Deborah Batson, Eula Maye Batson and Billy M. Batson VS South Louisiana Medical Center and State Of Louisiana Through the Department of Health & Human Resources

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STATE OF LOUISIANA COURT OF APPEAL FIRST CIRCUIT NUMBER 2006 CA 1998 DEBORAH BATSON EULA MAYE BATSON AND BILLY M BATSON VERSUS SOUTH LOUISIANA MEDICAL CENTER AND STATE OF LOUISIANA THROUGH THE DEPARTMENT OF HEALTH AND HUMAN RESOURCES Judgment Appealed Thirty Rendered JUN 1 3 2007 from the second Judicial District Court In and for the Parish of Terrebonne Louisiana Docket Number 101 385 Honorable John R Walker Stephen S Stipelcovich Michael J Samanie Houma Gregory LA Judge Presiding Counsel for Plaintiffs Deborah Batson Batson C Weiss Mandeville LA and Appellees Eula Maye Billy M Batson Counsel for Defendants Appellants South Louisiana Medical Center and State of Louisiana the Department through of Health and Human Resources BEFORE N CARTER C J r WHIPPLE AND McDONALD JJ WHIPPLE J This matter is before again that South Louisiana Medical Center and the State of Louisiana SLMC through the Department of Health and finding Human Resources collectively refelTed to had not satisfied the trial comi ordering 2 the decedent 15 April defendants herein the State as 1997 judgment following in this matter and 322 169 05 awarded in the expenses for flexion contracture Deborah Batson For the paid s the State to pay judgment for medical until of the trial judgment a declaring 1 comi and from appeal us on with we 15 1997 suffered injuries interest from judicial reasons April 21 July by 1991 affirm FACTS AND PROCEDURAL HISTORY This injuries protracted litigation suffered by Deborah Batson while SLMC in Houma Louisiana comi in 1990 and 1991 hospitalized original suit for malpractice trial of this matter the at trial injuries Those three separate injuries 1 were comi acts of negligence Having found fmiher detennined that three a causing a the trial Batson s MLSSA applied separate and of the to each separate and independent injury comi awarded plaintiffs three contractures um independent In its April separate act 15 and injuries on damages Malpractice Liability injuries and also awarded medical expenses 2 elated 500 000 00 cap separate fOlih in LSA R S 40 1299 39 F Services Act flexion 2 sepsis and related injuries decubitus ulcers set At the medical a found that Batson had suffered three separate and unrelated resulting from independent trial from arose 3 the as for State of negligence 1997 judgment 500 000 00 caps for for each of the three 1 InJunes In its challenged initial appeal of the April the trial court s With court erred in to the regard the State s is not thereof an court Batson care argued that the court found 40 1299 39 F a 2d 613 619 750 2d 949 So medical expenses awarded rev merit no recitation that the patient is and related benefits and the d in part The State and it also made on other never no amount App 1st 99 0232 grounds challenged further to specifically 1 South Louisiana Medical Center 98 0038 La v 727 So 11 19 99 applied caps of future medical expenses amount judgment shall include s the State judgment the State medical expenses awarded this in need of future medical Cir 12 28 98 La Batson Additionally argument noting that LSA R S stated that the or awarding 1997 finding that multiple statutory pursuant to LSA R S 40 1299 39 F trial 15 the challenge past to the future medical expenses awarded Instead the State s appeal primarily challenged holding that multiple caps applied With regard the Louisiana Batson was to to trial comi s 500 000 00 caps for her three separate independent injuries holding that the MLSSA does statutory caps for multiple Batson independent damages D 99 0232 p 11 acts of La 11 19 99 v negligence trial that not finding 957 Batson I 99 0232 at p 11 that prohibit multiple produce separate The and Batson Supreme then remanded the matter to this court with instructions to review under each cap s separate and South Louisiana Medical Center 750 So 2d 949 court the issue of multiple caps Supreme Comi ultimately affirmed the entitled the Court quantum 750 So 2d at 957 IThe plaintiffs named in the judgment were Batson and her parents Billy M Batson and Eula Maye Batson Subsequently Batson died as a result of her injuries and her father Billy M Batson was substituted as pmiy plaintiff Batson v South Louisiana Medical Center 98 0038R La App 1 st Cir 12 22 00 778 So 2d 54 56 n 1 writ denied 2001 0960 La 11 5 01 792 So 2d 740 l J On remand under each cap Batson this finding La App La 11 5 1 st Cir 12 22 00 01 Leah However entitled to was discretion in its awards 98 0038R pp 27 28 68 69 writ denied 2001 0960 on remand judgment to this in its favor the State court setting forth that had been by virtue of the settlement between plaintiffs and Robeli Angelito and Medforce Physical Therapy Services Batson II 98 0038R at pp The State contended that the state health representing one which Batson damages from all qualified by the physical therapy was 778 So only state were 2d care Rowe at 66 qualified entitled to health fully physical recover providers Thus it contended because the cap for each claim in settlement 23 24 was the Inc physical therapy defendants and that Batson providers care 1 500 000 00 in total to s plaintiffs nothing because the judgment purportedly therapy defendants paid court 778 So 2d 54 792 So 2d 740 raised the issue that it satisfied abuse of the trial no had been awarded damages that South Louisiana Medical Center Batson II v it owed affirmed the court amount defendants exceeded all three caps entitled the State had further no liability to plaintiffs Batson II 98 0038R at pp 23 24 778 So 2d at 66 Noting that the settlement by the physical therapy defendants involved Batson s flexion law there contractures was no proceeds against i e basis for any the claim for ulcers claim granting the State obligation sepsis this comi ruled that only for the and related to the claim this State comi 2Plaintiffs these defendants s liability to paid plaintiffs for 1 636 949 91 court pursuant Batson II 98 0038R at p 23 4 of two malpractice claims injuries and the claim for decubitus found that the trial were matter credit from these settlement remaining Batson II 98 0038R at p 24 778 So regard a as a n 2d However with at 66 67 Batson had s flexion never actually made to their settlement 6 778 So 2d at 66 contractures n 6 agreement a with determination as qualified health state to whether the care physical therapy defendants providers who were covered by the MLSSA for the instant claim and that this detennination could be made an evidentiary hearing at 27 778 So 2d at 67 68 the limited purpose of on the trial court Thus the the flexion contractures claim was remanded whether the State determining 3 only following level Batson II 98 0038R matter to was in fact were at pp 26 the trial entitled court to a for credit Batson II 98 0038R at p 27 778 So 2d at 68 The Louisiana Supreme Court then denied the State writs of certiorari and review of this comi s opinion South Louisiana Medical Center 2001 0960 La the Because definitive as trial to the comi 15 April s 1997 in Batson II 11 5 01 injuries 792 So v 2d 740 final and damages awarded for the sepsis and related injuries claim and the decubitus ulcer claim upon the denial of the State the State Batson became judgment for application s paid the damages with interest caps awarded in the and also paid the writ application judgment for those amounts satisfaction of the Medicare and Medicaid liens s had plaintiffs for a total two paid in payment of 2 103 389 71 Plaintiffs then executed acknowledging this payment 3This co wi defendants of Satisfaction Pmiial a from the State but Judgment specifically recognizing that also held that if in fact the trial court determined that the state health physical then the State would be relieved of therapy providers its liability to plaintiffs for the flexion contractures claim alone as Batson would have already received the statutory cap for that claim from a qualified state health care provider However we fwiher recognized that if the physical therapy defendants were found not to be qualified state health care providers no reduction would be warranted This finding was based on the trial cowi s indication in the record that it had specifically held that even after reducing the flexion contractures award by the percentage of fault attributable to the settling physical therapy defendants the pOliion of Batson s general damages were care for which SLMC and the State would be liable exceeded the trial court had already taken into consideration a reduction of the State s share of fault of the plaintiffs by the propOliionate specifying the amOlmts it was awarding 68 n 500 000 00 physical therapy Batson II 98 0038R at p 27 8 5 n Thus liability to defendants in 8 778 So 2d at t his partial satisfaction of judgment does State of Louisiana from the awarded damages the judgment by this court in full force and effect and is On remand from this the State comi entitled to concluded that the health the was care or finding 1 that the State plaintiffs for On the MLSSA Thus cc was not this not were defined in LSA R S 40 1299 39 A comi s to plaintiffs by Center Batson denied the State s on 1997 November 5 court to any credit the trial application court against court s state health was Batson its state held that liability care comi v La when the Louisiana further review of the last that the providers as also affirmed to any credit plaintiffs South Louisiana Medical 858 So 2d 653 the Louisiana 11 5 03 Supreme remaining issue in the State 6 to pmiies Supreme Batson 857 So v 2d 490 judgment therefore became final and definitive 2003 or judgment finding entitled not for writ of celiiorari 2003 2077 qualified negligence and rendered Consequently this November 5 2003 Louisiana Medical Center 15 not state were III 2002 2381 La App 1st Cir 6 27 03 Thereafter claims the trial contracture trial qualified physical therapy defendants April the issue of whether virtue of the settlement between and the 660 661 portion of excluded coverage under LSA R S conclusion that the State against its liability on plaintiffs and other non court affirmed physical therapy defendants the trial comi Additionally the the entitled and the by this judgment sic the trial acts he t the damages hereby remains physical therapy defendants the settlement between appeal and that contracture the flexion on and that such iv a 1997 discharge contractures defendants had committed gross wanton acts 40 1299 39 A 15 April comi to in any way claim for flexion affected not credit providers under physical therapy willful a on s the flexion to peliaining estate not Comi South The as of Comi denied the State s appeal However the State thereafter refused to pay the awarded for past medical expenses related that contending State 15 no 1997 to contractures due were Because of the the flexion contractures claim April plaintiffs filed declaratory judgment requesting that the trial judicial declaration of the claim the medical expenses awarded in the to pay judgment related motion for the flexion further medical expenses continuing refusal s to 322 169 95 amount court proper amounts that remained due a render a by the State pursuant to the April 15 1997 judgment The State of celiain Batson s opposed negotiated medical the motion for the Medicare amounts treatment contending that based plaintiffs and Medicaid liens for longer were no its payment on entitled to the amounts awarded for medical expenses for the flexion contractures claim in the 15 1997 entire medical expenses claim totaled Medicare lien by payment including approximately by payment care Thus the State contended plaintiffs 1 009 932 22 were not medical expenses entitled written off recover pending to the court in any way related sepsis and flexion to s had and a satisfied a Medicaid lien contractually adjusted by the or as contractually adjusted Judgment plaintiffs acknowledged represented 43 616 78 that Medicaid programs damages those pOliions of the or written off that in the Pmiial Satisfaction of that all medical liens had been satisfied there are her claim for contractures and judgment previously rendered the final Additionally the State contended and the State to the Medicare despite to Batson 184 204 87 and that all other amounts of in the amount of provider pursuant although expenses for the flexion contractures in the amount of medical expenses had been health the State contended that judgment Specifically April Based 7 no other outstanding liens damages for decubitus ulcers on this statement the State contended the Pmiial Satisfaction of agreement between the parties medical expenses Following were a hearing the collateral before it under the comi for not source final s judgment had comi 15 final 1997 to declaratory judgment not relitigate now The trial comi precise sum Thus the court and rendered the State plaintiffs the claims for all arguments stating that the issue of medical rule declaring that April s be allowed declaratory judgment s motion for plaintiffs on detennination of the was a compromise a through which plaintiffs plaintiffs had been addressed in the court that the State would asseli constituted extinguished the trial comi rejected the State expenses due Judgment fully s final judgment and the issue or again to noted that the only issue plaintiffs still owed were granted plaintiffs motion judgment in plaintiffs favor satisfied its obligations under the judgment and ordering that the State 322 169 05 amount awarded in the April 15 1997 pay judgment which had become final From this erred in judgment the State appeals contending that the trial 1 failing to lule that the State Medicaid and Medicare liens awarding plaintiffs that plaintiffs liens in Batson s s payment of Batson fully satisfied the April 15 1997 322 169 05 in medical expenses and 2 judgment failing to order expenses related to sepsis related injuries decubitus ulcers and flexion a adjusted acceptance of full payment of the Medicaid and Medicare partial satisfaction of judgment for medical constituted s court contractures waiver of any claim for medical expenses DISCUSSION In its first erred in assignment of error the State contends that the trial ruling that the portion of the April 15 1997 medical expenses for the flexion contractures claim had 8 comi judgment awarding not been satisfied by payment of the Medicaid and Medicare liens plaintiff may not recover contractually adjusted the its position the State relies by health a requirements of the Medicaid and Medicare 5 10 00 759 So Cir 00 13 9 So 2d 422 now raising judgment which has been a 4 v transaction or occurrence 96 0173 judicata is not judgments Leon of a care provider pursuant In programs La support of App La 2nd Cir 4th App We conclude however that the State is substantive previous discretionary Moore challenge to the matter April arising from suit LSA R S 676 So 2d 1077 4231 13 15 1997 La App La 7 2 99 It the same promotes Avenue Plaza L L C 1079 to be 1st Cir 4 199 747 So v The doctrine of res and mandates the effect 98 1792 505 writ denied 99 1294 4As the a final and definitive for many years La 7 2 96 v generally 2000 1628 Lagasse and final resolution of disputes judicial efficiency that of medical expenses Nanda 33 242 v judicata bars relitigation of a subject Res Falgoust upon Terrell 2d 1026 and Suhor 770 precluded from 502 portion written off or to that damages as asserting given final 731 So 2d 2d 20 correctly notes in Tenell the Second Circuit Comi of Appeal held plaintiff personal injury action may not recover as damages the amounts written off or contractually adjusted under the Medicaid program because neither the plaintiff nor Medicaid had incuned those expenses that were written off TelTell 759 So 2d at 1031 Additionally in Suhor the Fomih Circuit Court of Appeal held that because the plaintiff could not be allowed to recover a non existent debt and because recovery would be a windfall to the plaintiff the plaintiffs claim for medical expenses classified as Medicare write offs was properly dismissed Suhor 770 So 2d at 427 Moreover as the State acknowledges in its appellate brief the Louisiana Supreme that State in a Comi in Bozeman a State 2003 1016 v La 7 2 04 879 So 2d 692 704 705 has now plaintiff is unable to recover Medicaid write off amounts in that given by a patient to obtain Medicaid benefits However noting that Medicare is financed by compulsory payroll taxes the Supreme Comi recognized therein that a plaintiff is entitled to recover the write off amount where the plaintiff s some way in order to obtain the collateral source patrimony has been diminished in benefits Notably the State concedes in its brief that vis a vis Medicare write offs given it is arguable that plaintiffs may have been entitled to the the holding in Bozeman specifically no held that a consideration is difference between the 177 20 832 which represents the full amount of the Medicare Emphasis added Nonetheless the State continues to argue that the trial comi elTed in ruling that it had failed to satisfy the April 15 1997 judgment arguing that it had satisfied its obligation for the medical expenses award at least with regard to the amOlmt of the Medicaid lien lien and the 78 43 616 that the State paid in satisfaction of that lien 9 A final judgment that decides the merits of the Louisiana State final LSA C C P judgment judgment art 1841 95 1529 University Tolis is conclusive between the LSA R S 13 4231 Avenue Plaza L L C final 95 or 676 So 2d Court denies Supreme confirmed if no fmiher review is an 2d 1206 Plaza L L C 676 So LSA C C P 2d at 1079 direct review on at 1079 Moreover or modify enol no comi has 2166 E mis Tolis 660 So revise jurisdiction or reverse the a of the in the sense 2167 2d at 1206 in the final judgment Avenue Plaza L L C of the Avenue Once of power and judgment regardless if if the judgment is judgment becomes final and definitive and acquires the authority adjudged A sought within the time fixed by law application for certiorari filliher review on a Supervisors of 660 So pmiies except in pmi is judgment becomes final and definitive and acquires the authority thing adjudged the Board of v 16 10 La in whole case a final of the thing authority to magnitude of the 676 So 2d at 1079 Tolis 660 So 2d at 1206 The issue of Batson flexion 1997 claim contractures judgment wherein s was comi definitive writs as with contractures to s April all 15 pOliions regard to claim conclusively adjudicated in the April plaintiffs medical expenses for Batson the trial entitlement to medical expenses related to the s flexion 1997 contractures judgment on 322 169 95 as on The State may or Supreme Court denied appeal regarding the flexion of November 5 reversal not now on this issue 2003 or the 10 to do so April was not 15 1997 subject to any other issue raise the issue of the medical expense award where it failed past the merits became final and judgment acquired the authority of a thing adjudged and modification revision for On November 5 2003 of the judgment when the the final issue Thus awarded were 15 propriety of the past in the many years that this matter was pending definitive and on and where the appeal the authority assignment of acquired of a has become final and judgment This thing adjudged assigmnent of error lacks merit In its second erred in failing to find that error the State argues that the trial plaintiffs acceptance of payment of the Medicaid and Medicare liens in the Patiial Satisfaction of Judgment amounted waiver of its claims for additional payments of medical expenses of its argument the State relies upon the Judgment statement in Plaintiffs herein states as a suppOli paid That portion follows and represent aver In to the Satisfaction of that all Medicaid and Medicare liens had been of the Satisfaction of Judgment court to court and this the State of Louisiana that all Medicaid and Medicare liens have been extinguished and there are no other outstanding liens pending in any way related to her claim for damages for decubitus ulcers sepsis and flexion contractures made by Deborah Batson arising out of or related to her hospitalization at the fonner South Louisiana Medical Center there are any such liens representative outstanding In the event that Teresa Batson of the estate of Deborah L Hensley Batson as agrees to defend and hold the State of Louisiana harmless for any such claims and obligations in consideration of the payment referenced herein We find language no Emphasis added merit to the State s attempted interpretation of the above Clearly by this language plaintiffs acknowledged only that Medicare and Medicaid liens had been satisfied language suggest support or collect the additional generally Martin 127 98 707 So v sums a finding awarded or plaintiffs 2d 1287 1292 not compromise tendered comi was any further claim the the defendant 11 way waived their 97 826 wherein the amount no owed under the Elmwood Medical Center agreement clearly stated that the judgment and did that In does this rights judgment La the to See App 5th Cir held that a release in satisfaction of the plaintiff had against Indeed in the partial satisfaction of judgment plaintiffs specifically requested that the clerk of court for the Thirty second Judicial District be directed to enter but only it for sepsis and decubitus ulcers as partial cancellation a peliained to flexion April Moreover flexion plaintiffs of judgment does the State of Louisiana from the contractures and 15 1997 The contracture effect and is not 1997 judgment on damages further stated in the follows as partial satisfaction discharge 15 April the satisfaction of the statutory caps Partial Satisfaction of Judgment This of the Comi the not in any way estate awarded damages claim for s by this comi pOliion of the judgment pertaining on the to damages hereby remains in full force and affected by this judgment Emphasis in original F or these plaintiffs reasons we and awarded for Batson and definitive the s a flexion against plaintiffs herein govelTIS and limits the State judgment against therefor Pmiial plaintiffs the Medicare and satisfy Satisfaction of to rights claim in the Judgment collect the April sums 1997 final 15 Indeed we a in to this note tragic that we are State private we troubled citizen ability s protecting governmental priorities being upset by 12 despite to the S from funds public sums enforcement of to collect 10 C by judicial a art XII judgment provision provides payable except LSA Const art XII at regard the recognize that LSA Const this constitutional effect section 1 O C is aimed case With plaintiffs the State shall be by the legislature further continuously resisted payment of judgments rendered against the 10 C to contention that s judgment rejecting these arguments to the State to sums contractures pronouncement of its obligation S of the waiver of fact that the State has awarded merit no payment of execution somehow constituted In of acceptance Medicaid liens also find that no appropriated Nonetheless fisc and seeks to in avoid the payment of substantial money judgments dealing It is not aimed at with the S tate the courts in limiting Lee Hargrave a general manner and Statutory in HOliatory Provisions of the Louisiana Constitution of 1974 43 La Law Rev 647 655 emphasis added 1983 for payment of judgments against paying authority sums state To meaningless to a the State before the challenge for in provided We fUliher observe that this constitutional scheme was designed legislature the legal final and definitive hold otherwise would not render judgment of the to allow the con ectness courts judgments against the of of this State 5 Accordingly the State s second assignment of enor also lacks merit CONCLUSION F or the above and the trial cOUli of Louisiana not owe declaring through satisfied the the amount s Department April 322 169 05 for medical expenses related Costs of this appeal reasons the April 22 2005 judgment of that South Louisiana Medical Center and the State the cOUli of foregoing to 15 as of Health and Human Resources had 1997 judgment awarded in the the flexion in the amount of and that the defendants April contractures 6 687 50 are 15 1997 claim is affirmed assessed equally against South Louisiana Medical Center and the State of Louisiana Depmiment of Health and judgment through the Human Resources AFFIRMED 5However plaintiffs did not we are answer unable to consider the appeal or an award ofsanctions in this matter because request sanctions 13

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