Legislation that would change how medical malpractice claims are screened before reaching court advanced from the Senate Committee on Health, Hospitals and Human Services on Tuesday, with lawmakers approving reforms that include an Affidavit of Merit requirement, a longer review period and new standards governing medical experts.
Bill 36-0048, sponsored by Senator Novelle Francis Jr., would require an Affidavit of Merit to accompany medical malpractice complaints, providing an expert assessment of whether reasonable grounds exist to pursue the allegation. The measure would also extend the Medical Malpractice Action Review Committee’s review period from 90 days to 180 days and establish qualifications for experts providing opinions in malpractice matters.
Mr. Francis said the legislation is intended to “create safeguards and guardrails that not only protect our most vulnerable but also supports overall quality of care.” He maintained that the reforms are not intended to “minimize those people who have been harmed by medical malpractice.”
Supporters told lawmakers that requiring expert medical support earlier in the process could help filter out claims lacking sufficient medical grounding while allowing cases involving legitimate allegations of negligence to continue.
“It strengthens our healthcare system, protects our courts, and ensures that malpractice cases filed in this Territory are grounded in legitimate medical evidence,” Assistant Attorney General Royette Valmont Russell testified.
The Department of Health also supported the amended measure. Chief Legal Counsel Mackeish Taylor-Jones said explicitly requiring an Affidavit of Merit would “enhance the review process while preserving access to the courts for legitimate claims.”
A finding by the Medical Malpractice Action Review Committee that a case lacks merit would not itself prevent a complainant from proceeding to court, according to testimony Tuesday. Supporters nevertheless argued that an unfavorable expert review could discourage plaintiffs from bearing the expense of pursuing claims that lack sufficient medical support.
Darlene Baptiste, chief executive officer of the Governor Juan F. Luis Hospital and Schneider Regional Medical Center, described the proposal as an “important and necessary step” in reforming the territory’s medical malpractice system, while emphasizing that it should be viewed only as a beginning.
She agreed that having a qualified medical expert examine a proposed claim could help determine whether reasonable grounds exist for maintaining a malpractice action before extensive litigation follows.
For Ms. Baptiste, the issue also intersects with the territory’s longstanding difficulty recruiting and retaining physicians. She told lawmakers that the Virgin Islands’ “medical malpractice environment is one of several factors that can influence a physician’s decision about where to establish or continue a practice.”
When hospitals cannot attract or retain physicians, she said, patients may have to travel outside the Virgin Islands for care that could otherwise be provided locally. The hospitals also lose revenue that would have been generated by offering those services in the territory.
Testimony from Dr. William Kendall gave lawmakers a physician’s perspective on that concern. Dr. Kendall, a St. Thomas native who returned home to work as a general surgeon at both territorial hospitals, said his sister had cautioned him about practicing medicine in the Virgin Islands but that he chose to return anyway.
He later found himself named in three malpractice lawsuits.
Dr. Kendall said he was “shocked” by the “nature of some of the claims and allegations,” contending that “several of the allegations were inconsistent with what actually transpired and did not reflect the care that was provided.”
The pending lawsuits, he testified, had “a profound and damaging impact on my professional career.” Dr. Kendall said he has lost “at least 30 civilian employment opportunities” and has been unable to accept opportunities to return to military service because of the unresolved malpractice cases.
He argued that lengthy malpractice litigation can affect not only physicians but also patients and the broader healthcare system. According to his testimony, some physicians practicing locally have come to regard malpractice litigation as an unavoidable part of working in the Virgin Islands.
Dr. Kendall has since chosen not to continue practicing in the territory, leaving the Virgin Islands without a general surgeon who had returned home to serve at both hospitals.
Attorney Julie Beberman, representing the territorial hospitals, cautioned lawmakers against expecting an immediate effect on physician recruitment if the bill becomes law.
Asked by Senator Kenneth Gittens whether the reforms would make a meaningful difference in attracting doctors, Ms. Beberman said “it's going to take a period of time.”
She predicted that the territory could eventually see “a resulting reduction in the number of cases and the broad swath of the cases,” but characterized any benefit as a long-term development rather than an instantaneous change.
The Department of Health told lawmakers that 70 medical malpractice cases are currently pending.
Committee members also examined whether the new requirements could create additional obstacles for low-income patients seeking redress after alleged medical errors. Senators questioned witnesses about the cost of obtaining an expert affidavit and whether someone whose claim receives an unfavorable review would still retain access to the courts.
Senate President Milton Potter asked DOH to provide definitive data showing how many malpractice cases have historically been determined to be frivolous, seeking to establish the size of the problem the legislation is intended to address.
Senator Kurt Vialet generally supported the concept, arguing that eliminating unsupported cases could allow the malpractice system to concentrate resources on legitimate complaints.
“We have to get rid of the frivolous claim because then it would allow you more time to deal with the real claims,” he said.
The amended proposal goes beyond the affidavit requirement. The substitute legislation discussed Tuesday also establishes standards governing medical experts, addresses the standard of care and burden of proof, modifies aspects of the Medical Malpractice Action Review Committee and extends the period available for review of proposed complaints from 90 to 180 days.
The original version of Bill 36-0048 also proposed increasing the territory’s medical malpractice recovery limit from $250,000 to $400,000. Mr. Francis said Tuesday that provision has been removed from the revised measure, leaving the current $250,000 statutory cap unchanged.
The committee voted to advance the measure, which now heads to the Committee on Rules and Judiciary for further consideration.
