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Cook County Hospital Lien Found to be Invalid

A bench trial brought by the mother of 12-year-old Akeem Manago resulted in a $200,000 judgement in favor of Akeem. The case was brought by Akeem’s mother, April Pritchett. Akeem suffered permanent scars, pain and suffering and loss of normal life resulting in this judgment. Akeem was treated for his burns at Cook County’s Stroger Hospital, which accumulated $79,572 in bills. In the bench trial judgment, there was no award for medical expenses, although the hospital bills were presented to the judge by stipulation of the parties.

Pritchett faced liability for Akeem’s hospital bills under the Family Expense Statute. However, the court ruled that the defendants in the case were not liable for health-care damages because “no evidence was adduced to establish that April Pritchett had any expectation that she had to pay any of the $79,572 back to Stroger Hospital.”

The county nevertheless asserted a hospital lien against the $200,000 judgment based on Section 10(a) of the Health Care Services Lien Act.

It was argued on behalf of Akeem that a lien under the statute could not attach to a judgment in favor of a minor, particularly if the judgment does not include an award for medical expenses.

Subject to certain statutory caps, Section 10(a) generally provides that a health-care provider “shall have a lien upon all claims and causes of action of the injured person for the amount of the health-care professional’s or health-care provider’s reasonable charges up to the date of payment of damages to the injured person.”

In this case, the judge extinguished the county’s lien based on its failure to appear at the trial.

Cook County appealed the lien ruling. Akeem did not request review of the zero judgment on medical damages.

When the Illinois Appellate Court issued its first decision in this case, the 1st District reversed the ruling against Cook County – with Justice Jesse G. Reyes delivering the majority opinion.

Akeem petitioned for a re-hearing that was supported by an amicus brief from the Illinois Trial Lawyers Association (ITLA).

In June 2016, the Illinois Appellate Court changed its mind and affirmed the order that extinguished the county’s lien with again Justice Reyes delivering the opinion of the court.

First of all, the new opinion and the rehearing stated that the county “was not required to intervene in the underlying personal-injury action to protect its lien.”

The county argued in the rehearing that a hospital lien may be enforced against the minor. The act, referring to the “injured person,” does not distinguish between minors and adults. Accordingly, the county contends the plain language of the act permits a hospital lien to be enforced against the minor.

The plaintiff, however, argued that the central contention is that there can be no lien against a minor because there is no underlying debt based on his status as a minor.

The plaintiff’s argument, the appeals panel stated, overlooked points of statutory and common law. In the Estate of Inloe, 109 Ill.App.3d 1089 (1982), it was ruled that the clear and mandatory language of the act creates such debts and liability of the injured person secured by lien, regardless of any such remedy at common law.

Second of all the court pointed out that under common law, the [S]upreme [C]ourt has long held a minor or minor’s estate may incur debt or other obligations by operation of law.  Smith v. Smith, 69 Ill.308 (1873). It is also well established, as a general rule, that a minor or the minor’s estate may be liable for necessaries furnished to the minor. While a minor may incur a debt, there is no basis for the county to seek reimbursement in this case because of the operation of the Family Expense Statute. The Family Expense Statute provides, in relevant part: “The 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.”

It is well established that under the Family Expense Statute, parents are liable for the medical expenses of their children.  Graul v. Adrian, 32 Ill.2d 345 (1965).  Consequently, our [S]upreme [C]ourt has 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 the result of the wrongful act of a third-party.  Id.

The Graul decision stands for proposition that due to the operation of the Family Expense Statute, any cause of action to recover for medical expenses is that of the parent and not of the child.

Although the two rights of actions, the injury suffered by the minor and their parents right to recover expenses under the Family Expense Statute, the two are frequently merged with the child’s cause of action into a single lawsuit.  Typically, the parent seeks medical expenses under a separate count of the complaint.

As only a parent can recover for his or her child’s medical expenses, it follows that the county cannot pursue a lien against a minor plaintiff under the act. Accordingly, where the parent has not assigned his or her cause of action to the minor, regardless of whether or not medical expenses are awarded, under the act and award cannot be attached to any judgment obtained by a minor unless the lien is sought under the Family Expense Statute. The “injured person” in [S]ection 10(a) of the act extends to the parents of a minor. The court went on to say that the broader interpretation of the scope of the term “injured person” in [S]ection 10(a) of the act avoids an inconsistency and gives an effect to both statutes, particularly where the purpose of both statutes is to aid creditors.

In cases where damages for medical expenses are not awarded, or the judgment is insufficient to satisfy a lien, the health-care professional or provider would ultimately seek to recover from the minor’s parent or parents in any event.

The court concluded in this matter, where Pritchett, the mother of Akeem, did not assign her cause of action for medical expenses to the injured minor plaintiff, no lien exists under the act. Thus, the circuit court did not err in extinguishing the county’s lien. In this case, the trial judge did not enter an award of medical expenses. The appellate court stated that as we interpret the act to mean that the hospital lien can only attach to an award of medical expenses, and since the trial court did not award medical expenses, there can be no lien.

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

Kreisman Law Offices has been handling medical malpractice lawsuits, catastrophic injury cases, automobile accident cases, truck accident cases and motorcycle accident 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 Bridgeview, Chicago Ridge, Arlington Heights, Berwyn, Brookfield, Schaumburg, St. Charles, Palatine, Oak Park, Lockport, Lake Forest, Hinsdale, Gurnee, Glencoe, Geneva, Lincolnwood, Hinsdale, Des Plaines, Morton Grove, Chicago (Horner Park, Greek Town, Gold Coast, Englewood, Edgewater, DePaul University Area, Bronzeville, Canaryville, Avondale, Armour Square, Lincoln Park, Kelvyn Park, Prairie District, Printer’s Row, Ravenswood Gardens, Wrigleyville), Matteson, Melrose Park and Norridge, Ill.

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