Federal Circuits, 1st Cir. (October 18, 1993)
Docket number: 92-2214
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U.S. Supreme Court - Schweiker v. Wilson, 450 U.S. 221 (1981)
U.S. Supreme Court - PruneYard Shopping Center v. Robins, 447 U.S. 74 (1980)
U.S. Supreme Court - Harris v. McRae, 448 U.S. 297 (1980)
U.S. Supreme Court - Washington v. Davis, 426 U.S. 229 (1976)
U.S. Supreme Court - Lehman Brothers v. Schein, 416 U.S. 386 (1974)
U.S. Court of Appeals for the 2nd Cir. - Zhang v. Keisler (2nd Cir. 2007)
U.S. Court of Appeals for the 1st Cir. - Kansallis v. Fern (1st Cir. 1994)
U.S. Court of Appeals for the 1st Cir. - Dennis Dipinto and Kieran Cunningham, Plaintiffs, Appellants, v. John Sperling, in His Capacity as President of Lodge # 8 of the Fraternal Order of Police and the City of Newport, Et Al., Defendants, Appellees., 9 F.3d 2 (1st Cir. 1993) Plaintiffs, Appellants, v. John Sperling, in His Capacity as President of Lodge # 8 of the Fraternal Order of Police and the City of Newport, Et Al., Defendants, Appellees.
U.S. Court of Appeals for the 2nd Cir. - Zheng v. BIA (2nd Cir. 2007)
David Efron with whom Law Offices of David Efron, was on brief, for plaintiff, appellant.
Efren T. Irizarry-Colon with whom Elisa M. Figueroa-Baez, was on brief, for defendants, appellees.Before SELYA, CYR and BOUDIN, Circuit Judges.CYR, Circuit Judge.Marta Nieves appeals a district court order dismissing the medical malpractice action she brought in behalf of her minor son Angel Luis Hernandez Nieves against Angel Gelpi, M.D., and Gonzalez Recio, M.D., whom the district court found immune from suit pursuant to P.R.Laws Ann. tit. 26, § 4105. We affirm.* BACKGROUNDWe recite the facts in the light most favorable to plaintiff. See Goldman, Antonetti, Ferraiuoli, Axtmayer & Hertell v. Medfit Int'l, Inc., 982 F.2d 686, 689 (1st Cir.1993) (summary judgment). In December 1983, Marta Nieves entered the Federico Trilla Hospital ("the Hospital"), a privately owned and operated medical facility in Puerto Rico. Appellee Angel Gelpi and Jose Melendez, medical residents under the supervision of the attending physician, Dr. Ailed Gonzalez Recio, undertook the delivery of Nieves' son Angel. The three physicians were affiliated with the University of Puerto Rico Medical School ("UPR"). Later, Angel was diagnosed with serious physical and mental impairments, allegedly attributable to asphyxiation during childbirth.In December 1990, Nieves, by that time a resident of Florida, brought this diversity action against, inter alia, UPR, Drs. Gelpi and Gonzalez Recio, and their insurers, alleging professional negligence. See P.R.Laws Ann. tit. 31, §§ 5141-5142.1 Defendants answered and moved to dismiss the complaint pursuant to Fed.R.Civ.P. 12(b)(1) and 12(b)(6). UPR, noting its status as an "arm" of the Commonwealth of Puerto Rico, asserted its Eleventh Amendment immunity from unconsented suit, see Perez v. Rodriguez Bou, 575 F.2d 21, 25 (1st Cir.1978), and its insusceptibility to federal diversity jurisdiction, see Moor v. County of Alameda, 411 U.S. 693, 717, 93 S.Ct. 1785, 1799, 36 L.Ed.2d 596 (1973).The two appellees, who claimed to be UPR "employees," hence physicians employed by the Commonwealth, relied on P.R.Laws Ann. tit. 26, § 4105 (Supp.1989) as a basis for dismissal:No health service professional may be included as a defendant in a civil suit for damages due to malpractice caused in performance of his profession while said health service professional acts in compliance with his duties and functions as an employee of the Commonwealth of Puerto Rico, its dependencies, instrumentalities and municipalities.Id. Section 4105, a provision of Act No. 74 of 1976, otherwise known as the Medico-Hospital Professional Liability Insurance Act (MHPLIA), was enacted to alleviate the severe malpractice insurance crisis facing Puerto Rico. See generally Enriquez Perez v. Fernandez, 108 P.R. Dec. 674, 677-80 (1979). The appellee doctors contend that any patient injured by the professional negligence of a physician covered by section 4105 has legal recourse only against the physician's employer, or the Commonwealth, which is immune from compensatory damages liability in excess of $75,000, see P.R.Laws Ann. tit. 32, § 3077(a), and, in any event, not amenable to suit in federal court.2On January 31, 1992, following eight months of discovery, Nieves filed her opposition to the motion to dismiss. Nieves contended that section 4105 violated the Equal Protection Clause and the Due Process Clause of the United States Constitution and their counterpart clauses in the Puerto Rico Constitution. Alternatively, Nieves argued that there remained a genuine issue of material fact with respect to whether Drs. Gelpi and Gonzalez Recio were UPR "employees" entitled to section 4105 immunity, or merely "independent contractors" employed pursuant to a contract between the Hospital and UPR.On the same day that Nieves filed her opposition to the motion to dismiss, the district court dismissed the complaint as to all defendants.3 Three weeks later, however, the two appellee physicians filed a "reply" to Nieves' opposition, to which they attached a sworn statement by a UPR dean attesting that Dr. Gonzalez Recio was an "employee" of the UPR medical school campus in December 1983, and that Dr. Gelpi was a "resident" in the UPR medical graduate program. On April 7, 1992, Nieves filed a motion for clarification and reconsideration, expressing concern that the district court overlooked the arguments presented in the opposition memorandum she filed the day the court dismissed the complaint. The district court denied the motion to reconsider.IIDISCUSSIONA. Constitutionality of Section 4105.Nieves contends that section 4105 violates the equal protection and due process clauses of the Puerto Rico Constitution4 because it (1) discriminates against "poor" people--an inherently "suspect" class under Puerto Rico constitutional law--who have no economic option but to use the low-cost public health services provided by physicians employed by the Commonwealth, or (2) divests all patients treated by Commonwealth-employed physicians of a "fundamental" constitutional right; that is, the right to recover full compensatory damages for injuries caused by physician negligence.5 Nieves argues, therefore, that her constitutional challenges require us to subject section 4105 to "strict scrutiny." She requests that the district court's interpretation of Puerto Rico law be set aside, or that these constitutional questions be certified to the Puerto Rico Supreme Court. See P.R.Laws Ann. tit. 4, App. I-A, Rule 27(a).6Under Puerto Rico law, a statutory classification that "affects fundamental rights of the citizen or is intended against a suspect classification" is subjected to "strict scrutiny," a heightened standard under which the Commonwealth must demonstrate "a compelling state interest which justifies the classification and that the [classification] necessarily encourages the attainment of that interest." Zachry Int'l of Puerto Rico v. Superior Court of Puerto Rico, 104 P.R. Dec. 267, 277-78 (1975) (emphasis added). We have been unable to find a reported Puerto Rico decision squarely addressing the constitutional questions raised by Nieves. The cases cited by appellees, and presumably endorsed by the district court, are distinguishable, either because they involve statutory classifications which do not implicate the species of "fundamental right" or "suspect class" relied on by Nieves in the present case, see, e.g., Lind Rodriquez v. Commonwealth of Puerto Rico, 112 P.R. Dec. 67 (1982); Vazquez Negron v. Department of Health of Puerto Rico, 109 P.R. Dec. 19 (1979),7 or because they treat with arguments exclusively based on the United States Constitution, not the Commonwealth constitution, see, e.g., Rodriquez Diaz v. Sierra Martinez, 717 F.Supp. 27, 32 (D.P.R.1989) (presuming that Lind and Vazquez also determined § 4105's validity under the United States Constitution, undertaking its own independent inquiry of federal case law, and citing Schweiker v. Wilson, 450 U.S. 221, 101 S.Ct. 1074, 67 L.Ed.2d 186 (1981)); supra note 5.Absent controlling state-law precedent, a federal court sitting in diversity has the discretion to certify a state-law question to the state's highest court. See Lehman Bros. v. Schein, 416 U.S. 386, 391, 94 S.Ct. 1741, 1744, 40 L.Ed.2d 215 (1974). Before this discretionary decision is even considered, however, we must first undertake our own prediction of state law for we may conclude that "the course [the] state court[ ] would take is reasonably clear." Porter v. Nutter, 913 F.2d 37, 41 n. 4 (1st Cir.1990); cf. Salve Regina College v. Russell, 499 U.S. 225, 239-40, 111 S.Ct. 1217, 1225, 113 L.Ed.2d 190, 203 (1991) (court of appeals erred by deferring to district court interpretation of local state law).1. Suspect Class Based on "Social Condition".The equal protection clause of the Puerto Rico Constitution, eclectically patterned on such works as the American Declaration of the Rights and Duties of Man and the Universal Declaration of the Rights of Man, is more liberally phrased than its federal counterpart. See Pruneyard Shopping Ctr. v. Robins, 447 U.S. 74, 81, 100 S.Ct. 2035, 2040, 64 L.Ed.2d 741 (1980) (state constitution may afford more, but not less, protection than Federal Constitution). Specifically, Article II, section 1, of the Commonwealth constitution bans discrimination based on "social origin or condition." See supra note 4. The Puerto Rico Supreme Court has held that any statutory classification that discriminates on the basis of a "human dignity" standard enumerated in Article II, section 1, is inherently "suspect." See, e.g., Leon Rosario v. Torres, 109 P.R. Dec. 804, 813-14 (1980). Thus, although its precise contours remain undefined, "poverty" is considered a suspect classification under the Commonwealth constitution, triggering "strict scrutiny" analysis unobtainable under the Equal Protection Clause of the United States Constitution. Compare, e.g., Molina v. Urban Renewal and Hous. Corp., 114 P.R. Dec. 295, 312 (1983) (summarizing history of Puerto Rico's constitutional convention, noting that "there can be no doubt that the drafters of our Constitution thought it was basic that there be no discrimination against any person by reason of the person's poverty ... and any classification based on this should be regarded with suspicion and be strictly scrutinized") (Irizarry, J., concurring), with, e.g., Harris v. McRae, 448 U.S. 297, 323, 100 S.Ct. 2671, 2691, 65 L.Ed.2d 784 (1980) ("[P]overty, standing alone, is not a suspect classification.").Notwithstanding the unique history, culture and legal traditions of Puerto Rico, and the absence of a federal lodestar for a constitutional classification based on poverty, see San Antonio Indep. Sch. Dist. v. Rodriguez, 411 U.S. 1, 28, 93 S.Ct. 1278, 1294, 36 L.Ed.2d 16 (1973) (noting that, unlike race or gender, "the class of disadvantaged 'poor' cannot be identified or defined in customary equal protection terms"), we are confident that Nieves would not prevail on her claim under existing Commonwealth law. The claim falters on evidentiary grounds in that the summary judgment record is plainly deficient to enable a determination that the immunity scheme established by section 4105 operates to discriminate on the basis of a suspect classification.Nieves does not contend that section 4105 discriminates--either on its face or as applied--against "poor" patients. Nor is it self-evident that patients utilizing public health services in Puerto Rico--a facially neutral statutory classification--are all, or even primarily, "poor." In addition, since section 4105 merely provides a "defense" which may be invoked by private civil litigants, i.e., public health service doctors, against any patient allegedly injured as a result of medical malpractice by a public health service physician, Nieves cannot demonstrate that the Commonwealth has applied the statute selectively against only that subset of public health service patients who are "poor." Rather, Nieves' only colorable argument is that section 4105 has the actual effect of discriminating against "poor" people because a disproportionate share of public health services in Puerto Rico is administered to the "poor." Given this position, we think that Nieves' proposed showing would not establish unlawful discrimination under existing Puerto Rico judicial authority.As a preliminary matter, we note that Nieves' claim of disparate impact rests on a fragile foundation. The data are presented in the form of a lawyer's assertions,8 rather than in the form required by Rule 56(e),9 and are much less compelling and probative than Nieves' counsel claims.10 Nonetheless, we assume, for present purposes only, that many of the users of Puerto Rico public health services are likely to be poorer than the average population. Still, we are not persuaded that the Puerto Rico courts would find that such a showing was a dispositive basis from which to declare section 4105 unconstitutional.In addition to raw statistical data of disproportionate impact, we think the Commonwealth courts would require evidence (e.g., historical patterns of discrimination against the targeted class, or pre-enactment legislative history) that the Puerto Rico legislature enacted section 4105 with an invidious discriminatory purpose or intent against the "poor" as a class. Cf., e.g., Personnel Adm'r of Massachusetts v. Feeney, 442 U.S. 256, 278-80, 99 S.Ct. 2282, 2295-97, 60 L.Ed.2d 870 (1979) (upholding gender-neutral state statute that gave civil service employment preference to "veterans," even though preferred class was proven to be 98% male, absent proof that Legislature enacted it "because of," rather than "in spite of" its adverse effects on women); Washington v. Davis, 426 U.S. 229, 239, 96 S.Ct. 2040, 2047, 48 L.Ed.2d 597 (1976) (upholding testing for police officer applicants, despite statistical evidence that test had disproportionate adverse impact on black applicants, absent other evidence of "racially discriminatory purpose" of legislative enactment). Nieves proffered no such evidence of discriminatory purpose. In fact, section 4105's legislative history suggests that the Legislature was animated by far more beneficent motives--concern that inflationary malpractice insurance premiums would dry up the supply of physicians willing to practice in public health services, depriving many Puerto Rican families of quality health care. See generally Enriquez Perez, 108 P.R. Dec. at 677-80.Given this shortfall, we simply lack a reliable evidentiary base from which to appraise whether section 4105 discriminates against the alleged suspect classification under Commonwealth law.112. Fundamental Right to Civil Suit for Damages.Nieves' alternate constitutional claim bypasses the problematic "poverty" classification discussed above. Nieves contends that "strict scrutiny" analysis is required because the Puerto Rico Constitution guarantees the "fundamental" right to maintain a civil suit for full compensatory damages, see Torres v. Castillo Alicea, 111 P.R. Dec. 792, 801-802 (1981), without regard to whether the challenged statutory classification targets a suspect class. She argues that section 4105 unconstitutionally deprives a non-suspect class--all patients who use Puerto Rico public health services--of this fundamental right without positing a compelling governmental interest in its classification scheme. But cf., e.g., Christensen v. Ward, 916 F.2d 1462, 1472 (10th Cir.) (pursuit of state-law tort action not fundamental right guaranteed by Federal Constitution), cert. denied,Try vLex for FREE for 3 days
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