Boyd BURCHFIELD, Plaintiff-Appellant, v. UNITED STATES of America, Department of Veteran Affairs, Defendants-Appellees.
No. 98-2024.
United States Court of Appeals, Eleventh Circuit.
March 2, 1999.
168 F.3d 1252
Harry M. Hobbs, Walter O. Hobbs, Jr., Tampa, FL, for Plaintiff-Appellant. Charles R. Wilson, U.S. Attorney, Tamra Phipps, Asst. U.S. Attorney, Susan Roark Waldron, Asst. U.S. Attorney, Tampa, FL, for Defendants-Appellees.
A plaintiff who sues under the Federal Tort Claims Act,
I.
While on active duty with the United States Army in 1968, Burchfield developed a tumor of the pituitary gland. Army doctors operated to remove the tumor, but it reoccurred in 1986 and Burchfield underwent five additional surgeries, the last in 1990. As a result of the surgeries, Burchfield developed panhypopituitarism (non-functioning of the pituitary gland), which caused his body to stop producing cortisone, thyroid hormone, and testosterone. To replace some of these natural hormones his doctors, VA employees, prescribed a corticosteroid, Prednisone. As far as the record before us shows, Burchfield‘s doctors did not accompany this prescription with a program of dietary supplements to combat osteoporosis, such as Vitamin D, calcium or calcitonin. The doctors also prescribed injectable testosterone, which can help to restore sexual function and prevent osteoporosis. After a short time Burchfield discontinued the testosterone treatments, telling his doctors that he disliked their side effects and that he was not interested in regaining sexual function. It is not clear whether Burchfield‘s doctors informed him that injectable testosterone treatments could help prevent osteoporosis.
Pursuant to the requirements of
Beginning August of 1990 and in subsequent years, physicians employed by the Department of Veterans Affairs prescribed a medication for Mr. Burchfield, prednisone. Mr. Burchfield‘s use of this medicine caused him to develop osteoporosis, resulting in severe and continuing maladies and injuries, including but not limited to the collapse or fracture of several vertebrae and ribs. . . . These injuries resulted from negligence of the Department‘s agents.2
The claim listed thirteen doctors who had treated Burchfield. After six months, during which the VA failed to make a final disposition of the claim, Burchfield filed suit in district court. His complaint alleged, inter alia, that osteoporosis was a “known and anticipated effect[] of corticosteroid therapy”3 and that his doctors were negligent in failing to initially diagnose osteoporosis, to monitor him for the condition during his treatment, and to administer a bone strengthening regimen.4 At the bench trial, Burchfield‘s medical expert, Dr. Thomas Zizic, stated that prescribing the corticosteroid Prednisone did not in itself deviate from the standard of care.5 He testified, however, that Burchfield‘s doctors deviated from the standard of care by treating him with Prednisone without taking certain other steps, such as performing initial baseline tests for osteoporosis and prescribing such supplements as calcium and Vitamin D to counteract the treatment‘s effects.6
After Dr. Zizic testified, the district court addressed the issue of its jurisdiction under the FTCA. It found that Burchfield‘s administrative claim had alleged only that the VA‘s doctors were negligent in prescribing Prednisone, while at trial Burchfield had raised a “significant[ly] different claim[]” that the VA had “caus[ed] or contribut[ed] to the exacerbation of osteoporosis by failing to diagnose it properly and by failing to treat it properly.”7 On the basis of this distinction, the district court held that Burchfield had failed to meet the requirements of
II.
We review a district court‘s grant of judgment as a matter of law de novo. Morris v. Crow, 117 F.3d 449, 455 (11th Cir.1997).
A plaintiff bringing a claim against the United States under the FTCA must first present the claim to the appropriate federal agency and wait for the agency to finally deny it. An agency‘s failure to dispose of a claim within six months is deemed to be a final denial. See
To satisfy
Congress had a dual purpose in enacting
We keep
An administrative agency is deemed to be on notice not only of the theories of recovery stated in the claim, but of the theories of recovery that its reasonable investigation of the specific allegations of the claim should reveal. In Rise v. United States, 630 F.2d 1068 (5th Cir.1980), the plaintiff presented an administrative claim that Army physicians failed to diagnose and treat his wife‘s aneurysm. After bringing suit on that assertion, he amended his complaint to allege
The district court in this case noted Rise‘s holding that an administrative claim does not need specifically to enumerate all possible theories of liability. It nonetheless found that Burchfield‘s claim could not give notice of the issues raised in his lawsuit; this was not because Burchfield had failed to lay out all of his legal theories, but because he had not drawn the VA‘s attention to certain facts, such as his doctors’ failure to diagnose osteoporosis, perform initial tests, and prescribe Vitamin D or calcium.10 We conclude that the court interpreted Rise too narrowly. An administrative claim can put an agency on notice of theories of liability not spelled out therein. All that is required is that the theory put forward in the complaint filed in the district court be based on the facts that are stated in the administrative claim.
In this case, it is hard to imagine what facts Burchfield could have included in his administrative claim that would have allowed the VA to conduct a more thorough investigation of the claim. The claim stated all the essential aspects of Burchfield‘s case—the time period, the fact that his doctors had prescribed Prednisone, the causal link between his use of the Prednisone and his osteoporosis, and the assertion that the VA‘s agents were negligent—although it did not contain every factual detail that he later introduced at trial. These other details, such as his doctors’ failure to prescribe dietary supplements and to monitor his condition, were so closely related to the essential material contained in the claim that they would have come to light during the VA‘s reasonable investigation of the claim. An agency cannot use an overly technical reading of the language of a claim as a reason to turn a blind eye to facts that become obvious when it investigates the alleged events.
In Rise, we held that because the plaintiff‘s administrative claim mentioned a patient‘s transfer to a civilian hospital, “the Army‘s investigation of the death should have produced . . . evidence that [the civilian hospital‘s] facilities may have been inadequate . . . and, consequently, that referring Mrs. Rise there might have been negligence.” Rise, 630 F.2d at 1071. The Second Circuit similarly has held that an administrative claim can put an agency on notice of facts it should discover during its investigation of the claim. In Johnson by Johnson v. United States, 788 F.2d 845, 848-49 (2d Cir.1986), it found that an administrative claim, which alleged that a government employee had attacked a minor but did not mention facts suggesting that anyone other than the employee was at fault, gave the government sufficient notice of the plaintiff‘s negligent supervision claim. “Although the claim supplied no facts evidencing negligent supervision and did not allege all the factual elements of such a theory of liability, a reasonably thorough investigation of the incident should have uncovered any pertinent information in the government‘s possession relating to the agency‘s knowledge, or lack of knowledge, of any prior sexual misconduct by its employee . . . .” Id. at 849 (citing Rise).
Our holding does not mean that agency investigations must go beyond the scope of the matters alleged in administrative claims.
Here, Burchfield‘s administrative claim stated that his doctors prescribed Prednisone and that his “use of” the Prednisone caused osteoporosis. It gave the VA sufficient information, including the dates of his treatment and the names of his doctors, to allow the VA to refer to the medical records in its possession to investigate Burchfield‘s use of the medication and the surrounding circumstances. Burchfield presented evidence, in the form of Dr. Zizic‘s testimony, that a doctor who prescribed Prednisone to a patient in Burchfield‘s condition had a duty to monitor, and take steps to prevent, the medication‘s side effects. A person with reasonable expertise in medicine, investigating Burchfield‘s claim that his use of Prednisone caused osteoporosis, would therefore have asked whether the doctors who prescribed the Prednisone also undertook the closely related tasks of prescribing appropriate accompanying medication, such as calcium and Vitamin D, and monitoring the drug‘s effects, and would have discovered that they did not. Thus, Burchfield‘s administrative claim satisfied the requirements of
III.
Accordingly, we REVERSE the decision of the district court and REMAND the case for further proceedings in accordance with this opinion.
