Insight

Public Health Emergencies, Medical Review Panels, and Gross Negligence – Where Does Louisiana Currently Stand?

Published on: August 5, 2024

Under the Louisiana Health Emergency Powers Act (“LHEPA”), a plaintiff must establish a medical provider’s gross negligence in a medical malpractice case when the treatment at issue occurred during a declared state of public health emergency.^ However, the Louisiana Supreme Court recently ruled that a medical review panel shall not consider gross negligence when the medical treatment occurred during a declared state of public health emergency.

In Sebble v. St. Luke’s, the plaintiff instituted a medical review panel for a medical malpractice claim related to medical treatment provided from June 17, 2020 to June 24, 2020. This treatment was received during a declared state of public health emergency. Sebble asked the court for a declaratory judgment to state that the gross negligence standard, usually applied during a state of public health emergency, should not be considered or applied in medical review panel proceedings conducted pursuant to the Louisiana Medical Malpractice Act (“LMMA”).

In response, the health care provider also sought a declaratory judgment that LHEPA’s standard of gross negligence applied and that the medical review panel must consider and analyze the claim under the gross negligence standard. The trial court ruled in favor of Sebble declaring that the gross negligence standard shall not be considered or applied in the medical review panel proceeding. The Louisiana Fourth Circuit Court of Appeal affirmed.

The Louisiana Supreme Court examined provisions of the LMMA and the LHEPA and affirmed the trial court and court of appeal. The court agreed there is a distinction between a medical standard of care (considered by the medical review panel) and a legal standard of care (dictated by the LHEPA). The panel of medical experts is only qualified to render an opinion based on the medical standard of care. The panel’s opinion is then considered by the trier of fact in making a judicial determination.

Medical review panels include an attorney chairperson. However, the Supreme Court stated that the attorney chairperson is not authorized to instruct the panel on gross negligence. The Supreme Court also rejected a proposed two-step process where the panel would first determine whether the medical provider breached the standard of care; and only if the panel found a breach would it consider whether there was gross negligence. The Court rejected this proposal because the legislature did not provide for this process in the statute.

Although the Court agreed that the LHEPA is an immunity statute, it made clear that immunity is an affirmative defense that can only be plead in civil litigation. The statute provides for two defenses at the panel stage: right of action and prescription. Therefore, immunity provided under the LHEPA may not be invoked until a civil action is instituted district court.

However, Sebble was 4-3 decision, with a dissent by Justices Weimer, Cain, and McCallum, which may suggest this issue could resurface in the future. For now, under Sebble, gross negligence is not to be considered by the medical review panel.

References:

Sebble v. St. Luke’s, 2023-C-00483 (La. 10/20/23), 379 So.3d 615.

^ La. R.S. 29:766(A).

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Keogh Cox & Wilson, Ltd. provides this blog as a public service for general information only. The materials contained herein may not reflect the most current legal developments or even express the opinion of all or even most of Keogh Cox attorneys. Such material does not constitute legal advice or form any attorney-client relationship. Keogh Cox and all contributing author(s) expressly disclaim all liability to any person with respect to the contents of this Web site and Blog and expect that no reliance will be made upon the information provided.

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Sudden Shifts - Burden Shifting under Louisiana Law

Winning or losing in court often comes down to who possesses the burden of proof. Like a driver at a four-way stop, a litigant has to know when it is their turn.

Civil Procedure Article 966, the "Summary Judgment Article," provides that the mover bears the burden of proof. The Louisiana Supreme Court recently addressed this burden in Dan Veuleman & Jody Veuleman v. Mustang Homes, LLC, 2013-C-190 (La. 4/5/13), - So. 3d - in the context of insurance coverage.

The general rule in Louisiana is that an insurer bears the burden of proving that a loss falls within a policy exclusion. In Veuleman, the insurer argued that the loss was excluded through a "work product" exclusion. However, the "work product" exclusion contained a "subcontractor" exception. The plaintiffs argued that the work was performed by a subcontractor and should for that reason be covered under the policy.

At the hearing, the insurer introduced its policy as evidence of the exclusion. However, it offered no evidence to show who performed the work at issue. The plaintiffs attempted to introduce an affidavit to establish that the work was performed by a subcontractor. The court of appeal rejected the affidavit as insufficient and concluded that the plaintiffs did not establish that their claims were spared from the work product exclusion.

The Louisiana Supreme Court disagreed. It stressed that the insurer, not the plaintiff, possessed the burden of proving that the policy exclusion applied. The Court stated that "[t]he insurer offered no proof to accomplish its burden." Id. at 1. 

The Veuleman Court held that the appellate court "erroneously shifted the burden of proof on the motion for summary judgment" to the plaintiffs and that the insurer had the burden to show that "the exception [to the exclusion] is not met." In keeping, the Court vacated the summary judgment and remanded the matter for further proceedings.

The Veuleman decision reminds that a litigant should be aware when it is their turn to go.

Insight

Hurricane Ida: Governor Extends Legal Deadlines

We previously reported that the Louisiana Supreme Court issued Orders suspending prescriptive, peremptive and abandonment periods for thirty days in the wake of Hurricane Ida. Governor John Bel Edwards has now issued a Proclamation. In addition to other actions, the Proclamation provides that legal deadlines applicable to “legal proceedings in all courts, administrative agencies, and boards” are suspended until September 24, 2021.

The Proclamation also authorizes hotels and motels to cancel reservations which would result in the displacement or eviction of first responders, health care workers, or anyone performing disaster-related work.

Insight

Louisiana Supreme Court Clarifies “Reasonably Anticipated Use” in Product Liability Claim

Plaintiff Brady Hardisty and a coworker attempted to use chains attached to a tractor to pull a Caterpillar bulldozer from the mud. A chain snapped and struck plaintiff in the head and face. Hardisty sued Caterpillar under allegations that its product was unreasonably dangerous. Caterpillar filed a Motion for Summary Judgment arguing Hardisty was not engaged in a “reasonably anticipated use” of its product. Both the trial court and the appellate court identified “material issues of fact” in denying Caterpillar’s motion. The Supreme Court reversed, and entered summary judgment for Caterpillar.^

Caterpillar cited its Operation Manual that warned against the use of chains and gave a safer alternative. Hardisty asserted that material issues of fact existed as to whether Caterpillar “knew or should have known” that users were not following product warnings. Hardisty offered opinions from its expert witness that: (1) Caterpillar knew of the danger because it warned against the use of chains and (2) experience showed that the use of chains was a common practice in the industry.

The Hardisty court reasoned that the expert’s own “experience” was insufficient to refute Caterpillar’s evidence that it received no report of prior similar accidents. However, the Court cited to earlier case law for the proposition that even actual knowledge would not defeat the motion, stating:

The jurisprudence has recognized that knowledge of the potential and actual intentional abuse of a product does not create a question of fact on the question of reasonably anticipated use when the manufacturer expressly warned against the danger of such misuse.

In a recent case handled by Keogh Cox, the federal Fifth Circuit affirmed summary judgment for defendants, citing Hardisty for the proposition that a manufacturer may reasonably expect that its users will follow “clear and direct” product warnings. See Friels v. Louisiana State Administrative Office of Rick Management, et al.

References:

^Hardisty v. Walker, 25-00239 (La. 6/3/25), 410 So,3d 774.

Louisiana State Administrative Office of Rick Management, et al., No. 24-30688, 8/15/25. Opinion not designated for publication. 5th Cir. R. 47.5.

Catherine S. Giering

Partner
Louisiana Supreme Court
Medical Malpractice
Medical Review Panel
Negligence