Opinion ID: 867568
Heading Depth: 2
Heading Rank: 4

Heading: Whether remedies provided by APSA and MMA are mutually exclusive

Text: ¶ 18 Defendants and amici argue that even a series of acts of medical malpractice cannot provide a basis for an APSA action. Malpractice claims, they say, may be pursued only under the provisions and remedies contained in MMA. This contention fails for several important reasons. ¶ 19 First, we would eviscerate APSA and completely defeat legislative purpose were we to adopt Defendants' argument. According to MMA, a medical malpractice action is not limited to claims against physicians but includes claims against any licensed health care provider whose negligence, misconduct, errors or omissions caused injury or death. A.R.S. § 12-561(2). A licensed health care provider is defined as any person or entity licensed by the state to provide health care, medical services, nursing services or other health-related services. A.R.S. § 12-561(1)(a). Thus, if MMA provides an exclusive remedy, all or at least the great majority of caregivers to the incapacitated would be immune from APSA actions and APSA would be a toothless tiger. Further, MMA prohibits medical malpractice actions based upon assault and battery. A.R.S. § 12-562(B). This directly conflicts with the APSA provisions defining abuse, inter alia, as intentionally inflicted harm and sexual abuse or assault. A.R.S. § 46-451(A)(1)(a) and (d). The text is clear, but even if it were not, we must conclude that the legislature could not have intended to immunize a doctor, nurse, or other provider from APSA liability for sexual assault or other intentionally inflicted injury. ¶ 20 Nor does the statute's text permit us to conclude that something more than negligence is required to constitute abuse. What more could that be? Defendants suggest that a mental state greater than mere lack of due care is required, such as intent to harm or at least disregard of the likely harm. Supplemental Brief of Defendant Beach at 1. But abuse as a basis for an action is defined as being either intentional harm, negligent harm, unreasonable confinement, or sexual abuse or assault. A.R.S. § 46-451(A)(1)(a) to (d). Thus, the legislature explicitly stated that both intentionally caused harm and negligently caused harm could constitute abuse. Nor could we conclude that the legislature meant to require a showing of gross negligence to sustain a plaintiff's burden of proving abuse. The statute speaks only of negligent acts or omissions. The legislature surely knows how to require a showing of gross negligence, having used that term in a great number of statutes. See, e.g., A.R.S. § 33-1551(C)(2) (Grossly negligent means a knowing or reckless indifference to the health and safety of others.). ¶ 21 But we need not rely on logic to conclude that acts of medical negligence can form the basis for an APSA claim. We are required by text to reject Defendants' argument that MMA and APSA civil actions are mutually exclusive. The APSA statute addresses the issue explicitly in these words: A civil action authorized by this section is remedial and not punitive and does not limit and is not limited by any other civil remedy or criminal action or any other provision of law. Civil remedies provided under this title are supplemental and not mutually exclusive. A.R.S. § 46-455(M). ¶ 22 The text is therefore quite clear: MMA is a civil remedy, and APSA is not limited by any other civil remedy. APSA was enacted subsequent to the 1976 adoption of MMA and, as the text states, provides a supplement to other civil remedies. We thus conclude that when the requirements described in paragraph 19 are met, acts of medical negligence, including a single act in some situations, may provide a basis for an APSA action.