Title: Gregory G. Phelps v. Physicians Insurance Company of Wisconsin, Inc.
Citation: 2005 WI 85
Docket Number: 2003AP000580
State: Wisconsin
Issuer: Wisconsin Supreme Court
Date: June 22, 2005

2005 WI 85 
 
 
SUPREME COURT OF WISCONSIN 
 
 
 
 
 
CASE NO.: 
2003AP0580 
COMPLETE TITLE: 
 
 
Gregory G. Phelps, Marlene L. Phelps,  
Estate of Adam Phelps, Deceased, by his  
Special Administrator, Gregory G. Phelps,  
and Caroline Phelps and Kyle Phelps,  
minors, by their Guardian ad Litem,  
William M. Cannon,  
          Plaintiffs-Respondents-Petitioners, 
     v. 
Physicians Insurance Company of  
Wisconsin, Inc., a Wisconsin insurance  
corporation, and Matthew Lindemann, M.D.,  
          Defendants-Appellants- 
          Cross Petitioners. 
 
 
 
 
REVIEW OF A DECISION OF THE COURT OF APPEALS 
2004 WI App 91 
Reported at:  273 Wis. 2d 667, 681 N.W.2d 571 
(Ct. App. 2004-Published) 
 
 
OPINION FILED: 
June 22, 2005   
SUBMITTED ON BRIEFS: 
        
ORAL ARGUMENT: 
March 3, 2005   
 
 
SOURCE OF APPEAL: 
 
 
COURT: 
Circuit   
 
COUNTY: 
Milwaukee   
 
JUDGE: 
Michael P. Sullivan   
 
 
 
JUSTICES: 
 
 
CONCURRED: 
        
 
CONCUR/DISSENT: 
PROSSER, J., concurs in part, dissents in part 
(opinion filed). 
ROGGENSACK, J., joins the concurrence/dissent. 
 
DISSENTED: 
        
 
NOT PARTICIPATING: WILCOX, J., did not participate.   
 
 
 
ATTORNEYS: 
 
For 
the 
plaintiffs-respondents-petitioners 
there 
were 
briefs by William M. Cannon, Sarah F. Kaas and Cannon & Dunphy, 
S.C., Brookfield, and oral argument by William M. Cannon. 
 
For the defendants-appellants-cross petitioners there were 
briefs by John S. Skilton, Christopher G. Hanewicz, Gabrielle E. 
Bina and Heller Ehrman White & McAuliffe LLP, Madison; and 
 
 
2
Michael B. Van Sicklen, Michael S. Heffernan and Foley & Lardner 
LLP, Madison, and oral argument by Michael B. Van Sicklen and 
John S. Skilton. 
 
 
An amicus curiae brief was filed by Emile H. Banks, Jr., 
Vicki L. Arrowood and Emile Banks & Associates, LLC, Milwaukee, 
on behalf of OHIC Insurance Company. 
 
An amicus curiae brief was filed by Timothy J. Muldowney 
and LaFollette, Godfrey & Kahn, Madison, on behalf of the 
Wisconsin Medical Society, American Medical Association and 
Wisconsin Hospital Association, Inc.; Laura J. Leitch, Madison, 
on behalf of Wisconsin Hospital Association, Inc.; Mark L. Adams 
and Melanie E. Cohen, Madison, on behalf of the Wisconsin 
Medical Society; and Leonard Nelson and AMA Litigation Center, 
Chicago, IL, on behalf of the American Medical Association. 
 
An amicus curiae brief was filed by Gerald J. Bloch, Frank 
Crivello and Warshafsky, Rotter, Tarnoff, Reinhardt & Bloch, 
S.C., Milwaukee, on behalf of the Wisconsin Academy of Trial 
Lawyers. 
 
 
2005 WI 85 
NOTICE 
This opinion is subject to further 
editing and modification.  The final 
version will appear in the bound 
volume of the official reports.   
No.  2003AP580  
(L.C. No. 
99 CV 7971 
STATE OF WISCONSIN  
 
 
   : 
IN SUPREME COURT 
 
 
Gregory G. Phelps, Marlene L. Phelps,  
Estate of Adam Phelps, Deceased, by his  
Special Administrator, Gregory G. Phelps,  
and Caroline Phelps and Kyle Phelps,  
minors, by their Guardian ad Litem,  
William M. Cannon,  
 
          Plaintiffs-Respondents- 
          Petitioners, 
 
     v. 
 
Physicians Insurance Company of  
Wisconsin, Inc., a Wisconsin insurance  
corporation, and Matthew Lindemann, M.D.,  
 
 
          Defendants-Appellants- 
          Cross Petitioners. 
 
FILED 
 
JUN 22, 2005 
 
Cornelia G. Clark 
Clerk of Supreme Court 
 
 
 
 
 
REVIEW of a decision of the Court of Appeals.  Reversed and 
cause remanded. 
 
¶1 
ANN WALSH BRADLEY, J.   This medical malpractice case 
arises out of the death of Adam Phelps at St. Joseph's Hospital 
in Milwaukee on November 24, 1998.  At that time, Marlene 
Phelps, and her unborn twins, Adam and Kyle, were under the care 
No. 
2003AP580   
 
2 
 
of Dr. Matthew Lindemann, who was then an unlicensed first-year 
medical resident.  The complaint alleged, and the circuit court 
found in a trial to the court, that Dr. Lindemann negligently 
caused Adam's death.  The circuit court then apportioned 80% of 
the causal negligence to Dr. Lindemann and 20% to St. Joseph's 
hospital.  The court of appeals subsequently reversed.1   
 
¶2 
The petitioners, Gregory and Marlene Phelps, et al., 
seek review of the decision of the court of appeals.  They 
contend that the court of appeals erred in holding that (1) 
excusable neglect warranted granting the defendants' motion to 
extend the time within which to pay their jury fee thus 
preserving their right to a jury trial; and (2) Dr. Lindemann 
was subject to the standard of care applicable to "his class."  
Additionally, the petitioners argue that the health care 
services review privilege found in Wis. Stat. § 146.38 (1997-98) 
does not apply to this case.2 
¶3 
Cross-petitioners, 
Dr. 
Lindemann 
and 
Physicians 
Insurance Company of Wisconsin, Inc., also seek review of the 
decision of the court of appeals.  The cross-petitioners assert 
that the court of appeals erred in narrowly construing the term 
"health care provider" as it appears in Wis. Stat. § 893.55(4), 
so as to exclude Dr. Lindemann from its protection.  According 
                                                 
1 Phelps v. Physicians Ins. Co., 2004 WI App 91, 273 
Wis. 2d 667, 681 N.W.2d 571 (reversing the order for judgment of 
the circuit court for Milwaukee County, Michael P. Sullivan, 
Judge).  
2 All references to the Wisconsin Statutes are to the 1997-
98 version unless otherwise noted.   
No. 
2003AP580   
 
3 
 
to the cross-petitioners, such a result is contrary to the 
legislative intent and inconsistent with this court's prior case 
law.3 
¶4 
We conclude that (1) the cross-petitioners waived 
their right to a jury trial by not timely paying the jury fee, 
and the circuit court properly denied their motion to extend 
time for paying the fee; (2) Dr. Lindemann should be held to the 
standard 
of 
care 
applicable 
to 
an 
unlicensed 
first-year 
resident; (3) the health care services review privilege found in 
Wis. Stat. § 146.38 does not apply to this case; and (4) the cap 
on noneconomic damages imposed by Wis. Stat. § 893.55(4)(b) does 
not apply to Dr. Lindemann under the facts presented.  However, 
we remand the matter to the circuit court for a determination of 
whether Dr. Lindemann was a "borrowed employee" of St. Joseph's 
Hospital and therefore entitled to the cap protection as an 
"employee" 
of 
a 
health 
care 
provider 
under 
Wis. 
Stat. 
§ 893.55(4)(b).  Accordingly, we reverse the decision of the 
                                                 
3 The cross-petitioners also maintain that the surviving 
children should not have been awarded "loss of society and 
companionship" damages stemming from their mother's "emotional 
distress injuries."  The court of appeals declined to address 
this issue on grounds that it was inadequately briefed.  Phelps, 
273 Wis. 2d 667, ¶49.  We therefore deem it waived and do not 
address it here. 
No. 
2003AP580   
 
4 
 
court of appeals and remand to the circuit court for further 
proceedings.4 
I 
 
¶5 
The relevant facts are not in dispute.  Marlene Phelps 
(hereinafter "Marlene") discovered that she was pregnant with 
twins in June 1998.  Soon thereafter, she started bleeding and 
was successfully treated at St. Joseph's Hospital in Milwaukee.  
After that episode, she was placed on strict home bed rest. 
¶6 
Marlene's pregnancy progressed without incident until 
October 18, 1998, when another bleeding episode occurred.  She 
was admitted to St. Joseph's Hospital and continued her program 
of bed rest.  Two days later, an ultrasound revealed that one of 
the twins was a breech presentation (legs first).  Based on this 
                                                 
4 The issue of whether Dr. Lindemann was a "borrowed 
employee" of St. Joseph's hospital arose twice at the circuit 
court level.  The defendants argued, both in their brief in 
opposition to the plaintiffs' motion for declaratory judgment 
and their brief in support of a motion to reconsider, that Dr. 
Lindemann was a "borrowed employee" and therefore entitled to 
the cap protection under Wis. Stat. § 893.55(4)(b).  The circuit 
court, however, never explicitly addressed the merits of the 
issue. 
In its decision, the court of appeals remanded the matter, 
explaining, "The trial court made no findings on that issue.  As 
noted, we cannot find facts."  Phelps, 273 Wis. 2d 667, ¶46 n. 
10.  Like the court of appeals, because we cannot find facts, we 
remand to the circuit court the issue of whether Dr. Lindemann 
was a "borrowed employee" of St. Joseph's Hospital.  In doing 
so, we are mindful that this may ultimately be dispositive of 
our discussion of the cap on noneconomic damages.  Nevertheless, 
for completeness, we address the applicability of the cap in 
Section VI. 
No. 
2003AP580   
 
5 
 
finding, Marlene was deemed a high-risk patient who required a 
c-section for delivery of the twins.   
¶7 
In the early morning of November 24, 1998, Marlene was 
awakened with constant suprapubic pain.  The on-call resident, 
Dr. Matthew Lindemann, was contacted.  Dr. Lindemann was an 
unlicensed first-year resident and an employee of the Medical 
College of Wisconsin.  His primary duty was to assess and report 
findings and differential diagnoses to an upper level senior 
resident or to the attending obstetrician.  He had no authority, 
however, to provide primary obstetrical care or perform a c-
section on Marlene. 
¶8 
Dr. 
Lindemann 
ordered 
lactated 
ringers 
to 
be 
administered at 2:40 a.m. for suspected contractions.  They did 
not alleviate Marlene's pain.  At 3:00 a.m., Dr. Lindemann 
reached a differential diagnosis of pubic symphysis pain, 
bladder pain, labor or placental abruption.  Accordingly, he 
ordered a foley catheter to determine if Marlene had a bladder 
infection.  The urinalysis returned at 3:50 a.m. indicated that 
she did not.  
¶9 
Due to the continued pain she was experiencing, 
Marlene requested at 4:15 a.m. that the attending nurse call Dr. 
Lindemann again.  Fetal heart monitoring and an ultrasound 
established that the twins' heart rates were within normal 
ranges.  Dr. Lindemann informed Marlene that he would take a 
picture of the ultrasound so that he could consult an upper 
level senior resident.   
No. 
2003AP580   
 
6 
 
¶10 After this examination, Dr. Lindemann ordered a potent 
narcotic, Demerol, to be administered to Marlene at 4:50 a.m. 
and 5:20 a.m.  Dr. Lindemann never satisfactorily explained his 
whereabouts between 4:15 a.m. and 6:00 a.m.  However, there is 
no evidence that he ever contacted an upper level senior 
resident to discuss Marlene's case. 
¶11 Marlene remained in pain when Dr. Lindemann examined 
her again at 6:00 a.m.  At 6:45 a.m., her husband Gregory Phelps 
(hereinafter "Gregory") arrived at the hospital.  Marlene 
informed Gregory that she felt the need to defecate and asked 
for assistance to get to the commode.  At 7:00 a.m., while 
sitting on the commode, she reached down and felt toes extending 
from her.   
¶12 Her husband rushed to the nurses' desk where he found 
another doctor, who delivered Adam Phelps (hereinafter "Adam") 
at 7:20 a.m.  Adam was immediately rushed to the neonatal 
intensive care unit where resuscitation efforts began.  The 
efforts proved unsuccessful, and he was pronounced dead at 7:36 
a.m.  Adam's death was caused from a combination of asphyxia due 
to cord entrapment and placental abruption, which impaired his 
oxygen supply. 
¶13 During this time, Marlene was rushed from her room to 
the operating room where anesthesia was administered at 7:30 
a.m.  The second twin, Kyle, was delivered at 7:43 a.m.  
Afterward, the treating physicians questioned Dr. Lindemann 
about his decisions, his whereabouts, and his diagnosis.  Dr. 
No. 
2003AP580   
 
7 
 
Lindemann's responses were primarily that he did not know or 
remember. 
¶14 Marlene, Gregory, and their two children Caroline and 
Kyle (collectively, "the Phelpses") subsequently brought suit on 
the ground of negligence.  On April 14, 2000, they filed an 
amended summons and complaint, naming Dr. Lindemann and his 
insurer, 
Physicians 
Insurance 
Company 
of 
Wisconsin, 
Inc. 
(collectively, "PIC").  PIC filed an answer on May 30, 2000, and 
demanded a trial by jury.   
¶15 On July 10, 2001, the trial court entered a standard 
scheduling order, which provided as material to the jury-trial 
issue:  "Jury fees must be paid in accordance with Local Rule 
#371 on or before 9-1-01 or the jury shall be deemed waived."5  
PIC missed this deadline, paying the $72 jury fee by letter 
dated September 12, 2001, which was then filed by the clerk of 
circuit court on September 13, 2001.  PIC did not send a copy of 
the late payment letter to the Phelpses' counsel. 
¶16 Assuming that the jury fee had been paid on time, on 
September 11, 2002, counsel for the Phelpses and PIC filed with 
the trial court a "stipulation to amend scheduling order," 
which, among other things, set a "12 person Jury Trial" for 
December 4, 2002.  They later filed their respective proposed 
jury verdicts and proposed jury instructions with the court. 
                                                 
5 Uppercasing omitted; bolding in original; underlined date 
handwritten. 
No. 
2003AP580   
 
8 
 
¶17 Two 
days 
before 
the 
scheduled 
jury 
trial, 
the 
Phelpses' lawyer contacted the court, having discovered that the 
jury fee was paid late in violation of the scheduling order and 
local rule.  He argued that such action, coupled with PIC's 
failure to notify him of the late payment, resulted in a waiver 
of the right to a jury trial.  In a telephone conference the 
next day, the trial court judge agreed, concluding that PIC had 
waived its right to a jury trial.  The court explained:  
This is a highly-complicated matter.  I haven't been 
able to concentrate on anything else because of this 
issue now this afternoon, but that is neither here nor 
there.  That is an aside, but the point of the matter 
is it's very clear in the scheduling order that if you 
don't pay the jury fee timely[,] which I did not know 
until now, the jury is waived.  Gentlemen, the jury is 
waived.  I'll see you tomorrow morning.  We are trying 
this case to the court. 
¶18 On December 4, 2002, the day of trial, counsel for PIC 
moved the circuit court to enlarge, nunc pro tunc, the time for 
them to pay the jury fee.  In support of this request, counsel 
offered the testimony of Attorney Donald Peterson, whose firm 
was previously responsible for PIC's representation.  Attorney 
Peterson explained that he became ill with kidney cancer in late 
August 2001, continued to do some work, but "stopped going into 
the office."  He indicated that the file was shuffled between 
him and another attorney and that, as a result, the jury fee was 
not timely paid.   
¶19 Despite this proffered argument of excusable neglect, 
the circuit court denied defense counsel's motion to enlarge the 
time and ordered the case to be tried to the court.  The circuit 
No. 
2003AP580   
 
9 
 
court noted the complexity of the case and observed that there 
were several pending motions in limine.  It appeared concerned 
that the case may not be able to be tried in the allotted time, 
requiring further delay.  The court stated: 
Well, you know, I suppose the argument goes that I 
could extend the time for the jury and I guess that is 
the argument that is made, but there is [sic] a huge 
number of issues in this case, okay, and a lot of 
issues about what evidence ought to be before the 
trier of fact and what won't go before the trier of 
fact, many of which, the majority of which, as a 
matter of fact, have been raised by the defense and 
Dr. 
Lindemann 
which 
have 
complicated 
this 
case 
tremendously, and in my opinion, it's not a suitable 
place for me to exercise my discretion for those 
reasons.  That is largely it.  It's a situation of the 
defense's making my position.  This is a time of year 
it's going to be very difficult to get this case in as 
it is before the Christmas break and, you know, given 
the complications that have come up in the case 
because of claims of - requests by the defense for 
motions in limine, requests by the plaintiffs for 
motions in limine, additional discovery and all of 
this, these are things the court can handle in a court 
trial a lot more simply and keep the case moving so we 
get these parties their day in court, and I - sorry, 
but we are going to try this case to the court, folks. 
¶20 During the course of the eight-day trial, the circuit 
court ordered the production of a letter from Dr. Dennis 
Worthington, the chairman of the Section of Maternal Fetal 
Medicine at St. Joseph's Hospital, to Dr. Dwight Cruikshank, the 
chairman of the Department of Obstetrics and Gynecology at the 
Medical College of Wisconsin.  In the letter, Dr. Worthington 
complained that Dr. Lindemann had "failed in a number of areas" 
in connection with his treatment of Marlene.   
No. 
2003AP580   
 
10 
 
¶21 At the completion of trial, the circuit court found 
that Dr. Lindemann negligently caused Adam's death.  In its 
decision, the circuit court determined Dr. Lindemann to be 
causally negligent in his care and treatment under both the 
standard of care applicable to a first-year resident and the 
standard of care of a physician treating an obstetrical patient.  
It then apportioned 80% of the causal negligence to Dr. 
Lindemann and 20% to St. Joseph's Hospital.  Gregory and Marlene 
were awarded $901,015, while their children Caroline and Kyle 
Phelps were each awarded $45,000.6  PIC appealed. 
¶22 The court of appeals reversed and remanded for a jury 
trial, concluding that the circuit court had failed to apply the 
proper analysis with regard to the late payment of the jury fee, 
and that the defense counsel's late payment was caused by 
excusable neglect.  Phelps v. Physicians Ins. Co., 2004 WI App 
91, ¶¶12-13, 273 Wis. 2d 667, 681 N.W.2d 571.  The court of 
appeals also held that as a first-year resident, Dr. Lindemann 
was not a licensed physician and should have been held to the 
standard of care "applicable to his class."  Id., ¶25. 
¶23 In addressing Dr. Worthington's letter concerning Dr. 
Lindemann's care of Marlene, the court of appeals determined 
that Dr. Lindemann was a "health care provider" for purposes of 
Wis. Stat. § 146.38 and set forth factual inquiries to be made 
                                                 
6 We do not address whether these damages are affected by 
our recent decisions in Pierce v. Physicians Insurance Co. of 
Wisconsin, Inc., 2005 WI 14, 278 Wis. 2d 82, 692 N.W.2d 558, and 
Maurin v. Hall, 2004 WI 129, 276 Wis. 2d 18, 688 N.W.2d 655.  
Such issues were not briefed or argued by the parties. 
No. 
2003AP580   
 
11 
 
on remand for determining the applicability of the privilege.  
Id., ¶¶36, 40.  Finally, the court of appeals ruled that the cap 
on noneconomic damages imposed by Wis. Stat. § 893.55(4)(b) did 
not apply to Dr. Lindemann.  Id., ¶47.  Both the Phelpses and 
PIC petitioned this court for review.   
II 
¶24 This case presents us with several issues.  Initially, 
we must determine whether PIC waived its right to a jury trial 
by failing to timely pay the jury fee, and if so, whether the 
circuit court properly exercised its discretion when it denied 
PIC's request to enlarge the time on the basis of excusable 
neglect.  The decision to forgive late payment of a jury fee is 
within the circuit court's discretion.  Chitwood v. A.O. Smith 
Harvestore Prods., Inc., 170 Wis. 2d 622, 628, 489 N.W.2d 697 
(Ct. App. 1992).  Accordingly, we review the decision of the 
circuit court to determine if it erroneously exercised its 
discretion. 
¶25 Additionally, we must address the proper standard of 
care for Dr. Lindemann, a then unlicensed first-year medical 
resident. 
 This presents 
a 
question 
of 
law 
subject to 
independent appellate review.  See Taft v. Derricks, 2000 WI App 
103, ¶10, 235 Wis. 2d 22, 613 N.W.2d 190.  Finally, we must 
resolve the applicability of two statutes to this case:  the 
health care services review privilege found in Wis. Stat. 
§ 146.38, and the cap on noneconomic damages imposed by Wis. 
Stat. § 893.55(4)(b).  The interpretation and application of 
these statutes also present questions of law subject to 
No. 
2003AP580   
 
12 
 
independent appellate review.  Dunn County v. Judy K., 2002 WI 
87, ¶13, 254 Wis. 2d 383, 647 N.W.2d 799 (citing Waukesha County 
v. Steven H., 2000 WI 28, ¶16, 233 Wis. 2d 344, 607 N.W.2d 607). 
III 
 
¶26 We turn first to the issue of whether PIC waived its 
right to a jury trial by failing to timely pay the jury fee, 
and, if so, whether the circuit court properly exercised its 
discretion when it denied PIC's motion to enlarge the time on 
the basis of excusable neglect.  PIC submits that the answer to 
both of these questions is "no."  It maintains that late payment 
of a jury fee is not a basis for finding waiver of the right to 
trial by jury.  Additionally, it asserts that the circuit court 
erroneously exercised its discretion by denying its motion to 
extend the time for paying the jury fee.  As such, PIC asks that 
we uphold the decision of the court of appeals to reverse and 
remand for a new jury trial. 
 
¶27 The Phelpses counter that PIC waived its right to a 
jury trial by failing to timely pay the jury fee as required by 
the scheduling order and local rule.  They also contend that the 
court of appeals erred in finding excusable neglect that 
warranted granting PIC's request the morning of trial to enlarge 
the time to pay the jury fee.  According to the Phelpses, the 
evidence in the record supports affirming the decision of the 
circuit court to waive the jury trial and proceed with a bench 
trial instead. 
 
¶28 Article I, Section 5 of the Wisconsin Constitution 
provides that "the right of trial by jury shall remain 
No. 
2003AP580   
 
13 
 
inviolate."7  However, that same section makes clear that "a jury 
may be waived by the parties in all cases in the manner 
prescribed by law."  Wis. Const. art. I, § 5.  Wisconsin Stat. 
§§ 805.01(3) and 814.61 are but two examples of how waiver may 
be effectuated.  Wisconsin Stat. § 805.01(3) provides: 
Waiver.  The failure of a party to demand in 
accordance with sub. (2) a trial in the mode to which 
entitled constitutes a waiver of trial in such mode.  
The right to trial by jury is also waived if the 
parties or their attorneys of record, by written 
stipulation filed with the court or by an oral 
stipulation made in open court and entered in the 
record, consent to trial by the court sitting without 
a jury.  A demand for trial by jury made as herein 
provided may not be withdrawn without the consent of 
the parties. 
 
¶29 Meanwhile, Wis. Stat. § 814.61(4), the provision more 
relevant to this case, states: 
Jury fee.  For a jury in all civil actions . . . a 
nonrefundable fee of $6 per juror demanded to hear the 
case to be paid by the party demanding a jury within 
the time permitted to demand a jury trial.  If the 
jury fee is not paid, no jury may be called in the 
action, and the action may be tried to the court 
without a jury. 
(Emphasis added.) 
¶30 From the language of Wis. Stat. § 814.61(4), it is 
evident that the failure to pay a jury fee is a basis for 
finding waiver of the right to trial by jury.  Because the venue 
                                                 
7 The right of trial by jury is also codified by Wis. Stat. 
§ 805.01.  It reads:  "The right of trial by jury as declared in 
article I, section 5 of the constitution or as given by a 
statute and the right of trial by the court shall be preserved 
to the parties inviolate." 
No. 
2003AP580   
 
14 
 
of this case is Milwaukee County, the time permitted to pay the 
jury fee is dictated by the court's scheduling order and local 
court rules.  Here, paragraph 9 of the court's scheduling order 
provides that "[j]ury fees must be paid in accordance with Local 
Rule #371 on or before 9-1-01 or the jury shall be deemed 
waived."  Milwaukee County Circuit Court Local Rule 371 states 
that if a party requesting a jury fails to timely pay the fee:  
"[I]t shall constitute a waiver of the right of jury trial and 
consent by all parties to a trial to the court sitting without a 
jury." 
¶31 This court has previously recognized that a reasonable 
jury fee does not violate the right of trial by jury as 
guaranteed by the Wisconsin Constitution.  State v. Graf, 72 
Wis. 2d 179, 185, 240 N.W.2d 387 (1976).  In Graf, we confronted 
the issue in the context of a civil traffic forfeiture action.  
We noted that, "[j]ury fees have been rather uniformly found to 
be compatible with a right to a jury trial."  Id. (citing Annot. 
32 A.L.R. 865).  Furthermore, we quoted the following language 
as providing a rationale for such fees: 
"The Constitution does not guarantee to the citizen 
the right to litigate without expense, but simply 
protects 
him 
from 
imposition 
of 
such 
terms 
as 
unreasonably and injuriously interfere with his right 
to 
a 
remedy 
in 
the 
law, 
or 
impede 
the 
due 
administration of justice." 
Id. 
(quoting 
Adams 
v. 
Corriston, 
7 
Minn. 
456 
(1862)).  
Accordingly, we held that "prepayment of jury fees and other 
costs as a condition for a jury trial . . . was not a violation 
No. 
2003AP580   
 
15 
 
of the Wisconsin Constitution's preservation of the right to a 
jury trial."  Id. at 188. 
¶32 Any further concern PIC may have regarding the timing 
requirement of the jury fee is foreclosed by the case of State 
ex rel. Prentice v. County Court, 70 Wis. 2d 230, 234 N.W.2d 283 
(1975).  There, a motorist filed her demand for a jury trial 
with payment of jury fee one day outside the applicable 
timetable.  As a result, the court set the matter for bench 
trial.  The motorist argued, among other things, that denial of 
a jury trial deprived her of a basic constitutional right.  This 
court disagreed, reasoning that "while a defendant has a right 
to trial by jury in a civil case, he has no vested right under 
art. I, sec. 5, to the manner or time in which that right may be 
exercised or waived, since these are merely procedural matters 
to be determined by law."  Id. at 240.  This holding is 
dispositive in the present case, resulting in waiver of PIC's 
right to a jury trial.   
¶33 Thus, 
the 
relevant 
question 
becomes 
whether the 
circuit court properly exercised its discretion when it denied 
PIC's motion to enlarge the time on the basis of excusable 
neglect.  We have described excusable neglect as "'that neglect 
which might have been the act of a reasonably prudent person 
under the same circumstances.'  It is 'not synonymous with 
neglect, carelessness or inattentiveness.'"  Hedtcke v. Sentry 
Ins. Co., 109 Wis. 2d 461, 468, 326 N.W.2d 727 (1982) (quoting 
Giese v. Giese, 43 Wis. 2d 456, 461, 168 N.W.2d 832 (1969)).  
When analyzing this standard, we may undertake our own review of 
No. 
2003AP580   
 
16 
 
the record to determine whether it "provide[s] support for the 
circuit court's decision."  Id. at 471. 
¶34 In the present case, the circuit court admittedly did 
not apply the excusable neglect standard when confronted with 
PIC's request the day of trial for an enlargement of time.  
Instead, it recognized that there were "a lot of issues about 
what evidence ought to be before the trier of fact and what 
won't go before the trier of fact."  The court observed that 
"the majority of [the issues]" were "raised by the defense and 
Dr. 
Lindemann 
which 
have 
complicated 
this 
case 
tremendously . . . ."8  The court appeared concerned about 
getting the "parties their day in court" and not having to 
reschedule the case.9  It noted that because of the many 
complications raised, including motions in limine by both sides 
together with a request for additional discovery, that it would 
be difficult, even as a trial to the court, to get this case 
completed in the allotted time. 
                                                 
8 In its opinion, the court of appeals cautioned that the 
fact a case might be easier to resolve without a jury trial does 
not trump the constitutional guarantee to one.  Phelps, 273 
Wis. 2d 667, ¶14 (citing Fabrikant v. Bache & Co., 609 F.2d 411, 
419-432 (9th Cir. 1979) (there is no complexity-exception to the 
Seventh Amendment to the United States Constitution), cert. 
denied sub nom.)  Although we are mindful of this concern, we 
conclude that there is sufficient evidence to sustain the 
circuit court's ruling. 
9 The record indicates that the case was initially scheduled 
for trial on September 16, 2002.  Subsequently, it was 
rescheduled for trial on December 4, 2002.   
No. 
2003AP580   
 
17 
 
 
¶35 Although the circuit court did not apply the proper 
legal standard, we are satisfied that the record supports its 
decision to deny PIC's request for a motion to enlarge time.  
The reason for this largely stems from PIC's actions, or lack 
thereof, after mailing in its late payment.  At that time, PIC 
had the option to be forthright, notify the circuit court and 
opposing counsel about the problem, and move for an enlargement 
of time to pay the jury fee.  It chose none of these options.  
Indeed, 15 months passed by before the issue was raised.  Even 
then, it was not raised by PIC but rather by opposing counsel.  
We view these facts as fatal to PIC's claim. 
¶36 On this matter, Hedtcke is instructive.  There, this 
court made clear that, "an enlargement of time will be allowed 
after the time has run only when the initial failure to do the 
act was the result of excusable neglect and there has been no 
inexcusable delay in moving for enlargement."  Hedtcke, 109 
Wis. 2d at 469-70 n.3 (emphasis added).  Although Attorney 
Peterson's illness may have accounted for the initial failure to 
pay the fee,10 it cannot justify the subsequent delay in moving 
for an enlargement of time.  See also Millis v. Raye, 16 
                                                 
10 The Phelpses dispute this, noting that a review of 
Attorney Peterson's work-related activities in the summer and 
fall of 2001 reveals that he attended the deposition of 
Marlene's treating obstetrician the day after the jury fee was 
due.  In support of this argument, the Phelpses filed a motion 
to supplement the record with a series of correspondence 
purporting to answer whether Attorney Peterson was indeed in the 
office on the dates that he claimed.  Because we do not resolve 
the first issue on this basis, we now deny that motion. 
No. 
2003AP580   
 
18 
 
Wis. 2d 79, 83, 113 N.W.2d 820 (1962) (counsel's failure to move 
for an enlargement of time until 14 weeks after a deadline 
passed is not excusable neglect).  As a result, we uphold the 
circuit court's decision to deny PIC's motion for enlargement of 
time. 
IV 
 
¶37 The next issue we must address is the proper standard 
of care for Dr. Lindemann, a then unlicensed first-year 
resident.  PIC maintains that Dr. Lindemann should have been 
held to the standard of care applicable to an unlicensed first-
year resident.  The Phelpses, on the other hand, assert that the 
standard of care should be that of an average, fully licensed 
physician who provides obstetrical care. 
 
¶38 A leading case in Wisconsin regarding the standard of 
care for physicians is Johnson v. Agoncillo, 183 Wis. 2d 143, 
515 N.W.2d 508 (Ct. App. 1994).  There, Dr. Agoncillo, a family 
practitioner with a general medical practice, undertook to treat 
a high-risk obstetrical patient.  The child was born early and 
suffered complications stemming from his prematurity.  The 
Johnsons alleged that Dr. Agoncillo was negligent because he did 
not fulfill the standard of care applicable to physicians who 
specialize 
in 
treating 
high-risk 
obstetrical 
patients.  
Accordingly, they argued that the circuit court erred by not 
instructing the jury that Dr. Agoncillo should be held to the 
standard of care applicable to those specialists. 
 
¶39 The court of appeals rejected the Johnsons' claim.  In 
doing so, it explained that the fact "that Dr. Agoncillo chose 
No. 
2003AP580   
 
19 
 
to care for and treat Ms. Johnson during her high-risk pregnancy 
did not transform his 'class' of physician to that of those who 
treat high-risk obstetrical patients."  Id. at 152.  As a 
result, the court of appeals concluded that Dr. Agoncillo "was 
and he remained a general family practitioner who treated 
obstetrical patients and, as instructed by the trial court, he 
was thus 'required to use the degree of care, skill, and 
judgment which is usually exercised in the same or similar 
circumstances' by the average physician in that class."  Id.   
 
¶40 The pattern jury instructions on medical negligence 
reflect the two competing standards of care at issue in Johnson:  
one for general physicians and one for specialists.  Wis JI——
Civil 1023 provides in relevant part:  
In (treating) (diagnosing) (plaintiff)'s (injuries) 
(condition), (doctor) was required to use the degree 
of care, skill, and judgment which reasonable (doctors 
who are in the general practice) [or] (specialists who 
practice the specialty which (doctor) practices) would 
exercise in the same or similar circumstances, having 
due regard for the state of medical science at the 
time (plaintiff) was (treated) (diagnosed).  A doctor 
who fails to conform to this standard is negligent.  
The burden is on (plaintiff) to prove that (doctor) 
was negligent. 
 
¶41 The problem, of course, with Johnson and Wis JI——Civil 
1023 is that both ignore the unique status of an unlicensed 
first-year resident.11  As an unlicensed first-year resident, Dr. 
                                                 
11 Although they are graduates of medical school, first-year 
residents are unlicensed to practice medicine.  The reason for 
this is that Wis. Stat. § 448.05(2) requires an additional 
"postgraduate training of 12 months" before issuance of a 
license.  
No. 
2003AP580   
 
20 
 
Lindemann's authority was limited.  Although he could refer to 
himself as an "M.D.," his freedom of action was more restricted 
than that of a licensed physician.  Indeed, the circuit court 
found that Dr. Lindemann "had no authority or privileges to 
provide primary obstetrical care," and "was not supposed to act 
as the primary attending physician."  Rather, "[h]is primary 
duty was to assess and report findings and differential 
diagnoses to an upper level senior resident or to the attending 
obstetrician." 
 
¶42 This court has not previously addressed the peculiar 
status of unlicensed first-year residents in the context of 
medical malpractice.  Only a few states have addressed the 
question of whether first-year residents should be held to the 
same standard of care as licensed physicians, and the results 
appear somewhat mixed.  Compare, e.g., Rush v. Akron Gen. Hosp., 
171 N.E.2d 378, 381 (Ohio Ct. App. 1957) ("[w]hat is required in 
the case of an [unlicensed] intern is that he shall possess such 
skill and use such care and diligence in the handling of 
emergency cases as capable medical college graduates serving 
hospitals 
as 
interns 
ordinarily 
possess 
under 
similar 
circumstances . . . .") with Centman v. Cobb, 581 N.E.2d 1286, 
1288 (Ind. Ct. App. 1991) ("[w]e conclude that such [a first-
year resident] is a practitioner of medicine required to 
exercise the same standard of skill as a physician with an 
unlimited license to practice medicine.").   
¶43 Answering 
this 
question 
now, 
we 
determine 
that 
physicians like Dr. Lindemann should be held to the standard of 
No. 
2003AP580   
 
21 
 
care applicable to an unlicensed first-year resident based on 
the 
unique 
restrictions 
described 
above.12 
 
Although 
we 
anticipate this new standard of care to be lower than that of an 
average licensed physician in some cases, we do not expect that 
it will become a grant of immunity.  After all, unlicensed 
first-year residents are graduates of a medical school who 
provide sophisticated health care services appropriate to their 
"in training" status.  Therefore, unlicensed residents could 
still be found negligent if, for example, they undertook to 
treat outside the scope of their authority and expertise, or 
they failed to consult with someone more skilled and experienced 
when the standard of care required it. 
¶44 In the present case, the circuit court found Dr. 
Lindemann to be causally negligent under both standards of care.  
That is, it found him to be negligent under the standard 
applicable to a first-year resident as well as under the 
standard 
applicable 
to 
an 
average 
physician 
treating 
an 
obstetrical patient.13  The circuit court then apportioned 80% of 
the causal negligence to Dr. Lindemann and 20% to St. Joseph's 
Hospital.  The court of appeals questioned this conclusion, 
                                                 
12 Thus, our decision should not be read as an open 
invitation to further nuance the basic classifications of 
general practitioner and specialist.  Although we establish a 
separate standard for an unlicensed physician, we do not intend 
separate standards for licensed "in training" physicians. 
13 Contrary to the assertion of PIC, there was an effort 
made to prove that Dr. Lindemann met the lower standard of care.  
Indeed, PIC's own experts, Drs. Broekhuizen and Clark, addressed 
the matter.   
No. 
2003AP580   
 
22 
 
noting that the percentages of comparative negligence allocated 
to Dr. Lindemann and St. Joseph's presumably may be influenced 
by a change in the standards by which their relative conduct was 
measured.  Phelps, 273 Wis. 2d 667, ¶23. 
¶45 The apportionment of comparative negligence is a 
matter left to the trier of fact.  Voight v. Riesterer, 187 
Wis. 2d 459, 467, 523 N.W.2d 133 (Ct. App. 1994).  Where more 
than one reasonable inference can be drawn from the evidence, 
appellate courts will accept the inference drawn by the trier of 
fact.  Id. (citing Brain v. Mann, 129 Wis. 2d 447, 452, 385 
N.W.2d 227 (Ct. App. 1986)).  Appellate courts will sustain the 
apportionment of comparative negligence unless the circuit 
court's determination was clearly erroneous.  Id. (citing Wis. 
Stat. § 805.17(2)).  Examining the record in the present case, 
we are satisfied that the circuit court's exercise of discretion 
was not clearly erroneous. 
¶46 Here, 
the 
circuit 
court's 
factual 
findings 
and 
conclusions of law specifically delineate the ways in which Dr. 
Lindemann violated both standards of care.14  From these findings 
and conclusions emerge two primary faults that are equally 
applicable 
to 
unlicensed 
first-year 
residents 
and average 
physicians treating an obstetrical patient:  (1) the failure to 
consult with another physician, whether an upper level resident 
or an attending obstetrician; and (2) the failure to move 
                                                 
14 To the extent the circuit court erred in applying the 
standard of care applicable to an average physician treating an 
obstetrical patient, we deem that error harmless. 
No. 
2003AP580   
 
23 
 
Marlene to the Labor and Delivery section of the hospital.  The 
court's decision states in relevant part: 
• At 4:15 a.m. "The standard of care applicable to 
a first year resident and the standard determined 
by this court in its letter decision [of an 
average 
physician 
treating 
an 
obstetrical 
patient], required the patient to be moved to 
Labor and Delivery and the attending physician or 
the staff physician to be contacted to assess the 
patient." 
• At 6:00 a.m., "The standard of care required Dr. 
Lindemann 
to 
notify 
an 
upper 
level 
senior 
resident or the attending obstetrician and move 
Marlene Phelps to the Labor and Delivery section 
for closer monitoring by labor and delivery 
nurses and the staff or attending obstetrician." 
• That the defendant, Dr. Matthew Lindemann was 
negligent in his care and treatment of Marlene 
Phelps and Adam Phelps under both the standard of 
care applicable to a first year resident and the 
standard determined to be applicable by this 
court in its decision dated November 27, 2002. 
¶47  Thus, as applied to the facts of this case, the 
competing standards of care were not as disparate as the court 
of appeals surmised.  A review of the record indicates that the 
circuit court found Dr. Lindemann negligent under either 
standard, and that his negligent conduct was essentially the 
same:  (1) the failure to consult with another physician; and 
(2) the failure to move Marlene to the Labor and Delivery 
section of the hospital.  Given these findings, we are not 
persuaded 
that 
the 
percentages 
of 
comparative 
negligence 
allocated to Dr. Lindemann for his actions and St. Joseph's 
Hospital for the implementation of its residency program would 
No. 
2003AP580   
 
24 
 
be influenced by a change in the standards by which their 
relative conduct was measured.  Accordingly, we conclude that 
the circuit court's exercise of discretion was not clearly 
erroneous.  
V 
 
¶48 We turn next to the applicability of the health care 
services review privilege found in Wis. Stat. § 146.38.  This 
issue stems from a letter written by Dr. Worthington to Dr. 
Cruikshank regarding Dr. Lindemann's actions on November 24, 
1998.  In the letter, Dr. Worthington complained that Dr. 
Lindemann had "failed in a number of areas," which he specified, 
in connection with his treatment of Marlene.  PIC claims that 
the letter was protected from disclosure by Wis. Stat. § 146.38.  
The Phelpses, by contrast, argue that the privilege does not 
apply. 
 
¶49 Wisconsin Stat. § 146.38(1m) provides, with exceptions 
not material here, that "[n]o person who participates in the 
review or evaluation of the services of health care providers 
. . . may disclose any information acquired in connection with 
such review or evaluation."  Wis. Stat. § 146.38(2) addresses 
several distinct categories of materials created by the statute 
and the applicability of the privilege to each one:   
All 
organizations 
or 
evaluators 
reviewing 
or 
evaluating the services of health care providers shall 
keep a record of their investigations, inquiries, 
proceedings and conclusions.  No such record may be 
released to any person under s. 804.10(4) or otherwise 
except as provided in sub. (3).  No such record may be 
used in any civil action for personal injuries against 
No. 
2003AP580   
 
25 
 
the 
health 
care 
provider 
or 
facility; 
however, 
information, documents or records presented during the 
review or evaluation may not be construed as immune 
from discovery under s. 804.10(4) or use in any civil 
action merely because they were so presented. Any 
person who testifies during or participates in the 
review or evaluation may testify in any civil action 
as to matters within his or her knowledge, but may not 
testify as to information obtained through his or her 
participation in the review or evaluation, nor as to 
any conclusion of such review or evaluation. 
¶50 The purpose of the health care services privilege is 
to "'protect the confidentiality of the peer review process, in 
the hope that confidentiality would encourage free and open 
discussion, among physicians knowledgeable in an area, of the 
quality of treatment rendered by other physicians.'"  Braverman 
v. Columbia Hospital, 
Inc., 
2001 
WI 
App 
106, 
¶14, 244 
Wis. 2d 98, 629 N.W.2d 66 (quoting State ex rel. Good Samaritan 
v. Moroney, 123 Wis. 2d 89, 98, 365 N.W.2d 887 (Ct. App. 1985)).  
The peer review contemplated by the statute is designed to aid 
physicians on the hospital staff in maintaining and improving 
the quality of their work.  Id. (citing Moroney, 123 Wis. 2d at 
98). 
 
¶51  In analyzing this issue, the first question posed is 
whether Dr. Lindemann is a "health care provider," so that Dr. 
Worthington's letter might qualify as a "review or evaluation" 
of Dr. Lindemann's "services" in connection with treatment of 
Marlene.  The term "health care provider" is not defined in the 
statute for the health care services review privilege.  However, 
by virtue of § 146.38(1)(b), it "includes an ambulance service 
provider, as defined in s. 146.50(1)(c), an emergency medical 
No. 
2003AP580   
 
26 
 
technician, 
as 
defined 
in 
s. 
146.50(1)(e), 
and 
a 
first 
responder, as defined in s. 146.50(1)(hm)."  Significantly, none 
of these three categories would qualify as "health care 
providers" under the more limited definition found in Wis. Stat. 
ch. 655, which governs medical malpractice claims against health 
care providers.15 
 
¶52 Although it appears that the definition of "health 
care provider" under Wis. Stat. § 146.38(1m) is more expansive 
than the definition of "health care provider" under Wis. Stat. 
ch. 655, we need not definitely resolve the question.  Instead, 
we determine that even if Dr. Lindemann is a "health care 
provider" under Wis. Stat. § 146.38(1m), the peer review 
privilege here does not apply because the letter was not part of 
the peer review evaluation process. 
 
¶53 The parties dispute whether the information in Dr. 
Worthington's letter was "acquired in connection with such 
review or evaluation."  In addressing this matter, we note that 
the party asserting the health care services review privilege 
bears the burden of establishing two conditions.  First, the 
investigation must be part of a program organized and operated 
to improve the quality of health care at the hospital.  Mallon 
                                                 
15 Wisconsin Stat. §§ 655.001(8) and 655.002(1)(a) together 
define "health care provider," as relevant here, as "[a] 
physician."  As we have seen, a "physician" is, as relevant 
here, "a medical . . . physician licensed under ch. 448."  Wis. 
Stat. § 655.001(10m).  Because Dr. Lindemann was not yet 
licensed when he treated Marlene, he was not a "health care 
provider" under Wis. Stat. ch. 655. 
No. 
2003AP580   
 
27 
 
v. Campbell, 178 Wis. 2d 278, 287, 504 N.W.2d 357 (Ct. App. 
1993).  Second, the person conducting the investigation must be 
acting on behalf of, or as part of a group with relatively 
constant 
membership, 
officers, 
a 
purpose 
and 
a 
set 
of 
regulations.  Id.   
 
¶54 We conclude that PIC cannot meet its burden.  Here, 
the testimony of Patricia Kaldor, the vice-president in charge 
of patient services at St. Joseph's Hospital, established that 
any investigation conducted of Dr. Lindemann was initiated by 
the hospital.  Moreover, Dr. Worthington confirmed that the 
hospital's peer review committee was not convened to review Dr. 
Lindemann's 
case.16 
 
Thus, 
we 
are 
satisfied 
that 
the 
investigation of Dr. Lindemann was initiated to report a problem 
to Dr. Cruikshank, the supervisor of the residency program in 
which Dr. Lindemann was enrolled, and not to improve the quality 
of health care at the hospital.  Accordingly, we determine that 
Wis. Stat. § 146.38 does not apply to this case. 
VI 
 
¶55 Finally, we consider the applicability of the cap on 
noneconomic damages imposed by Wis. Stat. § 893.55(4)(b).  PIC 
argues that the damage limitations provided in Wis. Stat. 
§ 893.55(4) apply to unlicensed first-year medical residents.  
Meanwhile, the Phelpses contend that the damage limitations do 
                                                 
16 This fact is significant as Wis. Stat. § 146.38 is 
generally referred to as the "peer review" statute.   
No. 
2003AP580   
 
28 
 
not apply to unlicensed first-year residents who are not covered 
by Wis. Stat. ch. 655. 
 
¶56 Wisconsin Stat. § 893.55 has two parts.  Subsections 
(1)-(3) set forth the statutes of limitations for actions to 
recover damages for injury arising from treatment by a health 
care provider: 
(1) Except as provided by subs. (2) and (3), an action 
to recover damages for injury arising from any 
treatment or operation performed by, or from any 
omission by, a person who is a health care provider, 
regardless of the theory on which the action is based, 
shall be commenced within the later of: 
(a) Three years from the date of the injury, or 
(b) One year from the date the injury was discovered 
or, in the exercise of reasonable diligence should 
have been discovered, except that an action may not be 
commenced under this paragraph more than 5 years from 
the date of the act or omission. 
(2) If a health care provider conceals from a patient 
a prior act or omission of the provider which has 
resulted in injury to the patient, an action shall be 
commenced within one year from the date the patient 
discovers the concealment or, in the exercise of 
reasonable 
diligence, 
should 
have 
discovered 
the 
concealment or within the time limitation provided by 
sub. (1), whichever is later. 
(3) When a foreign object which has no therapeutic or 
diagnostic purpose or effect has been left in a 
patient's body, an action shall be commenced within 
one year after the patient is aware or, in the 
exercise of reasonable care, should have been aware of 
the presence of the object or within the time provided 
by sub. (1), whichever is later. 
(Emphasis added.) 
No. 
2003AP580   
 
29 
 
 
¶57 Subsections (4)-(5), 
by contrast, 
set 
forth the 
procedure for implementing the noneconomic damage cap in Wis. 
Stat. ch. 655. 
(4)(a) In this subsection, "noneconomic damages" means 
moneys intended to compensate for pain and suffering; 
humiliation; embarrassment; worry; mental distress; 
noneconomic effects of disability including loss of 
enjoyment of the normal activities, benefits and 
pleasures of life and loss of mental or physical 
health, well-being or 
bodily 
functions; 
loss of 
consortium, society and companionship; or loss of love 
and affection. 
(b) The total noneconomic damages recoverable for 
bodily injury or death, including any action or 
proceeding based on contribution or indemnification, 
may not exceed the limit under par. (d) for each 
occurrence on or after May 25, 1995, from all health 
care providers and all employees of health care 
providers acting within the scope of their employment 
and providing health care services who are found 
negligent and from the patients compensation fund. 
(c) A court in an action tried without a jury shall 
make a finding as to noneconomic damages without 
regard to the limit under par. (d) . . . 
(d) The limit on total noneconomic damages for each 
occurrence under par. (b) on or after May 25, 1995, 
shall be $350,000 and shall be adjusted by the 
director of state courts . . .  
(e) Economic damages recovered under ch. 655 for 
bodily injury or death, including any action or 
proceeding based on contribution or indemnification, 
shall be determined for the period during which the 
damages are expected to accrue, taking into account 
the estimated life expectancy of the person, then 
reduced to present value, taking into account the 
effects of inflation. 
(f) Notwithstanding the limits on noneconomic damages 
under this subsection, damages recoverable against 
health care providers and an employee of a health care 
provider, acting within the scope of his or her 
No. 
2003AP580   
 
30 
 
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).  
(5) Every award of damages under ch. 655 shall specify 
the sum of money, if any, awarded for each of the 
following for each claimant for the period from the 
date of injury to the date of award and for the period 
after the date of award, without regard to the limit 
under sub. (4) (d) . . .  
(Emphasis added.) 
 
¶58 As noted above, the subdivision at issue is Wis. Stat. 
§ 893.55(4)(b).  Within that subdivision, the parties dispute 
the meaning of the term "health care provider."  The term 
"health care provider" is used elsewhere in Wis. Stat. § 893.55, 
in subsections (1) and (2).  Typically, a term used in multiple 
subsections within a statute is given the same meaning.  General 
Castings Corp. v. Winstead, 156 Wis. 2d 752, 759, 457 N.W.2d 557 
(Ct. App. 1990).  However, as the court of appeals recognized, 
"[t]his is one of those rare instances where it does not."  
Phelps, 273 Wis. 2d 667, ¶42. 
 
¶59 In Clark v. Erdmann, 161 Wis. 2d 428, 468 N.W.2d 18 
(1991), this court considered whether the medical malpractice 
statute of limitations found in Wis. Stat. § 893.55(1) applied 
to podiatrists.  It concluded that it did, reasoning that the 
term "plainly applies to anyone who professionally provides 
health care to others.  Podiatrists do exactly that:  they 
provide health care to others; and, like other professional 
health care providers, they are licensed to practice by the 
No. 
2003AP580   
 
31 
 
state medical examining board pursuant to ch. 448, Stats."  Id. 
at 438-39.  The Clark decision is distinguishable from the 
present case, however, as it addressed Wis. Stat. § 893.55(1) 
dealing with the statute of limitations.  There was no issue 
before it regarding Wis. Stat. ch. 655 or the noneconomic damage 
cap in Wis. Stat. § 893.55(4).   
 
¶60 Since Clark, the court of appeals has extended this 
broad reading of "health care provider" to other health 
professions.  See, e.g., Webb v. Ocularra Holding, Inc., 2000 WI 
App 25, ¶¶8-15, 232 Wis. 2d 495, 501-09, 606 N.W.2d 552 
(optometrists), overruled on other grounds, Paul v. Skemp, 2001 
WI 42, 242 Wis. 2d 507, 625 N.W.2d 860; Arenz v. Bronston, 224 
Wis. 
2d 
507, 
512-15, 
592 
N.W.2d 
295 
(Ct. 
App. 
1999) 
(chiropractors); and Ritt v. Dental Care Associates, 199 Wis. 2d 
48, 60-64, 543 N.W.2d 852, (Ct. App. 1995) (dentists).  Again 
though, these cases considered only the applicability of Wis. 
Stat. § 895.55's statutes of limitation.  None of them held that 
the medical malpractice noneconomic damage cap in Wis. Stat. 
§ 893.55(4) applied to health care providers who are not subject 
to Wis. Stat. ch. 655.   
 
¶61 Relying on the above cases, PIC maintains that Dr. 
Lindemann should also be considered a "health care provider" 
under Wis. Stat. § 893.55, as he professionally provided health 
care to Marlene as an unlicensed first-year resident.  The 
problem with this argument, of course, is that it ignores the 
context in which the term "health care provider" is used.  This 
case does not involve subsections (1)-(3) and the applicable 
No. 
2003AP580   
 
32 
 
statutes of limitations.  Rather, it involves subsections (4)-
(5) and the cap on noneconomic damages.  This is significant, 
for subsections (4)-(5) specifically reference Wis. Stat. ch. 
655 and/or the patients compensation fund.17  Likewise, Wis. 
Stat. § 655.017, which sets forth the cap on noneconomic damages 
in medical malpractice actions, specifically references Wis. 
Stat. § 893.55(4).18 
 
¶62 If we were to accept PIC's argument and hold the cap 
in Wis. Stat. § 893.55(4) applicable to all health care 
providers, regardless of whether they fell outside Wis. Stat. 
ch. 655, troubling questions emerge.  For example, what would 
the purpose of Wis. Stat. § 655.017 be?  PIC's reading of Wis. 
Stat. § 893.55(4) as an independent cap on noneconomic damages 
would appear to render it superfluous.  Moreover, how would 
courts apply Wis. Stat. § 893.55(4)(b), which references the 
                                                 
17 The "patients compensation fund" refers to the Wisconsin 
Patients Compensation Fund established by Wis. Stat. § 655.27.  
18 Wisconsin Stat. § 655.017, entitled "Limitation on 
noneconomic damages," provides:  
The amount of noneconomic damages recoverable by a 
claimant or plaintiff under this chapter for acts or 
omissions of a health care provider if the act or 
omission occurs on or after May 25, 1995, and for acts 
or omissions of an employee of a health care provider, 
acting within the scope of his or her employment and 
providing health care services, for acts or omissions 
occurring on or after May 25, 1995, is subject to the 
limits under s. 893.55(4)(d) and (f). 
(Emphasis added.) 
 
No. 
2003AP580   
 
33 
 
Fund's payment limit, and Wis. Stat. § 893.55(4)(e) and (5), 
which expressly reference damages awarded "under ch. 655"?  
These cannot be applied to a non-chapter 655 case or non-chapter 
655 health care provider.  As a result, these provisions become 
conflicting and meaningless as applied to non-chapter 655 health 
care providers. 
 
¶63 PIC's construction of "health care provider" in Wis. 
Stat. § 893.55 would also lead to absurd results.  See Strenke 
v. Hogner, 2005 WI 25, ¶48, __ Wis. 2d __, 694 N.W.2d 296 ("Laws 
must be interpreted, considering the legal and practical 
consequences, to avoid unreasonable and absurd results.").  The 
history behind the creation of Wis. Stat. ch. 655 in 1975 and 
the noneconomic damage cap in Wis. Stat. §§ 655.017 and 
893.55(4) in 1985 was in response to a perceived medical 
malpractice liability insurance crisis.  Yet, PIC would have us 
give any entity that professionally provides health care 
services (e.g., optometrists, chiropractors, dentists, etc.) the 
benefit of limited liability as well as Fund coverage, despite 
the fact that these entities do not pay into the Fund.  This we 
decline to do.  Such an expansion is best left to the 
legislature. 
 
¶64 In the end, we view the provisions in Wis. Stat. 
§ 893.55 regulating the award of noneconomic damages and Wis. 
Stat. ch. 655 as inextricably intertwined.  Recognizing this 
interplay, the court of appeals observed: "[t]he legislature has 
unambiguously declared that the cap on noneconomic damages in 
WIS. STAT. § 893.55(4)(b) applies only to those who are health-
No. 
2003AP580   
 
34 
 
care providers under WIS. STAT. ch. 655, and to 'employees of 
health care providers' as the phrase is further limited by 
§ 893.55(4)(b)."  Phelps, 273 Wis. 2d 667, ¶45.  We agree with 
this conclusion.  Thus, because Dr. Lindemann was not a "health 
care provider" as the term is defined by Wis. Stat. ch. 655, we 
determine that the cap on noneconomic damages imposed by Wis. 
Stat. § 893.55(4)(b) does not apply.19   
VII 
 
¶65 In sum, we conclude that (1) the cross-petitioners 
waived their right to a jury trial by not timely paying the jury 
fee, and the circuit court properly denied their motion to 
extend time for paying the fee; (2) Dr. Lindemann should be held 
to the standard of care applicable to an unlicensed first-year 
resident; (3) the health care services review privilege found in 
Wis. Stat. § 146.38 does not apply to this case; and (4) the cap 
on noneconomic damages imposed by Wis. Stat. § 893.55(4)(b) does 
not apply to Dr. Lindemann under the facts presented.  However, 
we remand the matter to the circuit court for a determination of 
whether Dr. Lindemann was a "borrowed employee" of St. Joseph's 
Hospital and therefore entitled to the cap protection as an 
"employee" 
of 
a 
health 
care 
provider 
under 
Wis. 
Stat. 
                                                 
19 Like the court of appeals, we are mindful that the 
exclusion from Wis. Stat. ch. 655 of first-year residents is 
somewhat anomalous because they, like licensed physicians, 
provide some health care services to patients.  Phelps, 273 
Wis. 2d 667, ¶47.  However, that is what the statutes provide, 
and the legislature is free to remedy this incongruity if it so 
chooses.  
No. 
2003AP580   
 
35 
 
§ 893.55(4)(b).  Accordingly, we reverse the decision of the 
court of appeals and remand to the circuit court for further 
proceedings.20 
By the Court.—The decision of the court of appeals is 
reversed and the cause is remanded to the circuit court.  
¶66 JON P. WILCOX, J. did not participate. 
 
                                                 
20 During the pendency of the appeal, the petitioners filed 
a motion to strike the brief of amicus curiae Ohio Insurance 
Company.  The motion is denied.   
No.  2003AP580.dtp 
 
1 
 
 
¶67 DAVID T. PROSSER, J.   (concurring in part, dissenting 
in part).  Practically speaking, medical residents "provide 
health care."  Yet the majority concludes that medical residents 
are 
not 
"health 
care 
providers" 
by 
applying 
a 
strict 
interpretation of the definitions in Wis. Stat. ch. 655 to the 
term "health care provider" in Wis. Stat. § 893.55(4)(b). 
¶68 However "anomalous" this determination might be,21 it 
would be tolerable if the majority simultaneously recognized 
that the legislature has for years extended the coverage of 
chapter 
655 
and 
Wis. Stat. § 893.55(4)(c) 
and 
(f) 
to 
an 
"employee of a health care provider," see Wis. Stat. §§ 655.005, 
655.017, and 893.55(4)(b),22 and that Dr. Matthew Lindemann was 
indisputably an "employee" of some health care provider whose 
status would trigger his coverage under the relevant statute.  
Instead, the majority ducks the issue.  The majority remands to 
the circuit court the question whether Dr. Lindemann was a 
"borrowed employee" of St. Joseph's Hospital, majority op., ¶4, 
ignoring the fact that the circuit court has implicitly made two 
previous findings that Dr. Lindemann was not such an employee.23  
The majority's remand, without a word of criticism or guidance, 
                                                 
21 Phelps v. Physicians Ins. Co., 2004 WI App 91, ¶47, 273 
Wis. 2d 667, 681 N.W.2d 571. 
22 All of the provisions of chapter 655, including the 
damage caps, apply to "employees" of health care providers.  See 
Wis. Stat. § 655.005(1). 
23 No one disputes that St. Joseph's Hospital is a health 
care provider.   
No.  2003AP580.dtp 
 
2 
 
is a tacit approval of those two findings, which means that the 
circuit 
court 
is 
likely 
to 
reinstate 
its 
two 
prior 
determinations.   
¶69 The conclusion that a medical resident rendering 
medical care to a hospital's patients within the scope of the 
resident's duties is not an "employee" of the hospital or any 
other applicable "health care provider," and thus is not covered 
by chapter 655 or the Patients Compensation Fund, is more than 
"anomalous."  It defies common sense.   
¶70 Although I agree with some parts of the majority 
opinion——such as the applicable standard of care and the health 
care services review privilege——I write separately largely to 
discuss points of disagreement.   
¶71 My concurrence/dissent is divided into three parts.  
In part I, I reluctantly join the majority's conclusion that the 
circuit court did not erroneously exercise its discretion in 
ruling that the defendants waived the right to a jury trial 
because they did not pay the jury fee on time under the local 
rule.  In this connection, I address two important subtopics: 
(A) The lack of uniformity among local rules on jury fee 
payment, and (B) The circuit court's obfuscation of the 
applicable standard of care, which would not have been permitted 
if there had been a jury trial.  In part II, I dissent from the 
majority's 
decision 
that 
the 
damage 
caps 
in 
Wis. Stat. § 893.55(4) do not apply to medical residents.  In 
part III, I comment on the circuit court's award of damages to 
Gregory Phelps for negligent infliction of emotional distress, 
No.  2003AP580.dtp 
 
3 
 
in light of this court's recent decision in Pierce v. Physicians 
Insurance Co., 2005 WI 14, 278 Wis. 2d 82, 692 N.W.2d 558. 
I 
¶72 I reluctantly agree with the majority's conclusion 
that the circuit judge did not erroneously exercise his 
discretion in holding that the defendants waived their statutory 
right to a jury trial.  Because the circuit court did not employ 
the proper standard of "excusable neglect," this court's 
decision must rest entirely on the facts in the record, and 
specifically the fact that the defendant, more than 15 months 
before trial, paid the jury fee 11 days late.  The defendants 
did not comply with the applicable Milwaukee County Circuit 
Court rule regarding payment of the jury fee and, as a 
consequence, they did not get a jury.  See majority op., ¶¶34-
35.  Our affirmance of the court's ruling sets an extremely high 
bar to reverse excusable neglect determinations in future cases.  
Nonetheless, I would affirm and take this opportunity to discuss 
the disparity among local rules governing the payment of jury 
fees.   
A. 
Local Rules 
 
¶73 Wisconsin Stat. § 805.01 preserves the right to a jury 
trial in civil cases, so long as the right is not waived.  The 
statute makes no mention of the timing of payment of jury fees.  
Accordingly, that detail is left to local rules. 
 
¶74 A circuit court has the authority to "adopt and amend 
rules governing practice in that court," so long as the rules 
No.  2003AP580.dtp 
 
4 
 
are "consistent with rules adopted under s. 751.12[24] and 
statutes 
relating 
to 
pleading, 
practice, 
and 
procedure."  
Wis. Stat. § 753.35.25  Most Wisconsin counties have adopted such 
rules; eleven have not.26  The local rule at issue in this case, 
Milwaukee County Circuit Court Local Rule 371, was presumably 
adopted pursuant to this authority. 
¶75 A circuit court has wide discretion in enforcing local 
rules.  Kustelski v. Taylor, 2003 WI App 194, ¶15, 266 
Wis. 2d 940, 669 N.W.2d 780 (citing Kotecki & Radtke, S.C. v. 
Johnson, 192 Wis. 2d 429, 447, 531 N.W.2d 606 (Ct. App. 1995)).  
However, this discretion is not unlimited.  The local rule may 
not conflict with a state statute.  Geneva Nat'l Cmty. Assoc., 
Inc. v. Friedman, 228 Wis. 2d 572, 586-87 n.8, 598 N.W.2d 600 
(Ct. App. 1999) (citing Cmty. Newspapers, Inc. v. City of West 
Allis, 158 Wis. 2d 28, 32-33, 461 N.W.2d 785 (Ct. App. 1990)).  
Similarly, the local rule may not conflict with the uniform 
judicial administrative rules promulgated by the supreme court.  
SCR 70.34 (1978).  In some cases, local rules may even be 
                                                 
24 "The state supreme court shall, by rules promulgated by 
it from time to time, regulate pleading, practice and procedure 
in judicial proceedings in all courts, for the purposes of 
simplifying the same and of promoting the speedy determination 
of litigation upon its merits. . . ."  Wis. Stat. § 751.12(1). 
25 See 185 Wis. 2d xv (1993) (Wisconsin Supreme Court Order 
creating Wis. Stat. § 753.35). 
26 The following counties have no local rules: Columbia, 
Door, Douglas, Florence, Green Lake, Iron, Langlade, Oconto, 
Pierce, Polk, and Price.  See Wisconsin circuit court rules by 
county, 
available 
at 
http://www.wisbar.org/AM/Template.cfm?Section=Circuit_court_rule
s2 (last visited June 17, 2005). 
No.  2003AP580.dtp 
 
5 
 
preempted by common law doctrines.  Miller Brewing Co. v. DILHR, 
210 Wis. 2d 26, 36, 563 N.W.2d 460 (1997) (citing Local 174, 
Teamsters v. Lucas Flour Co., 369 U.S. 95, 104 (1962)). 
¶76 Amid this array of authority, practitioners must 
remain cognizant of the occasionally significant variation 
between one county's local rules and another's.  For example, in 
Milwaukee, as we have seen in this case, the jury fee must be 
paid within 30 days after the scheduling conference.  Milwaukee 
Cty. Ct. R. 371.  By contrast, in Sheboygan County, the jury fee 
must be paid at or before the scheduling conference.  Sheboygan 
Cty. Ct. R. 206.  In Waukesha County, the fee must be paid at or 
before the pre-trial conference.  Waukesha Cty. Ct. R. 6.1.  In 
Marinette County, the jury fee is payable at or before the 
scheduling or pre-trial conference, whichever comes first.  
Marinette Cty. Ct. R. 207.  Many other local rules do not 
reference any timetable for payment of the jury fee, apparently 
leaving such decisions entirely up to the discretion of 
individual circuit judges.   
¶77 When numerous circuit courts create local rules to 
augment a statewide rule, it is nearly inevitable that the local 
rules will conflict with each other.  For example, prior to 
1992, Wis. Stat. § 802.08(2) ("Summary judgment") read in part: 
"The [summary judgment] motion shall be served at least 20 days 
before the time fixed for the hearing.  The adverse party prior 
to the day of hearing may serve opposing affidavits."  In 
practice, this rule proved to be unfair because the nonmovant 
could serve opposing affidavits the day before the hearing, 
No.  2003AP580.dtp 
 
6 
 
giving minimal notice and opportunity for the court and the 
movant to prepare.  Because of this, "a plethora of local court 
rules resulted." Judicial Council Note, 1992, § 802.08, Stats. 
(citing Cmty. Newspapers, 158 Wis. 2d [at 32 n.3]).  To provide 
a statewide remedy, this court acted by amending the rule to its 
current form: "Unless earlier times are specified in the 
scheduling order, the [summary judgment] motion shall be served 
at least 20 days before the time fixed for the hearing, and the 
adverse party shall serve opposing affidavits, if any, at least 
5 
days 
before 
the 
time 
fixed 
for 
the 
hearing."  
Wis. Stat. § 802.08(2).27  The court made the change to "preclude 
such local rules and promote uniformity of practice."  Judicial 
Council Note, 1992, § 802.08, Stats. 
¶78 In 
my 
view, 
similar 
action 
is 
warranted 
here.  
Although the exact time set for payment of the jury fee may not 
be important, some reasonable "uniformity of practice" is.  The 
court should consider a uniform rule to avoid allowing local 
rules governing payment of the jury fee to become a snare, 
trapping unwary litigants and depriving them of the right to a 
jury trial.   
¶79 In this case, the jury trial fee was paid 11 days late 
but more than 15 months before trial.  Although such minimal 
delay did not appear to prejudice any party's preparation for 
trial, the circuit court chose not to retroactively extend the 
time for filing.  Appellate courts will normally uphold the 
                                                 
27 See 168 Wis. 2d xxi (1992) (Wisconsin Supreme Court Order 
amending Wis. Stat. § (Rule) 802.08(2)). 
No.  2003AP580.dtp 
 
7 
 
circuit court's ruling in the enforcement of local rules.  See 
Kolupar v. Wilde Pontiac Cadillac, Inc., 2004 WI 112, ¶31, 275 
Wis. 2d 1, 
683 
N.W.2d 58. 
 
I 
reluctantly 
concur 
in 
the 
majority's decision to do so in this case. 
B. 
Standard of Care 
¶80 In any negligence case, the plaintiff must prove that 
the defendant breached a duty of care to the plaintiff.  See, 
e.g., Morden v. Cont’l AG, 2000 WI 51, ¶45, 235 Wis. 2d 325, 611 
N.W.2d 659.  In a medical malpractice case, the plaintiff must 
provide expert testimony to establish the defendant’s breach of 
the appropriate standard.  Olfe v. Gordon, 93 Wis. 2d 173, 180, 
286 N.W.2d 573 (1980).28   
¶81 The circuit court's pretrial ruling in this case 
appeared to obviate the need for proof as to the applicable 
standard of care.  In a letter to counsel for both sides, Judge 
Sullivan stated: "During [the time in question, Dr. Lindemann] 
assumed the mantle of a physician treating an obstetrical 
patient.  Therefore, that must be the standard to which he is 
                                                 
28The Olfe court said: 
In 
medical 
malpractice 
actions, 
Wisconsin 
law 
generally requires the plaintiff to introduce expert 
testimony 
as 
to 
the 
standard 
of 
care 
and 
the 
defendant's departure from it. "Without such testimony 
the jury has no standard which enables it to determine 
whether the defendant failed to exercise the degree of 
care and skill required of him."   
Olfe v. Gordon, 93 Wis. 2d 173, 180, 286 N.W.2d 573 (1980) 
(citing Froh v. Milwaukee Medical Clinic, S. C., 85 Wis. 2d 308, 
317, 270 N.W.2d 83 (Ct. App. 1978); Francois v. Mokrohisky, 67 
Wis. 2d 196, 204, 226 N.W.2d 470 (1975)). 
No.  2003AP580.dtp 
 
8 
 
held."  However, in the circuit court's "Conclusions of Law," 
Judge Sullivan wrote "the defendant, Dr. Matthew Lindemann was 
negligent in his care and treatment of Marlene Phelps and Adam 
Phelps under both the standard of care applicable to a first 
year resident and the standard of care determined to be 
applicable by this court in its decision dated November 27, 
2002."  
¶82 In a holding I fully join, the majority determines 
that the circuit court's initial decision was incorrect.  
Majority op., ¶¶43-47.  Instead of adopting a "treating 
physician" standard, the circuit court should have used the 
standard 
of 
care 
applicable 
to 
an 
unlicensed 
first-year 
resident.  Id., ¶43.  The majority opinion focuses on affirming 
the circuit court's findings that show "the ways in which Dr. 
Lindemann violated both standards of care."  Majority op., ¶46.  
It reinforces the court's action with the conclusory comment 
that "To the extent the circuit court erred in applying the 
standard of care applicable to an average physician treating an 
obstetrical patient, we deem that error harmless."  Majority 
op., ¶46 n.13. 
¶83 I strongly disagree.  The majority relies on the 
circuit court's post-hoc rationalization that Lindemann was 
negligent under either standard of care.  It ignores the fact 
that the conduct of the trial would have been different if the 
circuit court's original ruling had favored the standard of care 
applicable 
to 
an 
unlicensed 
first-year 
resident——the 
same 
standard the majority now recognizes as the proper one——instead 
No.  2003AP580.dtp 
 
9 
 
of the standard applicable to an average physician treating an 
obstetrical patient. 
¶84 The following examples illustrate the point.  Dr. 
Dennis Worthington was one of Lindemann's supervisors in the 
obstetrics department at St. Joseph's.  During his testimony at 
trial on December 5, 2002, Dr. Worthington had the following 
exchange with the plaintiffs' counsel:   
Q: 
 . . . [D]id you reach a conclusion on whether or 
not Dr. Lindemann failed to meet the standard of care 
required of him at St. Joseph's Hospital? 
A: 
Yeah——I'm not sure that there is a definitive 
standard of care for——for interns that is——in terms of 
standard of care it—— 
At that point, the plaintiffs' counsel cut off the answer, 
saying "Doctor, maybe I can help you.  The court has set what 
the standard is——."  Defense counsel objected, asking that Dr. 
Worthington be allowed to answer the original question without 
clarification.  The court refused, and allowed plaintiffs' 
counsel to "paraphrase" the question as follows: 
Q: Doctor, I'm going to read you this definition of 
medical negligence as decided by this court and ask 
you to accept this as the definition of negligence 
that applies to Dr. Lindemann.  "In treating and 
diagnosing Marlene Phelps' condition, Dr. Matthew 
Lindemann was required to use the degree of care, 
skill and judgment which reasonable physicians who 
treat obstetrical patients would exercise in the same 
or similar circumstances having due regard for the 
state of medical science at the time the plaintiff was 
treated and diagnosed.  A doctor who fails to conform 
to this standard is negligent."   . . .  
¶85 Perhaps realizing the problem, the circuit court took 
a different approach during the testimony of the plaintiffs' 
expert, Dr. David Acker, on December 10, 2002.  After Acker 
No.  2003AP580.dtp 
 
10 
 
testified that he believed Lindemann violated "the standard of 
care," the circuit judge intervened: 
THE COURT: Now, let me ask you this question.  
Assuming——Let's assume the standard were different and 
the standard was that of a first year resident.  What 
would your position be? 
THE WITNESS: It's the same because [Lindemann was] not 
looking for the right diagnosis. 
THE COURT: Sure. 
THE 
WITNESS: 
I'm——everything that 
I've 
tried to 
describe—— 
THE COURT: [Lindemann] just needed to do something 
else. 
THE WITNESS: That's it.  You don't have to know what 
this is to do something else.  And in fact, he knew 
what it was, pain not related to labor. 
THE COURT: Sure.  
 
¶86 As the trial advanced, the parties' understanding of 
the standard of care issue evolved, as evidenced by the 
following exchange during the direct examination of defense 
expert Dr. Frederik Broekhuizen: 
Q: Doctor, by way of an offer of proof if the court 
believes this is an inappropriate question, based upon 
your 
experience, 
would 
you 
expect 
a 
first-year 
resident, an intern, to meet the standard of care of 
an attending [physician]? 
[PLAINTIFFS' ATTORNEY]:  . . . I want to make sure 
that that is what is understood here.  This is an 
offer of proof. 
. . . .  
THE COURT: I will allow it as an offer of proof.  I 
made the ruling in the case and that I'll have to live 
with, and there's been a lot of testimony here so far 
what a first-year resident ought to be doing even from 
No.  2003AP580.dtp 
 
11 
 
the plaintiffs' witnesses.  So to a certain degree, 
let's hear what he has to say. 
. . . .  
Q: Doctor, assuming the standard of care applicable to 
Dr. Lindemann was that of a first-year resident in his 
second 
obstetric 
rotation, 
do 
you 
believe 
Dr. 
Lindemann met that standard of care in his care and 
treatment of Mrs. Phelps on the morning of 11/24/98? 
A: I think he did.  (Emphasis added.) 
 
¶87 The above excerpts reveal the shifting sands that 
developed at trial, with the parties at different times 
proceeding under three different approaches as to the applicable 
standard of care: 1) the treating physician standard (Dr. 
Worthington's testimony); 2) the first-year resident standard 
(Dr. Broekhuizen's testimony); 3) both standards (Dr. Acker's 
testimony).  At times, the court took over questioning the 
expert witnesses.   
 
¶88 This uncertainty permeated the conduct of the trial.  
Therefore, I do not agree that the circuit court's error was 
harmless because the defendant was not permitted to make a 
sustained case on what this court now deems the applicable 
standard of care.  Because no jury was present, the court did 
not have to grapple with instructions forthrightly stating its 
view of the law.   
¶89 Moreover, we cannot know how application of the 
correct standard would have altered the court's apportionment of 
damages.  The court decided that Dr. Lindemann was 80 percent 
responsible and St. Joseph's was 20 percent responsible for the 
incident.  Had the circuit court proceeded under the appropriate 
standard of care, it might have decided that St. Joseph's had a 
No.  2003AP580.dtp 
 
12 
 
higher degree of culpability given its responsibility to 
supervise Dr. Lindemann.  The degree of supervision expected of 
a hospital in its relationship with an unlicensed first-year 
resident 
is 
likely 
quite 
different 
from 
the 
degree 
of 
supervision expected of the same hospital in its relationship 
with an experienced physician.   
¶90 In a trial to the court, all the participants should 
understand the rules of engagement.  See State v. Watkins, 2002 
WI 101, ¶81, 255 Wis. 2d 265, 647 N.W.2d 244.29  In the absence 
of a jury, the circuit court must provide a "clear analysis of 
its thinking on the legal issues" in the case.  Id.  Because the 
court did not do so in this case, the parties deserve another 
trial at which the applicable standard of care is clear.  
II 
¶91 The majority concludes that Dr. Lindemann is not a 
health care provider, is not covered by chapter 655, is not 
covered by the Patients Compensation Fund, and is not subject to 
                                                 
29 The Watkins court wrote in a criminal context, but the 
same fundamental principle applies here.  We stated:  
When a case is tried to a jury, all the players——
judge, 
jury, 
prosecutor, 
defense 
attorney, 
and 
defendant——should understand the parameters of the 
jury verdict.  The preparation of jury instructions 
forces the parties to clarify the issues on the record 
and 
identify 
what 
charges 
and 
defenses 
may 
be 
considered by the jury.  When a case is tried to the 
court, the court may reach the same conclusion a jury 
would reach but fail to articulate the operative legal 
principles for its decision. 
State v. Watkins, 2002 WI 101, ¶81, 255 Wis. 2d 265, 647 
N.W.2d 244. 
No.  2003AP580.dtp 
 
13 
 
the medical malpractice damage caps.  In so holding, the 
majority 
accepts 
the 
plaintiff's 
contention 
that 
"the 
noneconomic damage cap in § 655.017, as implemented through 
§ 893.55(4), does not apply to a first-year unlicensed medical 
resident who is not covered by Chapter 655."  I do not dispute 
that residents are not "health care providers" under a stringent 
interpretation of Wis. Stat. § 655.002.  However, unlike the 
majority, I would hold that the circuit court's two rulings that 
Lindemann was not St. Joseph's "employee" were clearly erroneous 
findings of fact.  Based on the facts in the record, I would 
hold that Lindemann was St. Joseph's "employee" as a matter of 
law.   
¶92 Alternatively, to the extent that the circuit court's 
rulings could be considered discretionary decisions applying the 
facts of this case to the appropriate legal standard, I would 
hold that the two rulings were erroneous exercises of discretion 
because they reflect a complete absence of discretionary 
decision-making.  See Hess v. Fernandez, 2005 WI 19, ¶12, 278 
Wis. 2d 283, 692 N.W.2d 655 ("A court misused its discretion if 
the court failed to exercise its discretion, the facts do not 
support the court's decision, or the court applied the wrong 
legal standard."). 
¶93 Prior 
to 
discussing 
the 
circuit 
court's 
determinations, 
it 
is 
essential 
to 
review 
the 
peculiar 
employment status of medical residents. 
¶94 The employment status of medical residents is somewhat 
unusual.  For purposes of analysis, the Medical College of 
No.  2003AP580.dtp 
 
14 
 
Wisconsin (MCW) presently offers 83 residency and fellowship 
programs.30  The doctors serving in these programs did not 
necessarily attend medical school at MCW; graduates of any 
medical school may apply for an MCW residency position.31  
Residents selected for one of these programs generally rotate 
through two or three of the Medical College's 14 affiliated 
hospitals.32  For instance, in the Obstetrics & Gynecology 
program, residents rotate through three institutions: Froedtert 
Hospital, 
St. 
Joseph's 
Hospital, 
and 
Columbia-St. 
Mary's 
Hospital.33   
¶95 To simplify the administration of these programs, the 
14 affiliated hospitals formed The Medical College of Wisconsin 
Affiliated 
Hospitals 
(MCWAH), 
a 
nonprofit, 
charitable 
corporation exempt from federal income tax under § 501(c)(3) of 
the Internal Revenue Code.  MCWAH's Executive Director, Dr. 
Mahendr Kochar, testified about MCWAH's nature and function.  
MCW provides funding to MCWAH for administrative and clerical 
services.  The residents selected to serve at the 14 affiliated 
                                                 
30 See 
http://www.mcw.edu/display/router.asp?docid=2422 
(last visited June 17, 2005). 
31 Lindemann was never a student at the Medical College of 
Wisconsin (MCW).  After his graduation from the University of 
North Dakota School of Medicine, he earned a position in MCW's 
Obstetrics & Gynecology residency program.  
32 See 
http://www.mcw.edu/display/router.asp?docid=2422 
(last visited June 17, 2005). 
33 See 
http://www.mcw.edu/display/router.asp?docid=4010 
(last visited June 17, 2005). 
No.  2003AP580.dtp 
 
15 
 
hospitals sign contracts with MCWAH,34 and each of the affiliated 
hospitals contributes to MCWAH in order to fund the residents' 
salaries and benefits.  In effect, "MCWAH simply takes funds 
provided by hospitals to pay the resident, deposits it into an 
account, and then issues a check to the resident."  Dr. Kochar 
testified that MCWAH had no  
control of the residents at the various hospitals 
where they are placed.  This is pursuant to agreements 
with the hospitals and in keeping with the original 
intent of the creation of MCWAH in 1980.  MCWAH is, in 
essence a conduit to facilitate payments, and has no 
supervisory or control role over the residents.   
The circuit court agreed when it granted partial summary 
judgment dismissing MCWAH from the case: "MCWAH did not control 
the performance of Dr. Lindemann's duties as a resident 
physician."  
¶96 Having 
briefly 
delineated 
the 
general 
employment 
status of medical residents in the MCW program, I turn to the 
question of the applicability of chapter 655 and the medical 
malpractice damage caps to Dr. Lindemann.  The majority opinion 
adopts the part of the court of appeals' decision remanding the 
cause "for a determination of whether Dr. Lindemann was a 
'borrowed employee' of St. Joseph's Hospital and therefore 
entitled to the cap protection as an 'employee' of a health care 
provider under Wis. Stat. § 893.55(4)(b)."  Majority op., ¶4.  
Both the majority and the court of appeals ignore the fact that 
the circuit court has already ruled on this issue twice.  Both 
                                                 
34 As do all residents, Dr. Lindemann signed a contract with 
MCWAH.  
No.  2003AP580.dtp 
 
16 
 
times, the circuit court determined that Dr. Lindemann was not 
an employee, and therefore not covered by the damage caps.   
¶97 This issue arose for the first time as a result of the 
plaintiffs' 
motion 
for 
declaratory 
judgment 
as 
to 
the 
applicability of chapter 655 to the case.  The defendants, in a 
brief opposing the plaintiffs' motion, argued that chapter 655 
applied because Lindemann was a "de facto employee or agent of a 
hospital 
or 
a 
borrowed 
employee 
of 
the 
attending 
physician . . . . "  See Wis. Stat. § 655.005.35  The defendants' 
argument on this point was nearly six pages in length, 
extensively discussing the applicable legal standards.  The 
circuit court summarily dismissed these arguments in a decision 
letter.  The court simply stated that it was "not persuaded that 
defendant Lindemann is entitled to the protection of Chapter 655 
of the statutes . . . ."  The court relied on the fact that 
Lindemann was not a "physician" as that term is defined in 
chapter 655; the decision letter never mentioned the defendants' 
argument that Lindemann was an "employee" of a health care 
provider, and therefore covered by chapter 655. 
¶98 The defendants brought a motion for reconsideration, 
and again briefed and argued the "employee" issue to the court.  
In a one-sentence response to these arguments, the circuit court 
                                                 
35 "Any person  . . . having a claim or a derivative claim 
against a health care provider or an employee of the health care 
provider, for damages for bodily injury or death due to acts or 
omissions of the employee of the health care provider acting 
within the scope of his or her employment and providing health 
care 
services, 
is 
subject 
to 
this 
chapter."  
Wis. Stat. § 655.005(1).   
No.  2003AP580.dtp 
 
17 
 
wrote, "Defendants' motion to reconsider the court's July 18, 
2000 decision holding that Chapter 655 does not apply in this 
case is denied."  
¶99 The court of appeals has held that whether MCWAH 
residents are employees of the hospitals at which they serve is 
a "factual issue."  Estate of Hegarty v. Beauchaine, 2001 WI App 
300, ¶77, 249 Wis. 2d 142, 638 N.W.2d 355.  As such, "[t]he 
trier of fact must determine whether [MCWAH] intended to 
relinquish control to the hospital, the attending physician, or 
someone else."  Id., ¶76.   
¶100 We defer to the circuit court's findings of fact 
unless they are "clearly erroneous."  See, e.g., Schreiber v. 
Physicians Ins. Co. of Wis., 223 Wis. 2d 417, 426, 588 N.W.2d 26 
(1999).  However, the application of facts to a legal standard 
is a question of law subject to de novo review.  State v. Wills, 
193 Wis. 2d 273, 277, 533 N.W.2d 165 (1995).  If there is both a 
disputed question of fact and a disputed question of law, this 
court should "first review the facts under a clearly erroneous 
standard of review and then determine [the question of law] 
under a de novo standard of review . . . ."  Id. at 277-78.  The 
circuit court was thus faced with a question of fact (whether 
MCWAH relinquished control of Lindemann to St. Joseph's) and a 
question of law (whether Lindemann became St. Joseph's "borrowed 
employee").   
¶101 In Hegarty, a lengthy, well-reasoned opinion, the 
court of appeals discussed precisely the same issue——namely, 
whether a resident directly employed by MCWAH is a "borrowed 
No.  2003AP580.dtp 
 
18 
 
employee" of the hospital at which the resident serves at the 
time of the alleged malpractice.  Hegarty, 249 Wis. 2d 142, 
¶¶57-78.  In that case, it was undisputed that residents 
associated with MCWAH are "employees" of MCWAH in the general 
sense, as the circuit court also found in this case.36  Id., ¶58.   
¶102 As the Hegarty court recognized, the more difficult 
question is whether the residents are also "borrowed employees" 
of the hospitals at which they serve.  The critical issue is who 
"control[led]" the residents' activities.  Id., ¶61 (citing 
Pamperin v. Trinity Mem'l Hosp., 144 Wis. 2d 188, 199, 423 
N.W.2d 848 (1988) ("The right to control is the dominant test in 
determining whether an individual is a servant.")).  To answer 
this question, the court of appeals adopted a test we developed 
in Seaman Body Corp. v. Industrial Commission, 204 Wis. 157, 235 
N.W. 433 (1931): 
The relation of employer and employee exists as 
between a special employer to whom an employee is 
loaned whenever the 
following facts concur: (a) 
Consent on the part of the employee to work for a 
special employer; (b) Actual entry by the employee 
upon the work of and for the special employer pursuant 
to an express or implied contract so to do; (c) Power 
of the special employer to control the details of the 
work to be performed and to determine how the work 
shall be done and whether it shall stop or continue. 
Hegarty, 249 Wis.2d 142, ¶68 (citing Seaman, 204 Wis. at 163). 
 
¶103 Under Seaman, there is a presumption that,  
[i]n 
the 
absence 
of 
evidence 
to 
the 
contrary, 
 . . . the actor remains in his [or her] general 
employment so long as, by the service rendered 
another, he [or she] is performing the business 
                                                 
36 See Findings of Fact, #11.  
No.  2003AP580.dtp 
 
19 
 
entrusted to him [or her] by the general employer. 
There is no inference that because the general 
employer has permitted a division of control, [the 
employer] has surrendered it.   
Id., ¶69 (citing Borneman v. Corwyn Transp., 212 Wis. 2d 25, 43-
44, 567 N.W.2d 887 (Ct. App. 1997)).  MCWAH therefore had to 
overcome this presumption with evidence that "it relinquished 
full control of its servant."  Id., ¶¶70-71. 
¶104 In Hegarty, the court of appeals determined that 
whether MCWAH had "relinquished full control" of the resident 
was a factual determination to be resolved by the circuit court.  
It therefore remanded to allow that court to answer the 
following two questions: "(1) at any time, was [the resident] a 
servant of [MCWAH], i.e., was she employed by [MCWAH] and was 
she subject to [MCWAH's] control or right to control; and, if so 
(2) did [MCWAH] loan [the resident] to another and surrender the 
right to control [the resident] to that other institution or 
person?"  Id., ¶78.  The circuit court should have asked——and 
answered——the same questions in this case in response to the 
plaintiffs' 
motion 
for 
declaratory 
judgment 
as 
to 
the 
applicability of chapter 655 and the defendants' subsequent 
motion for reconsideration. 
¶105 Additionally, the circuit court could have considered 
the plaintiffs' pretrial brief in support of a motion for 
declaratory judgment, in which the plaintiffs convincingly 
argued that Lindemann "was an employee or actual agent of St. 
Joseph's."  As the plaintiffs noted in that filing, the 
following 
facts 
are 
undisputed: 
(1) 
St. 
Joseph's 
fully 
reimbursed MCWAH for Lindemann's stipends, costs, expenses, and 
No.  2003AP580.dtp 
 
20 
 
other benefits; (2) Lindemann was required to comply with the 
policies and procedures of St. Joseph's; (3) Lindemann testified 
that St. Joseph's had the right to control his day-to-day 
activities at the hospital; and (4) St. Joseph's provided its 
residents with free meals, free parking, free laundry services, 
discounts in the cafeteria, use of the hospital's scrub outfits, 
use of a room to rest in, and funding for educational 
conferences. 
¶106 This argument was consistent with the plaintiffs' 
earlier filings.  In their original complaint, filed September 
30, 1999, the plaintiffs named the Patients Compensation Fund as 
a defendant and alleged that the Fund  
is a mandatory health care liability risk sharing plan 
created by Chapter 655  . . . whose obligations and 
responsibilities include making payments in excess of 
underlying insurance limits on behalf of negligent 
health care providers in the State of Wisconsin, 
including  . . . any individual acting with real or 
apparent 
authority 
of 
St. 
Joseph's 
Hospital 
of 
Franciscan Sisters, Milwaukee, Inc. including, but not 
limited to, Matthew Lindemann, M.D. . . .  
(Emphasis added.) 
 
¶107 The plaintiffs also indicated their intent to file a 
medical mediation request "pursuant to Chapter 655 of the 
Wisconsin Statutes . . . ."  The plaintiffs reiterated the claim 
that Lindemann was an "agent, servant, and/or employee" of St. 
Joseph's no less than nine times in the complaint.  
 
¶108 The plaintiffs filed an amended summons and complaint 
April 14, 2000.  In the amended complaint, the plaintiffs named 
as additional defendants the Medical College of Wisconsin 
Affiliated Hospital (MCWAH), its insurer, Physicians Insurance 
No.  2003AP580.dtp 
 
21 
 
Company of Wisconsin (PIC), and Lindemann, as an individual.  
The amended complaint alleged that chapter 655 did not apply to 
Lindemann, but continued to name the Fund as a defendant.  While 
now alleging that "MCWAH was the employer of the defendant, 
Matthew Lindemann, M.D.," the Phelpses repeatedly alleged that 
Lindemann was an "agent, servant, and/or employee" of St. 
Joseph's, or alternatively an "individual over whom St. Joseph's 
had supervisory control and responsibility with respect to 
medical care provided to patients . . . ."  
 
¶109 In a response to interrogatories dated May 31, 2000, 
MCWAH admitted both that "[MCWAH] was the employer of Matthew 
Lindemann on November 24, 1998" and that "St. Joseph's Hospital 
of Franciscan Sisters, Milwaukee, Inc. was the de facto employer 
of Matthew Lindemann on November 24, 1998."  In a separate 
response, St. Joseph's admitted that MCWAH was Lindemann's 
employer, but denied that St. Joseph's was Lindemann's de facto 
employer.  
 
¶110 In time, the circuit court recognized that, "MCWAH did 
not control the performance of Dr. Lindemann's duties as a 
resident physician."  Accordingly, MCWAH could not be held 
liable under the doctrine of respondeat superior, and the 
circuit court granted its motion for summary judgment on 
November 14, 2000.   
¶111 Given all these facts and both sides' arguments, it is 
hard to imagine how Lindemann does not qualify as St. Joseph's 
"employee."  St. Joseph's self-serving argument that it was not 
Lindemann's de facto employer is difficult to square with the 
No.  2003AP580.dtp 
 
22 
 
realities of the situation.  The absence of a finding that 
Lindemann was St. Joseph's "employee" means that medical 
residents are effectively the only workers in a hospital not 
covered by the damage caps, despite the fact that as new 
doctors, they are perhaps most in need of the protections in 
chapter 655.  The Legislature could not have intended such a 
restrictive definition of "employee" in this context. 
¶112 I conclude that the circuit court's initial decision 
that chapter 655 did not apply, and its denial of the 
defendants' motion for reconsideration, effectively means that 
it found that Lindemann was not St. Joseph's employee.  The 
decision therefore implicitly contained both a clearly erroneous 
finding of fact (that MCWAH did not relinquish control of 
Lindemann to St. Joseph's) and an incorrect conclusion of law 
(that Lindemann was not St. Joseph's "borrowed employee").  I 
would reverse the circuit court's decision on this issue, and 
hold as a matter of law that Lindemann is subject to chapter 655 
because he is an "employee" of a health care provider, St. 
Joseph's 
Hospital. 
 
See 
Wis. Stat. §§ 655.005, 
655.017, 
893.55(4)(b). 
¶113 Alternatively, to the extent the circuit court's 
rulings on this issue were discretionary decisions, they should 
also be reversed.  In my view, the circuit court did not 
exercise any discretion at all.  This court has often written 
that "discretion 'is not the equivalent of unfettered decision-
making.'"  Split Rock Hardwoods, Inc. v. Lumber Liquidators, 
Inc., 2002 WI 66, ¶65, 253 Wis.2d 238, 646 N.W.2d 19 (citing 
No.  2003AP580.dtp 
 
23 
 
Hartung v. Hartung, 102 Wis. 2d 58, 66, 306 N.W.2d 16 (1981)).  
As we have explained, 
"A discretionary determination, to be sustained, must 
demonstrably 
be 
made 
and 
based 
upon 
the 
facts 
appearing in the record and in reliance on the 
appropriate 
and 
applicable 
law." 
 
Hartung, 
102 
Wis. 2d at 66.  In Howard v. Duersten, the court 
stated: "The trial court must undertake a reasonable 
inquiry and examination of the facts as the basis of 
its decision. The exercise of discretion must depend 
on facts that are of record or that are reasonably 
derived by inference from the record and the basis [of 
that] exercise of discretion should be set forth."  
Howard v. Duersten, 81 Wis.2d 301, 305, 260 N.W.2d 274 
(1977) (emphasis added). As the Hartung court put it, 
"[A] discretionary determination must be the product 
of a rational mental process by which the facts of 
record and law relied upon are stated and are 
considered together for the purpose of achieving a 
reasoned and reasonable determination." Hartung, 102 
Wis.2d at 66 (emphasis added). In reviewing these 
discretionary 
determinations, 
an 
appellate 
court 
should not be expected to read the mind of the trial 
judge.  
Split Rock Hardwoods, 253 Wis. 2d 238, ¶65. 
¶114 The circuit court's conclusory rulings on this issue 
do not satisfy this test, and should be vacated.  Upon remand, 
the circuit court should not simply rely on its prior rulings in 
this regard because those rulings reflect a complete absence of 
any exercise of discretion.  Instead, on remand, the circuit 
court should apply the facts and arguments described above to 
determine whether Lindemann qualified for cap protection as a 
"borrowed 
employee" 
of 
St. 
Joseph's 
under 
the 
standards 
described above.    
 
 
No.  2003AP580.dtp 
 
24 
 
III 
¶115 Finally, I question whether the circuit court's award 
of $200,000 to Gregory Phelps, the father, for negligent 
infliction of emotional distress is warranted under our decision 
in Pierce.  In that case, we allowed a mother of a stillborn to 
raise such a claim based on the mother's unique status as both 
"a participant, and a victim of the actionable conduct——medical 
malpractice——that gave rise to her claim."  Pierce, 278 
Wis. 2d 82, ¶¶13, 15.   
¶116 The majority chooses not to address the impact of 
Pierce, because "such issues were not briefed or argued by the 
parties."  Majority op., ¶21 n.6.  It should be noted that by 
letter dated March 30, 2004, Dr. Lindemann asked the court of 
appeals to delay its decision, pending this court's resolution 
of Pierce and Maurin v. Hall, 2004 WI 100, 274 Wis. 2d 28, 682 
N.W.2d 866.  Phelps, 273 Wis. 2d 667, ¶50 n.11.  The court 
declined to do so, but allowed that, "[a]lthough the Pierce 
decision may impact this case, its application vel non will 
depend on the facts adduced at the trial on remand."  Id. 
¶117 Because of this court's decision, there will be no 
trial on remand.  However, Dr. Lindemann will be permitted to 
argue that he qualified as an employee of a health care 
provider, and therefore is entitled to the benefits of chapter 
655.  He should also be allowed to argue the Pierce issue, as 
the court of appeals envisioned.   
¶118 If the circuit court's award to Gregory Phelps stands, 
it represents a dramatic expansion of the scope of delivery room 
No.  2003AP580.dtp 
 
25 
 
"bystander" 
claims 
in 
Wisconsin. 
 
Gregory 
was 
not 
a 
"participant" in the medical malpractice, as was the plaintiff 
in Pierce.  However, the issue involves questions of fact not 
briefed to us, perhaps because the parties believed that 
(pursuant to the court of appeals' opinion) they would have the 
opportunity to argue the issue on remand.  I would allow both 
sides to do so.  
¶119 For the foregoing reasons, I respectfully concur in 
part and dissent in part. 
¶120 I am authorized to state that Justice PATIENCE DRAKE 
ROGGENSACK joins this opinion. 
 
 
 
No.  2003AP580.dtp 
 
 
 
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