Court Opinion

ID: 9662060
Source: CourtListenerOpinion
Date Created: 2023-08-23 22:58:10.155721+00
Date Added: 2024-06-11T18:14:36.231908
License: Public Domain

CORNYN, Justice,
joined by GONZALEZ, Justice,
dissenting.
[I]t is not an adequate discharge of duty for courts to say: We see what you are driving at, but you have not said it, and therefore we shall go on as before.
Johnson v. United States, 163 F. 30, 32 (1st Cir.1908) (Holmes, J.).
I disagree with the court on two counts: first, in its conclusion that this is not a case of alleged medical negligence recast under Tex.Bus. & Com.Ann. §§ 17.41-17.63. (Vernon 1987 & Supp.1994), the Texas Deceptive Trade Practices Act (DTPA), to avoid the bar created by section 12.011 of the Medical Liability and Insurance Improvement Act, Tex. Rev.Civ.Stat.Ann. art. 4590i (Vernon Supp. 1994) (MLIIA); and second, in its holding that “[t]he language of section 12.01(a) is clear, unambiguous, and when construed as written, not devoid of meaning,” supra 889 S.W.2d at 241. The court’s reading renders this statutory provision meaningless. Rather than nullify the statute, the court is duty-bound to ascertain the legislature’s intent. When the words of a statute produce a doubt as to the meaning the legislature intended, a court’s role has long been to determine the “reason and spirit of it.” 1 William Blackstone, COMMENTARIES *61. Bogged down by semantics, the court succeeds in determining neither.
MEDICAL NEGLIGENCE CLAIMS RECAST AS DTPA CLAIMS
On April 13, 1987, Janice S. Rhodes sued Bob Sorokolit, M.D., a plastic surgeon, for claims arising out of breast augmentation and abdominal scar revision surgery that So-rokolit performed on Rhodes on February 5, 1985. In paragraph III of her original petition, Rhodes characterized her claim as a “medical negligence cause of action.” She alleged that her surgery and follow up care were negligently performed by Sorokolit, and that such negligence was a proximate cause of damages traditionally recognized in medical negligence cases: pain, mental anguish, physical disfigurement, and medical expenses.
After Sorokolit filed his general denial to the original petition, Rhodes filed an amended petition. In that petition she retained her characterization of her claim as “a medical negligence cause of action,” reiterated her *244earlier negligence allegations and personal injury damage claims, and added new allegations under the DTPA. Rhodes later abandoned her negligence allegations.
In response to the filing of Plaintiffs First Amended Original Petition, Sorokolit filed special exceptions, claiming that section 12.01 of the MLIIA barred Rhodes’ DTPA claim. Agreeing that the MLIIA barred Rhodes’ DTPA claims, the trial court sustained the exceptions. When Rhodes declined to amend her pleadings in light of this ruling, the trial court dismissed her case. The court of appeals reversed the trial court’s judgment and remanded the case for a trial on Rhodes’ express warranty and knowing misrepresentation claims. We granted writ of error to decide whether section 12.01 of the MLIIA bars a DTPA claim for personal injury against a health care provider.
On this much the court and I agree: “Claims that a physician or health care provider was negligent may not be recast as DTPA actions to avoid the standards set forth in the Medical Liability and Insurance Improvement Act.” Supra 889 S.W.2d at 242. By all indications, the legislature sought to prevent such recasting by enacting section 12.01 of the MLIIA. But contrary to the court’s conclusion, that is precisely what has happened here.
CONSTRUCTION OF THE STATUTE
Under our traditional method of statutory construction, we begin with the words used: If the meaning of the statute is plain, we apply it as written. Moreno v. Sterling Drug, Inc., 787 S.W.2d 348, 352 (Tex.1990). We consider the entire statute, however, not just the disputed part. See State v. Terrell, 588 S.W.2d 784, 786 (Tex.1979). When the entire MLIIA is considered, it is apparent that an ambiguity exists, for to give section 12.01 the meaning attributed by the court would render that section meaningless. Under such circumstances, our duty is to ascertain and enforce the legislature’s evident purpose in enacting the statute. See Pennington v. Singleton, 606 S.W.2d 682, 686 (Tex.1980).
Despite contrary evidence of the legislature’s general and specific purposes, the court concludes “that section 12.01(a) only precludes a DTPA suit against a physician for negligence — that is, a suit founded on a breach of the accepted standard of medical care.” 889 S.W.2d at 242. But the court’s construction frustrates, rather than facilitates, the legislature’s purpose. First, the court’s construction not only renders section 12.01 meaningless, it is meaningless in and of itself. DTPA suits are not based on negligence. As we have previously noted:
The DTPA does not represent a codification of the common law. A primary purpose of the enactment of the DTPA was to provide consumers a cause of action for deceptive trade practices without the burden of proof and numerous defenses encountered in a common law fraud or breach of warranty suit.
Smith v. Baldwin, 611 S.W.2d 611, 616 (Tex.1980). Thus the “accepted standard of medical care” — just like the “ordinary care” standard in general negligence suits — is irrelevant to a cause of action under the DTPA.2
Responding to what it perceived to be a “medical malpractice insurance crisis,” the legislature intended the MLIIA to reformulate the entire law of medical malpractice in Texas. MLIIA at § 1.02(a)(5). The statute’s preface explicitly states that the legislature intended to
make certain modifications to the liability laws as they relate to health care liability claims only and with an intention of the legislature to not extend or apply such *245modifications of liability laws to any other area of the Texas legal system or tort law.
Id. at § 1.02(b)(7). To that end, all legal theories of recovery for personal injury and death against a health care provider were brought within the Act’s framework. See Jim M. Perdue, The Law of Texas Medical Malpractice, 22 Hous.L.Rev. 1, 35-36 (1985) (concluding that the MLIIA forecloses application of DTPA to malpractice claims.).
Consequently, the legislature dictated that all health care liability claims, whether sounding in tort or contract, would thenceforth be analyzed under the rubric of a negligence cause of action, each depending on proof of a health care provider’s deviation from accepted standards of medical practice. Thus, contrary to the court’s conclusion that the term “negligence” is not defined in the MLIIA, the statute renders synonymous the phrases “health care liability claim” and “medical negligence cause of action.” A “health care liability claim” is defined as
a cause of action against a health care provider or physician for treatment, lack of treatment, or other claimed departure from accepted standards of medical care or health care or safety which proximately results in injury to or death of the patient, whether the patient’s claim or cause of action sounds in tort or contract.
MLIIA at § 1.03(a)(4). Theories of assault and battery, negligence and fraud, previously used in informed consent cases, were supplanted by a statutory cause of action created by the MLIIA, based on a negligence standard. Id. at § 6.02. Pre-suit notice requirements were enacted, id. at § 4.01; application of the common law negligence doctrine of res ipsa loquitur was restricted, id. at § 7.01; damage caps were implemented, id. at § 11.02; statutes of limitation were restricted, id. at § 10.01; and the standards for admission of expert testimony were codified. Id. at § 14.01. All of these statutory requirements are circumvented by the court’s decision.
It should be obvious that the legislature did not intend to lower the burden of proof for the victim of medical malpractice in response to what it found to be a medical malpractice insurance crisis. Yet that is the effect of the court’s holding. The court’s application of the DTPA to health care liability claims eliminates the plaintiffs burden to establish that harm was foreseeable, an essential element of proximate cause. In its place, the DTPA substitutes the lesser burden of producing cause.3 Furthermore, permitting health care liability suits under the DTPA eliminates the requirement of expert testimony in a medical malpractice ease.4 These consequences are hardly consistent with the reason and spirit of the MLIIA. By enacting section 12.01(a), the legislature intended to prohibit DTPA suits against physicians arising from the provision of professional medical services.
Finally, the court has construed section 12.01 to allow a DTPA cause of action that is, in turn, barred by a 1977 amendment to the statute of frauds, another part of the same comprehensive statutory plan. Besides being misleading — to Ms. Rhodes and other litigants who will rely on the court’s apparent recognition of a cause of action, only to find it barred by the statute of frauds — this construction violates our own mandate that “[i]n ascertaining the intent of the Legislature, all laws bearing on the same subject are to be considered and given effect.” See lessen Assocs., Inc. v. Bullock, 531 S.W.2d 593, 600 n. 9 (Tex.1975). The statute of frauds now provides in pertinent part:
§ 26.01 Promise or Agreement Must be in Writing
(a) A promise or agreement described in Subsection (b) of this section is not en*246forceable unless the promise or agreement, or a memorandum of it, is
(1) in writing; and
(2) signed by the person to be charged with the promise or agreement or by someone lawfully authorized to sign for him.
(b) Subsection (a) of this section applies to:
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(8) an agreement, promise, contract, or warranty of cure relating to medical care or results thereof made by a physician or health care provider as defined in Section 1.03, Medical Liability and Insurance Improvement Act of Texas. This section shall not apply to pharmacists.
Tex.Bus. & Com.Code Ann. § 26.01(b)(8) (Vernon 1987).5
For these reasons, I would reverse the judgment of the court of appeals and render judgment for Sorokolit.

. That section follows the subheading, "MISCELLANEOUS PROVISIONS, Exception From Certain Laws,” and provides:
Sec. 12.01. (a) Notwithstanding any other law, no provisions of Sections 17.41-17.63, Business & Commerce Code [DTPA], shall apply to physicians or health care providers as defined in Section 1.03(3) of this Act, with respect to claims for damages for personal injury or death resulting, or alleged to have resulted from negligence on the part of any physician or health care provider.
(b) This section shall not apply to pharmacists.

. Commentators agree that when section 12.01 is interpreted in this manner as a bar to DTPA actions, it is "of limited or no value.” Darrell L. Keith, The Texas Medical Liability and Insurance Improvement Act — A Survey and Analysis of its History, Construction and Constitutionality, 36 Baylor L.Rev. 265, 308 (1984); David Bragg, Phillip Maxwell & Joe Longley, Texas Consumer Litigation § 2.02, at 34 n. 90 (2d ed.1983). In their 1992 supplement, though, Messrs. Bragg, Maxwell, and Longley state, "the Legislature has exempted from the DTPA pure negligence claims brought against health providers,” id. at 24 (Supp.1992), an interpretation which seems to contradict their 1983 statement that as a bar to DTPA liability, section 12.01 was "of limited, if any value.”

. Tex.Bus. & Com.Code Ann. § 17.50(a) (Vernon 1987).

. See, e.g., Hood v. Phillips, 554 S.W.2d 160, 165-66 (Tex.1977) ("Unless the mode or form of treatment is a matter of common knowledge or within the experience of the layman, expert testimony will be required to meet this burden of proof.”). See Darrell L. Keith, Medical Expert Testimony in Texas Medical Malpractice Cases, 43 Baylor L.Rev. 1, 5 (1991). Elimination of the conventional requirement of expert testimony in medical malpractice suits is also inconsistent with the specific standards for admission of expert witness testimony enacted by the legislature in 1989. See id. at 9 n. 29 (citing Tex.Rev.Civ. Stat.Ann. art. 4590i, § 14.01).

. Rhodes' allegations are based solely on oral misrepresentations and warranties. See supra 889 S.W.2d at 240.