Title: Johannesen v. Salem Hospital

State: oregon

Issuer: Oregon Supreme Court

Document:

Filed: December 26, 2003
IN THE SUPREME COURT OF THE STATE OF OREGON
JASON JOHANNESEN,
Personal Representative for the Estate of
Salina Johannesen, deceased,
Plaintiff-Relator,
         v.
SALEM HOSPITAL,
DAVID WEST,
and OREGON HOSPITAL ANESTHESIOLOGY GROUP, PC,
Defendants-Adverse Parties.
(CC 00C19280; SC S49323)
         Original proceeding in mandamus.*
         Argued and submitted January 10, 2003.
         Kathryn H. Clarke, Portland, argued the cause and filed
the brief for plaintiff-relator.  With her on the brief was
Richard M. Rogers, Portland.
         Billy M. Sime, Parks, Bauer, Sime & Winkler, LLP,
Salem, argued the cause and filed the brief for defendant-adverse
party Salem Hospital.  With him on the brief were Keith J. Bauer
and J. Marie Bischman, Salem.
         John Hart, Hoffman, Hart & Wagner LLP, Portland, waived
appearance for defendant-adverse party David West, M.D.
         Michael T. Stone, Brisbee & Stockton LLC, Hillsboro,
waived appearance for defendant-adverse party Oregon Hospital
Anesthesiology Group, PC.
         Before Carson, Chief Justice, and Gillette, Durham,
Riggs, De Muniz, and Balmer, Justices.**
         RIGGS, J.
         Peremptory writ to issue.
         Balmer, J., concurred and filed an opinion in which
Gillette, J., joined.
         *On petition for a writ of mandamus from an order of
Marion County Circuit Court, Paul J. Lipscomb, Judge.
         **Leeson, J., resigned January 31, 2003, and did not
participate in the decision of this case.  Kistler, J., did not
participate in the consideration or decision of this case.
         RIGGS, J.
         In this original mandamus proceeding, we are called
upon to apply the legal standards governing a trial court's
decision on a motion under ORS 18.535 (2001) (1) to amend a
complaint to add a punitive damages claim in a medical
malpractice action.  In the case from which this proceeding
arises, the trial court denied plaintiff's motion to amend his
complaint on the ground that he had not presented "clear and
convincing" evidence that defendants had acted with malice. 
Because we conclude that the trial court did not apply the proper
test in making that determination and that plaintiff's motion
satisfied the statutory requirements for amendment of the
complaint, plaintiff is entitled to a peremptory writ of
mandamus.
         The underlying action arises out of the medical
treatment of Salina Johannesen ("Johannesen"), plaintiff's now-deceased wife.  Although plaintiff named other defendants to the
action, the only claim at issue in this proceeding is the claim
against Salem Hospital ("defendant") as the employer of the
nurses who treated Johannesen.  We recount the actions of
Johannesen's doctors at some length, however, because the facts
regarding overall medical care help to explain plaintiff's
contention that the nursing staff should have intervened on
Johannesen's behalf.
         We present the evidence submitted in support of the
motion to amend in the light most favorable to the plaintiff. 
See ORS 18.535(3) (directed verdict standard applies). 
Johannesen consulted Dr. West for prenatal care.  During her
pregnancy, she developed preeclampsia/pregnancy-induced
hypertension, a potentially fatal condition.  Delivery of the
child is the only definitive treatment for severe preeclampsia. 
After Johannesen developed symptoms of preeclampsia, West left
the office for about two weeks, entrusting Johannesen's care to a
nurse practitioner who had limited experience with preeclampsia. 
During West's absence, Johannesen's condition worsened.  
         Upon his return, West arranged for Johannesen to be
hospitalized.  She was admitted on November 8, 1999, with
evidence of severe pregnancy-induced hypertension.  Later that
day, West transferred Johannesen out of the hospital's Labor and
Delivery Unit and into the Postpartum Unit, which decreased the
amount of monitoring she would receive.  Johannesen suffered high
blood pressure accompanied by headaches, visual disturbances, and
epigastric pain, which are signs of end organ injury.  West
treated her with antacids and a pain killer.  West did not order
medication to reduce the chances of seizure until November 10,
and he did not order any medication to control her blood pressure
until she had lapsed into a coma.  
         On November 10, 1999, West decided to induce labor and
attempt a vaginal delivery.  He did not disclose to Johannesen
that she was at risk for a fatal brain hemorrhage during the six
to eight hours that he planned to allow for labor.  Johannesen
was transferred back to the Labor and Delivery Unit at 5:35 a.m.
on November 10.  Johannesen had a severe headache, such severe
visual disturbance that she was unable to see, and epigastric
pain.  Dr. Anderson, the anesthesiologist, saw her twice that
morning.  After Johannesen labored all morning without success,
West transferred her to the operating room for a caesarean
section at approximately 12:50 p.m.  She fit all the definitional
criteria of coma before the first incision was made.  The doctors
performed the delivery without seeking a neurological
consultation.  When plaintiff asked why his wife was "sleeping,"
Anderson told him that his wife was tired.  
         Johannesen never recovered consciousness and died on
November 17, 1999.  The cause of death was a brain hemorrhage. 
Plaintiff brought this action against West, Oregon Anesthesiology
Group, P.C., and defendant.  Plaintiff reportedly has settled the
claims against both West and the anesthesiology group, leaving
only the claim against defendant.
         In the trial court, plaintiff moved for leave under
ORS 18.535 to amend his complaint to add a claim for punitive
damages.  In support of the motion, plaintiff submitted, among
other things, an affidavit from an expert witness, Dr.
Mahlmeister, R.N., Ph.D., setting out what she considered to be
the failures of the Salem Hospital nursing staff.  The court
denied plaintiff's motion.  Plaintiff then brought the present
proceeding seeking a writ of mandamus.  He asks this court to
direct the trial court to vacate its order denying the motion to
amend his complaint to allege punitive damages and to require the
trial court to enter an order allowing plaintiff to amend the
complaint.  In the alternative, plaintiff asks this court to
require the trial court to reconsider plaintiff's motion in light
of Bolt v. Influence, Inc., 333 Or 572, 43 P3d 425 (2002). 
         When interpreting statutes, this court first looks to
the text and context of the statute at issue.  PGE v. Bureau of
Labor and Industries, 317 Or 606, 610-11, 859 P2d 1143 (1993). 
ORS 18.550 provides in part:
"Punitive damages shall not be awarded against a
health practitioner if:
"(1) The health practitioner is licensed,
registered or certified as:
"* * * * *
"(g) A nurse under ORS 678.040 to 678.101; * * *
and
"(2) The health practitioner was engaged in
conduct regulated by the license, registration or
certificate issued by the appropriate governing body
and was acting within the scope of practice for which
the license, registration or certificate was issued and
without malice."
That statute applies to 19 categories of health practitioners. 
However, as the parties acknowledge, the statute does not include
a hospital, such as defendant, within the list of health
practitioners to which the statute applies.
         Defendant argues that, despite the fact that it is not
a health practitioner under the statute, it may assert the
statute's protection against a punitive damages award because
plaintiff's claim asserts that defendant is vicariously liable
for harm caused by health care practitioners who defendant
employed.  According to defendant, it may not be held vicariously
liable for punitive damages because plaintiff's evidence is not
sufficient to demonstrate that defendant's servants –- nurses who
are health practitioners –- acted with malice in harming
Johannesen.
         Defendant's argument assumes that defendant may invoke
the standards in ORS 18.550 if plaintiff relies on a theory of
vicarious liability arising from the conduct of health
practitioners that defendant employed.  Plaintiff challenges that
assumption for a number of reasons.  We have no occasion in this
case to decide whether defendant's assumption is correct.  That
is so because, as we explain below, even if defendant is entitled
in this context to rely on the "without malice" standard in ORS
18.550(2), the record here is sufficient to create a triable
issue about whether the health practitioners that defendant
employed acted "without malice" under the statute.  To address
that question, we must construe the statutory phrase "without
malice," and we turn now to that issue.  
         When the legislature adopted ORS 18.550 in 1987 (Or
Laws 1987, ch 774, § 4), the term "malice" had a well-established
definition in Oregon law.  In 1951, this court stated that
"[i]n civil cases malice has been held to mean the
intentional doing of [an] injurious act without
justification or excuse.  A tort committed with a bad
motive or so recklessly as to be in disregard of social
obligations, or an act wantonly, maliciously or
wickedly done, is such a malicious act as authorizes
the awarding of punitive damages." 
Linkhart v. Savely, 190 Or 484, 505-06, 227 P2d 187 (1951)
(citations omitted; emphasis added). (2)  ORS 18.550 provides
no special definition of malice.  Accordingly, we conclude that
the well-defined legal meaning of that term that was accepted in
1987 applies.  See Gaston v. Parsons, 318 Or 247, 253, 864 P2d
1319 (1997) (examining meaning of undefined statutory term in
light of its well-defined legal meaning).  "Without malice" thus
means without the kinds of conduct that this court listed in
Linkhart.
         Under ORS 18.550 and ORS 18.535, to amend a complaint
to allow for punitive damages against health practitioners, a
plaintiff must present evidence that the health practitioner
acted with malice.  Here, the trial court stated in a letter
opinion that there was no "clear and convincing" evidence of
malice.  At the time of its ruling, however, the trial court did
not have the benefit of this court's decision in Bolt, which, as
plaintiff correctly asserts, established the proper test for
determining when a party may amend a complaint to add a claim for
punitive damages.  Bolt held that the court should apply a "no
evidence" standard in determining whether to allow an amendment
for punitive damages under ORS 18.535.  333 Or at 578.  Thus, the
trial court failed to apply the proper test when considering
plaintiff's motion to amend the complaint to allow for punitive
damages. 
         Although we could, in the exercise of discretion, end
our opinion here, we elect not to do so.  To facilitate the
processing of the case, we choose to consider whether the record
contains some evidence that defendant's health practitioners
acted with malice, in the sense discussed in Linkhart.  In this
case, plaintiff submitted expert affidavits in support of his
motion to amend his complaint to add a claim for punitive
damages.  In her affidavit Mahlmeister, an expert registered
nurse, maintained that the Salem Hospital nursing staff had acted
here with aggravated disregard for their professional duties. 
Mahlmeister faulted the Salem Hospital nurses for failing to
object to West's orders, failing to request blood pressure or
anti-seizure medications, and failing to insist on a prompt
delivery.  In Mahlmeister's opinion, the Salem Hospital nurses
"had an absolute duty to advocate for [Johannesen] to assure her
safety."  Indeed, Mahlmeister stated that their failures to act
"showed outrageous indifference" to Johannesen's health and
safety.  
         The trial court faulted the affidavit, stating that
Mahlmeister was not qualified to offer an opinion about the
nurses' state of mind.  That is an incorrect characterization of
Mahlmeister's affidavit.  The affidavit contains explanations of
the care that Johannesen allegedly should have received and an
expert assessment of the care that she did receive.  A jury,
properly instructed, could use that evidence to infer a reckless
indifference to Johannesen's health; that evidence would permit a
finding of malice.
         Defendant makes an additional argument that it cannot
be held vicariously liable for punitive damages without evidence
of fault on its part.  Defendant's arguments to the contrary
notwithstanding, this court has considered and rejected that
theory.  See Stroud v. Denny's Restaurant, 271 Or 430, 435, 532
P2d 790 (1975) ("[I]f the servant has committed a tort within the
scope of his employment so as to render the corporation liable
for compensatory damages, and if the servant's act is such as to
render him liable for punitive damages, then the corporation is
likewise liable for punitive damages.").  We perceive no reason
to revisit that decision in this case.  At this stage, we cannot
decide finally whether defendant is vicariously liable for the
conduct of its health practitioners.  It is sufficient to state
that defendant is incorrect in arguing that the record
demonstrates that its health practitioners acted without malice. 
Consequently, factual disputes surrounding defendant's possible
vicarious liability for its servants' conduct require the court
to grant plaintiff's motion to amend.
         The State Court Administrator shall issue a peremptory
writ of mandamus directing the trial court to vacate its order
denying plaintiff's motion to amend his complaint to add a claim
for punitive damages and to enter an order allowing that
amendment.
         Peremptory writ to issue.
         BALMER, J., concurring.
         I agree that plaintiff is entitled to a peremptory
writ, and I agree with the majority's interpretation of the word
"malice" in ORS 18.550(2).  I write separately, however, to
identify the consequences of that interpretation because the
legislature may not have intended them.
         The majority opinion correctly notes that the
legislature adopted ORS 18.550(2) in 1987 and that that statute
prohibits the award of punitive damages against certain licensed
health practitioners if "the health practitioner was engaged in
conduct regulated by the license * * * and was acting within the
scope of practice for which the license * * * was issued and
without malice."  (Emphasis added.)  The majority opinion also
correctly points out that the legislature did not define the term
"malice" in ORS 18.550(2) and that the term, as it relates to
punitive damages, previously had been defined in this court's
cases.  That definition, as the majority opinion states, includes
tortious conduct so reckless as to be in disregard of social
obligations.  For those reasons, I agree with the majority's
interpretation of ORS 18.550(2).
         What the majority opinion fails to make clear, however,
is the result that follows from those conclusions, viz., that, if
the legislature intended, by enacting ORS 18.550(2), to change
the standard required to obtain an award of punitive damages
against a health practitioner by requiring a showing of "malice,"
it failed in that effort.  As the majority demonstrates, under
this court's punitive damages cases, the term "malice"
encompasses the different kinds of wrongful conduct that
traditionally have justified a jury awarding punitive damages,
whether that conduct was intentionally wrongful, "wicked,"
"wanton," or recklessly in disregard of social obligations.  By
using the word "malice," then, the legislature essentially stated
a tautology:  No punitive damages could be recovered unless
punitive damages could be recovered.  
         Defendant asserts that the majority's interpretation of
ORS 18.550(2) "would render the statute purposeless."  It argues
that this court should reject such an interpretation because the
statute and the legislative history demonstrate that the
legislature intended "to limit punitive damage awards against
healthcare professionals."  Defendant cites 1000 Friends of
Oregon v. Wasco County Court, 299 Or 344, 358, 703 P2d 207
(1985), for the proposition that this court should not "deem a
legislative act meaningless unless no other reasonable conclusion
is available."  
         It is not unreasonable to suggest, as defendant does,
that the legislature would not have adopted ORS 18.550(2) unless
it intended to change the law regarding the award of punitive
damages against health practitioners.  Moreover, the legislative
history, which both parties discuss in their briefs to this
court, supports the proposition that at least some members of the
committee that drafted the bill that became ORS 18.550(2)
expected that they were changing the law.  (As plaintiff points
out, ORS 18.550 was part of a larger "tort reform" bill that
included a "cap" on noneconomic damages.)
         It remains, however, that, in amending the statute, the
legislature used a legal term -- "malice" -- without defining
that term and, according to the legislative history, with an
understanding of the way that the Oregon courts previously had
used that term.  Absent a separate definition of the term, the
legislature must be deemed to have meant to use the term in that
traditional, well-understood sense.  That being the case, the
lead opinion's conclusion on this issue is inescapable.
         Gillette, J., joins in this concurring opinion.
1. ORS 18.535 was amended in 2003; those amendments do not apply to this action.  Or
Laws 2003, ch 552, § 2.  All references to ORS 18.525 in this opinion are to the 2001 version of
that statute.
2. In the same year that the legislature enacted ORS 18.550, this court commented on the
evolution of the term, noting that as punitive damages were extended beyond torts involving
actual ill-will "to other forms of culpable misconduct, * * * 'malice' was redefined to encompass
them."  Andor v. United Air Lines, 303 Or 505, 512 n 8, 739 P2d 18 (1987).