This appeal 1 presents two somewhat thorny issues relating to the remedial scope and application of the Federal Tort Claims Act (FTCA), 28 U.S.C. §§ 1346(b), 2671-2680. Initially, we hold that the FTCA’s intentional tort exclusion bars a claim for damages based on the unauthorized performance of surgery. We then conclude, however, that the operation of that exclusion is nullified in the present context by an immunity statute dealing specifically with medical tort claims arising out of the actions of Veterans Administration (VA) personnel.
I
Plaintiff Verdie Mae Franklin, on her own behalf and as administratrix of the estate of her late husband, Lonnie B. Franklin, appeals from a judgment of the district court dismissing this action under the FTCA. Mrs. Franklin brought suit against the United States claiming the death of her husband was the result of unauthorized surgery performed at a VA hospital in Oklahoma City, Oklahoma. The district court held that the action was in essence one for battery and therefore barred by the intentional tort exclusion contained in 28 U.S.C. § 2680(h), which specifies that the waiver of sovereign immunity effected by the FTCA does not extend to battery claims unless the conduct of investigative or law enforcement officers is involved. We review this question of subject matter jurisdiction de novo.
See, e.g., Maddick v. United States,
Within the scope of its waiver of sovereign immunity, the FTCA makes the United States liable on tort claims “in the same manner and to the same extent as a private individual under like circumstances,” 28 U.S.C. § 2674, and “in accordance with the law of the place where the act or omission occurred,” 28 U.S.C. § 1346(b). Thus, we resolve questions of liability under the FTCA in accordance with the law of the state where the alleged tortious activity took place.
See Flynn v. United States,
In contrast to questions of liability, however, the threshold jurisdictional issue whether the government has even consented to a certain type of tort suit, particularly as that issue entails interpretation of the various exceptions to the waiver of immunity listed in § 2680(h), is a matter of federal law.
United States v. Neustadt,
In the general area of unauthorized medical treatment, the traditionally recognized theory of recovery has been that of battery. See, e.g., 61 Am.Jur.2d Physicians, Surgeons, Etc. § 197 (1981); Restatement of Torts § 13 cmt. e, § 16 cmt. a, illus. 1, § 18 cmt. e, illus. 1 (1934); Restatement (Second) of Torts § 13 cmt. e, § 18 cmt. d, illus. 1 (1965). More recently, however, courts and legislatures have recognized a particular subspecies of negligent unauthorized treatment, in which the patient admittedly consented to surgery, but on the basis of an inadequate disclosure of the medical considerations involved, such as potential risks, benefits, and alternative treatment options. This exception to common law battery, often referred to as the doctrine of informed consent, is evidently now also the prevailing view. See 61 Am.Jur.2d Physicians, Surgeons, Etc., § 199; W. Page Keeton et al., Prosser and Keeton on the Law of Torts (Prosser) § 18, 120-21 (5th ed. 1984). Oklahoma recognizes and distinguishes these two distinct causes of action in a fairly representative manner:
If treatment is completely unauthorized and performed without any consent at all, there has been a battery. However, if the physician obtains a patient’s consent but has breached his duty to inform, the patient has a cause of action sounding in negligence for failure to inform the patient of his options, regardless of the due care exercised at treatment, assuming there is injury.
Scott v. Bradford,
In light of the intentional tort exclusion set out in § 2680(h), this distinction between the doctrines of informed consent and medical battery is critical to the cause of action under review. If the negligence theory applies, redress against the government under the FTCA is available,
see, e.g., Haley v. United States,
*1497 The factual basis for the claim asserted in the two-page complaint was that, although Mrs. Franklin and her husband had both made it clear he was not to be operated on without her prior approval, surgery ultimately was performed without either’s consent. Aplt. Addendum Vol. I, tab 1. This is unquestionably a medical battery claim. The complaint neither invoked the doctrine of informed consent by name nor alleged any of the elements of the tort. Thus, even though the complaint identified plaintiffs alleged damages as the “direct and proximate result of the negligence of the Defendant,” id. at 2 (emphasis added), it stated a claim for battery, not negligence, and therefore ran afoul of the § 2680(h) exclusion.
However, before the action was dismissed, the district court entered a pretrial order, which supersedes the complaint as the basis for disposition of the case.
See Hullman v. Board of Trustees of Pratt Community College,
This argument actually raises two separate questions' that must be addressed sequentially. First, should a claim of unauthorized surgery based on incapacity to consent be treated as merely one variant of the lack-of-consent theory and, thus, a medical battery, or should it be grouped with uninformed consent claims under the rubric of negligence?
3
Applying a similar medical battery/informed consent distinction from Illinois law, the Seventh Circuit held in
Lojuk v. Quandt,
*1498
That brings us to the second question alluded to above, which appears to be the focus of Mrs. Franklin’s appellate argument, i.e., even if the immediate cause of injury is deemed a battery, can an FTCA plaintiff escape the bar of § 2680(h) by arguing that the battery was the natural consequence of prior governmental negligence, here, for example, in inadequately assessing Mr. Franklin’s capacity to consent and failing to recognize the need to consult Mrs. Franklin?
See
Aplt. Brief in Chief at 4-6. The only apposite authority cited to support an affirmative answer to this question is
Shearer v. United States,
The following passage from the plurality opinion in Shearer has informed the interpretation of § 2680(h) in numerous subsequent cases:
The Federal Tort Claims Act’s waiver of sovereign immunity does not apply to “[a]ny claim arising out of assault [or] battery,” 28 U.S.C. § 2680(h), and it is clear that [plaintiffs] claim arises out of the battery committed by Private Heard. No semantical recasting of events can alter the fact that the battery was the immediate cause of [the decedent’s] death and, consequently, the basis of [plaintiffs] claim.
[Plaintiff] cannot avoid the reach of § 2680(h) by framing her complaint in terms of negligent failure to prevent the assault and battery. Section 2680(h) does not merely bar claims for assault or battery; in sweeping language it excludes any claim arising out of assault or battery. We read this provision to cover claims like [plaintiffs] that sound in negligence but stem from a battery committed by a Government employee.
Since
Shearer,
however, the Supreme Court has recognized one category of battery-related cases that falls outside the preclusive compass of § 2680(h). Specifically, when a negligence claim against the government arises out of an incident of battery but is in no way contingent on the perpetrator’s federal employment status, i.e., when the government’s liability is based on its breach of a duty owed the victim that is independent of its relationship, if any, to the perpetrator, § 2680(h) does not bar recovery under the FTCA.
Sheridan v. United States,
Here, the government would have no potential liability if not for the fact that those responsible for the intentionally tortious medical care alleged in the complaint were VA employees. 6 Indeed, the “negligent” pre-surgical conduct complained of in the pretrial order is part and parcel of the very battery claim that has implicated § 2680(h) from the outset. Consequently, the distinction drawn in Sheridan does not alter our conclusion, under the Shearer approach previously adopted by this circuit in Hoot, 7 that this case falls within the scope of § 2680(h).
One last matter raised by the pretrial order should be addressed briefly. The order includes two allegations of institutional-type negligence that might implicate, on a more general level, the direct responsibility of the VA hospital itself: “(i) Defendant owed a duty to [plaintiffs] to follow its procedure regarding consent,” and “(j) Defendant is guilty of negligence for its failure to follow its own procedures regarding consent.” Aplt. Addendum Vol. I, tab 2, at 4. Beyond these vague and conclusory allegations of negligence, however, the pretrial order fails to specify what the pertinent procedures were, why their nonobservance was material, and how all this related to Mr. Franklin’s death.
Negligence standing alone, without causal connection to cognizable injury, is not actionable.
Key v. Liquid Energy Corp.,
Accordingly, we agree with the district court that the cause of action asserted by Mrs. Franklin falls within the scope of § 2680(h). Under most circumstances, that conclusion would mandate dismissal of the case for lack of subject matter jurisdiction.
See, e.g., Davis v. United States,
II
The Federal Employees Liability Reform and Tort Compensation Act (Liability Reform Act), Pub.L. No. 100-694, 102 Stat. 4563, 4564 (1988), substantially amended 28 U.S.C. § 2679 to make the FTCA the exclusive’ remedial vehicle for redress of tortious
*1500
acts committed by
“any
employee of the Government while acting within the scope of his office or employment.” Section 2679(b)(1) (emphasis added). Prior to passage of the Liability Reform Act, however, various individually-targeted immunity statutes served to shield particular groups of government, employees from personal tort liability in the same manner, for example, 10 U.S.C. § 1089 (military medical personnel), 38 U.S.C. § 4116 (current version at 38 U.S.C. § 7316
8
) (VA medical personnel), and 42 U.S.C. § 233 (Public Health Service medical personnel).
See United States v. Smith,
The operative provision of the VA immunity statute, § 4116(a), which made the FTCA remedy the exclusive means of redress for medical-related torts, was construed to protect VA personnel from liability only when the government assumed potential liability under the FTCA. Thus, in circumstances where the government’s waiver of sovereign immunity was excluded by § 2680(h) and, therefore, the injured party had no possible remedy under the FTCA, a cause of action against the responsible health worker could be maintained.
See, e.g., Lojuk v. Quandt,
For many years, VA medical personnel have been protected from personal liability in medical malpractice actions arising out of allegedly negligent conduct in the furnishing of medical care or treatment to veterans. However, the Government does not extend this immunity to actions arising out of intentional conduct — so-called “intentional torts.” In some instances, State law characterizes an act of medical malpractice as an intentional tort, leaving VA medical personnel potentially liable for an action for which the law intends the Government to assume liability. As an exam-pie, if a patient consents to an operation on his left elbow, but the physician mistakenly operates on the right elbow, responsibility for this action would lie with the United States. However, if the suit was based on a theory that a battery occurred, which is defined as any contact with a person without that person’s consent, the Government is not allowed to assume the employee’s liability. In essence, State law, which controls the character of the action brought against VA medical personnel, could defeat the intent of the Federal law to provide such employees with immunity.
H.R.Rep. No. 100-191, 100th Cong., 2d Sess. 19 (1988), reprinted in 1988 U.S.C.C.A.N. 432, 450. The precise method chosen by Congress to address this development is critical to the application of § 2680(h) in this case.
Congress could have resolved the problem directly by amending § 4116(a) to (1) state specifically that personal VA medical immunity extended to intentional torts (regardless of the § 2680(h) exclusion), or (2) indicate more generally that such immunity was not contingent on the existence of a substitute remedy under the FTCA (thus making § 2680(h) irrelevant). If either of these approaches had been taken, the government’s liability exposure under the FTCA would not have been affected; instead, the injured party would have been left without redress. However, Congress took an entirely different tack. Retaining the idea that extensions of VA personal immunity should be contingent on the government’s correlative assumption of FTCA liability — and thereby preserving a potential remedy for the injured party — Congress chose instead “to expand the circumstances under which the Federal government accepts liability for the acts of its employees acting within the scope of their employment so as to cover actions of VA health-care employees that are characterized as intentional torts under the laws of various states.” 1988 U.S.C.C.A.N. at 502-03 (emphasis added). To accomplish this, Congress added the following provision to § 4116:
*1501 (f) The exception provided in section 2680(h) of title 28 shall not apply to any claim arising out of a negligent or wrongful act or omission of any person described in subsection (a) of this section in furnishing medical care or treatment ... while in the exercise of such person’s duties in or for the Department of Medicine and Surgery.
This amendment applies to pre-existing claims, such as those considered here, “as to which a final judgment ha[d] not been rendered as of the date of the enactment [May 20, 1988].” Pub.L. No. 100-322, § 203(a)(2), 102 Stat. 509.
Although we know of no case applying § 4116(f) to an FTCA claim, we have found several decisions construing its essentially identical counterpart from the military medical immunity act, 10 U.S.C. § 1089(e), in that context. These cases indicate that similar historical antecedents and congressional motives underlay inclusion of the same provision in both immunity statutes,
see also
1988 U.S.C.C.A.N. at 450,459, and, moreover, that the effect of the provision is to insulate the individual government employee by nullifying § 2680(h) and thereby expanding the injured party’s remedy against the government under the FTCA.
See, e.g., Newman v. Soballe,
As the contra citations reflect, there is a dissenting view on this question, but it is very difficult to reconcile with the legislative history recounted above and, more importantly, with the plain, unqualified language of the statute, which states that the § 2680(h) exclusion “shall not apply to any claim arising out of a negligent or wrongful act or omission [of the particular agency’s medical personnel]” (emphasis added), not just to nonFTCA claims asserted against the individual employees. If Congress had wished to leave the government’s sovereign immunity undisturbed, it could simply have extended these personal immunities directly, without abrogating the FTCA exclusion contained in § 2680(h). Furthermore, we note that the extension of personal immunities in conjunction with the correlative restriction of sovereign immunity is entirely consistent with the overall scheme of immunizing employees indirectly through FTCA exclusivity statutes to begin with.
Even accepting the construction of § 4116(f) advanced thus far, however, the question remains whether the subsequent passage of the more comprehensive Liability Reform Act, particularly its amendment to 28 U.S.C. § 2679(b) mentioned at the outset of this section, altered the government’s FTCA liability in any pertinent respect. It is true, for instance, that this new legislation immunizes
all
federal employees without regard to either their residual liability exposure under the existing immunity statutes (such as § 1089 and § 4116) or the government’s assumption of tort responsibility for their newly immunized actions (in contrast to the earlier statutes, the text and history of the Liability Reform Act reflect no intent to offset personal immunity with government liability).
See United States v. Smith,
499 U.S. at — - —, — - —,
It is a “ ‘cardinal principle of statutory construction that repeals by implication are not favored.’ ”
AMREP Corp. v.
*1502
FTC,
Accordingly, we hold that § 2680(h) does not bar application of the FTCA to tort claims arising out of the conduct of VA medical personnel within the scope of § 4116(f). Should Congress decide that, in light of its new approach to employee immunity reflected in the Liability Reform Act, this result is no longer a necessary or desirable accommodation for the extension of tort immunity to VA personnel, Congress can always repeal the pre-existing statutory scheme in which it expressly made that accommodation. Unless and until such action is taken, however, we must give effect to the plain language of § 4116(f).
III
Finally, Mrs. Franklin challenges two collateral rulings issued by the district court before final disposition of the case. First, she objects to the denial of her motion for additional time to obtain an expert witness to support her belated allegations regarding informed consent/negligence. The district court deemed this request “completely untimely, speculative, prejudicial to the defendant, as well as contrary to the Court’s scheduling order previously entered, upon which the parties and Court have relied.” Aplt. Addendum Vol. I, tab 3, at 8. We do not take issue with this assessment. However, given our conclusion in section I that this case does not implicate negligence principles, we are constrained to hold simply that the matter is moot.
Mrs. Franklin’s second objection is that the district court erred in granting the government’s motion to reduce the ad dam-num clause in the complaint pursuant to 28 U.S.C. § 2675(b). This provision states:
Action under [the FTCA] shall not be instituted for any sum in excess of the amount of the claim presented to the federal agency [as required for exhaustion of administrative remedies under § 2675(a) ], except where the increased amount is based upon newly discovered evidence not reasonably discoverable at the time of presenting the claim to the federal agency, or upon allegation and proof of intervening facts, relating to the amount of the claim.
Id. (emphasis added).
The basis for the increased amount sought by Mrs. Franklin is her allegation that the *1503 hospital form purportedly reflecting Mr. Franklin’s signed consent to surgery, first produced in discovery years after the events in question (the hospital evidently did not include it with other materials informally made available much earlier), has been “altered or otherwise misrepresented” by the government. Aplt. Brief in Chief at 9. Referring to the operative statutory. condition underscored above, the district court denied increased damages on this basis because there was “no indication in plaintiffs response [to the government’s motion] as to how this relates ‘to the amount of the claim’ as required by statute, or why that informa-ción would justify increased damages.” Aplt. Addendum Vol. I, tab 3, at 7.
Likewise, on appeal, there is no legal argument or authority provided to support the facially dubious position that fraudulent or abusive discovery practices relate to the amount of the underlying claim in litigation. This omission alone would warrant affirmance of the district court’s ruling on the point.
See Phillips v. Calhoun,
The judgment of the United States District Court for the Western District of Oklahoma dismissing this action is AFFIRMED in part, REVERSED in part, and the cause is REMANDED for further proceedings consistent with this opinion.
Notes
. The parties have indicated they do not seek oral argument and, after examining the briefs and appellate record, this panel has determined unanimously that oral argument would not materially assist the determination of this appeal. See Fed.R.App.P. 34(a); 10th Cir.R. 34.1.9. The case is therefore ordered submitted without oral argument.
. A few courts have avoided this result by regarding medical batteries as only "technical” batteries that should escape the reach of § 2680(h).
See Woods v. United States,
. The plaintiff's position in the pretrial order was ambiguous on the matter, characterizing the associated tort claim as battery at one point and as negligence at another. See Aplt. Addendum Vol. I, tab 2, at 2-4.
. The attempt to avoid this conclusion by alternatively alleging that Mr. Franklin's incapacity vitiated his
informed consent, see
Aplt. Addendum Vol. I, tab 2, at 3, is of no avail. Because a claim of uninformed consent proceeds from the premise that consent was in fact given and focuses instead on the adequacy of pre-consent disclosures,
see, e.g., Scott,
. Four justices concurred on the alternative basis that the plaintiff's claim was, in any event, barred under the
Feres
doctrine,
see Feres v. United States,
. We note that neither the complaint nor the pretrial order alleges a claim for negligent hiring, training, or supervision of the VA personnel involved, and, in any event, even after
Sheridan
it is doubtful on our alleged facts whether such a claim, which would still ultimately derive from the government's employment relationship to the immediate tortfeasors, would escape the reach of § 2680(h).
See Sheridan v. United States,
. Absent sufficient reason to conclude that a prior decision of this court is no longer good law, this panel is not free to depart from circuit precedent.
United States ex rel. Rent It Co. v. Aetna Casualty & Surety Co.,
. For clarity of exposition, we shall refer to this statute throughout by its designation at the time of the events in this case. The version set out under the new designation includes no pertinent substantive changes.
. Indeed, the Supreme Court was asked in
Smith
to hold that the Liability Reform Act impliedly repealed § 1089 with respect to an issue of government
employee
liability.
See Smith,
499 U.S. at —,
