THE STATE OF SOUTH CAROLINA
In The Supreme Court
Myrtle Beach Hospital,
Inc., d/b/a Grand Strand
Regional Medical Center, Petitioner,
v.
City of Myrtle Beach and
Myrtle Beach Police
Department, Respondents.
ON WRIT OF CERTIORARI TO THE COURT OF
APPEALS
Appeal From Horry County
J. Stanton Cross, Jr., Special Circuit Judge
opinion No. 25140
Heard April 18, 2000 - Filed June 5, 2000
AFFIRMED AS MODIFIED
Fred B. Newby and Michael H. Sartip, both
of Newby, Pridgen & Sartip, of Myrtle Beach, for
petitioner.
James B. Van Osdell and Charles B. Jordan, Jr.,
both of Van Osdell, Lester, Howe & Jordan, P.A., of
Myrtle Beach, for respondents.
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Myrtle Beach Hospital v. City of Myrtle Beach
JUSTICE PLEICONES: We granted certiorari to decide
whether the Court of Appeals was correct in holding that a city is not
obligated to pay a hospital for medical care rendered to the city's pretrial
detainees: Myrtle Beach Hospital v. City of Myrtle Beach, 330 S.C. 590, 510
S.E.2d 439 (Ct. App. 1998). We affirm the Court of Appeals holding that the
Hospital cannot recover under any of the theories it advances, but modify the
quantum meruit test used by the Court of Appeals.
FACTS
Respondents (the City) operate a lock-up facility to house pre-trial
detainees. Pursuant to the City's policy, if a detainee needs medical
attention, the facility contacts the Horry County Emergency Medical
Services (EMS) to evaluate and treat the detainee. If EMS determines
further treatment is required, it transports the detainee to petitioner
Hospital, which operates the only hospital emergency room in Myrtle Beach.
As a result of this policy, the Hospital has accrued approximately $300,000
in unpaid medical bills. 1 When the City refused to pay these bills, the
Hospital brought this action.
The parties filed cross-motions for summary judgment, and the circuit
court granted the City's motion, finding no theory under which it was
responsible for these bills. On appeal, the Court of Appeals affirmed. Myrtle
Beach Hospital, supra.
The parties agree that the City is required by the Federal Constitution
to ensure that a detainee receives necessary medical care. City of Revere v.
Mass. Gen. Hosp., 463 U.S. 239, 103 S.Ct. 2979, 77 L. Ed.2d 605 (1983)(due
process requires that detainees be provided medical care). 2 Whether the
1 The City's policy is to pay the bills if the treatment is required because
of an injury occurring during the arrest or as the 'direct result' of the
incarceration.
2 Although City of Revere involved the specific question of the duty
owed to an individual injured by municipal police officers in the performance (2 cont'd...)
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Myrtle Beach Hospital v. City of Myrtle Beach
governmental entity holding the detainee or the medical provider should
bear the cost of medical care rendered to the detainee is a matter of state
law. City of Revere, 463 U.S. at 245. Whether South Carolina law requires
the City to pay for the medical care received by its detainees is the issue
here.
Summary judgment is proper when there is no genuine issue as to any
material fact and the moving party is entitled to a judgment as a matter of
law. Quality Towing, Inc., v. City of Myrtle Beach, Op. No. 25103 (S.C, Sup.
Ct. filed April 3, 2000)(Shearouse Advance Sheet #13 at 7). There are no
contested facts here.
ISSUES
(1) Is the City obligated to pay the medical bills of its detainees because
this duty should be implied from statutes or regulations?;
(2) Do public policy considerations impose a duty upon the City to pay the
bills?;
(3) Is there an obligation to pay on the part of the City, arising from an
implied-by-law contract or from quantum meruit?
ANALYSIS
A. Legislative Intent
The Hospital acknowledges, as it must, that no state statute requires
the City to bear the medical expenses of the pretrial detainees. It relies
instead on "legislative intent," gleaned from several statutes imposing duties
upon the Department of Corrections (DOC) regarding inmates or upon
counties with regard to chain gangs, and from a "regulation" promulgated by
the DOC. We will discuss the regulation first.
(2 continued...) of their duties, we agree with the parties and other courts considering the
issue that the reasoning in City of Revere applies with equal force to the
duty owed to pretrial detainees.
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Myrtle Beach Hospital v. City of Myrtle Beach
Pursuant to S.C. Code Ann. § 24-9-20 (Supp. 1999), every municipal
lock-up facility such as the one operated by the City is subject to an annual
inspection by a division of the DOC. The inspection "shall be based on
standards established by the South Carolina Association of Counties and
adopted by the [DOC] . . . ." Id.
Pursuant to this mandate, the DOC promulgated a document entitled
"Minimum Standards for Local Detention Facilities - Type I Facilities -
Overnight Lockup" (the Minimum Standards). The Hospital refers to certain
of the provisions of the Minimum Standards and especially relies on Section
2054:
2054 EMERGENCIES. Each facility shall provide
twenty-four (24) hour emergency medical and dental
care availability, as outlined in a written plan which
includes arrangements for:
(a) Emergency evacuation of inmates from the
facility
(b) Use of an emergency medical vehicle
(c) Use of one (1) or more designated hospital
emergency rooms or other appropriate health
facilities
(d) Emergency on-call physician and dentist
services when the emergency health facility is not
located in a nearby community.
According to the Hospital, this "regulation" evinces a legislative intent that
the City bear the cost of medical services rendered to the detainees. We
disagree.
These Minimum Standards have never been subject to the legislative
scrutiny afforded regulations under the Administrative Procedures Act. 3
Instead, they are merely the product of the County Association, adopted by
3 Cf. Stuckey v. State Budget and Control Bd, Op No. 25090 (S.C. Sup.
Ct. filed March 20, 2000)(Shearouse Adv. Sheet # 11 at 10)(Toal, J.,
dissenting)(would not bind affected person to regulation not promulgated
pursuant to APA).
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Myrtle Beach Hospital v. City of Myrtle Beach
the DOC, an executive agency. They cannot validly be viewed as expressing
anything about legislative intent. 4
Looking at the actual legislative intent expressed in our statutes, we
find that it undermines rather than supports the Hospital's position. The
Hospital points to statutes expressing the State's policy to render "humane
treatment" to persons serving a term in the State Penitentiary, S.C. Code
Ann. § 24-1-20 (1989); to one instructing that the DOC director is responsible
"for the proper care, treatment, feeding, clothing, and management of the
prisoners confined therein", S.C. Code Ann. § 24-1-130 (Supp. 1999); a statute
requiring certain entities using state convicts to reimburse the DOC for
"moneys expended . . . for medical attention . . . ." S.C. Code Ann. § 24-1-160
(Supp. 1999); and, to provisions made for the comfort and treatment of
prisoners in county jail [§ 24-5-80 and § 24-7-70 (1985)] and of convicts
working on chain gangs. §§ 24-7-60; 24-7-80; 24-7-110 (1985).
In our view, these statutes express the legislative intent that jailers
(whether county or state) are to bear the expenses, including those incurred
in rendering health care, for persons incarcerated following their convictions.
Applying the maxim of statutory interpretation expressio unius est exclusio
alterius, the absolute silence of the Legislature on the subject of expense
allocation, or even minimal living standards, for the pretrial detainees held
in municipal facilities defeats any "legislative intent" claim. 5
We agree with the Court of Appeals that Hospital cannot prevail on its
"legislative intent" theory.
4 This is not to suggest that the DOC could not be held to its duty to
adopt standards, or to conduct inspections of local facilities pursuant to § 24-
9-20; or that the City would not be subject to sanctions for failure to abide by
these regulations. See S.C. Code Ann. § 24-9-30 (Supp. 1999) "Enforcement
of minimum standards."
5 The absence of specific legislation does not, however, mean that
municipalities may treat pretrial detainees inhumanely or with deliberate
indifference, or consciously disregard their rights.
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Myrtle Beach Hospital v. City of Myrtle Beach
B. Public Policy
The Hospital contends that "public policy" requires that the City pay
the medical bills incurred by the detainees. As discussed above, the
Legislature has chosen not to impose a duty upon the City under these
circumstances. Further, the only indirect evidence we can find regarding a
South Carolina municipality's duty to pay is a 1960 opinion by the Attorney
General determining that there is no such obligation. 1960 Op. Atty. Gen.
293. 6
The Hospital relies heavily on opinions from other jurisdictions to
support its argument that we should find a duty to pay arising from public
policy. All these cases, except those decided by Arkansas 7 and Nebraska, 8
involve the construction of state statutes or regulations imposing certain
duties upon jailers. 9 Our review of these decisions convinces us that whether
to reallocate the financial burden of indigent predetainee medical care, and
the method of any such reallocation, is one best left to the legislative process
which is better equipped to allow input from all interested parties. We
6 Compare 1899 Op. Atty. Gen. 204, stating that a county would be
liable for the medical treatment afforded a prisoner wounded while being
arrested, if the prisoner were in custody.
7 Union County v. Warner Brown Hosp., 297 Ark. 460, 762 S.W.2d 798
(1989).
8 Lutheran Medical Center v. City of Omaha, 229 Neb. 802, 429 N.W.
2d 347 (1988).
9 Although the Court of Appeals concluded that North Carolina
represented a minority view, we disagree. North Carolina imposes a duty on
the governmental entity to pay medical expenses incurred by persons in its
custody. Spicer v. Williamson, 132 S.E. 291 (N.C. 1926). This duty arises
from a state statute requiring the county to provide medical attention to
persons confined in the county jail. In Craven County Hospital v. Lenoir
County, 331 S.E. 2d 690 (N.C. App. 1985), relied upon by the Court of
Appeals, the issue was whether the governmental entity owed a duty to pay
medical bills incurred by a person who was not in custody at the time of the
injury.
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Myrtle Beach Hospital v. City of Myrtle Beach
therefore affirm the Court of Appeals' conclusion that public policy does not
compel the City to reimburse the Hospital for these costs.
C. Implied by law contract or quantum meruit
The Hospital argues that the Court of Appeals should have required
respondents to pay the bills under either a theory of quantum meruit or
contract implied by law. We disagree.
First, we correct a misstatement of law which first appeared in 1981.
Prior to our decision in Piedmont Premium Service. Inc. v. South Carolina
Ins. Co., 277 S.C. 99, 283 S.E.2d 828 (1981), we used the terms quantum
meruit, quasi-contract, and contract implied by law as equivalent terms, to
distinguish those situations where equity would aid recovery from those
where law provided the remedy, that is, express contracts or contracts
implied in fact. 10 See,e.g., United States Rubber Products Inc. v. Town of
Batesburg , 183 S.C. 49, 190 S.E. 120 (1937); Rainwater v. Hobeika, 208 S.C.
433, 38 S.E.2d. 495 (1946). In a law action, the measure of damages is
determined by the parties' agreement, while in equity, "the measure of the
recovery is the extent of the duty or obligation imposed by law, and is
expressed by the amount which the court considers the defendant has been
unjustly enriched at the expense of the plaintiff." Town of Batesburg , 190
S.E. at 126.
In Piedmont Premium, supra, we erroneously defined a contract
implied by law as resting on "a duty imposed by law and treated as a
contract for purposes of remedy only." Id., 283 S.E.2d at 829. Piedmont
Premium directly quoted 17 C.J.S. Contracts § 4(b) as the source of this
definition of a contract implied by law (equitable). In fact, § 4(b) 11 is a
discussion of implied in fact ( legal) contracts. We overrule Piedmont
10 See Stanley Smith & Sons v. Limestone College, 283 S.C. 430 322
S.E.2d 474 fn.l (Ct. App. 1984)("The unfortunate use of "implied contract" to
connote both true ("implied in fact") and quasi ("implied in law") contracts
has led to much confusion").
11 Now found at 17 C.J.S. Contracts § 6(b)(1999) following a 1999
revision. See section conversion chart at p. 398 of volume 17.
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Myrtle Beach Hospital v. City of Myrtle Beach
Premium to the extent it erroneously defines a contract implied by law and
return to our original view: quantum meruit, quasi-contract, and implied by
law contract are equivalent terms for an equitable remedy.
Further, we note this Court's current test for quantum meruit differs
from that used by the Court of Appeals, and further note a discrepancy
between the two courts' implied by law tests. Interestingly, the Court of
Appeals' implied by law test is the same as this Court's quantum meruit
analysis:
(1) benefit conferred by plaintiff upon the defendant;
(2) realization of that benefit by the defendant; and
(3) retention of the benefit by the defendant under
circumstances that make it inequitable for him to retain it
without paying its value.
Compare, e.g., Columbia Wholesale Co. v. Scudder May, N.V., 321 S.C. 259,
440 S.E.2d 129 (1994)(quantum rneruit test) with Webb v. First Fed. Sav. &
Loan Ass'n, 300 S.C. 507, 388 S.E.2d 823 (Ct. App. 1989)(implied by law
test).
We adopt the Scudder May test as the sole test for a quantum
meruit /quasi-contract/implied by law claim. We therefore overrule the
following cases to the extent they rely on this different quantum meruit test
first announced by the Court of Appeals in Webb v. First Fed. Savings &
Loan Ass'n, supra:
(1) valuable services or materials were furnished;
(2) to the defendant;
(3) who accepted, used and enjoyed them;
(4) under such circumstances as reasonably notified the
defendant that the plaintiff was expecting to be paid
by the defendant.
Bonaparte v. Bonaparte, 317 S.C. 256, 452 S.E.2d 836 (1995); Myrtle Beach
Hosp. v. City of Myrtle Beach, 330 S.C. 590, 510 S.E.2d 439 (Ct. App. 1998);
Wade v. Brooks, 306 S.C. 553, 413 S.E.2d 333 (Ct. App. 1992); Muller v.
Myrtle Beach Golf & Yacht Club, 303 S.C. 137, 399 S.E.2d 430 (Ct. App.
1990) cert. dismissed 305 S.C. 330, 408 S.E.2d 242 (1991); and Webb v. First
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Myrtle Beach Hospital v. City of Myrtle Beach
Fed. Savings & Loan Ass'n, 299 S.C. 1, 382 S.E.2d 4 refiled 300 S.C. 507, 388
S.E.2d 823 (Ct. App: 1989).
Applying the Scudder May quantum meruit test in this case, we hold
that the Hospital cannot prevail on this equitable theory. The first two
elements are that the City received and retained a benefit. Here, it is the
detainee rather than the City that receives and retains the benefits conferred
by the Hospital. 12 Further, since the only duty on the City is that imposed by
the Due Process Clause of the federal constitution, and since that duty is
fulfilled "by seeing that [the detainees are] taken promptly to a hospital that
provide [s] the treatment necessary for his injury," City of Revere, 463 U.S. at
245, we do not perceive any inequity in not requiring the City to reimburse
the Hospital. 13
For the reasons given above, the decision of the Court of Appeals is
AFFIRMED AS MODIFIED.
TOAL, C.J., MOORE, WALLER, and BURNETT, JJ., concur.
12 To be sure, the City receives an incidental benefit in the sense that
the existence of the Hospital facilitates the City's constitutional duty to
ensure the detainee receives necessary medical care.
13 The Hospital may seek to recover, as it now does, its expenses from
the detainee, his private insurance, or from federal or state indigent medical
care funds if available. We simply decide that, as between the City and the
Hospital, equity does not require the City to bear these costs.
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