Understanding The Gonzalez Act In U.S. Military Medical Malpractice Cases

In 1946, the Federal Tort Claims Act (FTCA) was enacted, which recognized liability resulting from negligent actions (or inactions) of federal employees operating within the range of their official duties. This meant that the United States would bear potential liability in a suit instead of the individual employee. One of the exclusions within the Act allowed for military physicians to find themselves liable for incidents of medical malpractice. In the 1970s, cases of medical malpractice began to emerge more frequently, leading Congress to enact the Medical Malpractice Immunity Act to shield federal healthcare providers in the armed forces from malpractice liability. This Act, commonly referred to as the “Gonzalez Act”, substituted the federal government in as the defendant in these matters. Public policy favored this as generally we did not want to discourage physicians (that were badly needed) to provide care to the military stationed overseas. During this time period, various similar statutes tailored for specific segments of the federal government also emerged.

1n 1988, the federal government implemented broad legislation known as the Westfall Act (Liability Reform Act), which essentially extended the FTCA to protect all of its individual employees from tort liability. The only exceptions pertained to what was known as “Bevins Actions”, which applied to acts that fundamentally violated the Constitution. The Westfall Act sought to simplify the immunity standards and remove the many classifications added over time. After the Westfall Act, there was confusion as to what the effect was on the agency-specific rules such as the Gonzalez Act. Did these older laws still apply?

In recent years, the Supreme Court has finally clarified where the agency specific immunity statutes stand in regards to the wide-ranging Westfall Act. Steven Levin, who underwent cataract surgery at a U.S. Navy hospital, brought a medical malpractice suit after he was severely injured. The Gonzalez Act was challenged in the case, which ended up being heard by the Supreme Court, who ruled that despite the existence of the Westfall Act, the Gonzalez Act was still recognized and viable.

A similar federal occupationally-specific immunity statute existed for Public Health Serve (PHS) employees that began in 1970. The Supreme Court encountered this statute in litigation and was tasked with clarifying its status relative to the Westfall Act and FTCA in a medical negligence case that resulted in a fatality. The family of the victim alleged that PHS providers had exhibited “deliberate indifference’ towards his medical needs, which was considered a constitutional violation at the time. Since the Westfall Act provided an exclusion for these constitutional violations, the Act’s immunity would not protect the defendant. The defense sought protection based on the PHS immunity statute, which did not have such exclusions. The court explained that the Westfall Act did not limit, restrict, or repeal the individual statutes that existed for specific segments of government employees.