47 F.4th 12
1st Cir.2022Background
- In 2010, minor C.A.K. received ER treatment at Hospital San Antonio; her condition worsened and she later lost nearly all kidney function, requiring dialysis and a transplant in 2014.
- Kenyon (parents and child) sued Hospital San Antonio (HSA) and several ER physicians for medical malpractice; original federal EMTALA claim was dismissed in 2013 and malpractice claims were refiled in 2014 in federal court under diversity jurisdiction.
- Puerto Rico amended Article 41.050 several times (2011, 2012, 2013 (Law 150), and 2017 (Law 99)); Law 150 (2013) included a retroactivity clause applying the immunity/limits to causes filed since June 27, 2011 that were not finally adjudicated.
- Defendants (physicians and insurer SIMED) moved for summary judgment arguing Law 150 immunized the physicians from malpractice liability; the district court granted partial summary judgment for the physicians and SIMED but left HSA claims to proceed.
- Kenyon sought reconsideration citing Oquendo-Lorenzo; the district court denied reconsideration. Appeals of both the summary judgment and denial of reconsideration were consolidated before the First Circuit.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Retroactivity scope of Law 150: does it apply to Kenyon's suit filed after June 27, 2011? | Kenyon: retroactivity ambiguous; should be read narrowly and not apply to conduct predating San Antonio-specific protections. | Defendants: retroactivity text unambiguous and covers causes filed since June 27, 2011 that were not finally adjudicated. | Held: Law 150's retroactivity clause plainly applies to Kenyon's post-2011 filed, unresolved claims. |
| Immunity under Article 41.050: are the ER physicians immune from malpractice suits? | Kenyon: statute shouldn't bar suit for conduct before the physicians were explicitly included; immunity not appropriate. | Defendants: physicians fall within Article 41.050 protections for ER staff at San Antonio Hospital. | Held: Physicians are immune under the 2013 version of Article 41.050; summary judgment proper as to physicians and SIMED. |
| Due process (Commonwealth and federal): does retroactive application violate due process or access-to-courts? | Kenyon: retroactivity deprives vested property right in cause of action and fundamental right to access courts; strict scrutiny required. | Defendants: no vested/fundamental right; rational-basis review applies and statute rationally aims to protect public coffers and health services. | Held: Kenyon waived federal claim; under Commonwealth due process (evaluated by federal standards) only rational‑basis review applies; statute is not arbitrary or irrational and does not violate due process. |
| Puerto Rico Civil Code §3 (non-retroactivity/vested rights): does §3 bar retroactive application? | Kenyon: §3 forbids retroactivity prejudicing acquired rights; his cause of action is an acquired right. | Defendants: tort causes are not acquired/vested rights absent final judgment; PR precedent permits retroactivity when public interest justifies it. | Held: §3 does not bar retroactive application here; Kenyon's tort claim was not a vested/acquired right. |
| Motion to reconsider based on Oquendo-Lorenzo: was denial an abuse of discretion? | Kenyon: Oquendo-Lorenzo changed controlling law such that reconsideration was warranted. | Defendants: Oquendo-Lorenzo is persuasive only and factually distinct (surgeon/OG issues), not an intervening change. | Held: Denial affirmed — no intervening change and decision not on point. |
Key Cases Cited
- Hannon v. City of Newton, 744 F.3d 759 (1st Cir. 2014) (standard of review for legal questions on appeal)
- Quality Cleaning Prods. R.C., Inc. v. SCA Tissue N. Am., LLC, 794 F.3d 200 (1st Cir. 2015) (federal court must apply substantive Puerto Rico law and local interpretive methods)
- Hammond v. United States, 786 F.2d 8 (1st Cir. 1986) (retroactive statute foreclosing ongoing tort action does not necessarily violate due process because tort rights do not vest until final judgment)
- Defendini Collazo v. E.L.A., 134 P.R. Dec. 28 (P.R. 1993) (Puerto Rico Supreme Court: no fundamental right to bring civil action; economic/regulatory statutes reviewed for reasonableness)
- Oquendo-Lorenzo v. Hospital San Antonio, Inc., 256 F. Supp. 3d 103 (D.P.R. 2017) (district court decision addressing Article 41.050 application to different physicians at San Antonio Hospital)
- Puffer's Hardware, Inc. v. Donovan, 742 F.2d 12 (1st Cir. 1984) (Rule 5.1 notice defects do not necessarily forfeit constitutional claims; appellate discretion on response)
- Nieves v. Univ. of P.R., 7 F.3d 270 (1st Cir. 1993) (rejecting interpretation that a fundamental right to commence civil actions exists under Puerto Rico law)
- Nebbia v. New York, 291 U.S. 502 (1934) (state economic regulations reviewed under rational-basis principles)