Court Opinion

ID: 9513928
Source: CourtListenerOpinion
Date Created: 2023-08-06 22:42:21.548112+00
Date Added: 2024-06-11T09:06:06.236263
License: Public Domain

CROTHERS, Justice,
concurring in part and dissenting in part.
[¶ 42] I cannot agree that as a matter of law North Dakota’s Good Samaritan Act precludes a physician from claiming immunity from civil liability for actions taken while providing voluntary assistance during an in-hospital medical emergency. I therefore concur in the result because I would have remanded this case for trial on disputed issues of fact arising under our law.
[¶ 43] The majority holds as a matter of law that Dr. Khokha cannot be immune from suit because he was paid for rendering medical care within his employer’s hospital. I disagree with them because they *875read more into our law than the Legislature said, and because implicit in their holding is that Dr. Khokha had a duty as a matter of law to treat any and all patients who cross the hospital threshold.
[¶ 44] Important facts in this case include that Dr. Khokha had no prior relationship with or connection to Rosie Cham-ley. She was not his patient, and he had never treated, diagnosed, or participated in any care or treatment of Rosie Chamley before he entered the operating room. Dr. Khokha had no employment or business relationship with Rosie Chamley’s surgeon, Dr. Shahin. Dr. Khokha responded to Dr. Shahin’s request for help during surgery on Rosie Chamley, when she experienced a life-threatening situation. But, as Dr. Shahin testified, Dr. Khokha had no obligation to enter the operating room and assist. Indeed, Dr. Khokha answered Dr. Shahin’s urgent call for help after another surgeon employed by Mercy Hospital refused — with impunity — to assist.
[¶ 45] Dr. Khokha was not an emergency room physician whose job was to provide emergency medical care. Nothing in his contract required Dr. Khokha to provide emergency medical services. At the time of Rosie Chamley’s emergency, Dr. Khokha was not “on call” for emergencies and he was not part of a “code blue” or emergency response team. Instead, he was in the physicians’ lounge at the hospital, waiting for surgical staff to become available so he could begin operating on his own patient.
■ [¶ 46] The majority, holds as a matter of law that Dr. Khokha had an expectation of remuneration disqualifying him from immunity under the Act because he was a salaried employee of the hospital where he rendered the care giving rise to this suit. Their conclusion is reached in reliance on that part of N.D.C.C. § 32-03.1-04 providing: “Any person rendering aid or assistance with an expectation of remuneration shall not be covered by the provisions of this chapter.” However, their disposition-as-a-matter-of-law fails to harmonize words of the entire statute. They therefore ignore, or perhaps find superfluous, the preceding portion of the same statute providing:
Nothing in this chapter may be construed to deprive any physician or surgeon licensed in this state of the right to collect reasonable fees for any acts of aid, assistance or treatment....
N.D.C.C. § 32-03.1-04.1
[¶ 47] As an apparent proxy for harmonizing express words of this statute, they instead conclude availability of immunity is determined by going outside the statute and adding a test for the physical location where Dr. Khokha rendered services. See Majority opinion at ¶ 18 (“It is important to note that it is the combination of Dr. Khokha’s being a salaried employee of the hospital and performing the procedure in the hospital that caused him to have an expectation of remuneration when he was rendering the aid.”) (emphasis in original). Doing so, they ignore the rules of statutory construction requiring that we *876read the Act as a whole and harmonize its provisions, they improperly add words to the statute that the Legislature did not see fit to include, and they overlook the underlying purpose of the Good Samaritan Act.
[¶ 48] We are required to construe and apply statutes by looking first at the words used in the statute, giving them their plain, ordinary, and commonly understood meaning. N.D.C.C. § 1-02-02. When an ambiguity exists, as it does here, we must read related sentences and statutes as a whole to harmonize and give meaning to each word and phrase. See Lawrence v. N.D. Workers Comp. Bureau, 2000 ND 60, ¶ 19, 608 N.W.2d 254 (citations omitted).
[¶ 49] Section 32-03.1-04, N.D.C.C., both allows a physician to charge a fee for services in connection with treatment rendered, and withholds immunity if services are rendered “with an expectation of remuneration.” I read these separate provisions of the same statute, together with the record before us, and conclude summary judgment was inappropriate because there is not but one conclusion to be reached.
[¶ 50] Dr. Khokha had no medical relationship with Dr. Shahin or Rosie Chamley. Dr. Khokha was not an emergency medical provider. He was not on call to attend emergencies encountered by other patients. Nor was he on a “code” or emergency response team. He arguably had no obligation to join Dr. Shahin’s surgery. Dr. Khokha was present in the hospital to perform surgery on his own patient and was being paid by Mercy Hospital regardless whether he volunteered to help save the patient’s life. He therefore had “an expectation of remuneration” even if he ignored Dr. Shahin’s plea for help and stayed in the doctors’ lounge to watch television. Under these circumstances, I cannot agree with my colleagues that Dr. Khokha should be stripped of immunity as a matter of law because he received the same pay for trying to save the life of another physician’s patient as he would have, had he done nothing.
[¶ 51] The majority and Justice Maring avoid analyzing the tension in section 32-03.1-04 by concluding for all time and in all cases that doctors have no immunity when services are rendered in the hospital where the physician is employed and paid for rendering services. Majority opinion at ¶ 19; Maring concurrence at ¶ 22. I disagree with their flawed approach because it adds a term to the statute that the Legislature did not.
[¶ 52] The majority reads section 32-03.1-04 as if it included words limiting immunity to actions outside hospitals. But North Dakota’s Good Samaritan Act provides no such location-specific restriction for coverage under the circumstances of this case, a conclusion conceded by Justice Maring. Maring concurrence at ¶ 30. By comparison, the Legislature has demonstrated it knows how to create location-specific limitations for application of the Act when it wants to do so. See N.D.C.C. § 32-03.1-05 (“This chapter does not encompass a person who, at the time of the emergency, was employed expressly or actually for the purpose of providing emergency medical aid to humans, either within or outside of a hospital or other place or vehicle with medical equipment, for emergency medical aid or other assistance rendered in the regular course of their employment.”) (emphasis added).
[¶ 53] Long-standing precedent of this Court requires that we conclude, “The Legislature must be presumed to have meant what it said, and all that it said, and nothing else.” State v. Myers, 73 N.D. 687, 710, 19 N.W.2d 17, 29 (1945) (citing City of Dickinson v. Thress, 69 N.D. 748, 755, 290 N.W. 653, 657 (1940)). Unlike the majority and Justice Maring, I would take the Legislature at its word. I would not *877add language to the statute or impose restrictions on application of the Act that are not present in the plain words of the Legislature.
[¶ 54] I also believe adding an exclusion for hospital emergencies is contrary to public policy supporting the Act. “The obvious purpose of the Good Samaritan Act is to encourage those who do not have a preexisting duty to voluntarily act in times of emergency by limiting the threat of civil liability for the actions taken.” McDowell v. Gillie, 2001 ND 91, ¶ 13, 626 N.W.2d 666. This observation of legislative purpose is widely shared by other jurisdictions. See McKenna v. Cedars of Lebanon Hosp., 93 Cal.App.3d 282, 288, 155 Cal. Rptr. 631 (1979) (hospital physician considered “volunteer” even though he was chief resident); see also Burciaga v. St. John’s Hosp., 187 Cal.App.3d 710, 716, 232 Cal. Rptr. 75 (1986) (doctor’s presence in hospital and his status as active staff member not sufficient to establish pre-existing duty); Hirpa v. IHC Hospitals, Inc., 948 P.2d 785, 792 (Utah 1997) (physicians are protected by the Act when they respond to in-hospital emergency if they have no preexisting duty to do so); Henry v. Barfield, 186 Ga.App. 423, 367 S.E.2d 289, 291 (1988) (questions of material fact remained about hospital physician’s preexisting duty when he responded to in-hospital emergency when not “on call”).
[¶ 55] The Utah Supreme Court stated: Courts in other states “have uniformly held that the law is not meant to exempt all medical personnel in every emergency situation, but only those personnel who happen across an emergency outside the normal course of their work and who otherwise have no duty to assist.”
Hirpa, 948 P.2d at 790 (emphasis in original) (citations omitted).
If the doctor had a particular employment duty to aid the patient at the hospital ... then he had a duty to the patient to begin with; and in such a case he does not need a special inducement to offer aid, the aid he offers is not “voluntary” in the sense of a Good Samaritan, and public policy would be ill-served if he were relieved of the usual physician’s duty of care and given immunity in such a case.

Id.

[¶ 56] The New Jersey Supreme Court considered a case with similar issues to those at bar, and a dissenting Justice astutely observed:
I do not advocate the wholesale immunization of physicians and other professionals in hospitals. Rather, I would continue to tether the Good Samaritan statute to its original moorings, meaning I would apply its protections unless the person who administered the emergency aid had a pre-existing duty to act. See Praet v. Borough of Sayreville, 218 N.J.Super. 218, 224, 527 A.2d 486 (App. Div.) (observing that “threshold question in determining the applicability of the Good Samaritan Act is whether the person claiming its immunity had a preexisting duty”), certif. denied, 108 N.J. 681, 532 A.2d 253 (1987).
After remand, we might well conclude that Dr. Ranzini had such a duty and that she, and indeed most of her medical colleagues, would fall outside the purview of the Act. I am unwilling to reach that conclusion as a matter of law. Nor would I restrict the Act to all emergent situations except those found in a hospital unless the statute explicitly contained that restriction, which it does not.
Velazquez v. Jiminez, 172 N.J. 240, 798 A.2d 51, 66-67 (2002) (Verniero, J., dissenting).
[¶ 57] Here, Dr. Khokha had no affiliation with Dr. Shahin, and he had no doctor-patient relationship with Rosie Chamley before voluntarily entering the operating room to help Dr. Shahin. Nei*878ther Dr. Khokha nor Dr. Shahin thought Dr. Khokha had a duty to treat Rosie Chamley. Another surgeon employed by Mercy Hospital refused to join the lifesaving efforts. These facts suggest to me that Dr. Khokha was among those whom the Legislature was trying to induce to act without fear of liability. The result reached by the majority removes that inducement and reduces the chance the next patient in Rosie Chamley’s situation will survive the operating room. This can hardly be the result envisioned by the Legislature when adopting the Good Samaritan Act. See Sagan v. United States, 342 F.3d 493, 498 (6th Cir. 2003) (“ ‘The test is not whether the risk was increased over what it would have been if the defendant had not been negligent,’ but rather whether ‘the risk was increased over what it would have been had the defendant not engaged in the undertaking at all.’ ”).
[¶ 58] Finally, I note Justice Maring’s effort to capture the legislative intent behind North Dakota’s Good Samaritan Act as a whole. She gathers statements made during several legislative sessions which relate to a number of the different provisions in N.D.C.C. ch. 32-03.1. That exercise is destined to fail because chapter 32-03.1 is not a cohesive “Act” but a collection of immunity provisions aimed at protecting certain health care providers acting under specific circumstances. See Danny R. Veilleux, Annotation, Construction and application of “Good Samaritan” statutes, 68 A.L.R.4th 294, § 2[a] (“Issues of statutory applicability based on the particular party claiming coverage, like those based on the location of the treatment, must naturally be resolved with close attention to the particular statute granting the immunity.”).
[¶ 59] When examining North Dakota’s particular statutes, I do not claim to understand the dramatically different legislative philosophy behind N.D.C.C. § 32-OS. 1-04 which grants immunity for emergency care while allowing doctors “the right to collect reasonable fees” and N.D.C.C. § 32-03.1-02.1 which withholds immunity for doctors rendering obstetrical care if they “eollect[] a fee for rendering that care or assistance.” ' Nevertheless, that policy decision is left to the legislative branch and, absent constitutional infirmity, we judges cannot occupy ourselves with the wisdom of the enactment.
[¶ 60] Viewing the evidence in the light most favorable to Chamley, and giving Chamley the benefit of all favorable inferences, I would conclude summary judgment was not appropriate. Whether Dr. Khokha had an expectation of remuneration and whether he had a duty to care for Rosie Chamley under the facts of this case are not questions suitable for summary judgment. I would have reversed this case and remanded for trial. Having been unable to convince a majority of my colleagues to do so, I concur only in the result only to the extent we reverse the district court.
[¶ 61] GERALD W. VANDE WALLE, C.J., concur.

. The statute reads in its entirety: 32-03.1-04. Physicians or surgeons. Nothing in this chapter may be construed to deprive any physician or surgeon licensed in this state of the right to collect reasonable fees for any acts of aid, assistance or treatment; or any other person rendering aid or assistance under this chapter, or those whose property is necessarily damaged in the course of such aid or assistance under this chapter, of the right to reimbursement, from the injured or ill person or that person’s estate for any expenses or damages which appeared reasonable and necessary to incur under the circumstances. Any person rendering aid or assistance with an expectation of remuneration shall not be covered by the provisions of this chapter.