Barbara Gibson v. United States
1 F.4th 1129
| 9th Cir. | 2021Background
- In Sept. 2015 Johnny Gibson presented to a federally funded Montana clinic (CMCHC) with chest pain; clinicians did not evaluate or refer for a cardiac workup. One week later he suffered a fatal myocardial infarction and died after transport to St. Vincent Hospital.
- In 2018 Barbara Gibson (personal representative) filed FTCA wrongful-death and survival claims; the United States conceded negligence and the district court entered liability for the clinic’s failure to evaluate/treat.
- At trial the district court awarded damages but excluded the billed medical and ambulance charges (~$165,651) because St. Vincent and the ambulance provider had written off those bills under charity/hardship programs and never sought collection.
- Montana amended Mont. Code Ann. § 27-1-308 in 2021 to bar consideration of provider charges that were resolved by discounts, write-offs, gifts, etc., but that amendment applies only to claims accruing on or after April 30, 2021; Gibson’s claim accrued earlier.
- Because Montana precedent is unsettled on whether charitable write-offs may be recovered as damages or treated as a collateral source (and whether such write-offs fall under the “gifts or gratuitous contributions” exception), the Ninth Circuit certified two questions to the Montana Supreme Court and stayed further appellate submission.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether, for pre-4/30/2021 claims, a plaintiff in a survival action may recover the reasonable value of medical/ambulance care when providers wrote off the charges under charitable care programs | Gibson: may recover reasonable value despite write-off; recovery restores pre‑tort position and a write-off does not eliminate the reasonable value of services | U.S.: write-off means no actual economic loss to the estate (provider forgave the debt), so such charges should not be recoverable | Ninth Circuit did not decide on the merits; certified the question to the Montana Supreme Court |
| Whether a charitable care write-off is a collateral source under Mont. Code Ann. § 27-1-307, and if so whether it fits the “gifts or gratuitous contributions” exception (§ 27-1-307(1)(c)) | Gibson: written-off amounts are not properly treated as collateral-source offsets that bar recovery of reasonable value | U.S.: written-off amounts function as collateral-source payments/gifts and should reduce or eliminate recoverable medical damages under the collateral-source framework | Ninth Circuit certified the question to the Montana Supreme Court for authoritative interpretation |
Key Cases Cited
- F.D.I.C. v. Meyer, 510 U.S. 471 (federal FTCA choice-of-law principle)
- Newbury v. State Farm Fire & Cas. Ins. Co., 184 P.3d 1021 (Mont. 2008) (tort awards should not produce windfalls beyond medical expenses)
- Conway v. Benefis Health Sys., Inc., 297 P.3d 1200 (Mont. 2013) (similar principle limiting windfall recovery)
- Lampi v. Speed, 261 P.3d 1000 (Mont. 2011) (damages aim to restore pre‑tort position)
- Meek v. Mont. Eighth Judicial Dist., 349 P.3d 493 (Mont. 2015) (hospital bill admissible; court declined to decide recoverability of full bill when insurer/Medicare paid less)
- Five U’s, Inc. v. Burger King Corp., 962 P.2d 1218 (Mont. 1998) (Montana has cited Restatement authority on related tort rules)