Physicians in California could lose valuable protections of the Medical Injury Compensation Reform Act (MICRA) if a case before the state supreme court isn’t reversed.
The case, Winn v. Pioneer Medical Group, examines whether a claim based on medical negligence committed against an elderly patient can give rise to an action under the California Elder Abuse and Dependent Adult Civil Protection act, thus avoiding protections allowed in medical negligence cases under MICRA, California’s historic tort reform law. MICRA has helped keep liability insurance premiums low and ensured patients in the state have access to affordable health care by placing a $250,000 cap on noneconomic damages in medical liability lawsuits.
The case has come before the state supreme court following lower court decisions that called into question whether the case was of professional negligence or reckless neglect. The lawsuit arose after an elderly patient with peripheral vascular disease was treated over a period of time by Pioneer Medical Group (PMG) and, after her condition steadily worsened, died. The plaintiffs allege PMG violated the Elder Abuse Act by failing to provide the patient with proper care by not referring the patient to a specialist.
Professional negligence does not fall under the Elder Abuse Act, which specifically states that professional negligence should be governed by laws that apply to professional negligence – in this case, MICRA. A lower court held that if the conduct of a health care provider amounted to reckless neglect, then the Elder Abuse Act would apply.
The Litigation Center of the AMA and State Medical Societies, along with the California Medical Association, California Hospital Association and California Dental Association, is backing PMG. The groups filed an amicus brief last month to ask the state supreme court to reverse the state court of appeal’s ruling.
As defined by MICRA, professional negligence includes any negligent act—or failure to act—by a health care provider in the rendering of professional services. By contrast, the Elder Abuse Act’s definition of reckless neglect focuses on the failure to provide medical care at all and specifically excludes professional negligence.
“Alleged omissions by a health care provider that constitute ‘professional negligence’ within the meaning of MICRA cannot, as a matter of law, constitute ‘reckless neglect’ within the meaning of the Elder Abuse Act,” the amicus brief explained. “Interpreting ‘neglect’ under the Elder Abuse Act to include alleged omissions by health care providers while providing medical care threatens to undermine both statutory schemes’ goals by impairing the elderly’s access to care and circumventing procedural requirements for actions based on professional negligence.”
