The most significant issues are:
(1) Can a plaintiff maintain a separate claim under the Nursing Home Act, W.Va. Code 16-5C-1 et seq., along with a medical negligence claim? If so, is the statutory claim subject to the noneconomic damages “cap” found in the Medical Professional Liability Act, W.Va. Code 55-7B-1 et seq?
(2) Will a claim for breach of fiduciary duty lie in a case involving nursing home case?
(3) Is the $80,000,000 punitive damage award properly supported?
Dorothy Douglas was an Alzheimer’s patient who was admitted to a nursing home on September 4, 2009. Within three weeks, it is alleged that Mrs. Douglas was dehydrated, malnourished and largely unresponsive, and that she had fallen multiple times resulting in bruises and a head trauma. Mrs. Douglas died shortly thereafter.
Mrs. Douglas’ son, as plaintiff, sued the owner of the nursing home along with other, related companies that were responsible for budgeting and staffing at the home. The plaintiff brought the following legal claims: (1) a claim for medical negligence, (2) a claim for breach of fiduciary duty, and (3) a statutory claim arising under the NHA. The case proceeded to trial, and the jury awarded $11.5 million dollars in compensatory damages and $80 million in punitive damages.
The defendants argue that the MPLA applies broadly to all claims alleging medical negligence, including negligence occurring in a nursing home. Because the plaintiff’s claims are all “based on healthcare services rendered, or which should have been rendered” by the defendants, W.Va. Code 55-7b-2(i), they are covered by the MPLA. Thus, all non-MPLA claims should be dismissed and the MPLA’s $500,000 “cap” for noneconomic damages should be applied.
Fiduciary duty is one of the highest duties recognized in the law. West Virginia has recognized that a fiduciary duty exists between a healthcare provider and a patient, but only for purposes of maintaining the confidentiality of medical records. See, e.g., Morris v. Consolidation Coal Co., 191 W.Va. 426, 446 SE2d 648 (1994). Here, the defendants argues that there are no facts establishing any kind of fiduciary relationship between Mrs. Douglas and the nursing home.
Finally, the defendants argue that there are insufficient facts to support an award of punitive damages and, in any event, the award is unconstitutionally excessive under Garnes v. Flemming Landfill, Inc., 186 W.Va. 656, 413 S.E.2d 897 (1991).
The plaintiff notes that the NHA provides for a private right of action, and that the remedies under the NHA are “cumulative” and “in addition to all other penalties and remedies provided by law.” W.Va. Code 16-5C-15. Furthermore, only one of the defendants was actually a healthcare provider and, therefore, subject to the MPLA. The claims against the remaining companies were not premised on healthcare but, instead, on a failure to provide adequately for the nursing home’s budgetary and staffing needs.
Citing cases from Louisiana, Pennsylvania and Florida, the defendants argued that a fiduciary relationship with the nursing home existed--especially in light of Mrs. Douglas’ vulnerability as an Alzheimer’s patient and the defendants’ knowledge of their own short staffing. Thus, a jury issue was presented as to whether a fiduciary relationship existed under the facts presented.
With regard to punitive damages, the plaintiffs argue that a substantial award is warranted because the defendants had full knowledge of the staffing shortages at the nursing home. In fact, the home had been cited for staffing shortages only five months before Mrs. Douglas’ admission.
Nursing home litigation is on the rise. This case will likely have a significant impact on future litigation. Not only will the court determine the viability of two non-MPLA claims in the nursing home context, it will also determine whether MPLA’s damage “caps” apply to those claims. It is also anticipated that the case will provide a thorough Garnes analysis due to the size of the punitive damage award.