz, 191 Wis. 2d 573, 579 n.5, 531 
N.W.2d 93 (Ct. App. 1995). 
No. 
98-2437 
 
 
20
does not involve a suspect class, we use the rational basis 
standard of review. 
¶29 In applying the rational basis standard to equal 
protection challenges, this court is not concerned with the 
wisdom 
or 
correctness 
of 
the 
legislative 
determination.  
Strykowski, 81 Wis. 2d at 508.  Rather, we determine only 
whether there was a reasonable basis upon which the legislature 
enacted Wis. Stat. § 893.55(4)(f).  See id.  A statute that is 
based 
on 
classifications 
must 
meet 
five 
criteria 
for 
reasonableness: 
 
(1) 
All 
classifications 
must 
be 
based 
upon 
substantial distinctions which make one class 
really different from another. 
(2) 
The classification adopted must be germane to 
the purpose of the law. 
(3) 
The classification must not be based upon 
existing circumstances only and must not be so 
constituted as to preclude addition to the 
numbers included within a class. 
(4) 
To whatever class a law may apply, it must 
apply equally to each member thereof. 
(5) 
The characteristics of each class should be so 
far different from those of other classes as 
to reasonably suggest at least the propriety, 
having 
regard 
to 
the 
public 
good, 
of 
substantially different legislation. 
Id. at 509 n.8. 
¶30 Petitioners' equal protection argument has two parts. 
 First, medical personnel, as tortfeasors, would be immune from 
claims brought by adult children of parents who died as a result 
of medical malpractice.  Medical personnel would have immunity 
from damage awards for loss of society and companionship while 
other non-medical personnel would not.  Second, under the 
No. 
98-2437 
 
 
21
Respondents' interpretation of § 893.55(4)(f), adult children of 
parents who died as a result of medical malpractice would not be 
given the same opportunity to recover damages for loss of 
society and companionship as would minor children in the same 
circumstance.  However, this court has already held that medical 
malpractice actions are substantially distinct from other tort 
actions when it upheld the constitutionality of Wis. Stat. ch. 
655.  Strykowski, 81 Wis. 2d at 509.   
¶31 Because medical malpractice actions are substantially 
distinct from other tort actions, it is reasonable to conclude 
that the legislature has the constitutional authority to 
determine which classifications of persons are eligible to 
pursue a medical malpractice claim.  Possible justifications for 
the statutory limit on the ability of adult children to recover 
for loss of society and companionship when a parent dies as a 
result of medical malpractice include the prevention of, inter 
alia, a sudden increase in the number of malpractice suits, 
increased medical costs or decreased accessibility to health 
care.  Strykowski, 81 Wis. 2d at 508.  Furthermore, the 
distinction between adult children and minor children could be 
"the different degree of dependenc[y] which each would be 
presumed to have on their parents for their continued financial 
and emotional support."  Harris, 70 Wis. 2d at 252.  Minor 
children rely much more heavily on their parents for financial 
and 
emotional 
support 
than 
do 
adult 
children, 
and 
this 
difference is substantial.  Id. at 252-53.  Faced with the need 
to draw the line on who can collect for loss of society and 
No. 
98-2437 
 
 
22
companionship, we follow the view established by this, and other 
Wisconsin courts, that the availability of claims for loss of 
society and companionship should be limited to those who would 
suffer most severely from the loss of an intimate family 
relationship; 
adult 
children 
cannot 
be 
included 
in 
this 
classification.  See Conant, 229 Wis. 2d at 276-77; Rineck, 155 
Wis. 2d at 662; Theama v. City of Kenosha, 117 Wis. 2d 508, 515, 
344 N.W.2d 513 (1984).  Further possible justifications for 
treating 
medical 
personnel 
differently 
than 
non-medical 
personnel could follow similar policy reasoning, such as the 
prevention of increased health care costs, decreased health care 
services or physicians curtailing their practices.  Strykowski, 
81 Wis. 2d at 508.  As the Miller court has articulated, "[t]he 
public has an important interest in the quality of health care, 
and the legislature's efforts to promote that interest cannot be 
said to be unreasonable."16  191 Wis. 2d at 585.  Thus, Wis. 
Stat. 
§ 893.55(4)(f) 
satisfies 
the 
five 
criteria 
of 
reasonableness. 
¶32 For the foregoing reasons, the classifications of 
tortfeasors and tort victims are not arbitrary or irrational, 
but are based on reasonable and rational criteria.  Therefore, 
the Petitioners' equal protection argument must fail. 
IV. 
                     
16 As stated earlier, this court is not concerned with the 
wisdom or correctness of a legislative determination.  State ex 
rel. Strykowski v. Wilkie, 81 Wis. 2d 491, 508, 261 N.W.2d 434 
(1978). 
No. 
98-2437 
 
 
23
¶33 We hold that an adult child lacks standing to recover 
for loss of society and companionship in a wrongful death case 
involving medical malpractice.  The language of Wis. Stat. 
§ 893.55(4)(f), along with legislative history, shows that the 
classification of claimants entitled to bring a wrongful death 
suit for medical malpractice was not expanded to include adult 
children, and is limited to the classification of claimants 
enumerated in Wis. Stat. § 655.007.  Further, we hold that Wis. 
Stat. § 893.55(4)(f) does not violate the Equal Protection 
Clause of the Wisconsin Constitution.  Accordingly, the circuit 
court decision is affirmed.  
By the Court.—The judgment of the circuit court is 
affirmed. 
 
 
No. 
98-2437 
 
 
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