South Carolina Medical Malpractice Legislation

S 0083 General Bill (State of South Carolina), By McConnell, Moore, Campsen, Ryberg, O'Dell, Elliott,
Alexander, Gregory, Leatherman, Richardson and Bryant

A BILL TO ENACT THE "TORT REFORM ACT OF 2005 RELATING TO MEDICAL MALPRACTICE"
BY AMENDING TITLE 15, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO CIVIL
REMEDIES AND PROCEDURES, BY ADDING ARTICLE 3, CHAPTER 32, SO AS TO ESTABLISH
PROCEDURES GOVERNING THE AWARD OF NONECONOMIC DAMAGES;

TO AMEND CHAPTER 35,
TITLE 15, RELATING TO CIVIL REMEDIES AND PROCEDURES, BY ADDING SECTION
15-35-400, SO AS TO PROVIDE FOR OFFERS OF JUDGMENT AFTER COMMENCEMENT OF ANY
CIVIL ACTION BASED ON CONTRACT OR SEEKING THE RECOVERY OF MONEY DAMAGES; TO
AMEND CHAPTER 36, TITLE 15, RELATING TO CIVIL REMEDIES AND PROCEDURES, BY
ADDING SECTION 15-36-100, SO AS TO ESTABLISH STANDARDS FOR EXPERT WITNESSES IN
PROFESSIONAL MALPRACTICE ACTIONS; TO AMEND TITLE 15, RELATING TO CIVIL
REMEDIES AND PROCEDURES, BY ADDING CHAPTER 79, SO AS TO PROVIDE FOR MANDATORY
MEDIATION AND TO PERMIT BINDING ARBITRATION IN MEDICAL MALPRACTICE ACTIONS; TO
AMEND ARTICLE 1, CHAPTER 79, TITLE 38, RELATING TO THE JOINT UNDERWRITING
ASSOCIATION AND BOARD OF GOVERNORS FOR THE PATIENTS' COMPENSATION FUND, BY
ADDING SECTION 38-79-40, SO AS TO PROHIBIT A PERSON SERVING IN THESE AGENCIES
FROM BEING EMPLOYED OR COMPENSATED BY EITHER OF THESE AGENCIES; TO AMEND
SECTION 38-79-460, RELATING TO THE PATIENTS' COMPENSATION FUND, SO AS TO
PROVIDE THAT THE FUND SHALL BE MANAGED BY THE BOARD OF GOVERNORS RATHER THAN
THE STATE TREASURER; TO AMEND SECTION 38-79-470, RELATING TO THE PATIENTS'
COMPENSATION FUND, SO AS TO PROVIDE THAT MONEY SHALL BE WITHDRAWN FROM THE
FUND UPON SIGNATURE OF THE CHAIRMAN OF THE BOARD OF GOVERNORS; AND TO AMEND
SECTION 40-47-211, RELATING TO THE BOARD OF MEDICAL EXAMINERS, SO AS TO ALTER
THE MEMBERSHIP OF THE BOARD BY PROVIDING FOR LAY MEMBERS.

12/15/04 Senate Prefiled
12/15/04 Senate Referred to Committee on Judiciary
01/11/05 Senate Introduced and read first time SJ-123
01/11/05 Senate Referred to Committee on Judiciary SJ-123
02/02/05 Senate Committee report: Majority favorable with amend.,
minority unfavorable Judiciary SJ-24
02/03/05 Senate Special order SJ-23
02/03/05 Scrivener's error corrected
02/08/05 Senate Debate interrupted SJ-30
02/09/05 Senate Debate interrupted SJ-26
02/10/05 Senate Debate interrupted SJ-25

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VERSIONS OF THIS BILL

12/15/2004
2/2/2005
2/3/2005

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S. 83
Indicates Matter Stricken

Indicates New Matter

COMMITTEE REPORT

February 2, 2005

S. 83

Introduced by Senators McConnell, Moore, Campsen, Ryberg, O'Dell, Elliott, Alexander, Gregory, Leatherman, Richardson and Bryant

S. Printed 2/2/05--S. [SEC 2/3/05 5:11 PM]

Read the first time January 11, 2005.

THE COMMITTEE ON JUDICIARY
To whom was referred a Bill (S. 83) to enact the "Tort Reform Act of 2005 Relating to Medical Malpractice" by amending Title 15, Code of Laws of South Carolina, 1976, relating to civil remedies and, etc., respectfully

REPORT:
That they have duly and carefully considered the same and recommend that the same do pass with amendment:

Amend the bill, as and if amended, by striking all after the enacting words and inserting:

/ PART I

GENERAL ASSEMBLY FINDINGS
SECTION 1. The General Assembly finds that the sections presented in this act constitute one subject as required by Article III, Section 17 of the South Carolina Constitution, in particular finding that each change and each topic relates directly to or in conjunction with other sections to the subject of tort and other civil action reform as clearly enumerated in the title.

The General Assembly further finds that a common purpose or relationship exists among the sections, representing a potential plurality but not disunity of topics, notwithstanding that reasonable minds might differ in identifying more than one topic contained in the act.

PART II

DAMAGES
SECTION 2. Title 15 of the 1976 Code is amended by adding:

"CHAPTER 32

Article 3

Noneconomic Damage Awards
Section 15-32-200. This article may be cited as the 'South Carolina Noneconomic Damage Awards Act of 2005'.

Section 15-32-210. As used in this article, unless the context clearly requires otherwise:

(1) 'Ambulatory surgical facility' means a licensed, distinct, freestanding, self-contained entity that is organized, administered, equipped, and operated exclusively for the purpose of performing surgical procedures or related care, treatment, procedures, and/or services, by licensed health care providers, for which patients are scheduled to arrive, receive surgery or related care, treatment, procedures, and/or services, and be discharged on the same day. This term does not include Abortion Clinics.

(2) 'Claimant' means the person suffering personal injury.

(3) 'Economic damages' means pecuniary damages arising from medical expenses and medical care, rehabilitation services, custodial care, loss of earnings and earning capacity, loss of income, burial costs, loss of use of property, costs of repair or replacement of property, costs of obtaining substitute domestic services, a claim for loss of spousal services, loss of employment, loss of business or employment opportunities, and other monetary losses.

(4) 'Health care institution' an ambulatory surgical facility, a hospital, an institutional general infirmary, a nursing home, and a renal dialysis facility.

(5) 'Health care provider' means a physician, surgeon, osteopath, nurse, oral surgeon, dentist, pharmacist, chiropractor, optometrist, podiatrist, or similar category of licensed health care provider, including a health care practice, association, partnership, or other legal entity.

(6) 'Hospital' means a licensed facility with an organized medical staff to maintain and operate organized facilities and services to accommodate two or more nonrelated persons for the diagnosis, treatment and care of such persons over a period exceeding twenty-four hours and provides medical and surgical care of acute illness, injury or infirmity and may provide obstetrical care, and in which all diagnoses, treatment or care are administered by or performed under the direction of persons currently licensed to practice medicine and surgery in the State of South Carolina. This term includes a hospital that provides specialized service for one type of care, such as tuberculosis, maternity, or orthopedics.

(7) 'Institutional general infirmary' is a licensed facility which is established within the jurisdiction of a larger nonmedical institution and which maintains and operates organized facilities and services to accommodate two or more nonrelated students, residents, or inmates with illness, injury, or infirmity for a period exceeding twenty-four hours for the diagnosis, treatment, and care of such persons and which provides medical, surgical, and professional nursing care, and in which all diagnoses, treatment. or care are administered by or performed under the direction of persons currently licensed to practice medicine and surgery in the State of South Carolina. (See South Carolina Directory of Attorney Resources)

(8) 'Medical malpractice' means doing that which the reasonably prudent health care provider or health care institution would not do or not doing that which the reasonably prudent health care provider or health care institution would do in the same or similar circumstances.

(9) 'Noneconomic damages' means nonpecuniary damages arising from pain, suffering, inconvenience, physical impairment, disfigurement, mental anguish, emotional distress, loss of society and companionship, loss of consortium, injury to reputation, humiliation, other nonpecuniary damages, and any other theory of damages including, but not limited to, fear of loss, illness, or injury.

(10) 'Nursing home' means a licensed facility with an organized nursing staff to maintain and operate organized facilities and services to accommodate two or more unrelated persons over a period exceeding twenty-four hours which is operated either in connection with a hospital or as a freestanding facility for the express or implied purpose of providing skilled nursing services for persons who are not in need of hospital care. This term does not include assisted living, independent living, or community residential care facilities that do not provide skilled nursing services.

(11) 'Personal injury' means injuries to the person including, but not limited to, bodily injuries, mental distress or suffering, loss of wages, loss of services, loss of consortium, and other noneconomic damages and actual economic damages.

(12) 'Personal injury action' means an action for personal injury, including a wrongful death action pursuant to Sections 15-51-10 through 15-51-60 and a survival action pursuant to Section 15-5-90.

(13) 'Renal dialysis facility' means an outpatient facility which offers staff assisted dialysis or training and supported services for self-dialysis to end-stage renal disease patients.

(14) 'Skilled nursing services' means services that:

(a) are ordered by a physician;

(b) require the skills of technical or professional personnel such as registered nurses, licensed practical (vocational) nurses, physical therapists, occupational therapists, and speech pathologists or audiologists; and

Section 15-32-220. (A) In an action on a medical malpractice claim when final judgment is rendered against a health care provider other than a health care institution, the limit of civil liability for noneconomic damages of the health care provider, inclusive of all persons and entities for which vicarious liability theories may apply, is limited to an amount not to exceed two hundred fifty thousand dollars for each claimant, regardless of the number or defendant health care providers other than a health care institution against whom the claim is asserted or the number of separate causes of action on which the claim is based.

(B) In an action on a medical malpractice claim when final judgment is rendered against a single health care institution, the limit of civil liability for noneconomic damages, inclusive of all persons and entities for which vicarious liability theories may apply, is limited to an amount not to exceed two hundred fifty thousand dollars for each claimant.

(C) In an action on a medical malpractice claim when final judgment is rendered against more than one health care institution, the limit of civil liability for noneconomic damages for each health care institution, inclusive of all persons and entities for which vicarious liability theories may apply, is limited to an amount not to exceed two hundred fifty thousand dollars for each claimant and the limit of civil liability for noneconomic damages for all health care institutions, inclusive of all persons and entities for which vicarious liability theories may apply, is limited to an amount not to exceed five hundred thousand dollars for each claimant.

(D) The limitations of this section on the recovery of non-economic damages from a health care provider or health care institution or do not apply to actions in which the plaintiff has suffered paralysis. For purposes of this section, `paralysis' means quadriplegia or paraplegia.

(E) The provisions of this section do not limit the amount of compensation for economic damages suffered by each claimant in a medical malpractice claim.

(F) The limitations for noneconomic damages rendered against any health care provider do not apply if the jury or court determines that the defendant was grossly negligent, wilful, wanton, or reckless, and such conduct was the proximate cause of the claimant's noneconomic damages, or if the defendant has engaged in fraud or misrepresentation related to the claim, or if the defendant altered or destroyed medical records with the purpose of avoiding a claim or liability to the claimant.

(G) At the end of each calendar year, the State Budget and Control Board, Board of Economic Advisors must determine the increase or decrease in the ratio of the Consumer Price Index to the index as of December 31 of the previous year, and the limitation on compensation for noneconomic damages pursuant to subsection (A), (B), or (C) must be increased or decreased accordingly. As soon as practicable after this adjustment is calculated, the Director of the State Budget and Control Board shall submit the revised limitation on compensation to The State Register for publication pursuant to Section 1-23-40(2), and the revised limitation becomes effective upon publication in The State Register. For purposes of this subsection, 'Consumer Price Index' means the Consumer Price Index for All Urban Consumers as published by the United States Department of Labor, Bureau of Labor Statistics.

Section 15-32-230. The provisions of this article do not affect any right, privilege, or provision of the South Carolina Tort Claims Act pursuant to Chapter 78, Title 15."

PART III

PROCEDURAL PROVISIONS
SECTION 3. Chapter 35, Title 15 of the 1976 Code is amended by adding:

"Section 15-35-400. (A) Offer of Judgment. Except in domestic relations actions, after commencement of any civil action based upon contract or seeking the recovery of money damages, whether or not other relief is sought, any party may, at any time more than twenty days before the actual trial date, file with the clerk of the court a written offer of judgment signed by the offeror or his attorney, directed to the opposing party, offering to take judgment in the offeror's favor, or as the case may be, to allow judgment to be taken against the offeror, for a sum stated therein, for property, or to the effect specified in the offer. The offeror shall give notice of the offer of judgment to the offeree's attorney, or if the offeree is not represented by an attorney, to the offeree himself, in accordance with the service rules for motions and other pleadings set forth in the South Carolina Rules of Civil Procedure. Within twenty days after notification, or at least ten days prior to the trial date, whichever date is earlier, the offeree or his attorney may file with the clerk of the court a written acceptance of the offer of judgment. Upon the filing, the clerk shall enter immediately judgment of the stipulation. If the offer of judgment is not accepted within twenty days after notification or prior to or on the tenth day before the actual trial date, whichever date occurs first, the offer shall be considered rejected and evidence thereof is not be admissible except in a proceeding after the trial to fix costs, interests, attorney's fees, and other recoverable monies. Any offeror may withdraw an offer of judgment prior to its acceptance or prior to the date on which it would be considered rejected by giving notice to the offeree or his attorney in accordance with the service rules for motions and other pleadings outlined in the South Carolina Rules of Civil Procedure. Any offeror may file a subsequent offer of judgment in any amount provided that the subsequent offer supercedes any earlier offer that was rejected by the offeree or withdrawn by the offeror, and, on filing, terminates any rights of interest or costs that may have been applicable to the superceded offer. Notwithstanding this provision, an offer is not considered rejected upon the making of a counteroffer by the offeree, but shall remain effective until accepted, rejected, or withdrawn as provided in this subsection. Any and all offers of judgment and any acceptance of offers of judgment must be included by the clerk in the record of the case.

(B) Consequences of Non-Acceptance. If an offer of judgment is not accepted and the offeror obtains a verdict or determination at least as favorable as the rejected offer, the offeror shall be allowed to recover from the offeree: (1) any administrative, filing, or other court costs from the date of the offer until judgment; (2) if the offeror is a plaintiff, eight percent interest computed on the amount of the verdict or award from the date of the offer; or (3) if the offeror is a defendant, a reduction from the judgment or award of eight percent interest computed on the amount of the verdict or award from the date of the offer.

(C) This section shall not be interpreted to abrogate the contractual rights of any party concerning the recovery of attorney's fees or other monies in accordance with the provisions of any written contract between the parties to the action."

SECTION 4. Chapter 36, Title 15 of the 1976 Code is amended by adding:

"Section 15-36-100. (A) As used in this section, 'expert witness' means an expert who is qualified as to the acceptable conduct of the professional whose conduct is at issue and who:

(1) is licensed by an appropriate regulatory agency to practice his or her profession in the location in which the expert practices or teaches; and

(2)(a) is board certified by a national or international association or academy which administers written and oral examinations for certification in the area of practice or specialty about which the opinion on the standard of care is offered; or

(b) has actual professional knowledge and experience in the area of practice or specialty in which the opinion is to be given as the result of having been regularly engaged in:

(i) the active practice of the area of specialty of his or her profession for at least three of the last five years immediately preceding the opinion;

(ii) the teaching of the area of practice or specialty of his or her profession for at least half of his or her professional time as an employed member of the faculty of an educational institution which is accredited in the teaching of his or her profession for at least three of the last five years immediately preceding the opinion; or

(iii) any combination of the active practice or the teaching of his or her profession in a manner which meets the requirements of subitems (i) and (ii) for at least three of the last five years immediately preceding the opinion;

(3) is an individual not covered by subsections (A)(1) or (2), that has scientific, technical, or other specialized knowledge which may assist the tryer of fact in understanding the evidence and determining a fact or issue in the case, by reason of the individual's study, experience, or both. However, an affidavit filed pursuant to subsection (B) by an expert qualified under this subsection must contain an explanation of the expert's credentials and why the expert is qualified to conduct the review required by subsection (B). The defendant is entitled to challenge the sufficiency of the expert's credentials pursuant to subsection (E).

(B) In an action for damages alleging professional negligence against a professional licensed by or registered with the State of South Carolina and listed in subsection (G) or against any licensed health care facility alleged to be liable based upon the action or inaction of a health care professional licensed by the State of South Carolina and listed in subsection (G), the plaintiff must file as part of the complaint an affidavit of an expert witness which must specify at least one negligent act or omission claimed to exist and the factual basis for each claim based on the available evidence at the time of the filing of the affidavit.

(C)(1) The contemporaneous filing requirement of subsection (B) does not apply to any case in which the period of limitation will expire, or there is a good faith basis to believe it will expire on a claim stated in the complaint, within ten days of the date of filing and, because of the time constraints, the plaintiff alleges that an affidavit of an expert could not be prepared. In such a case, the plaintiff has forty-five days after the filing of the complaint to supplement the pleadings with the affidavit. Upon motion, the trial court, after hearing and for good cause, may extend the time as the court determines justice requires. If an affidavit is not filed within the period specified in this subsection or as extended by the trial court and the defendant against whom an affidavit should have been filed alleges, by motion to dismiss filed contemporaneously with its initial responsive pleading that the plaintiff has failed to file the requisite affidavit, the complaint is subject to dismissal for failure to state a claim. The filing of a motion to dismiss pursuant to this section, shall alter the period for filing an answer to the complaint in accordance with Rule 12(a), S.C. Rules of Civil Procedure.

(2) The contemporaneous filing requirement of subsection (B) is not required to support a pleaded specification of negligence involving subject matter that lies within the ambit of common knowledge and experience, so that no special learning is needed to evaluate the conduct of the defendant.

(D) This section does not extend an applicable period of limitation, except that if the affidavit is filed within the period specified in this section, the filing of the affidavit after the expiration of the statute of limitations is considered timely and provides no basis for a statute of limitations defense.

(E) If a plaintiff files an affidavit which is allegedly defective, and the defendant to whom it pertains alleges, with specificity, by motion to dismiss filed contemporaneously with its initial responsive pleading, that the affidavit is defective, the plaintiff's complaint is subject to dismissal for failure to state a claim, except that the plaintiff may cure the alleged defect by amendment within thirty days of service of the motion alleging that the affidavit is defective. The trial court may, in the exercise of its discretion, extend the time for filing an amendment or response to the motion, or both, as the trial court determines justice requires. The filing of a motion to dismiss pursuant to this section shall alter the period for filing an answer to the complaint in accordance with Rule 12(a), S.C. Rules of Civil Procedure.

(F) If a plaintiff fails to file an affidavit as required by this section, and the defendant raises the failure to file an affidavit by motion to dismiss filed contemporaneously with its initial responsive pleading, the complaint is not subject to renewal after the expiration of the applicable period of limitation unless a court determines that the plaintiff had the requisite affidavit within the time required pursuant to this section and the failure to file the affidavit is the result of a mistake. The filing of a motion to dismiss pursuant to this section shall alter the period for filing an answer to the complaint in accordance with Rule 12(a), S.C. Rules of Civil Procedure.

(G) This section applies to the following professions:

(1) architects;

(2) attorneys at law;

(3) certified public accountants;

(4) chiropractors;

(5) dentists;

(6) land surveyors;

(7) medical doctors;

(8) marriage and family therapists;

(9) nurses;

(10) occupational therapists;

(11) optometrists;

(12) osteopathic physicians;

(13) pharmacists;

(14) physical therapists;

(15) physicians' assistants;

(16) professional counselors;

(17) professional engineers;

(18) podiatrists;

(19) psychologists;

(20) radiological technicians;

(21) respiratory therapists; and

(22) veterinarians."

SECTION 5. Title 15 of the 1976 Code is amended by adding:

"CHAPTER 79
Section 15-79-110. As used in this chapter:

(2) 'Health care institution' an ambulatory surgical facility, a hospital, an institutional general infirmary, a nursing home, and a renal dialysis facility.

(3) `Health care provider' means a physician, surgeon, osteopath, nurse, oral surgeon, dentist, pharmacist, chiropractor, optometrist, podiatrist, or any similar category of licensed health care provider, including a health care practice, association, partnership, or other legal entity.

(4) 'Hospital' means a licensed facility with an organized medical staff to maintain and operate organized facilities and services to accommodate two or more nonrelated persons for the diagnosis, treatment and care of such persons over a period exceeding twenty-four hours and provides medical and surgical care of acute illness, injury or infirmity and may provide obstetrical care, and in which all diagnoses, treatment or care are administered by or performed under the direction of persons currently licensed to practice medicine and surgery in the State of South Carolina. This term includes a hospital that provides specialized service for one type of care, such as tuberculosis, maternity, or orthopedics.

(5) 'Institutional general infirmary' is a licensed facility which is established within the jurisdiction of a larger nonmedical institution and which maintains and operates organized facilities and services to accommodate two or more nonrelated students, residents or inmates with illness, injury or infirmity for a period exceeding twenty-four hours for the diagnosis, treatment and care of such persons and which provides medical, surgical and professional nursing care, and in which all diagnoses, treatment or care are administered by or performed under the direction of persons currently licensed to practice medicine and surgery in the State of South Carolina.

(6) 'Medical malpractice' means doing that which the reasonably prudent health care provider or health care institution would not do or not doing that which the reasonably prudent health care provider or health care institution would do in the same or similar circumstances.

(7) 'Nursing home' means a licensed facility with an organized nursing staff to maintain and operate organized facilities and services to accommodate two or more unrelated persons over a period exceeding twenty-four hours which is operated either in connection with a hospital or as a freestanding facility for the express or implied purpose of providing skilled nursing services for persons who are not in need of hospital care. This term does not include assisted living, independent living, or community residential care facilities that do not provide skilled nursing services.

(8) 'Renal dialysis facility' means an outpatient facility which offers staff assisted dialysis or training and supported services for self-dialysis to end-stage renal disease patients.

(9) 'Skilled nursing services' means services that:

(a) are ordered by a physician;

Section 15-79-120. At any time before a medical malpractice action is brought to trial, the parties shall participate in mediation governed by procedures established in the South Carolina Circuit Court Alternative Dispute Resolution Rules in effect at the time for the State or any portion of the State. Parties may also agree to participate in binding arbitration.

Section 15-79-130. If a judge finds that an expert health care provider or health care institution in a medical malpractice action in this State has offered testimony or evidence in bad faith or without a reasonable basis in fact or otherwise acted unethically in conjunction with testifying as an expert in deposition or at trial, the judge must report the expert to the state entity that licenses and regulates the profession of the expert or the type of health care entity represented by the expert."

PART IV

JOINT UNDERWRITING ASSOCIATION
SECTION 6. Article 1, Chapter 79, Title 38 of the 1976 Code is amended by adding:

"Section 38-79-40. A person who serves on the Board of the Joint Underwriting Association or the Board of Governors of the Patients' Compensation Fund is prohibited from being employed in any manner or compensated by the Joint Underwriting Association or the Patients' Compensation Fund, and this prohibition continues for one year after the person ceases to be a member of the board.

No provision of this section may be construed to prohibit an insurance agent from selling insurance products to the association."

SECTION 7. Section 38-79-460 of the 1976 Code is amended to read:

"Section 38-79-460. The Fund fund, and any income from it, must be held in trust, deposited in the office of the State Treasurer and kept in a segregated account entitled `Patients' Compensation Fund', invested and reinvested by the State Treasurer in the same manner as provided by law for the investment of other state funds in interest-bearing investments and may not become a part of the general fund of the State. All expenses of collecting, protecting, and administering the Fund must be paid from the Fund managed by the board according to its plan of operation developed pursuant to Section 38-79-430."

SECTION 8. Section 38-79-470(1) of the 1976 Code is amended to read:

"(1) Monies may be withdrawn from the Fund fund only upon the signature of the chairman of the Board of Governors or his designee upon written warrants of the Comptroller General, drawn on the State Treasurer to the payee designated in the requisition."

PART V

MEDICAL DISCIPLINARY COMMISSION
SECTION 9. Section 40-47-211 of the 1976 Code is amended to read:

"Section 40-47-211. (A) There is created the Medical Disciplinary Commission of the State Board of Medical Examiners to be composed of thirty-six forty-two members. The members of the commission Of these, thirty-six must be licensed physicians practicing their profession,. and five Five physician commissioners must be elected from each of the six congressional districts, and six physician members of the commission must be elected at large from across the State. The board shall conduct the elections, and the elections for the physician members shall provide for participation by any physician currently licensed and actively practicing medicine in South Carolina and residing in the congressional district in which the election is held. At-large physician members must be currently licensed and actively practicing medicine in South Carolina and must reside within the State at the time of election and throughout their term terms. One physician commissioner initially elected from each district shall serve for a term of one year and until his successor is elected and qualifies, one physician commissioner initially elected from each district shall serve for a term of two years and until his successor is elected and qualifies, and one physician commissioner initially elected from each district shall serve for a term of three years and until his successor is elected and qualifies. The successors of the initial physician commissioners shall serve for terms of three years or until their successors are elected and qualify. The members of the commission are limited to three terms. The members appointed to the board may not simultaneously serve as a commissioner. In case of any vacancy by way of death, resignation, or otherwise, the board shall appoint a successor to serve for the unexpired term. Where justice, fairness, or other circumstances so require, the board may appoint past commissioners to hear complaints in individual cases.

(B) Six members of the commission must be lay commissioners who each must have, at a minimum, a baccalaureate degree or the equivalent, and have no ascertainable ties to the health care industry. The lay commissioners must be appointed by the Governor from each of the six congressional districts, with the advice and consent of the Senate. Each lay commissioner must be a registered voter and reside in the congressional district he represents throughout his term. Each lay commissioner initially elected from each district shall serve for a term of three years and until his successor is elected and qualifies. The lay commissioners are limited to three consecutive terms.

(C) The commission is empowered to investigate and hear those complaints against physicians (medical and osteopathic) filed with the board pursuant to Section 40-47-200. The hearing must be conducted in accordance with Act 176 of 1977 (Administrative Procedures Act) and with regulations promulgated by the board and must be before a panel composed of at least three commissioners designated by the board, and one of those three commissioners must be a lay member. The panel is empowered to hear the matters complained of and to make findings of fact and recommendations as to disposition of those matters to the board. The panel shall make a certified report of the proceedings before it, including its findings of fact, conclusions, and recommendations, which must be filed together with a transcript of the testimony taken and exhibits as may have been in evidence before it with the administrator of the board, and a copy of the report must be delivered to the office of general counsel and the licensee or his counsel."

PART VI

DEPARTMENT OF INSURANCE AND GENERAL ASSEMBLY

REVIEW OF INSURER'S REDUCTION OF PREMIUMS TO REFLECT SAVINGS
SECTION 10. The Department of Insurance shall review data reported on annual statements by liability insurers, including, but not limited to, paid claims, reserves, loss adjustment expenses, and such additional data as the department may require by promulgation of bulletin, to determine savings related to a decrease in litigation and claims paid pursuant to litigation after the effective date of this act. The department may require special reports from insurers to determine if savings are realized as a result of the provisions of this act. The department shall compile a report of savings realized and submit it for General Assembly review upon request. Costs or expenses associated with the compilation of this report of savings shall be paid by the insurers pursuant to the provisions of Chapter 13 of Title 38. The Department of Insurance shall review premium and losses by line of insurance to determine if appropriate adjustments have been made based upon the department estimates of savings realized pursuant to the provisions of this act.

SECTION 11. As a majority of the health care community is insured through the South Carolina Medical Malpractice Joint Underwriting Association and the Patients' Compensation Fund and as it is essential for the General Assembly to understand the effects of changes to tort laws, the South Carolina Department of Insurance is given authority to request data regarding changes in claims practices from the South Carolina Medical Malpractice Joint Underwriting Association and the Patients' Compensation Fund. Such data may include paid claims, paid loss adjustment expense, case reserves, bulk reserves, and claim counts by quarter for the previous five years. The department may make such a request of the South Carolina Medical Malpractice Joint Underwriting Association and the Patients' Compensation Fund and such information must be provided within thirty days.

The Department of Insurance shall report annually to the Speaker of the House of Representatives, the President Pro Tempore of the Senate, and the Governor as to whether this and other related enactments have resulted in reductions in premiums and as to any other trends of significance which might impact premium cost.

PART VII

MISCELLANEOUS
SECTION 12. The provisions of this act do not affect any right, privilege, or provision of the South Carolina Tort Claims Act as contained in Chapter 78, Title 15 of the 1976 Code of South Carolina or the South Carolina Solicitation of Charitable Funds Act as contained in Chapter 56 of Title 33.

SECTION 13. The repeal or amendment by this act of any law, whether temporary or permanent or civil or criminal, does not affect pending actions, rights, duties, or liabilities founded thereon, or alter, discharge, release or extinguish any penalty, forfeiture, or liability incurred under the repealed or amended law, unless the repealed or amended provision shall so expressly provide. After the effective date of this act, all laws repealed or amended by this act must be taken and treated as remaining in full force and effect for the purpose of sustaining any pending or vested right, civil action, special proceeding, criminal prosecution, or appeal existing as of the effective date of this act, and for the enforcement of rights, duties, penalties, forfeitures, and liabilities as they stood under the repealed or amended laws.

SECTION 14. If any section, subsection, item, subitem, paragraph, subparagraph, sentence, clause, phrase, or word of this act is for any reason held to be unconstitutional or invalid, such holding shall not affect the constitutionality or validity of the remaining portions of this act, the General Assembly hereby declaring that it would have passed this act, and each and every section, subsection, item, subitem, paragraph, subparagraph, sentence, clause, phrase, and word thereof, irrespective of the fact that any one or more other sections, subsections, items, subitems, paragraphs, subparagraphs, sentences, clauses, phrases, or words hereof may be declared to be unconstitutional, invalid, or otherwise ineffective.

SECTION 15. Upon approval by the Governor, this act takes effect July 1, 2005, for claims arising after July 1, 2005, except that as of this act's effective date, the State Treasurer shall relinquish the management of funds in the Patient's Compensation Fund, created pursuant to Section 38-79-420, to the Board of Governors of the fund, and premiums paid on or after this act's effective date must be deposited with the Board of Governors of the fund. The fund must be fully transferred to the Board of Governors, and the State Treasurer may not hold any deposits of the fund as of ninety days after this act's effective date. /

Amend title to conform.

Majority favorable. Minority unfavorable.

C. BRADLEY HUTTO ROBERT FORD

For Majority. For Minority.

A BILL
TO ENACT THE "TORT REFORM ACT OF 2005 RELATING TO MEDICAL MALPRACTICE" BY AMENDING TITLE 15, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO CIVIL REMEDIES AND PROCEDURES, BY ADDING ARTICLE 3, CHAPTER 32, SO AS TO ESTABLISH PROCEDURES GOVERNING THE AWARD OF NONECONOMIC DAMAGES; TO AMEND CHAPTER 35, TITLE 15, RELATING TO CIVIL REMEDIES AND PROCEDURES, BY ADDING SECTION 15-35-400, SO AS TO PROVIDE FOR OFFERS OF JUDGMENT AFTER COMMENCEMENT OF ANY CIVIL ACTION BASED ON CONTRACT OR SEEKING THE RECOVERY OF MONEY DAMAGES; TO AMEND CHAPTER 36, TITLE 15, RELATING TO CIVIL REMEDIES AND PROCEDURES, BY ADDING SECTION 15-36-100, SO AS TO ESTABLISH STANDARDS FOR EXPERT WITNESSES IN PROFESSIONAL MALPRACTICE ACTIONS; TO AMEND TITLE 15, RELATING TO CIVIL REMEDIES AND PROCEDURES, BY ADDING CHAPTER 79, SO AS TO PROVIDE FOR MANDATORY MEDIATION AND TO PERMIT BINDING ARBITRATION IN MEDICAL MALPRACTICE ACTIONS; TO AMEND ARTICLE 1, CHAPTER 79, TITLE 38, RELATING TO THE JOINT UNDERWRITING ASSOCIATION AND BOARD OF GOVERNORS FOR THE PATIENTS' COMPENSATION FUND, BY ADDING SECTION 38-79-40, SO AS TO PROHIBIT A PERSON SERVING IN THESE AGENCIES FROM BEING EMPLOYED OR COMPENSATED BY EITHER OF THESE AGENCIES; TO AMEND SECTION 38-79-460, RELATING TO THE PATIENTS' COMPENSATION FUND, SO AS TO PROVIDE THAT THE FUND SHALL BE MANAGED BY THE BOARD OF GOVERNORS RATHER THAN THE STATE TREASURER; TO AMEND SECTION 38-79-470, RELATING TO THE PATIENTS' COMPENSATION FUND, SO AS TO PROVIDE THAT MONEY SHALL BE WITHDRAWN FROM THE FUND UPON SIGNATURE OF THE CHAIRMAN OF THE BOARD OF GOVERNORS; AND TO AMEND SECTION 40-47-211, RELATING TO THE BOARD OF MEDICAL EXAMINERS, SO AS TO ALTER THE MEMBERSHIP OF THE BOARD BY PROVIDING FOR LAY MEMBERS.

Be it enacted by the General Assembly of the State of South Carolina:

PART I

PART II

DAMAGES
SECTION 2. Title 15 of the 1976 Code is amended by adding:

"CHAPTER 32

Article 3

Noneconomic Damage Awards
Section 15-32-200. This article may be cited as the 'South Carolina Noneconomic Damage Awards Act of 2005.'

Section 15-32-210. As used in this article, unless the context clearly requires otherwise:

(1) 'Claimant' means the person suffering personal injury.

(2) 'Economic damages' means pecuniary damages arising from medical expenses and medical care, rehabilitation services, custodial care, loss of earnings and earning capacity, loss of income, burial costs, loss of use of property, costs of repair or replacement of property, costs of obtaining substitute domestic services, loss of employment, loss of business or employment opportunities, and other monetary losses.

(3) 'Medical malpractice' means doing that which the reasonably prudent health care provider would not do or not doing that which the reasonably prudent health care provider would do under the same or similar circumstances.

(4) 'Noneconomic damages' means nonpecuniary damages arising from pain, suffering, inconvenience, physical impairment, disfigurement, mental anguish, emotional distress, loss of society and companionship, loss of consortium, injury to reputation, humiliation, other nonpecuniary damages, and any other theory of damages including, but not limited to, fear of loss, illness, or injury.

(5) 'Personal injury' means injuries to the person including, but not limited to, bodily injuries, mental distress or suffering, loss of wages, loss of services, loss of consortium, and other noneconomic damages and actual economic damages.

(6) 'Personal injury action' means an action for personal injury, including a wrongful death action pursuant to Sections 15-51-10 through 15-51-60 and a survival action pursuant to Section 15-5-90.

Section 15-32-220. (A) In a medical malpractice personal injury action, the prevailing plaintiff may be awarded compensation for:

(1) economic damages suffered by the claimant; and

(2) noneconomic damages suffered by the claimant not to exceed two hundred-fifty thousand dollars, except as provided in subsections (C) and (D).

(B) The provisions of subsection (A)(2) shall not be made known to the jury through any means, including voir dire, the introduction of evidence, argument of counsel, or instructions to the jury.

(C) The limitations for noneconomic damages suffered by the claimant do not apply if the jury or court determines that defendant's conduct was wilful, wanton, reckless or malicious.

(D) At the end of each calendar year, the State Budget and Control Board, Board of Economic Advisors, must determine the increase or decrease in the ratio of the Consumer Price Index to the index as of December 31 of the previous year, and the limitation on compensation for noneconomic damages pursuant to subsection (A)(2) must be increased or decreased accordingly. As soon as practicable after this adjustment is calculated, the Director of the State Budget and Control Board shall submit the revised limitation on compensation to The State Register for publication pursuant to Section 1-23-40(2), and the revised limitation becomes effective upon publication in The State Register. For purposes of this subsection, 'Consumer Price Index' means the Consumer Price Index for All Urban Consumers as published by the United States Department of Labor, Bureau of Labor Statistics.

Section 15-32-230. The provisions of this article do not affect any right, privilege, or provision of the South Carolina Tort Claims Act pursuant to Chapter 78, Title 15."

PART III

PROCEDURAL PROVISIONS
SECTION 3. Chapter 35, Title 15 of the 1976 Code is amended by adding:

SECTION 4. Chapter 36, Title 15 of the 1976 Code is amended by adding:

"Section 15-36-100. (A) As used in this section, 'expert witness' means an expert who is qualified as to the acceptable conduct of the professional whose conduct is at issue and who:

(1) is licensed by an appropriate regulatory agency to practice his or her profession in the location in which the expert practices or teaches; and

(b) has actual professional knowledge and experience in the area of practice or specialty in which the opinion is to be given as the result of having been regularly engaged in:

(i) the active practice of the area of specialty of his or her profession for at least three of the last five years immediately preceding the opinion;

(G) This section applies to the following professions:

(1) architects;

(2) attorneys at law;

(3) certified public accountants;

(4) chiropractors;

(5) dentists;

(6) land surveyors;

(7) medical doctors;

(8) marriage and family therapists;

(9) nurses;

(10) occupational therapists;

(11) optometrists;

(12) osteopathic physicians;

(13) pharmacists;

(14) physical therapists;

(15) physicians' assistants;

(16) professional counselors;

(17) professional engineers;

(18) podiatrists;

(19) psychologists;

(20) radiological technicians;

(21) respiratory therapists; and

(22) veterinarians."

SECTION 5. Title 15 of the 1976 Code is amended by adding:

"CHAPTER 79
Section 15-79-1110. As used in this chapter:

(1) `Health care provider' means a physician, surgeon, osteopath, nurse, oral surgeon, dentist, pharmacist, chiropractor, optometrist, podiatrist, hospital, nursing home, or any similar category of licensed health care provider, including a health care practice, association, partnership, or other legal entity,

(2) `Medical malpractice' means doing that which the reasonably prudent health care provider would not do or not doing that which the reasonably prudent health care provider would do under the same or similar circumstances.

Section 15-79-130. If a judge finds that a health care provider in a medical malpractice action in this State may have engaged in any unjustifiable conduct in connection with testifying as an expert in deposition or at trial, the judge must report the expert to the state entity that licenses and regulates the profession of the expert or the type of health care entity represented by the expert."

PART IV

JOINT UNDERWRITING ASSOCIATION
SECTION 6. Article 1, Chapter 79, Title 38 of the 1976 Code is amended by adding:

No provision of this section may be construed to prohibit an insurance agent from selling insurance products to the association."

SECTION 7. Section 38-79-460 of the 1976 Code is amended to read:

SECTION 8. Section 38-79-470(1) of the 1976 Code is amended to read:

PART V

MEDICAL DISCIPLINARY COMMISSION
SECTION 9. Section 40-47-211 of the 1976 Code is amended to read:

PART VI

DEPARTMENT OF INSURANCE AND GENERAL ASSEMBLY REVIEW OF INSURER'S REDUCTION OF PREMIUMS TO REFLECT SAVINGS
SECTION 10. (A) An insurer licensed to transact business in this State must report to the South Carolina Department of Insurance all savings directly related to a decrease in litigation and claims paid pursuant to litigation after the effective date of this act.

(B) The Department of Insurance shall review data reported on annual statements by liability insurers, including, but not limited to, paid claims, reserves, loss adjustment expenses, and such additional data as the department may require by promulgation of its Bulletins, to determine the amount of savings, if any, related to a decrease in litigation and decrease, if any, in claims paid pursuant to litigation after the effective date of this act. The department may require special reports from insurers to determine if savings are realized as a result of the provisions of this act. The department shall compile a report of savings realized as a result of the provisions of this act and submit it for General Assembly review upon request. Costs or expenses associated with the compilation of this report on savings shall be paid by the insurers pursuant to the provisions of Chapter 13 of Title 38.

The Department of Insurance shall review premium and losses by line of insurance to determine if appropriate adjustments have been made based upon department estimates of savings realized pursuant to the provisions of this act.

PART VII

MISCELLANEOUS
SECTION 11. The provisions of this act do not affect any right, privilege, or provision of the South Carolina Tort Claims Act as contained in Chapter 78, Title 15 of the 1976 Code of South Carolina or the South Carolina Solicitation of Charitable Funds Act as contained in Chapter 56 of Title 33.

SECTION 12. The repeal or amendment by this act of any law, whether temporary or permanent or civil or criminal, does not affect pending actions, rights, duties, or liabilities founded thereon, or alter, discharge, release or extinguish any penalty, forfeiture, or liability incurred under the repealed or amended law, unless the repealed or amended provision shall so expressly provide. After the effective date of this act, all laws repealed or amended by this act must be taken and treated as remaining in full force and effect for the purpose of sustaining any pending or vested right, civil action, special proceeding, criminal prosecution, or appeal existing as of the effective date of this act, and for the enforcement of rights, duties, penalties, forfeitures, and liabilities as they stood under the repealed or amended laws.

SECTION 13. If any section, subsection, paragraph, subparagraph, sentence, clause, phrase, or word of this act is for any reason held to be unconstitutional or invalid, such holding shall not affect the constitutionality or validity of the remaining portions of this act, the General Assembly hereby declaring that it would have passed this act, and each and every section, subsection, paragraph, subparagraph, sentence, clause, phrase, and word thereof, irrespective of the fact that any one or more other sections, subsections, paragraphs, subparagraphs, sentences, clauses, phrases, or words hereof may be declared to be unconstitutional, invalid, or otherwise ineffective.

SECTION 14. Upon approval by the Governor, this act takes effect July 1, 2005, except that as of this act's effective date, the State Treasurer shall relinquish the management of funds in the Patient's Compensation Fund, created pursuant to Section 38-79-420, to the Board of Governors of the fund, and premiums paid on or after this act's effective date must be deposited with the Board of Governors of the fund. The fund must be fully transferred to the Board of Governors, and the State Treasurer may not hold any deposits of the fund as of ninety days after this act's effective date.

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A BILL TO ENACT THE "TORT REFORM ACT OF 2005 RELATING TO MEDICAL MALPRACTICE" BY AMENDING TITLE 15, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO CIVIL REMEDIES AND PROCEDURES, BY ADDING ARTICLE 3, CHAPTER 32, SO AS TO ESTABLISH PROCEDURES GOVERNING THE AWARD OF NONECONOMIC DAMAGES;

A BILL TO ENACT THE "TORT REFORM ACT OF 2005 RELATING TO MEDICAL MALPRACTICE"
BY AMENDING TITLE 15, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO CIVIL
REMEDIES AND PROCEDURES, BY ADDING ARTICLE 3, CHAPTER 32, SO AS TO ESTABLISH
PROCEDURES GOVERNING THE AWARD OF NONECONOMIC DAMAGES;