Case Name: Tina Lynette WATKINS, etc. v. LAKE CHARLES MEMORIAL HOSPITAL, et al.
Court: Louisiana Court of Appeal
Jurisdiction: Louisiana
Decision Date: 2004-12-15
Citations: 896 So. 2d 130
Docket Number: No. 2004-355
Parties: Tina Lynette WATKINS, etc. v. LAKE CHARLES MEMORIAL HOSPITAL, et al.
Judges: Court composed of SYLVIA R. COOKS, JIMMIE C. PETERS, MARC T. AMY, BILLY H. EZELL, and JOHN B. SCOFIELD , Judges.
Reporter: Southern Reporter, Second Series
Volume: 896
Pages: 130–143

Head Matter:
Tina Lynette WATKINS, etc. v. LAKE CHARLES MEMORIAL HOSPITAL, et al.
No. 2004-355.
Court of Appeal of Louisiana, Third Circuit.
Dec. 15, 2004.
R. Ray Orrill, Jr., Leslie A. Cordell, Orrill, Cordell & Beary, LLC, New Orleans, LA, for Plaintiff/Appellee, Tina Lynette Watkins, Individually.
Michael K. Prudhomme, Lundy & Davis, Lake Charles, LA, for Defendant/Appellant, Louisiana Patients’ Compensation Fund.
Court composed of SYLVIA R. COOKS, JIMMIE C. PETERS, MARC T. AMY, BILLY H. EZELL, and JOHN B. SCOFIELD , Judges.
John B. Scofield participated in this decision by appointment of the Louisiana Supreme Court as Judge Pro Tempore.

Opinion:
h COOKS, Judge.
The Louisiana Patient's Compensation Fund (LPCF) appeals a judgment from the trial court, awarding damages resulting from medical malpractice at the time of the minor plaintiffs birth. In addition to general damages and accrued medical and related expenses, future medical care and related benefits were quantified. The LPCF questions the trial court's determination of the amount of future medical care and related benefits, asserting that the relevant statute does not permit a particularized award, but only a determination as to whether the plaintiff was entitled to future medical expenses. It contends all determinations as to particularized expenses rests with the Louisiana Patient's Compensation Oversight Board. The LPCF further contests the quantum of the general damages award and the fashion in which the judgment awarded interest on the judgment. For the following reasons, we affirm the decision of the trial court.
Factual and Procedural Background
Tina Lynette Watkins appears in this matter on her own behalf as well as on behalf of her minor child, Dustin Watkins. The issues involved herein relate to Ms. Watkins' pregnancy and Dustin's birth. During her pregnancy, Ms. Watkins first visited Dr. Richard Barry, an obstetrician, in August 1990. At the time, Ms. Watkins was several months into her pregnancy. Dr. Barry eventually predicted a due date of December 4,1990. Ms. Watkins reported to Lake Charles Memorial Hospital (LCMH) on December 19th after the onset of labor. Dustin was delivered by caesarean section in the early morning hours of December 20,1990.
Ms. Watkins' petition alleges after his birth, Dustin began suffering from seizures, which required readmission to the hospital. Ms. Watkins contends Dr. Barry failed to properly calculate Dustin's due date. As a result Dustin received inadequate | ¿nutrition while in the womb causing him to suffer a stroke prior to birth. Dustin "is severely and permanently brain damaged, requiring constant, close, specialized care and monitoring, as well as continuous medications for pain and seizures."
Ms. Watkins named Dr. Barry and LCMH as defendants. Following a bench trial, judgment was rendered in favor of the Plaintiff. The totality of the fault was assigned to Dr. Barry. LCMH was subsequently dismissed. Damages were awarded as follows: Dustin's General Damages — $2,000,000.00; Ms. Watkins' Loss of Consortium — $250,000.00; Dustin's Loss of Anticipated Future Earnings — $241,020.00. A notation was made in the judgment regarding the necessary reduction to the $500,000 cap of the Medical Malpractice Act contained in La.R.S. 40:1299.42(B)(1) .
With regard to special damages, the trial court awarded "accrued medical and related (i.e. custodial care) expenses from December 24, 1990 through the date of judgment in the amount of $437,193.08 plus interest." Finally, the trial court found Dustin to be in need of future medical care, quantifying specific areas of future medical care and related benefits found to be appropriate.
13FoIlowing trial, Dr. Barry tendered $125,000 in satisfaction of the judgment for which he was résponsible under the Medical Malpractice Act and was dismissed Rfrom the proceedings. The LPCF intervened and appealed, asserting the following assignments of error:
1. The trial court erred in its rendition of judgment for future medical expenses in that it lacked the requisite subject matter jurisdiction to make such an award and its findings were contrary to LSA-R.S. 40:1299.43.
2. The trial court's award of attendant care was contrary to the rules and regulations promulgated by the Louisiana Patients' Compensation Fund.
3. The trial court's award of interest on the award of general damages and accrued damages from the date of filing with the Medical Review Panel until paid in full is contrary to LSA-R.S. 40:1299.42.
4. The amount of damages awarded was clearly excessive.
Discussion
Future Medical Expenses
In its first assignment of error, the LPCF questions trial court's finding and itemization of future medical care and benefits in its judgment. The LPCF contends the inclusion of these figures in the judgment exceeds the trial court's authority under the Medical Malpractice Act(Act). The LPCF argues the Act limits the trial court to a finding that a patient is or is not in need of future medical care and related benefits without the recitation of specific amounts. The LPCF insists it alone has statutory authority to determine the amounts owed for future medical expenses. In support of its position, the LPCF relies on language contained in Kelty v. Brumfield, 93-1142 (La.2/25/94), 633 So.2d 1210. We have carefully reviewed the referenced language but in the final analysis, we are not persuaded that Kelty requires us to ignore the clear language found in the Act. The Act specifically requires the trial court to determine the amount of future medicals due.
| ^Louisiana Revised Statute 40:1299.43(A)(2) provides, in relevant part:
In actions upon malpractice claims tried by the court, the court's finding shall include a recitation that the patient is or is not in need of future medical care and related benefits and the amount thereof (emphasis added)
Thus, Section A requires a determination as to whether a plaintiff is in need of future medical care; and, if so, further directs the court to specify the amount thereof. Rather than divest the trial court of jurisdiction to determine future medical expenses, the Act mandates that the trial court first render a judgment for future medical expenses and the amount thereof prior to plaintiff submitting a claim for payment to the LPCF.
Louisiana Revised Statutes 40:1299.43(C) provides, in relevant part:
(C)Once a judgment is entered in favor of a patient who is found to be in need of future medical care and related benefits or a settlement is reached between a patient and the patient's compensation fund in which the provision of medical care and related benefits is agreed upon and continuing as long as medical or surgical attention is reasonably necessary, the patient may make a claim to the patient's compensation fund through the board for all future medical care and related benefits directly or indirectly made necessary by the health care provider's malpractice unless the patient refuses to allow them to be furnished, (emphasis added.)
Although contained in the judgment, these expenses are not made execu-tory until review and approval by the LPCF or, if denied, upon subsequent order of the court under its continuing jurisdiction. See La.R.S. 40:1299.43(E).(1).
The judgment in the present case awarded $500,000 in general damages and | fi$437,193.08 plus interest for accrued medical and related care through the time of judgment. Further the judgment provides: "[Jjudgment [is] rendered in favor of the plaintiffs and against the defendant, Richard J. Barry, M.D., pursuant to LSA-R.S. 40:1299.43(A)(2) decreeing that plaintiff, Dustin Watkins, is in need of future medical care and related benefits in the following amounts.... " The judgment then includes the specific benefits found appropriate by the trial court. Our review indicates that this listing is consistent with the requirements of Section A. The trial court acknowledged the statutory scheme which requires a plaintiff to submit future claims to the LPCF stating: "[A]gain the Court is taking cognizance of the suit record that the Patient's Compensation Fund would be involved and that those amounts would be paid as they were incurred and submitted pursuant to the Act." We find no error in this portion of the trial court's judgment.
Accrued Medical Expenses and Attendant/Respite Care
A portion of the judgment also awarded "accrued medical and related (i.e. custodial care) expenses from December 24, 1990 through the date of judgment in the amount of $437,193.08 plus interest." These figures were treated as a separate element of recovery apart from the future medical care and related benefits, discussed above, and were reduced to a money judgment. The LPCF argues that casting it in judgment for accrued medical expenses was in error as these damages fall within La.R.S. 40:1299.43(B)'s definition of "future medical care and related benefits", over which the LPCF has exclusive authority. The LPCF, thus, contends the trial court lacks jurisdiction and therefore has no authority under the Act to make any determination as to future medical care, whether accrued at the time of trial or which |7may be incurred subsequently. Additionally, with respect to the award for attendant and respite care, the LPCF questions the quantum awarded, arguing that the figure found appropriate by the trial court is contrary to LPCF standards for payment for similar services.
We turn first to the question of whether the trial court has authority to cast LPCF in judgment for already incurred "future" medical expenses. The definition of "future medical care and related benefits" is contained in La.R.S. 40:1299.43(B)(1), which provides broadly, that:
"Future medical care and related benefits" for the purpose of this Section means all reasonable medical, surgical, hospitalization, physical rehabilitation, and custodial services and includes drugs, prosthetic devices, and other similar materials reasonably necessary in the provision of such services, after the date of injury.
(Emphasis added.)
Although this provision does not distinguish between medical expenses incurred from the date of injury to judgment or settlement and those expenses not yet incurred but which may be necessary after the date of judgment, the courts have routinely included already incurred medical expenses in the judgment and made then executory. See Hall v. Brookshire Bros., Ltd., 02-2404 (La.6/27/03), 848 So.2d 559, and other circuits following Hall. In Hall, the supreme court held interest was owed on "future" medical expenses which had already been incurred. Implicit in this holding is a finding that the trial court decision reducing these medical expenses to a money judgment was correct. Interpreting the Hall decision in any other way requires a strained interpretation which was never intended by the legislature. See | ffeRay v. Bartholomew, 03-1370 (La. App. 5 Cir. 3/30/04), 871 So.2d 492 (where the fifth- circuit approved the reduction of medical costs incurred up until the date of trial to a money judgment); Maxwell v. Soileau, 561 So.2d 1378 (La.App. 2 Cir.), writ denied, 567 So.2d 1124 (La. 1990)(where the second circuit included already incurred medical expenses in a money judgment awarded to plaintiff on appeal); and Fusilier v. Dauterive, 99-692 (La.App. 3 Cir. 1/10/01), 779 So.2d 950 (where this court awarded plaintiff $67,876.75, plus legal interest, for medical expenses incurred after the accident.) In LeRay, 871 So.2d 492, the fifth circuit stated:
The judgment further authorizes plaintiffs to make claims for such expenses to the LPCF, without entering a judgment on the exact sum. The only money judgment related to this issue is the award of $898,190.34 for medical expenses and related benefits already incurred. The trial court correctly made the distinction between medical expenses and related benefits incurred between the accident and the date of trial, and future medical expenses which will occur after trial. In recognizing this difference, the trial court correctly reduced the past medical expenses to a money judgment, but merely acknowledged the right of plaintiffs to bring a claim for any future medical expenses to the LPCF. We find that to be correct and within the trial court's grant of jurisdiction.
Id. at 502 (emphasis added).
Moreover, under the Act the trial court is vested with "continuing jurisdiction in cases where medical care and related benefits are determined to be needed by the patient." La.R.S. 40:1299.43(E)(1). The LPCF had a fair opportunity at trial to contest the amount requested by the plaintiff, which it did. We conclude the trial court had authority to make a determination regarding the amounts owed for past medical care and to reduce those amounts to a money judgment prior to the recent amendment, which simply sought to clarify the Act's requirement and codify existing jurisprudence on this issue.
[flAs noted, the LPCF contests the figure found appropriate for the past attendant care. We have reviewed the record and find no error in the determination made by the trial court regarding past accrued medical and related benefits.
Interest
In its next assignment of error, the LPCF questions the manner in which the judgment awarded interest. The judgment states: "IT IS FURTHER ORDERED, ADJUDGED AND DECREED that, pursuant to LSA-R.S. 40:1299.47(M), plaintiffs are entitled to recover interest at the judicial rate on the award of general and accrued damages from the date of filing with the Medical Review Panel until paid in full." The LPCF contends that the judgment is ambiguous in that it could appear to permit interest on the totality of general damages awarded rather than the $400,000 liability incurred by the LPCF after the reduction by the cap. It notes that this type of recovery is prohibited by La.R.S. 40:1299.42(B), which provides, in part, that a plaintiffs maximum recovery for a malpractice claim is "five hundred thousand dollars plus interest and costs" and that the health care provider is liable for not more than his or her one hundred thousand dollar responsibility under the statute "plus interest thereon." While perhaps the judgment is arguably vague, we find no error regarding interest on the accrued medical expenses. Hall, 848 So.2d 559. However, we amend the judgment to indicate more fully that interest is to be paid at the judicial rate on the award of $400,000.00 in general damages from the date of filing with the Medical Review Panel until paid in full. See La.R.S. 40:1299.47(M).
Quantum of Damages Awarded
After hearing evidence presented by the plaintiff, the trial court awarded $2,000,000 in general damages for Dustin's injuries, $250,000 for loss of consortium 1 into the plaintiff, and $241,020 in loss of earning capacity to Dustin. While recognizing the reduction to the $500,000 liability cap, the LPCF generally asserts that the figures awarded were clearly excessive, referencing cases in which lesser general damages were awarded to other children who suffered injury at the time of birth.
In reviewing an award for general damages, an appellate court must initially inquire whether the trier of fact abused its discretion in assessing the amount necessary given the circumstances of the injury. Cone v. Nat'l Emergency Serv., Inc., 99-934 (La.10/29/99), 747 So.2d 1085. Only in the event that the reviewing court finds an abuse of discretion is comparison made to prior awards for determination of the highest or lowest amount that was reasonably within the trier of fact's discretion. Id.
Our review of the record reveals no abuse of discretion in assessing $2,000,000 in general damages given the particular facts and circumstances of this case. It is uncontested that Dustin suffered brain damage due to the circumstances surrounding his birth. Dr. Bruce Roseman, a pediatric neurologist, explained that he felt that Dustin suffered a stroke approximately two days prior to his birth. As a result of the injury to the brain sustained during the stroke, Dustin has suffered seizures and has demonstrated cognitive function that was described as mentally retarded. In school, he functions well below his grade level and is in' remedial classes throughout the day. Furthermore, a number of witnesses testified to his behavioral difficulties, which included periods of both verbal and physical aggression. Dr. Rose- man opined that Dustin will need constant supervision throughout his life to diminish the possibility of injury to either Dustin or others. Dr. Roseman also explained that, in his opinion, Inwhen Dustin grows older he will probably be unable to work in an independent setting and should not be permitted to drive. The plaintiff also testified regarding Dustin's problems at home and school, explaining that she is often fearful for her family given the nature of Dustin's behavioral difficulties. In light of the nature of his injuries, we find no abuse of discretion in the general damages awarded as a result of the malpractice. Accordingly, the damages awarded are affirmed.
DECREE
For the foregoing reasons, we affirm that portion of the judgment in which the trial court quantified the future medical care and related benefits pursuant to La. R.S. 40:1299.43(A)(2), but clarify, to the extent the LPCF is genuinely confused, that it is not cast in money judgment at this time for those expenses. The plaintiff retains the right to seek all future medical care and related benefits with the Louisiana Patient's Compensation Statute as is authorized by La.R.S. 40:1299.43(C). We affirm that portion of the judgment including accrued medical care and related benefits in the money judgment in the amount of $437,193.08 plus legal interest. We amend the judgment to more fully indicate that interest is to be paid at the judicial rate on the award of $400,000.00 in general damages from the date of filing with the Medical Review Panel until paid in full. All costs for this appeal are assessed to the Louisiana Patient's Compensation Fund.
AFFIRMED, AS AMENDED.
PETERS, J., concurs in the result.
AMY, J., concurs in part and dissents in part and assigns reasons.
. Louisiana Revised Statutes 40:1299.42(B)(1) provides:
(1) The total amount recoverable for all malpractice claims for injuries to or death of a patient, exclusive of future medical care and related benefits as provided in R.S. 40:1299.43, shall not exceed five hundred thousand dollars plus interest and cost.
. The medical care portion of the judgment reads:
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that there be judgment rendered herein in favor of the plaintiffs and against the defendant, Richard J. Barry, M.D., pursuant to LSA-R.S. 40:1299.43(A)(2), decreeing that plaintiff, Dustin Watkins, is in need of future medical care and related benefits in the following amounts:
Educational Evaluation Occupational Therapy Evaluation Speech Therapy Evaluation Driving Evaluation Vocational Evaluation Psychological Counseling (25-30/yr @ $175.00/ea. x 5) Psychological Counseling (300/life, commencing at age 18, @ $175.00/ea.) Speech Therapy Occupational Therapy Tutoring Family Counseling Vocational Counseling $ 6,000.00 $ 925.00 $ 825.00 $ 650.00 $ 3,500.00 $ 21,875.00 $ 52,500.00 $ 65,000.00 $ 78,000.00 $ 39,520.00 $ 21,000.00 $ 5,000.00 Psychiatrist (initial evaluation) (2/mo. @ $175.00/ea. x 1 yr.) (1/mo. @ $175.00/ea. x 1 yr.) (4/yr. @ $175.00/ea. x 64 yrs.) Neurologist/Neurosurgeon (4/yr. @ $150.00/ea. x 64 yrs.) Pediatrician (6 /yr. @ $115.00/ea. x 5 yrs.) $ 1,200.00 $ 18,200.00 $ 9,100.00 $ 44,800.00 $ 38,000.00 $ 3,450.00 Diagnostic Testing (1/yr. @ $2,000.00/ea. x 5 yrs.) Case Manager (4/mo. @ $300.00/mo. x 12 mos. x 64 yrs.) $ 10,000.00 $ 230,400.00 Respite Care (20/hrs./wk. @ $15.00/hr. x 5 yrs) 78,000 Custodial care, value of special services functioning as nurse/attendant, from present until 2008 (when Dustin turns 18); 12/hrs/day x 7 days/wk. x 52/wks/yr. x $7.50 hr./ x 5 yrs. $ 163,800.00 Live-in support (24/hrs./day commencing @ age 18 @ $ 10.00/hr x 59 yrs.) $ 5,168,400.00 Medications: Concerta (54 mgs.) ($170.00/mo. x 64 yrs.) Concerta (18 mgs.) ($97.50/mo. x 64 yrs.) Clonidine ($22.50/mo. x 64 yrs.) $ 130,560.00 . $ 74,880.00 $ 17,280.00
. A qualified health care provider's limitation of liability under the Medical Malpractice Act is contained in La.R.S. 40:1299.42(B)(2), which provides:
(2) A health care provider qualified un der this Part is not liable for an amount in excess of one hundred thousand dollars plus interest thereon accruing after April 1, 1991, for all malpractice claims because of injuries to or death of any one patient.
. See Hall v. Brookshire Bros., 02-2404 (La.6/27/03), 848 So.2d 559 (wherein a jury found the plaintiff in need of in excess of $3,000,000.00 dollars); LeRay v. Bartholomew, 03-1370 (La.App. 5 Cir. 3/30/04), 871 So.2d 492 (wherein a jury found $8,000,000.00 dollars in future medical care and related benefits necessary).
. "The district court from which final judgment issues shall have continuing jurisdiction in cases where medical care and related benefits are determined to be needed by the patient."
. The date on which Dustin entered the hospital after having suffered seizures following his birth on December 20, 1990.
. A 2004 ' amendment to La.R.S. 40:1299.43(A)(4) clarifies that future medical expenses already incurred at the time of judgment shall be included in the money judgment and made executory. The amendment provides: "The remaining portion of the judgment, including the amount of future medical care and related benefits incurred up to the date of the response to the special interrogatory by the jury or the court's finding shall be paid in accordance with R.S. 40:1299.44(A)(7) and- R.S. 40:1299(B)(2)(a),(b), and (c).' "