Sean P. McGinley, Esq.
Kasey
Warner, Esq.
Rudolph L. DiTrapano, Esq.
United
States Attorney
J. Timothy DiPiero, Esq.
Stephen
M. Horn, Esq.
Mary Sadd Blaydes, Esq.
Assistant
United States Attorney
DiTrapano, Barrett & DiPiero, PLLC
United
States Attorney's Office
Charleston, West Virginia
Charleston,
West Virginia
Attorneys for the Plaintiffs
Attorneys
for the Defendants
Michele Grinberg, Esq.
C. Benjamin Salango, Esq.
Flaherty, Sensabaugh & Bonasso, P.L.L.C.
Charleston, West Virginia
Attorneys for Amicus Curiae,
West Virginia State Medical Association
CHIEF JUSTICE DAVIS delivered the Opinion of the Court.
JUSTICE MAYNARD dissents and reserves the right to file a dissenting opinion.
2. Where the issue
on an appeal from the circuit court is clearly a question of law or involving
an interpretation of a statute, we apply a de novo standard of review.
Syllabus point 1, Chrystal R.M. v. Charlie A.L., 194 W. Va. 138,
459 S.E.2d 415 (1995).
3. It is presumed the
legislature had a purpose in the use of every word, phrase and clause found
in a statute and intended the terms so used to be effective, wherefore an
interpretation of a statute which gives a word, phrase or clause thereof no
function to perform, or makes it, in effect, a mere repetition of another
word, phrase or clause thereof, must be rejected as being unsound, if it be
possible so to construe the statute as a whole, as to make all of its parts
operative and effective. Syllabus point 7, Ex parte Watson, 82
W. Va. 201, 95 S.E. 648 (1918).
4. 'Each word of a
statute should be given some effect and a statute must be construed in accordance
with the import of its language. Undefined words and terms used in a legislative enactment will be given their common, ordinary and accepted
meaning.' Syllabus point 6, in part, State ex rel. Cohen v. Manchin,
175 W. Va. 525, 336 S.E.2d 171 (1984). Syllabus point 2, State
v. Snodgrass, 207 W. Va. 631, 535 S.E.2d 475 (2000).
5. The West Virginia Medical
Professional Liability Act, W. Va. Code § 55- 7B-1, et seq.,
permits a third party to bring a cause of action against a health care provider
for foreseeable injuries that were proximately caused by the health care provider's
negligent treatment of a tortfeasor patient.
6. The provisions of
the Medical Professional Liability Act, W. Va. Code §§ 55-7B-1
to -11 (1986), govern actions falling within its parameters[.] Syllabus
point 3, in part, State ex rel. Weirton Medical Center v. Mazzone,
___ W. Va. ___, ___ S.E.2d ___ (No. 30360 June 19, 2002).
7. In order to maintain a third party action under the West Virginia Medical Professional Liability Act, a plaintiff must establish the elements of proof contained in W. Va. Code § 55-7B-3 (1986) (Repl. Vol. 2000).
Davis, Chief Justice:
This case comes before us upon certification from the
United States District Court for the Southern District of West Virginia. By
order entered September 20, 2001,
(See footnote 1) the district court presents
the following certified question: Does West Virginia's Medical Professional
Liability Act provide a cause of action by a third party against a health care
provider for foreseeable injuries to the third party proximately caused by the
health care provider's negligent treatment of a patient/tortfeasor? Upon
a review of the record presented for appellate consideration, the parties' arguments,
and the pertinent authorities, we answer the certified question in the affirmative.
We conclude that the West Virginia Medical Professional Liability Act [hereinafter
referred to as the MPLA], W. Va. Code § 55-7B-1,
et seq., does permit a third party to bring a cause of action against
a health care provider for foreseeable injuries that were proximately caused
by the health care provider's negligent treatment of a tortfeasor patient. However,
in order to maintain such a third party action under the MPLA, the plaintiff
must establish the elements of proof contained in W. Va. Code § 55-
7B-3 (1986) (Repl. Vol. 2000).
Dr. Srichai and Mr. Hoosier have had a physician-patient
relationship since approximately 1980. The district court found that, during
the seventeen year period immediately preceding the accident, Dr. Srichai
had prescribed numerous medications for Mr. Hoosier, including several controlled
substances for the management of pain, but that Dr. Srichai did not always
verify that such medications were medically necessary. For example, various
injuries with which Mr. Hoosier presented to the local emergency room were
inconsistent with the range of motion he reported to Dr. Srichai during office
visits, and which physical limitations Dr. Srichai found to exist. Moreover,
following Mr. Hoosier's release from incarceration in October, 1995,
(See footnote 4)
during which he had been weaned from all medications, he presented to
Dr. Srichai's office. At this visit, seven days after his release, Mr. Hoosier
reported that he needed prescriptions for nine different medications that
he had been taking while in jail, several of which were controlled pain management
substances; it does not appear, however, that Dr. Srichai validated that such
medications were necessary for the maintenance of Mr. Hoosier's health.
As a result of the injuries they sustained in the accident
with Mr. Hoosier, the plaintiffs
(See footnote 5) filed suit in the Circuit Court
of Logan County against Dr. Srichai and his employer, Community Health Foundation
of Man, Inc. [hereinafter referred to as CHF], alleging medical
professional liability resulting from the negligent prescription of controlled
substances to a patient with a known prescription drug dependency. Mr. Hoosier
was also named as a party defendant. On September 9, 1999, the action was removed
to the United States District Court for the Southern District of West Virginia
due to CHF's status as a federally funded program under the United States Department
of Health and Human Services, and the exclusive jurisdiction of federal courts
over claims brought under the Federal Tort Claims Act.
(See footnote 6)
Thereafter, Dr. Srichai and CHF moved to substitute
the United States as the party defendant based upon CHF's position as an agent
of the United States and Dr. Srichai's status as an employee thereof acting
within the scope of his employment. In conjunction with the United States'
substitution as the defendant to this proceeding, Dr. Srichai and CHF were
dismissed from this action.
Following various arguments by both parties regarding
the justiciability of a third party cause of action under the West Virginia Medical Professional Liability
Act, the district court, by order entered May 3, 2001, denied the United States'
motion for summary judgment and preliminarily found that the MPLA permitted
the plaintiffs' claims. Upon a bench trial, the district court concluded,
by order entered August 23, 2001, that the plaintiffs had satisfactorily proven
their entitlement to relief under the MPLA for injuries occasioned by Dr.
Srichai's negligent treatment of Mr. Hoosier. Thereafter, by order entered
September 20, 2001, the district court certified the above-quoted question
of law to this Court, requesting this Court to determine whether a third party
cause of action is permitted by the MPLA.
The particular question that has been certified for our determination in the case sub judice requires us to interpret the provisions of the Medical Professional Liability Act.
As such, we also accord a plenary review to this statutory inquiry. Where
the issue on an appeal from the circuit court is clearly a question of law
or involving an interpretation of a statute, we apply a de novo standard
of review. Syl. pt. 1, Chrystal R.M. v. Charlie A.L., 194 W. Va.
138, 459 S.E.2d 415 (1995). Accord State v. Paynter, 206 W. Va.
521, 526, 526 S.E.2d 43, 48 (1999) (To the extent that we are asked
to interpret a statute or address a question of law, our review is de novo.);
Syl. pt. 1, Appalachian Power Co. v. State Tax Dep't of West Virginia,
195 W. Va. 573, 466 S.E.2d 424 (1995) (Interpreting a statute or
an administrative rule or regulation presents a purely legal question subject
to de novo review.). With these standards in mind, we proceed
to consider the parties' arguments.
As the matter presented for our determination concerns a question of statutory construction, we must first examine the statutory provisions upon which the plaintiffs base their right of recovery. W. Va. Code § 55-7B-1 (1986) (Repl. Vol. 2000) sets forth the purpose of the Medical Professional Liability Act [MPLA], in part, (See footnote 8) as recognizing:
That as in every human endeavor
the possibility of injury or death from negligent conduct commands that protection
of the public served by health care providers be recognized as an important
state interest;
That our system of litigation
is an essential component of this state's interest in providing adequate and
reasonable compensation to those persons who suffer from injury or death as
a result of professional negligence;
. . . .
Therefore, the purpose of this
enactment is to provide for a comprehensive resolution of the matters and factors
which the Legislature finds must be addressed to accomplish the goals set forth
above. In so doing, the Legislature has determined that reforms in the common
law and statutory rights of our citizens to compensation for injury and death
. . . must be enacted together as necessary and mutual ingredients
of the appropriate legislative response.
In recognizing the need for greater reparation of injuries occasioned by medical
negligence, the Legislature further clarified the term '[m]edical professional
liability' to mean[] any liability for damages resulting from the
death or injury of a person for any tort or breach of contract based on health
care services rendered, or which should have been rendered, by a health care
provider or health care facility to a patient. W. Va. Code § 55-7B-2(d)
(1986) (Repl. Vol. 2000). It is this definitional language differentiating between
a person and a patient upon which the district court
based its finding of a third party right of recovery. Our task, then, is to decide whether the above-quoted statutory language permits
such a cause of action.
The primary object in construing a statute
is to ascertain and give effect to the intent of the Legislature. Syl.
pt. 1, Smith v. State Workmen's Comp. Comm'r, 159 W. Va. 108,
219 S.E.2d 361 (1975). To determine this legislative intent, we generally
look to the precise language employed by the Legislature. Where the
language of a statute is clear and without ambiguity the plain meaning is
to be accepted without resorting to the rules of interpretation. Syl.
pt. 2, State v. Elder, 152 W. Va. 571, 165 S.E.2d 108 (1968).
Accord Syl. pt. 1, State v. Jarvis, 199 W. Va. 635, 487
S.E.2d 293 (1997) ('A statutory provision which is clear and unambiguous
and plainly expresses the legislative intent will not be interpreted by the
courts but will be given full force and effect.' Syl. Pt. 2, State v. Epperly,
135 W. Va. 877, 65 S.E.2d 488 (1951).). See also West
Virginia Human Rights Comm'n v. Garretson, 196 W. Va. 118, 123, 468
S.E.2d 733, 738 (1996) (A statute is interpreted on the plain meaning
of its provision in the statutory context, informed when necessary by the
policy that the statute was designed to serve. (footnote and citation
omitted)).
Upon reading the definition of medical professional
liability contained in W. Va. Code § 55-7B-2(d), we are
not left with the impression that its terms are ambiguous, confusing, or capable
of more than one interpretation. Simply stated, this provision recognizes
a health care provider's legal responsibility for damages, in tort or in contract,
to a person who has sustained injuries or death as a result of such provider's provision
of, or failure to provide, health care services to a patient. Despite the
general clarity of this provision, however, the Legislature's use of the distinct
terms person and patient gives us pause as only one
of these words is defined in the MPLA's definitional section. See W. Va.
Code § 55-7B-2(e) (1986) (Repl. Vol. 2000) (defining patient).
Therefore, we must ascertain whether the words person and patient
employed in the definition of medical professional liability refer
to separate individuals or whether these terms are synonymous. See
Sizemore v. State Farm Gen. Ins. Co., 202 W. Va. 591, 596, 505
S.E.2d 654, 659 (1998) ('A statute is open to construction only where
the language used requires interpretation because of ambiguity which renders
it susceptible of two or more constructions or of such doubtful or obscure
meaning that reasonable minds might be uncertain or disagree as to its meaning.'
(quoting Hereford v. Meek, 132 W. Va. 373, 386, 52 S.E.2d 740,
747 (1949)) (emphasis added)).
In defining the concept of medical professional
liability, the Legislature employed both the word person
and the term patient: any liability for damages resulting
from the death or injury of a person for any tort or breach of contract
based on health care services rendered, or which should have been rendered,
by a health care provider or health care facility to a patient.
W. Va. Code § 55-7B-2(d) (emphasis added). Ordinarily, when
we construe a statute, we give effect to each word employed in a legislative
enactment. It has been a traditional rule of statutory construction
that 'the Legislature is presumed to intend that every word used in a statute
has a specific purpose and meaning[.]' Keatley v. Mercer County Bd. of
Educ., 200 W. Va. 487, 495, 490 S.E.2d 306, 314 (1997)
(quoting State ex rel. Johnson v. Robinson, 162 W. Va. 579, 582,
251 S.E.2d 505, 508 (1979)). In other words,
[i]t is presumed the legislature
had a purpose in the use of every word, phrase and clause found in a statute
and intended the terms so used to be effective, wherefore an interpretation
of a statute which gives a word, phrase or clause thereof no function to perform,
or makes it, in effect, a mere repetition of another word, phrase or clause
thereof, must be rejected as being unsound, if it be possible so to construe
the statute as a whole, as to make all of its parts operative and effective.
Syl. pt. 7, Ex parte Watson, 82 W. Va. 201, 95 S.E. 648 (1918).
Accord Mangus v. Ashley, 199 W. Va. 651, 658, 487 S.E.2d
309, 316 (1997) ('[C]ourts must presume that a legislature says
in a statute what it means and means in a statute what it says there.'
(quoting Martin v. Randolph County Bd. of Educ., 195 W. Va. 297,
312, 465 S.E.2d 399, 414 (1995) (quoting Connecticut Nat'l Bank v. Germain,
503 U.S. 249, 253-54, 112 S. Ct. 1146, 1149, 117 L. Ed. 2d
391, 397 (1992) (citations omitted)))); State ex rel. Ballard v. Vest,
136 W. Va. 80, 87, 65 S.E.2d 649, 653 (1951) (We cannot assume
in the absence of wording clearly indicating contrariwise that the Legislature
would use words which are unnecessary, and use them in such way as to obscure,
rather than clarify, the purposes which it had in mind in the enactment of
the statute.).
Here we are faced with a rather unique situation:
the word patient is statutorily defined, but the word person
is not. Pursuant to W. Va. Code § 55-7B-2(e), '[p]atient'
refers to a natural person who receives or should have received health
care from a licensed health care provider under a contract, expressed or implied. Absent
a pertinent statutory definition for person,
(See footnote 9) however, we must resort to
the commonly accepted meaning of this word.
Each word of a statute
should be given some effect and a statute must be construed in accordance
with the import of its language. Undefined words and terms used in a legislative
enactment will be given their common, ordinary and accepted meaning.
Syllabus point 6, in part, State ex rel. Cohen v. Manchin, 175 W. Va.
525, 336 S.E.2d 171 (1984).
Syl. pt. 2, State v. Snodgrass, 207 W. Va. 631, 535 S.E.2d 475
(2000). Accord Syl. pt. 3, in part, Ohio Cellular RSA Ltd. P'ship
v. Board of Pub. Works of West Virginia, 198 W. Va. 416, 481 S.E.2d
722 (1996) (In the absence of any specific indication to the contrary,
words used in a statute will be given their common, ordinary and accepted
meaning. (internal quotations and citations omitted)); Syl. pt. 4, State
v. General Daniel Morgan Post No. 548, V.F.W., 144 W. Va. 137, 107
S.E.2d 353 (1959) (Generally the words of a statute are to be given
their ordinary and familiar significance and meaning, and regard is to be
had for their general and proper use.).
The natural and obvious meaning of the word
'person' is a living human being. Massachusetts v. Welosky, 276
Mass. 398, 404, 177 N.E. 656, 659 (1931) (internal quotations and citations
omitted). It is a generic word of comprehensive nature . . .
[that] includes human beings[.] Illinois v. Guzzardo, 4 Ill. App.
2d 355, 360, 124 N.E.2d 39, 41 (1955) (citations omitted). Accord In
re Searight's Estate, 87 Ohio App. 417, 426, 95 N.E.2d 779, 784 (1950)
(defining person as [a] human being (internal quotations and citation
omitted)). Other authorities similarly define person as a
human being,
(See footnote 10) [a]n individual human being; a man,
woman, or child,
(See footnote 11) and a human being
as distinguished from an animal or a thing.
(See footnote 12) The common theme throughout
all of these definitions is the interpretation of a person as
a human being, without further qualification. By contrast, the Legislature
has defined a patient as a person, i.e., human being, who
has received, or should have received, health care from a licensed health
care provider. See W. Va. Code § 55-7B-2(e). Because
the general term person does not contain such a restriction or
limitation, we conclude that the Legislature intended the words person
and patient to refer to two distinct classifications of individuals,
e.g., individuals generally and those individuals who have obtained
medical care.
Given this differentiation in terminology, it is
apparent that the Legislature intended to allow individuals generally to recover
damages for injuries attributable to medical professional liability regardless of whether they are actually patients.
(See footnote 13)
Accordingly, we hold that the West Virginia Medical Professional Liability
Act, W. Va. Code § 55-7B-1, et seq., permits a third
party to bring a cause of action against a health care provider for foreseeable
injuries that were proximately caused by the health care provider's negligent
treatment of a tortfeasor patient.
(See footnote 14) The manner in which such
a third party plaintiff may proceed with such an action is further governed
by the requirements of the MPLA. The provisions of the Medical Professional
Liability Act, W. Va. Code §§ 55-7B-1 to -11 (1986), govern
actions falling within its parameters[.] Syl. pt. 3, in part, State
ex rel. Weirton Med. Ctr. v. Mazzone, ___ W. Va. ___, ___ S.E.2d
___ (No. 30360 June 19, 2002). Therefore, we hold further that, in order to
maintain a third party action under the West Virginia Medical Professional
Liability Act, a plaintiff must establish the elements of proof contained in W. Va.
Code § 55-7B-3 (1986) (Repl. Vol. 2000).
(See footnote 15)
For the foregoing reasons, then, we answer in the
affirmative the certified question posited by the district court. However,
such third party cause of action must conform to the MPLA's requirements for
the prosecution of medical professional liability claims generally.
Certified
Question Answered.
The Legislature hereby finds
and declares that the citizens of this state are entitled to the best medical
care and facilities available and that health care providers offer an essential
and basic service which requires that the public policy of this state encourage
and facilitate the provision of such service to our citizens:
That as in every human endeavor
the possibility of injury or death from negligent conduct commands that protection
of the public served by health care providers be recognized as an important
state interest;
That our system of litigation
is an essential component of this state's interest in providing adequate and
reasonable compensation to those persons who suffer from injury or death as
a result of professional negligence;
That liability insurance is
a key part of our system of litigation, affording compensation to the injured
while fulfilling the need and fairness of spreading the cost of the risks of injury;
That a further important component
of these protections is the capacity and willingness of health care providers
to monitor and effectively control their professional competency, so as to
protect the public and ensure to the extent possible the highest quality of
care;
That it is the duty and responsibility
of the Legislature to balance the rights of our individual citizens to adequate
and reasonable compensation with the broad public interest in the provision
of services by qualified health care providers who can themselves obtain the
protection of reasonably priced and extensive liability coverage;
That in recent years, the
cost of insurance coverage has risen dramatically while the nature and extent
of coverage has diminished, leaving the health care providers and the injured
without the full benefit of professional liability insurance coverage;
That many of the factors and
reasons contributing to the increased cost and diminished availability of
professional liability insurance arise from the historic inability of this
state to effectively and fairly regulate the insurance industry so as to guarantee
our citizens that rates are appropriate, that purchasers of insurance coverage
are not treated arbitrarily, and that rates reflect the competency and experience
of the insured health care providers.
Therefore, the purpose of
this enactment is to provide for a comprehensive resolution of the matters
and factors which the Legislature finds must be addressed to accomplish the
goals set forth above. In so doing, the Legislature has determined that reforms
in the common law and statutory rights of our citizens to compensation for
injury and death, in the regulation of rate making and other practices by
the liability insurance industry, and in the authority of medical licensing boards to effectively regulate and
discipline the health care providers under such board must be enacted together
as necessary and mutual ingredients of the appropriate legislative response.