Illinois Appellate Court Affirms Extinguishing Hospital’s Medical Lien for Services Provided to a Plaintiff-Minor

Cook County appealed an order entered by the Circuit Court judge that struck, dismissed and extinguished a hospital lien arising under the Healthcare Services and Lien Act (Act) (770 ILCS 23/1 et seq.) for services rendered to the plaintiff, minor child Akeem Manago, by Stroger Cook County Hospital.

On appeal, the county argued that the Circuit Court judge’s decision was wrong in extinguishing the lien, arguing (1) it was not required to intervene in plaintiff’s personal injury action against defendants Chicago Housing Authority (CHA) and H.J. Russell & Company, (2) a hospital lien may be enforced against a minor, and (3) the hospital lien may attach to a judgment but does not include an award of damages for medical expenses. The appeals panel’s decision relied in part on the fact that Akeem’s parent, April Pritchett, did not assign her cause of action for medical expenses to the injured minor plaintiff and thus the county does not have a lien under the act.

The underlying case arose out of injuries that Akeem sustained on Aug. 5, 2005 while he was a minor. The hospital (Stroger Cook County Hospital) provided care and treatment to Akeem for these injuries on various dates from August 2005 through September 2010. The hospital filed a notice of lien against the plaintiff for unpaid hospital bills on Aug. 10, 2009. The notice of lien was forwarded to the attorney for the plaintiff by certified mail. The enforceability of the lien against a judgment entered by the Circuit Court in the plaintiff’s underlying personal injury lawsuit is the subject of the appeal.

The underlying lawsuit was a 3-count negligence complaint against the CHA, Russell and A.N.B. Elevator Services through the minor’s mother and friend, Pritchett, which sought damages for personal injuries to Akeem sustained in an elevator operated and controlled by Russell and A.N.B. on CHA premises.  The record on appeal showed that notice of lien dated August 10, 2009 was mailed from the County to the plaintiff’s attorney by certified mail, stating that the County was asserting a lien upon plaintiff’s cause of action under the Act for medical and hospital services delivered to Akeem after his injury.

On Dec. 7, 2011, a bench trial was held without a court reporter in which the caption of the case listed Akeem Manago “et al.” as the plaintiff.  The Dec. 7, 2011 order indicated that following the presentation of evidence, “[p]laintiffs’” requested damages in the following amounts:

  • April Pritchett – $79,572.63 for medical bills stipulated to by the parties;
  • Akeem Manago – $704,000 broken down in this fashion: scarring –  $350,000; past pain and suffering – $300,000; and future loss of normal life – $54,000.

The defendants requested that they be found not guilty or in the alternative that plaintiff be found 50% responsible for his own injuries. The court rendered its findings that the CHA knew or should have known through its agents at Russell that minor residents could access the elevator roof while the elevator was in motion; notwithstanding actual or constructive notice, neither the CHA nor Russell inspected the elevator access doors to determine whether the doors were open and thereby permitted lawfully riding passengers to gain access to the elevator roof; Akeem ,even though directed by his mother not to ride on the roof, climbed onto the roof on Aug. 5, 2005 through one of the access panels; plaintiff suffered severe and permanent injuries; and plaintiff had established a prima facie against defendants but “Plaintiff April Pritchett” failed to do so because the parties stipulated to the medical bills but “no evidence was adduced to establish that April Pritchett had any expectation that she had to pay any of the $79,572.53 back to Stroger (Cook County) Hospital.”

The court entered an order awarding the plaintiff $250,000 for past, present and future scarring he will be forced to endure for the next 54.1 years and $75,000 for past, present and future pain and suffering; and $75,000 for past, present and future loss of normal life. The court further indicated plaintiff was 50% responsible for his own injuries and reduced the judgment from $500,000 to $250,000. No monies were awarded to the plaintiff for present or future medical expenses.

Pritchett filed a motion to reconsider for the Circuit Court’s failure to award damages for medical expenses.  At the same time, the defendants filed a motion to clarify the order on the ground that the court did not add up the damages correctly and in fact the total amount was $400,000, not $500,000 and thus the plaintiff’s net was $200,000 after the reduction. In addition, the defendants asked that the court retain jurisdiction for the adjudication of any liens. The minor plaintiff, Akeem, filed a motion to strike and extinguish the penalties lien. The plaintiff’s petition argued that a medical care provider has no claim for reimbursement of medical expenses against funds received by a minor from a tortfeasor pursuant to a judgment or settlement which does not include medical expenses and any claim for medical expenses incurred in treating the minor for injuries sustained due to a tortfeasor’s negligence belongs to the parents rather than the child. The Circuit Court judge granted the plaintiff’s motion to strike, dismiss and extinguish the county’s lien. In August 2013, the Illinois Appellate Court reversed the Circuit Court and remanded the matter for further proceedings. The plaintiff filed a petition for rehearing that was granted.

The county argued that the Circuit Court was wrong in striking, dismissing and extinguishing its statutory hospital lien. The court commented that the hospital as a lien holder had no standing to participate in a plaintiff’s personal injury lawsuit and cannot bring independent causes of action against the tortfeasors.  Wendling v. Southern Illinois Hospital Services, 242 Ill.2d 261,270 (2011).

The appeals panel stated that while a minor may incur a debt, there is no basis for the county to seek reimbursement in this case due to the operation of what is commonly known as the Family Expenses Statute, which is a provision of the Rights of Married Person Act (Family Expenses Statute) (750 ILCS 65/15).

The Family Expenses Statute states that expenses of the family and of the education of the children shall be chargeable upon the property of both husband and wife, or of either of them, in favor of creditors therefore, and in relation thereto, they may be sued jointly or separately.

The court found that as only a parent can recover for his or her child’s medical expenses, it follows that the county cannot pursue a lien against the plaintiff under the act as it is the parent, not the minor, who is liable for those expenses. Accordingly, where the parent has not assigned his or her cause of action to the minor, regardless of whether medical expenses are awarded, under the act, an award cannot be attached to any judgment obtained by a minor unless the lien is sought under the Family Expenses Statute. In the case of Graul v. Adrian, 32 Ill.2d 345, 347 (1965), the Illinois Supreme Court held that a parent may recover, in a separate action, medical and funeral expenses incurred by the parent for a child whose death occurs as a result of a wrongful act of a third party. As noted by the Illinois Supreme Court in Graul, the language of the Family Expenses Statute specifically makes the expenses of the family chargeable against the parents of the minor.

In sum, the Illinois Appellate Court concluded that the county’s purported lien was not invalidated for technical reasons. In addition, the county was not required to intervene in the personal injury lawsuit to protect its purported lien. The county, however, does not have a lien under the act when the parent did not assign her cause of action for medical expenses to the injured minor plaintiff. For these reasons, the judgment of the Circuit Court of Cook County is affirmed. There was a dissent filed in this case as well.

Manago v. The County of Cook, 2016 IL App (1st) 121365.

Kreisman Law Offices has been handling catastrophic injury cases, medical negligence cases and wrongful death cases for individuals and families who have been injured or killed by the negligence of another for more than 40 years, in and around Chicago, Cook County and surrounding areas, including Calumet City, South Barrington, Lincolnwood, Chicago (Hegewisch, Canaryville, Bridgeport, Hyde Park, Kenwood, South Shore, Wicker Park, Bucktown, Rogers Park, Albany Park), Morton Grove and Niles, Ill.

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