Opinion ID: 2371675
Heading Depth: 2
Heading Rank: 2

Heading: The Jurisdictional Interests in the Present Controversy

Text: Each of the four Restatement factors points to Maryland as the jurisdiction with the most significant relationship to this case. The place where the injury occurred was Marylandthat is where Ms. Burke suffered her stroke. The place where the [culpable] conduct causing the injury occurred also was Maryland that is where Dr. Higgins misread Ms. Burke's July 2000 MRI scan and wrote his misleading report, and that also is where Dr. Goodman failed to recognize the danger of a stroke and treat the blockage in Ms. Burke's carotid artery. As to the third Restatement factor, Ms. Burke lived and was employed in Maryland; GCM was incorporated there; and Dr. Higgins, Dr. Staples and Dr. Goodman all worked in Maryland. Finally, the parties' relationship was centered in Maryland that is where Ms. Burke consulted with Dr. Goodman and where each of her MRI scans was conducted. The facts on which the trial court based its finding of a nexus with the District of Columbia are all of lesser significance in our view. GCM's activities in the District had nothing to do with the tortious conduct at issue in this lawsuit, and if the District developed an interest in that tortious conduct because Ms. Burke subsequently chose to seek medical treatment for her stroke in this jurisdiction, it was an attenuated interest at best. Ms. Burke emphasizes the third fact cited by the trial court-GCM's transmission of her MRI reports into the District to Dr. Moore. If Dr. Moore had received a report identifying the blockage in her carotid artery, Ms. Burke contends, Dr. Moore would have prescribed medication or taken other measures to prevent her stroke. That may be so, but Ms. Burke's argument only underscores the fact that the central act of negligence, from which all of her damages stemmed, was Dr. Higgins's misreading of the July 2000 MRI scan, which occurred in Maryland. Moreover, GCM's provision of the July MRI report to Dr. Moore was not the sole, or even main, causal link between Dr. Higgins's negligence and Ms. Burke's injuries, for if the report misled Dr. Moore, it also misled Dr. Goodman. Had the report identified the carotid artery occlusion, presumably Dr. Goodman too would have treated Ms. Burke prophylactically (in which case she never would have consulted Dr. Moore). Finally, this was not a situation in which the MRI report was prepared for a physician in the District; it was prepared for Dr. Goodman in Maryland. Ms. Burke's subsequent decision to involve Dr. Moore was unilateral, after-the-fact, and not within appellants' contemplation. We therefore think that GCM's ministerial act of transmitting the previously prepared reports to Dr. Moore was not enough to establish a significant relationship between the District and Ms. Burke's case against appellants; the District's connection with that case was incidental at best. Thus, we conclude that Maryland has the more significant relationship to this dispute. As a rule, the state with the most significant relationship should also be the state whose policy is advanced by application of [its] law. Hercules, 566 A.2d at 41 n. 18 (internal quotation marks and citation omitted). See, e.g., Bledsoe v. Crowley, 270 U.S.App. D.C. 308, 311-12, 849 F.2d 639, 642-43 (1988) (holding, in a medical malpractice action, that [w]here the entire relationship between the parties was centered in Maryland and the allegedly tortious conduct occurred in that state, Maryland's interest in regulating the activity must be deemed the stronger one); see also RESTATEMENT (SECOND) OF CONFLICT OF LAWS § 145 cmt. e(1971). We conclude that Maryland does, indeed, have an interest in this case that outweighs any interests of the District. The Court of Appeals of Maryland has explained that the State's statutory cap on non-economic damages was enacted in response to a legislatively perceived crisis concerning the availability and cost of liability insurance in this State. This crisis resulted in the unavailability of liability insurance for some individuals and entities, especially those engaged in hazardous activities such as asbestos removal, and increasing difficulty in obtaining reinsurance. The crisis also affected the medical profession, resulting in excessive insurance premiums for doctors and declining services for patients, especially in high risk specialties such as obstetrics. Murphy v. Edmonds, 325 Md. 342, 601 A.2d 102, 114-15 (1992) (citations omitted). Thus, the Court of Appeals apprehended, [t]he General Assembly's objective in enacting the cap was to assure the availability of sufficient liability insurance, at a reasonable cost, in order to cover claims for personal injuries to members of the public. Id. at 115. Given that the instant case involves a personal injury claim asserted by a Maryland resident against Maryland doctors on account of medical services rendered in Maryland, the public policy underlying Maryland's statutory cap is directly implicated and would be advanced by applying the Maryland law. For the same reason, the District of Columbia has no comparable interest in this dispute. See Dunkwu v. Neville, 575 A.2d 293, 296 (D.C.1990) ([I]n this suit between a Virginia resident and a Virginia health care provider arising strictly from events in Virginia, it seems obvious that Virginia's governmental interest in capping liability for malpractice would outweigh the District's competing interest for choice of law purposes.). Our opinion in Stutsman, supra, is not to the contrary. In that case, it is true, we declined to apply Virginia's statutory cap on malpractice damages even though the plaintiff there was a Virginia resident and the alleged malpractice had occurred in Virginia. But the District of Columbia had two interests at stake in Stutsman that it does not have in the present case. First, unlike in this case, the defendants in Stutsman were District of Columbia corporations, and we found that the District had a significant interest . . . in holding its corporations liable for the full extent of the negligence attributable to them. 491 A.2d at 509-10 (emphasis added). (Conversely, we perceived Virginia's countervailing interest in applying its damages cap to be correspondingly attenuated because the defendants were foreign corporations with principal places of business outside the State. Id. at 511.) Second, and also unlike in this case, the plaintiff in Stutsman was employed in the District, and we found that the District had an interest in protecting a member of its work force who contracts for health services with a District of Columbia corporation within this forum and then is injured by the negligence of that corporation's agents. Id. at 510. While these considerations led us to conclude that the District had a substantial, overriding interest in the Stutsman litigation, they are absent here; accordingly, none of these factors would point to a stronger interest for the District of Columbia in the present case. Bledsoe, 270 U.S.App. D.C. at 312 n. 6, 849 F.2d at 643 n. 6. Ms. Burke argues that the District has a governmental interest in deterring foreign corporations from carelessly disseminating wrong medical information to District doctors who rely on that information. Perhaps so; but as Maryland law does not prevent a defendant from being adjudged liable for substantial damages, its application does not undermine the District's deterrence interest in any material sense. We conclude that Maryland has a greater interest in applying its statutory cap on non-economic damages to this controversy than the District has in applying no limitation on damages. Accordingly, while we do not grant appellants a new trial, we remand this case for the trial court to amend the judgment by reducing the non-economic damages portion of the jury's award to the maximum allowed under Maryland law. So ordered.