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Hodges v. Bossier Medical Center Healthcare6/21/2000
Judgment rendered June 21, 2000.
Application for rehearing may be filed within the delay allowed by art. 2166, La. C.C.P.
These consolidated writ applications question whether an employee with a work-related injury may sue her employer and its administrator of workers' compensation claims in tort when their delay in approving surgery allegedly caused a significant worsening of the employee's medical condition. For the reasons assigned below, we reverse the judgments of the trial court and grant the defendants' exceptions of no cause of action. Accordingly, the defendants' writ applications are granted and made peremptory.
FACTS
Christina Hodges, the plaintiff, was a nurse at Bossier Medical Center ("BMC"). According to the facts pled in her petition, in June 1997 she injured her back in a work-related accident. Her treating doctor prescribed a thoracotomy to relieve the compression to her spinal column. On April 14, 1998, she was referred to two other doctors, who concurred in the treating doctor's diagnosis and recommended surgery.
The plaintiff's employer and its administrator of workers' compensation claims requested another medical opinion, sending her to see another doctor on April 30, 1998. This physician likewise concurred with the other three doctors that surgery was necessary. However, the surgery was not approved by the employer or its claims administrator.
On June 10, 1998, the plaintiff underwent surgery, which was approved by her private medical insurer. During the procedure, it was discovered that her spine had collapsed, allegedly during the 56-day period between when her doctor recommended the procedure and the actual surgery.
In June 1999, the plaintiff brought the instant tort suit against her employer, Bossier Medical Center Healthcare Foundation, and the administrator of its workers' compensation claims, F.A. Richard and Associates, Inc., ("FARA"). She contended that her spine collapsed due to their failure to authorize necessary medical treatment when they knew that: (1) timely surgery was critical and (2) her condition was worsening to the point where her spine could collapse. She claimed that the defendants conspired to commit an intentional and willful act, i.e., the denial or delay of necessary medical treatment. She alleged that as a result of their deliberate and premeditated conduct, she sustained a collapsed spine which has caused her to suffer severe numbness, clumsiness, and excruciating pain and which has deprived her of the "use of her back and legs." She contends that she will never be able to return to the work force.
In her petition, the plaintiff further asserted that the Louisiana Workers' Compensation Act, La. R.S. 23:1201 et seq., does not shield the employer for its deliberate actions and that it provides no protection to a third-party company like FARA.
On July 1, 1999, BMC filed an exception of no cause of action, asserting that under Kelly v. CNA Insurance Company, 98-0454 (La. 3/12/99), 729 So. 2d 1033, it was immune from tort actions and the plaintiff's sole remedy was in workers' compensation .
On August 2, 1999, the trial court denied BMC's exception in a written opinion. In so ruling, the court noted that the Kelly case failed to resolve the question of whether the rationale of Weber v. State, 93-0062 (La. 4/11/94), 635 So. 2d 188, could be expanded to non-death cases when the employer's intentional refusal to pay for necessary medical services is substantially certain to result in a significant worsening of the claimant's condition. The trial court then distinguished Kelly, supra, on the basis that the denied treatment in that cas
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