A judge has ruled that the territory’s $250,000 cap on medical malpractice damages should stand, after a car crash victim sought $2 million from Schneider Hospital because she said doctors sent her home from the emergency room with undiagnosed pelvic injuries.
The case began on July 8, 2015, when plaintiff Jah-I-Dah Gumbs sustained severe injuries in a car crash and was transported to Schneider Hospital via ambulance, according to an opinion filed by V.I. Superior Court Judge Renee Gumbs Carty.
Gumbs complained of pain in her left leg, and said in a civil claim that a physician’s assistant only examined her left knee, which was not fractured. Gumbs was discharged the same day and provided with crutches, but said she “remained in excruciating pain and was bedridden after being discharged.”
Five days later, Gumbs returned to the hospital where doctors x-rayed her left femur and pelvis “which revealed a pelvic fracture and a dislocated femoral head,” and recommended she travel to the mainland for surgery.
Gumbs underwent hip surgery at Jackson Memorial Hospital in Miami, where a doctor “predicted that Gumbs will suffer from chronic pain in her left hip and leg for the rest of her life and will need additional surgeries in the years to come,” according to the opinion. “Gumbs alleges that the ongoing chronic pain and the need for future medical care resulted from the defendants’ failure to initially diagnose her fractured pelvis,” which “led to a significantly worse outcome” than if she’d been properly diagnosed on the first visit.
She filed a lawsuit against the hospital for negligence on June 19, 2017, seeking $2 million in damages, and filed a motion asking a judge to rule that the V.I. Code’s $250,000 per-incident cap on medical malpractice payouts violates the territory’s de facto constitution, the Revised Organic Act.
“As it stands, even if a jury concluded Gumbs was entitled to her claimed damages, this court would be required to reduce the award to $250,000 because of the damages limitations,” Judge Gumbs Carty wrote.
While legislative records pertaining to the V.I. Health Care Provider Malpractice Act passed in 1975 were destroyed “due to natural occurrences,” prior
court decisions “shed light on the legislative objectives,” the judge wrote.
A Third Circuit opinion found the “historical purpose of the statute is to provide continuing medical care in the face of rising malpractice costs and the unavailability of professional liability insurance resulting in the limitation and fear of cessation of medical practice in the islands,” according to Gumbs Carty’s opinion.
The territory’s medical system is so tenuous that allowing injured parties to collect more than $250,000 to cover their treatment costs could bring the whole infrastructure crashing down, the judge found.
“The Virgin Islands has only two hospitals and two federally qualified health centers. The territory struggles to recruit and retain providers, many of whom are deterred by low payment rates resulting in part from a large percentage of uninsured patients and high operating costs. In fact, the Virgin Islands has the least amount of health care professionals per capita of any state or territory. Most states have approximately 5,000 health care professionals per 100,000 people, while the Virgin Islands has only 1,210 healthcare professionals serving at least 106,977 people,” according to an opinion. “The situation is further complicated by the uncertainty and limits on federal Medicaid funding. By mitigating the cost of medical malpractice insurance premiums for healthcare providers, the statute attempts to ensure healthcare access for a greater number of residents in a quid pro quo arrangement.”
The Virgin Islands is not unique in this regard, the judge added, and other states and territories have similar caps.
The judge concluded that the statutory cap does not violate the Revised Organic Act and “it appears the Legislature acted with proper motives and best interest of Virgin Islands citizens in mind,” according to the opinion. “The limitation on damages is a rational means of minimizing government costs and ensuring the availability of healthcare, supported by evidence that it is working.”