Springhill Hospitals, Inc. v. Patricia Bilbrey West, [Ms. SC-2022-0719, Aug. 4, 2023] __ So. 3d ___ (Ala. 2023). In a Cunningham Bounds case, the Court (Mendheim, J.; Shaw, J., concurs specially, which Wise, Mendheim, and Stewart, JJ., join; Bryan, J., concurs specially, which Wise and Stewart, JJ., join; Parker, C.J., concurs in part and concurs in the result; Sellers, Mitchell, and Cook, JJ., concur in part and dissent in part) affirms the Mobile Circuit Court's $10 million judgment in a medical-negligence wrongful-death action against Springhill Memorial Hospital (SMH). The jury returned a $35 million dollar verdict which the trial court remitted to $10 million.
The Court rejects SMH’s new trial arguments asserting the following errors: (1) Plaintiff’s expert Dr. Rothfield was not similarly situated to its nurse and was improperly allowed to provide nursing standard of care testimony; (2) testimony concerning administration of Narcan (an opioid reversal drug) to Mr. West violated § 6-5-551's prohibition of evidence concerning acts or omissions not specifically pleaded in the complaint; (3) exclusion of other hospitals’ contemporaneous policies and practices relating to continuous pulse oximetry monitoring of patients receiving opioids was improper; and (4) insufficiency of evidence on SMH's negligent training of its nurses required a new trial under the good count/bad count rule.
As to the alleged evidentiary errors, the Court holds (1) Dr. Rothfield was qualified to offer testimony on hospital opioid policies, and that in any event, any error was harmless because Plaintiff offered nursing standard of care testimony from numerous witnesses whose qualifications were not challenged, Ms. **27-28; (2) the evidence relating to Narcan administration did not violate § 6-5-551 because it was not standard of care evidence, but was admitted on the cause of Mr. West’s death and to rebut Nurse Elenwa’s testimony that she did not administer Dilaudid to Mr. West, Ms. **33-34; (3) exclusion of evidence concerning opioid monitoring policies was within the trial court’s discretion, given that the defendant’s witnesses on the point were not offered as experts on the subject. Ms. **37-38.
As to the sufficiency of the evidence, the Court concludes that “the trial court did not submit [to the jury] separate claims based on distinct acts of negligence,” Ms. *40, and “SMH did not object to any of the instructions provided to the jury. Thus, no good count/bad count problem exists in this case.” Ms. *42.
The Court rejects SMH’s request to overrule decades of caselaw declaring unconstitutional former § 6-5-547’s $1 million cap on punitive damages in medical-malpractice wrongful-death actions. The Court emphasizes, "this Court has never chosen to ‘revive’ § 6-5-547, and that choice has not been for a lack of parties asking that we do so.” Ms. *44.
The Court also rejects SMH’s argument that further reduction of the $10 million dollar judgment was required under the Hammond v. City of Gadsden and Gore v. BMW factors. In response to SMH’s argument that the impact of inflation should not be considered, the Court notes
SMH offered no testimony to refute [Plaintiff’s expert] Professor Robert McLeod's inflation analysis in the post judgment hearing, particularly his point that if "inflation is not considered in performing such a comparative analysis, … the economic impact of a punitive damage award [would] diminish over time." That observation is important given our repeated admonition that "the purpose of punitive damages is … to punish the wrongdoer and to deter the wrongdoer and others from committing similar wrongs in the future." Green Oil [Co. v. Hornsby, 539 So. 2d 218, 222 (Ala. 1989)]. In other words, a punitive-damages amount that might have served as both a punishment and a deterrent in 1999 possibly would not serve those goals in 2022. Indeed, on appeal SMH has not attempted to refute the straightforward logic that inflation affects the real monetary value of a damages award. Professor McLeod testified that the Atkins [v. Lee, 603 So. 2d 937 (Ala. 1992)] award of $6,875,000 would be $13,843,488.29 in February 2022 dollars and $14,262,136.27 in May 2022 dollars.
The trial court’s post-judgment order observed that the amount of Plaintiff’s litigation expenses “is extremely high, and outweighs any amount incurred in a medical liability case to the undersigned's knowledge. It is well accepted within the legal community that it is very difficult to prevail as a plaintiff in a medical liability case. They are notoriously expensive to pursue, and, to the undersigned's personal knowledge, they are zealously defended, almost exclusively by seasoned and capable trial counsel.’” Ms. *76. The Court holds “SMH does not dispute any of the foregoing points from the trial court's order. Therefore, the expense of the litigation weighs against further remittitur.” Ms. *77.
On the remittitur issues, the Court concludes that “given the degree of reprehensibility of SMH’s conduct; the fact that Mr. West lost his life as a result of that conduct; the amounts of previously affirmed awards in other wrongful-death cases, including the reality of inflation in considering those awards; the goal of punishing the defendant in conjunction with the apparent lack of an economic impact of the current amount of the award upon SMH; and the cost incurred by Mrs. West after six years of litigation, we agree with the trial court that the remitted punitive-damages award of $10 million was reasonable.” Ms. *77.