:: Court Highlights Distinction Between Wrongful Death Claims And Claims By Estate In Subrogation Context

Where medical malpractice results in the death of a patient, the cause of action for medical malpractice survives, and may be asserted by the personal representative of the deceased. Id.; A.R.S. § 14-3110.

A survival claim compensates the decedent’s estate; a wrongful death claim compensates statutory beneficiaries for their losses. Gandy v. United States, 437 F. Supp. 2d 1085, 1087 (D. Ariz. 2006). A survival claim and a wrongful death claim are separate and distinct even when they originate from the same wrongful act . . .

MedCath Inc. Emple. Health Care Plan v. Stratton, 2015 U.S. Dist. LEXIS 5514 (D. Ariz. Jan. 16, 2015)

The federal courts distinguish between actions by an injured party or his estate and actions by his statutory beneficiaries under wrongful death statutes.  Two recent cases illustrate that distinction.

Stratton, cited above, is a wrongful death case.  The plan’s subrogation claims failed.

From the opinion:

ERISA “is built around reliance on the face of written plan documents.” U.S. Airways, 133 S. Ct. at 1548. ERISA permits Plaintiff to seek equitable relief to enforce the terms of the Plan, but the written plan documents authorize Plaintiff to recover payments for health care expenses incurred by Ms. Stratton only from proceeds paid in compensation for Ms. Stratton’s injuries. They do not entitle Plaintiff to recover from proceeds received in the wrongful death action for the losses suffered by Ms. Stratton’s children. Plaintiff’s subrogation and reimbursement rights do not apply in the circumstances of this action.

The Estate of Tracie Stratton was not a party to the wrongful death action and did not continue Ms. Stratton’s professional negligence action after her death. Plaintiff does not allege that the Estate has received any proceeds that would be subject to Plaintiff’s subrogation and reimbursement rights, i.e., compensation for Ms. Stratton’s injuries.

By contrast, in Norstan Inc. v. Lancaster, 58 Employee Benefits Cas. (BNA) 2451 (D. Ariz. June 25, 2014) (distinguished by the Stratton court), the ERISA plan’s right of subrogation and reimbursement applied to proceeds the estate recovered in a malpractice action for the same condition or injury for which the plan had paid medical expenses.  Thus, the plan’s subrogation claims succeeded in that case.

Note:  Though not cited in by the Stratton court, the seminal decisions on this issue are two Fourth Circuit cases: Liberty Corp. v. NCNB National Bank of South Carolina, 984 F.2d 1383 (4th Cir. 1993) and McInnis v. Provident Life & Accident Ins. Co., 21 F.3d 586 (4th Cir. 1994).  See discussion of these cases in Caterpillar, Inc. v. Wilhelm, 824 F. Supp. 2d 828 (C.D. Ill. 2009).