Title: Mayfield-Brown v. Sayegh (order)
Citation: N/A
Docket Number: 071167
State: Virginia
Issuer: Virginia Supreme Court
Date: October 31, 2008

VIRGINIA: 
 
 
In the Supreme Court of Virginia held at the Supreme Court 
Building in the City of Richmond, on Friday, the 31st day of 
October, 2008. 
 
Pamela E. Mayfield-Brown, 
 
 
 
Appellant 
 
   against 
Record No. 071167 
 
 
 
Circuit Court No. L06-3008 
 
Sue K. Sayegh, M.D., F.A.C.O.G., et al., 
 
Appellees. 
 
 
 
 
 
 
 
 
 
Upon an appeal from a judgment rendered by the Circuit 
Court of the City of Norfolk. 
 
 
Dominique Clark, et al., 
 
 
 
Appellants, 
 
   against 
Record No. 072312 
 
 
 
Circuit Court No. CL06-3679 
 
Margarita de Veciana, M.D., 
 
 
 
Appellee. 
 
 
 
Upon an appeal from a judgment rendered by the Circuit 
Court of the City of Norfolk. 
 
 
Melvin L. Wright, Administrator of the 
 Estate of Anne A. Wright, Deceased, 
 
 
Appellant, 
 
   against 
Record No. 071175 
 
 
 
Circuit Court No. L05-2396 
 
David F. Silver, M.D., et al., 
 
 
 
Appellees. 
 
 
 
Upon an appeal from a judgment rendered by the Circuit 
Court of the City of Norfolk. 
 
Upon consideration of the record, briefs, and argument of 
counsel, the Court is of the opinion that there is reversible error 
in the judgments of the circuit court. 
 
In these consolidated appeals, each appellant asserts that the 
 
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trial court erred in holding that Eastern Virginia Medical School 
Academic Physicians and Surgeons Health Services Foundation ("EVMS 
Health Services Foundation") and/or its employees and agents are 
entitled to charitable immunity.  EVMS Health Services Foundation 
has a stated purpose and organization very similar to that of the 
University of Virginia Health Services Foundation discussed in the 
recently decided case of University of Va. Health Servs. Found. v. 
Morris, 275 Va. 319, 657 S.E.2d 512 (2008).  Applying the analysis 
concerning charitable immunity that we articulated in Morris, this 
Court holds that the EVMS Health Services Foundation and/or its 
employees and agents are not entitled to charitable immunity. 
EVMS Health Services Foundation dedicates substantial 
resources to the billing and collection of fees.  It engages in 
systematic billing and collection practices similar to those 
employed by the University of Virginia Health Services Foundation.  
EVMS Health Services Foundation contracts with several outside 
collection agencies, including a law firm, which regularly seek 
legal redress for payments owed to the EVMS Health Services 
Foundation for services rendered. 
The amount of EVMS Health Services Foundation’s charity work 
as compared to its income is small.  For example, in 2003, its 
financial statements show that EVMS Health Services Foundation 
collected slightly more than 49% of the $67,868,935 amount billed 
to nonindigent patients, resulting in total net patient revenue of 
 
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$33,302,698.  EVMS Health Services Foundation’s financial 
statements show it forgave $1,984,722 in billings for indigent 
services.  Therefore, by treating indigent patients, EVMS Health 
Services Foundation failed to receive approximately $973,886 in 
collections.  Moreover, EVMS Health Services Foundation’s 2003 
financial statements also show an indigent care reimbursement from 
the Commonwealth of $787,464.  Thus, taking into account the 
Commonwealth’s reimbursement, EVMS Health Services Foundation’s 
actual shortfall in 2003, as a result of providing medical care to 
indigent patients, was $186,422.   
EVMS Health Services Foundation, as does University of 
Virginia Health Services Foundation, pays a large portion of its 
excess revenues to its clinicians.  EVMS Health Services Foundation 
does not distribute excess revenues based upon need or societal 
benefit.  Excess revenues are required to be paid to the clinical 
departments that earned the revenues, after deducting their pro 
rata share of expenses.  Each clinical department distributes the 
funds in accordance with a predetermined 70/20/10 distribution 
formula.  According to the formula, 70% is paid to the clinicians, 
20% to Eastern Virginia Medical School ("EVMS") for the use of the 
Dean and the remaining 10% to EVMS for the use of the department 
chairs.   
EVMS Health Services Foundation receives no charitable 
donations from individual donors.  EVMS Health Services Foundation 
 
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has never reported to the federal government receipts of any 
contributions from private benefactors, and it is forbidden from 
soliciting or accepting such contributions absent the consent of 
EVMS. 
Upon consideration of the above-referenced factors, it is 
clear that the manner in which EVMS Health Services Foundation 
actually conducts its affairs is like a profitable commercial 
business.  See Morris, 275 Va. at 340, 657 S.E.2d at 522.  EVMS 
Health Services Foundation is, therefore, not immune from tort 
liability under the doctrine of charitable immunity. 
Accordingly, the judgments of the trial court granting the 
special pleas of charitable immunity in Pamela E. Mayfield-Brown v. 
Sue K. Sayegh, M.D., F.A.C.O.G., et al., Dominique Clark, et al. v. 
Margarita de Veciana, M.D., and Melvin L. Wright, Administrator of 
the Estate of Anne A. Wright, Deceased v. David F. Silver, M.D., et 
al. are reversed, and the cases are remanded for further 
proceedings consistent with this order.  
This order shall be published in the Virginia Reports and 
shall be certified to the said circuit court. 
A Copy, 
          
 
Teste: 
 
 
 
Patricia L. Harrington, Clerk