Medical Malpractice Lawyers in Miami, Florida must follow the ever-changing Florida Statutes, Florida Case Law and, quite often Federal Statutes and opinions by Federal Courts all the way up to the United States Supreme Court.  One of the cases that could have an impact on Medical Malpractice cases throughout the United States is Delia v. E.M.A., a Minor, et al.  This post will delve into the general facts of this case and potential broad effects of the United States Supreme Court ruling to come.

E.M.A. (Emily) was born on February 25, 2000 in Hickory, North Carolina.  She was born with serious injuries at birth and cannot walk, crawl or converse in any manner.  She is also deaf and blind.  This was all a result of a cesarean delivery that went horribly wrong causing cerebral palsy.  A Medical Malpractice lawsuit was filed against the hospital and many other Defendants.  It was soon revealed that the obstetrician had a long history of abusing drugs – though he denied being on drugs at the time of the delivery.

The Medical Malpractice case was settled for a lump sum of $2.8 million.  The settlement did not delineate what portion of the settlement funds were for past or future medical expenses and what portion was for non-economic damages (pain and suffering and emotional distress).  The state of North Carolina estimated that it had already paid over $1.9 million in medicaid expenses.  Pursuant to N.C. Gen. Stat. § 108A-57, North Carolina asserted a statutory lien against 1/3 of the total settlement.  The statute provides that North Carolina has a lien of its full amount or 1/3 of the total recovery – whichever is lower.  E.M.A. took the position that the “Anti-Lien Provision” of the Medicaid Act, 42 U.S.C. § 1396p(a)(1), prohibited such a lien.  The federal statute states “No lien may be imposed against the property of any individual prior to his death on account of medical assistance paid or to be paid on his behalf under the State plan, except—…”  E.M.A. took the position that this statute preempted the North Carolina law as these type of settlement is considered “property”.

The trial court ordered 1/3 of the settlement be placed in the court registry pending the resolution of the lien.  E.M.A. filed a lawsuit in federal district court.  The federal district court held that the North Carolina law was consistent with the federal Anti Lien provisions.  An appeal was taken.  The United States Court of Appeals for the Fourth Circuit overturned the district court and held that an adversarial proceeding must be held to determine what portion of the settlement was for medical expenses subject to a lien and was portion was for non economic damages that are not subject to a lien.  Due to a conflict between North Carolina State court and the 4th Circuits ruling, The United States Supreme Court accepted the Petition for Writ of Certiorari.

If The United States Supreme Court affirms the 4th Circuit’s ruling, simple “catch-all” state law formulas to determine how much a state can recover from a Medical Malpractice case – or any any injury case for that matter – may no longer be sufficient.  Litigants may have to agree to what portion of a settlement is for past medical expenses or have an adversarial proceeding on the issue – assuming the amount was not decided by a jury.  Of course, it will not be a surprise if the state disagrees with the settlement amount that is agreed between the parties to be attributable to past medical expenses.  The United States Supreme Court affirming the 4th Circuits ruling may result in more litigation.  However, this will be necessary litigation.  Quite often the amount of medical expenses that state medicaid agencies claim to be attributable to the injuries that are the subject of litigation are simply not related.  This information needs to be flushed out in an adversarial proceeding.

Jeffrey S. Altman is a Miami Medical Malpractice Lawyer and Miami Car Accident Lawyer representing victims of Catastrophic Injury, Traumatic Brain Injury and Wrongful Death throughout the State of Florida.  Our office is located in Miami with quick access from North Miami, North Miami Beach, Miami Shores, Aventura and South Beach.  For a Free Consultation call 305.373.3730 or complete contact form on our website.