Ohio Supreme Court Rules on Two Cases Regarding Physicians

The Supreme Court of Ohio ruled 12/22 that, in personal injury cases, a jury considering the reasonable value of a plaintiff's medical treatment may hear evidence of both the amount originally billed by a medical care provider for treatment, and a lesser amount accepted by the care provider from an insurance company as full payment for the billed services. In its decision, written by Justice Judith Ann Lanzinger, the Court affirmed a ruling by the 1st District Court of Appeals, but disagreed with the portion of its holding that evidence of a “write-off” granted by a health care provider to a plaintiff's insurer was inadmissible at trial under the “collateral source rule.” Under the rule, jurors in a personal injury case are not informed about any recovery made by the plaintiff from sources other than the person who caused a plaintiff's injury or loss (the tortfeasor), so that the tortfeasor does not benefit from the plaintiff's own efforts by having his liability to the plaintiff reduced by any amount the plaintiff was able to recover from another source (such as the plaintiff's own insurance). Justice Lanzinger noted that, after the injury and complaint, the General Assembly enacted a specific statute, R.C. 2315.20, that allows defendants in personal injury cases to introduce evidence at trial of “any amount payable as a benefit to the plaintiff” as a result of his or her injury. While acknowledging that this statute limits the collateral source rule for claims arising after its effective date Lanzinger said the court of appeals concluded that “the collateral-source rule applies to any written-off amount agreed to by a plaintiff's health-care provider and insurer. We disagree. The collateral-source rule does not apply to write-offs of expenses that are never paid. The collateral-source rule excludes only ‘evidence of benefits paid by a collateral source.' Because no one pays the write-off, it cannot possibly constitute payment of any benefit from a collateral source. Because no one pays the negotiated reduction, admitting evidence of write-offs does not violate the purpose behind the collateral-source rule. The tortfeasor does not obtain a credit because of payments made by a third party on behalf of the plaintiff.” Lanzinger wrote. “Any difference between the original amount of a medical bill and the amount accepted as the bill's full payment is not a “benefit” under the collateral-source rule because it is not a payment, but both the original bill and the amount accepted are evidence relevant to the reasonable value of medical expenses.”

And earlier that week the Court ruled in a 6-1 decision that a physician who is employed as an instructor at a state university medical school at the time he performs a medical procedure on a private patient is acting within the scope of his public employment. The Court also determined that in these circumstances the physician is immune from personal liability for negligence when the physician is engaged in teaching one or more medical students or hospital residents. In this case, an accident victim and his family filed a medical malpractice suit in Hamilton County Common Pleas Court against several physicians and nurses who participated in his surgery. As a result of the surgery, the patient lost the use of his right arm and had little mobility in his left arm. Three physicians and the anesthesiology nurse named in the suit asserted claims that they were immune from personal liability for the patient's injuries because they were university employees. After much repeal and debate, the Ohio Supreme Court agreed to hear the care. Writing for the majority, Justice Evelyn Lundberg Stratton said, "We believe that this approach follows the language and intent of R.C. 9.86 and correctly focuses on the purpose of the employment relationship, not on the business or financial arrangements between the practitioner and the state. R.C. 9.86 is inclusive and makes no exception for persons who may simultaneously have other employment interests. It provides immunity for all state employees as long as they are acting within the scope of their employment when the injury occurs."