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St. Paul Fire And Marine Insurance Co. v. Eusea9/22/2000
This is an appeal from a declaratory judgment that determined a physician's status as a qualified health care provider under the Louisiana Medical Malpractice Act, LSA-R.S. 40:1200.41 et seq. (the Act). The judgment also determined which of two malpractice insurance policies covering the physician's activities would provide coverage for the malpractice claim asserted against the physician.
FACTS
Dr. Roger Blanchard was participating in a three-year family practice residency with Broadlawns Medical Center of Des Moines, Iowa (Broadlawns). His residency period ran from July 1, 1993, through June 30, 1996. A portion of his residency was spent working at the Ochsner Family Practice Clinic (Ochsner Clinic) in Matthews, Louisiana.
Pursuant to its employment contract with Dr. Blanchard, Broadlawns was to provide medical malpractice insurance for Dr. Blanchard, which would cover his activities during his residency. In fulfillment of its contractual obligation to provide medical malpractice insurance to Dr. Blanchard, Broadlawns included Dr. Blanchard as a covered physician under its excess insurance policy issued by St. Paul Fire and Marine Insurance Company (St. Paul). The excess policy had a liability limit of $30,000,000.00. This policy acted as excess insurance above Broadlawns' self-insured $250,000.00 per loss retention.
In addition to participating in the family practice residency at Ochsner, Dr. Blanchard sought additional income by "moonlighting" at Lady of the Sea General Hospital in Galliano, Louisiana. Dr. Blanchard obtained an occurrence policy of professional liability insurance with The Medical Protective Company (Medical Protective) for the period of February 10, 1995, through October 1, 1995. The Medical Protective Policy contained the following insuring agreement:
he Company hereby agrees to DEFEND and PAY DAMAGES, in the name and on behalf of the Insured or his estate,
A. IN ANY CLAIM FOR DAMAGES, AT ANY TIME FILED, BASED ON PROFESSIONAL SERVICES RENDERED OR WHICH SHOULD HAVE BEEN RENDERED, BY THE INSURED OR ANY OTHER PERSON FOR WHOSE ACTS OR OMISSIONS THE INSURED IS LEGALLY RESPONSIBLE, IN THE PRACTICE OF THE INSURED'S PROFESSION DURING THE TERM OF THE POLICY; and the following Endorsements:
Professional services, as referred to in this policy, shall mean only those professional services rendered by the Insured and on behalf of LADY OF THE SEA GENERAL HOSPITAL.
This policy is valid only for the Insured's "moonlighting" activities and does not apply to any aspect of the Insured's training program including any Internship, Residency, or Fellowship conducted by or through any Medical School or Hospital.
Further, this policy does not apply to any professional services rendered or which should have been rendered, after the Insured completes training and enters into the regular, full-time practice of medicine.
At the time he purchased the Medical Protective policy, Dr. Blanchard provided proof of insurance and paid the requested surcharge as a Class I health care provider for coverage as a qualified health care provider with the Louisiana Patient's Compensation Fund (PCF) for the period of February 10, 1995, through October 1, 1995.
On September 19, 1995, Dr. Blanchard examined Shirley Eusea at the Ochsner Clinic for multiple complaints, including a sore throat. Ms. Eusea's malpractice claim alleges Dr. Blanchard failed to run a throat culture or prescribe any form of antibiotics, but instead he released her without a return appointment. Five days later Ms. Eusea was admitted to St. Ann General Hospital, where she was diagnosed with septicemia, which result
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