A.R.S. 46-455(B) Interpretation

In Estate of McGill v. Albrecht, 203 Ariz. 525, 57 P.3d 384 (2002), the court examined "the interplay between APSA and the MMA" and addressed the question whether an APSA action under 46-455(B) may be based on medical negligence, including a single act of negligence as opposed to a pattern of negligent, abusive conduct. 203 Ariz. 525,1, 22, 57 P.3d at 385, 390. Noting the observation it had made in Denton v. Superior Court, 190 Ariz. 152, 156, 945 P.2d 1283, 1287 (1997), that the legislative purpose behind APSA was protection of Arizona's elderly population from abuse, the court found it "clear from the text of the statute, the conditions prevalent in this state, and the sparse legislative history that the statute was intended to increase the remedies available to and for elderly people who had been harmed by their caregivers." Estate of McGill, 203 Ariz. 525,6, 57 P.3d at 387. With these principles in mind, the court considered whether abuse or neglect as defined by the statute, see A.R.S. 46-451(A)(1), (A)(6), could include even a single act of medical negligence or whether the MMA provides the exclusive remedy for such negligence. Estate of McGill, 203 Ariz. 525,8, 57 P.3d at 387. the court held: To be actionable abuse under APSA, the negligent act or acts: (1) must arise from the relationship of caregiver and recipient; (2) must be closely connected to that relationship; (3) must be linked to the service the caregiver undertook because of the recipient's incapacity; (4) must be related to the problem or problems that caused the incapacity. Id.16, 57 P.3d 384. Relying, in part, on 46-455(M), the court rejected the arguments of the defendants and the amici curiae that the MMA provides the exclusive remedies for a single, or even a series of, negligent medical acts and that "something more" was required before such claims could be regarded as abuse for purposes of APSA. Id.18-21, 57 P.3d 384. It concluded that "when the requirements" it had identified "are met, acts of medical negligence, including a single act in some situations, may provide a basis for an APSA action." Id.22, 57 P.3d 384. In In re Estate of Wyatt, 232 Ariz. 506,8, 307 P.3d 73, 75 (App. 2013), the appellee-hospital argued that acute care hospitals, as a class, were exempt from liability under the APSA. Id. 9. The hospital first contended that the term "provide care" in 46-455(B) was ambiguous and therefore the legislative intent must be determined. Id.7. The Court, however, determined the phrase was unambiguous and that a hospital provides care, or, put another way, acts as a caregiver, whenever it takes responsibility for a patient's safety and wellbeing. Id.7-8. The hospital next argued that the legislature only intended the APSA to apply to facilities such as "assisted living centers and adult care homes, but not to acute care facilities that may have a vulnerable adult as a patient." Id.9. After examining the plain language "any . . . enterprise that has been employed to provide care" and the legislative history of the APSA, the Court concluded that acute care hospitals, like St. Mary's, are not exempt from APSA liability based on the fact that they primarily provide "acute care" to their patients. See id. 9, 14, quoting 46-455(B).