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MONDAY, OCTOBER 28, 2002

A federal appeals court last week set aside a $2.1 million medical malpractice award against the Indian Health Service.

In a unanimous decision, the 10th Circuit Court of Appeals agreed the IHS was liable for misdiagnosing a Navajo man who died of hantavirus, a rare respiratory disease. But a three-judge panel sided with federal government lawyers who said the judgment was too high.

The amount, the appeals court ruled on October 24, is limited by a "recovery cap" in New Mexico state law. "Here we hold that the government's liability is subject only to the $600,000 cap," Circuit Judge Ebel wrote for the majority.

The panel further said the award must be reduced because the IHS did not cause Hardy Haceesa's condition. "Haceesa's initial injury was not caused by the government, but rather by the hantavirus," Ebel wrote.

A federal judge must now reconsider, on remand, how much money to award to Haceesa's widow and daughter. A claim by the Haceesa estate for wrongful death was dismissed as untimely.

The key holding in the case was not that the Northern New Mexico Navajo Hospital, an IHS facility located on the Navajo Nation, failed to diagnose Haceesa properly. Even though the 23-year-old exhibited classic symptoms of a deadly disease that gained prominence after it was first reported among Navajo tribal members, he was told he had bronchitis.

Instead, the 10th Circuit found that the IHS is a "health care provider" subject to malpractice limits outlined in state law. Although the suit was brought under Federal Tort Claims Act (FTCA), a federal law, courts look to the local jurisdiction to determine damages.

Haceesa's case exemplified for many their distrust in the federal government. After the hantavirus began killing Navajos in the Four Corners region of the Southwest in 1993, federal health officials were blamed for cultural insensitivity and for failing to share information in a timely manner.

Five years later, the IHS facility in Shiprock appeared ill-equipped to handle the deadly disease. The nurse and doctor who sent Hacessa home on April 25, 1988, had no formal training in the hantavirus. The doctor was a contractor who had been at the only for just two days.

Haceesa's condition worsened and after a trip to a private clinic that was closer than the one a one-half hour drive to Shiprock, he was sent to the University of New Mexico. He died there on April 28.

The Haceesa family settled with San Juan Regional Medial Center, the private facility. A separate case against doctors there is pending.

Get the Ruling:
Haceesa v. United States (10/24)

Relevant Links:
Indian Health Service - http://www.ihs.gov

Related Stories:
Worries raised on hantavirus (8/9)
Navajo widow awarded $2.1M (6/13)
Mystery virus still causing deaths (4/23)