author: KNOLL, Justice. HUGHES, J.,

text:
    Majdi KHAMMASH, Maha Khammash, and Sarris, Sarrara and Danniah Khammash v. John E. CLARK, M.D., John E. Clark M.D., Ltd., Louisiana Spine and Sports Medicine, L.L.C., Gloria Wall, Heather B. Landry and Capitol City Physical Therapy Group.
    Nos. 2013-C-1564, 2013-C-1736.
    Supreme Court of Louisiana.
    May 7, 2014.
    Rehearing Denied July 1, 2014.

      Shockey & Associates, William Carl Shockey, Bradley Christopher Stidham, Baton Rouge, for Applicant (No. 2013-C-1564).
    The Rowe Law Firm, LLC, William C. Rowe, Jr., David Creighton Bolton, Baton Rouge, for Respondent (No. 2013-C-1564).
    The Rowe Law Firm, LLC, William C. Rowe, Jr., David Creighton Bolton, Baton Rouge, for Applicant (No. 2013-C-1736).

      Shockey & Associates, William Carl Shockey, Bradley Christopher Stidham, Baton Rouge, for Respondent (No. 2013-C-1736).
   KNOLL, Justice.

This medical malpractice action presents the issue of whether the Patient’s Compensation Fund (PCF) can be bound by summary judgment rendered solely against a defendant physician in the underlying malpractice proceeding on the issue of causation. Plaintiffs, Majdi Khammash and his wife and children, filed the instant suit against various defendants, including Dr. Gray Barrow. After approving plaintiffs settlement with Dr. Barrow for the $100,000 Medical Malpractice Act (MMA) cap, the District Court granted partial summary judgment, finding plaintiffs injuries were caused by the fault of Dr. Barrow. The case then proceeded to jury trial against the PCF for the remaining $400,000 MMA cap. The jury returned a verdict in the PCF’s favor, finding Dr. Barrow’s malpractice did not cause plaintiff damage. The Court of Appeal reversed, finding 12as a result of the partial summary judgment, the issue of causation was not properly before the jury, and remanded for a new trial on damages only. We granted these consolidated writs to address the extent, if any, the PCF is bound by the partial summary judgment on causation. Khammash v. Clark, 13-1564, 13-1736 (La.11/15/13), 125 So.3d 1096. For the following reasons, we find, in accordance with La.Rev.Stat. § 40:1299.44(C)(5)(a) and our holding in Graham v. Willis-Knighton Med. Ctr., 97-0188 (La.9/9/97), 699 So.2d 365, 372, the partial summary judgment against Dr. Barrow on the issue of causation is not binding on the PCF in plaintiffs claim for damages exceeding the $100,000 MMA cap. Further finding no manifest error in the jury’s factual findings on causation, we reverse the judgment of the Court of Appeal and reinstate the District Court’s judgment in its entirety.

FACTS

The facts underlying this litigation are essentially undisputed. On September 26, 2000, Majdi Khammash, while in the course and scope of his employment as a paramedic supervisor with Acadian Ambulance Service, injured his back. On October 3, 2000, he was treated by Dr. John E. Clark for this work-related injury. Dr. Clark diagnosed him with a soft disc protrusion in the right foramen at the L3-4 level and a large disc herniation in the right neural canal at the L4-5 level. Dr. Clark referred Mr. Khammash to physical therapy and, on October 31, 2000, released him to return to full duty work with no restrictions.

Almost three years later, on or about June 9, 2003, Mr. Khammash returned for treatment with Dr. Clark, reporting a return of his prior symptoms — recurrent lumbar pain — for a duration of approximately three weeks, not related to any recent event or injury. Dr. Clark performed a neurological exam, which was | ¡¡normal, but also ordered an MRI. His impression at that time was Mr. Kham-mash had a “fragile back” subject to a high risk of recurring pain.

Mr. Khammash returned to Dr. Clark on or about June 19, 2003, at which time he reported, in addition to the increase in pain, symptoms of pain radiation to his right lower extremities. The MRI showed a L3^4 broad base disc bulge with encroachment of the right L3 nerve root in the foramen. Again, Dr. Clark referred Mr. Khammash to physical therapy, which Mr. Khammash began on or about July 1, 2003.

On that date, the physical therapist placed Mr. Khammash in mechanical lumbar traction for twenty minutes. Mr. Khammash informed the therapist that, during the traction, he felt an immediate onset of pain in his back, radiating down to his right leg. Mr. Khammash returned for scheduled therapy two days later, on July 3, 2003, at which time he was again placed in mechanical lumbar traction, and again, he felt and reported the immediate onset of pain in his back and legs. Mr. Kham-mash testified, even though he was in pain, he was able to walk unassisted from his car to the physical therapy office, but after the traction treatment, his pain and weakness were so severe he had to be taken by wheelchair to his car.

On July 5, 2003, a Saturday, unable to withstand the increasing pain in his lower right back and leg, Mr. Khammash went to the emergency room of Our Lady of the Lake Regional Medical Center (ER). He was treated with pain and steroid medications and was released, with instructions to return to see Dr. Clark first thing Monday morning.

On Monday, July 7, 2003, Mr. Kham-mash reported to his regularly scheduled physical therapy appointment and immediately advised the therapist he Chad been to the ER due to the sudden increase in the severity of the pain and significant weakness in his right leg. As the therapist was examining him, his symptoms of pain and weakness were so severe she immediately transported him in a wheelchair to Dr. Clark’s office, located in the same building. Dr. Clark, however, was out of town, and Mr. Khammash was placed in a room and prepared for an epidural injection. Shortly thereafter, Dr. Barrow entered the room, introduced himself as Dr. Clark’s associate, and explained he was there to administer an epidural injection to alleviate Mr. Khammash’s pain. Dr. Barrow did not perform a physical examination of Mr. Khammash, either before or after administering the injection, nor did he consult with Mr. Khammash after the injection was administered.

On July 15, 2003, Mr. Khammash returned to Dr. Clark and reported an increase in the pain in his right extremities as well as the significant loss of use of his right leg. Dr. Clark re-performed a neurological exam, which this time was positive for “absent right deep tendon reflex.” Dr. Clark also ordered a nerve conduction study and an EMG, which revealed serious nerve impingement. Based on these findings, Dr. Clark diagnosed an active and acute right L-4 radiculopathy. He further testified he believed Mr. Khammash needed a spine surgical consult and his increasingly worsening symptoms presented a “time sensitive condition.”

However, due to miscommunications with Dr. Clark’s office staff, Mr. Kham-mash was not seen for a surgical consult until August 8, 2003. On that date, Dr. Paul Waguespaek, a neurosurgeon, diagnosed Mr. Khammash as having a herniated disc fragment on the L3^1 right side and recommended a discectomy, which he performed on August 20, 2003. At a post-op visit on September 5, 2003, Dr. Wag-uespack noted a significant improvement in Mr. Khammash’s pain symptoms, but only some improvement in the numbness and weakness in the right |5leg. He referred Mr. Khammash to physical therapy in hopes of his regaining some strength in the leg. However, when Mr. Khammash returned on November 20, 2003, his right leg had a “severely weakened” quadricep muscle, and Dr. Waguespack noted a visible sixty percent atrophy in the right leg as compared to the left.

On January 23, 2004, Dr. Waguespack performed a myelogram and post myelo-gram CT scan on Mr. Khammash and determined Mr. Khammash had nothing “going on in his back that required any kind of surgery.” Then on March 8, 2004, Dr. Waguespack reported to Mr. Kham-mash there was, unfortunately, nothing more he could do medically for his symptoms or condition.

On June 30, 2004, Mr. Khammash, together with his wife, and on behalf of their three minor children, filed a petition seeking damages from several defendants for alleged medical malpractice in failing to properly diagnose and treat Mr. Kham-mash’s spinal injury. Plaintiffs contended those acts of malpractice exacerbated Mr. Khammash’s initial injury and caused a needless and unnecessary delay during which his chances of making a full recovery were significantly diminished, leading to the permanent pain and weakness in Mr. Khammash’s back and legs.

On September 11, 2007, the plaintiffs filed leave to file a fourth amending petition based on the opinion of the medical review panel, which had been reviewing the claims against Drs. Clark and Barrow and concluded while Dr. Clark |6had not, Dr. Barrow had deviated from the appropriate standard of care. Thus, plaintiffs amended their action to add Dr. Barrow as a named defendant, alleging he failed to have in place the proper procedures whereby he could obtain adequate histories with regard to the patients he was overseeing for Dr. Clark; he failed to actually conduct a physical exam on Mr. Khammash; he failed to review prior records of the plaintiff and to observe a significant exacerbation of plaintiffs symptoms; and he failed to perform a proper work-up and make a spinal surgical referral when he saw Mr. Khammash on July 7, 2003.

As litigation continued, most of the named defendants were dismissed. On August 18, 2009, the plaintiffs filed a motion for partial summary judgment, seeking a finding that Dr. Barrow’s fault caused Mr. Khammash’s injuries. In support of their motion, the plaintiffs attached the decision of the medical review panel, the most relevant portion of which provides:

It is the opinion of this medical review panel that there was a deviation from the appropriate standard of care by Gray Barrow, M.D.... According to the records it appears Dr. Barrow did not examine Mr. Khammash on July 7, 2003. It was reported to Dr. Barrow by Ms. Wall [the physical therapist treating Mr. Khammash] that the patient was having increasing leg pain and weakness. An appropriate physical exam on July 7, 2003 might have prompted Dr. Barrow to perform further workup and make a spinal surgical referral at that time. It appears that the patient apparently had neurologic decline between the emergency room visit of July 5, 2003 and Dr. Clark’s visit on July 15, 2003. Retrospectively it appears a more aggressive approach should have been taken by the emergency room and by Dr. Barrow on July 7, 2003. Regrettably, a spinal surgeon opinion and further radiological workup such as a lumbar CT myelogram was not obtained at that time. The outcome may have been different as by July 15, 2003, the neuro-deficits were present.

The plaintiffs’ motion for partial summary judgment was set and heard on the same date as their supplemental petition seeking court approval of their settlement with Dr. Barrow and his insurer for $100,000 and allowing them to proceed for the additional $400,000 claimed in damages against the PCF.

|70n October 6, 2009, the District Court rendered judgment, approving the settlement pursuant to La.Rev.Stat. § 40:1299.44(0, and reserving plaintiffs’ remaining claims for damages against the PCF. That same day, the District Court also granted partial summary judgment in favor of the plaintiffs, finding: (1) Dr. Barrow “to be at fault with respect to the injuries to Majdi Khammash which are the subject of these proceeding”; (2) “the injuries complained of by Majdi Khammash ... were caused by the fault of [Dr. Barrow]”; (3) Majdi Khammash free of fault with respect to the injuries suffered by him; and (4) Dr. Barrow was precluded from raising the fault of any of the other named (since dismissed) defendants at the trial on the merits or including the fault of other parties in the jury verdict form. The next day, the PCF filed its Motion and Order to Enroll as Counsel of Record. At this time, Dr. Barrow, now replaced as a party by the PCF, was the only defendant for trial.

The matter then proceeded to a jury trial beginning on September 27, 2011, and on September 30, 2011, the following verdict was returned by the jury:

1) Do you find that the breach of the standard of care by Dr. Gray Barrow caused Mr. Khammash to suffer damages? [To which the jury checked: NO]

As directed, the jury then skipped all other inquiries and dated and signed the verdict form. The District Court rendered judgment in accordance with the jury verdict, dismissing plaintiffs’ claims with prejudice.

|8On plaintiffs appeal, the Court of Appeal, First Circuit, reversed and remanded this matter for a new trial against the PCF. Khammash v. Clark, 12 CA 0736 (LaApp. 1 Cir. 5/17/13), 2013 WL 2150711 (unpub). In so ruling, the appellate court focused upon the partial summary judgment, which established not only Dr. Barrow’s liability, but also causation of Mr. Khammash’s injuries. Giving proper effect to that judgment, it reasoned the District Court erred in allowing any testimony whatsoever concerning causation, as well as directing the jury and allowing inquiries in the jury verdict form to place the issue of the causation of plaintiffs damages before the jury. As the sole issue properly before the jury was the quantification, if any, of Mr. Khammash’s injury beyond $100,000, the appellate court reversed, vacated, and set aside the lower court’s judgment. Moreover, because the plaintiffs specifically sought a trial by jury and given Mr. Khammash’s injuries are complex and not subject to a clear-cut quantification, the appellate court remanded this matter for a new trial solely on the quantification of the damages suffered by Mr. Kham-mash, rather than conduct its own de novo review.

DISCUSSION

Both the plaintiffs and the PCF sought writs from this Court, raising the same legal question: to what extent, if any, is the PCF bound by the partial summary judgment finding Dr. Barrow caused the injuries to plaintiff?

On one hand, the plaintiffs contend Dr. Barrow’s settlement effectively operates as a stipulation of fault and causation of plaintiffs injuries, and therefore, the PCF is liable. Moreover, they reason the partial summary judgment against Dr. Barrow binds the PCF as res judicata and rely heavily upon our decision in Hanks v. Seale, 04-1485 (La.6/17/05), 904 So.2d 662, for the proposition that the partial summary judgment became final when the PCF failed to appeal it, thus precluding the PCF from contesting liability, which consists of a finding of both fault and |9causation. Consequently, they contend the jury should have never been queried about Dr. Barrow’s fault, and the PCF’s evidence geared to disputing fault/causation was admitted in error.

On the other hand, the PCF argues under the MMA the liability of a health care provider and the liability of the PCF are independent and the PCF is granted the right to conduct discovery, identify and retain expert witnesses, and prepare a defense, all of which the partial summary judgment would foreclose. The PCF even suggests part of the settlement included Dr. Barrow’s agreement not to oppose the summary judgment finding causation. In any event, the PCF posits, because the PCF was not and statutorily could not be a party defendant, it cannot be bound by the summary judgment against Dr. Barrow. We agree.

In 1975, the Legislature enacted the MMA, La.Rev.Stat. § 40:1299.41 et seq., to establish a framework for compensating persons who are injured as a result of medical malpractice committed by qualified health care providers. Bijou v. Alton Ochsner Med. Found., 95-3074, p. 4 (La.9/5/96), 679 So.2d 893, 896; Russo v. Vasquez, 94-2407, p. 5 (La.1/17/95), 648 So.2d 879, 882. The MMA limits the liability of a single qualified health care provider to $100,000 plus interest for all malpractice claims for injuries to or death of a patient. La.Rev.Stat. § 40:1299.42(B)(2). Any damages awarded or agreed to in excess of $100,000 may be recovered from the PCF; however, the total amount recoverable, exclusive of future medical care and related benefits, shall not exceed $500,000 plus interest and cost. La.Rev. Stat. § 40:1299.42(B)(1) and (3).

In this framework, as this Court has previously stated, the MMA neither contemplates the PCF as a party defendant, nor gives the PCF status as a co-obligor or insurer of the health care provider. Williams v. Kushner, 449 So.2d 455, 458 (La.1984); see also Hanks, 04-1485 at p. 9, 904 So.2d at 667. Rather, the _J_igPCF is a statutory intervenor “who has an interest in the proceedings between the claimant and the health care provider because any damages in excess of one hundred thousand dollars are payable by the Fund.” Felix v. St Paul Fire and Marine Ins. Co., 477 So.2d 676, 680-81 (La.1985); see also, Hanks, 04-1485 at p. 9, 904 So.2d at 668; Williams, 449 So.2d at 458, n. 16.

The PCF’s status as an intervenor was triggered herein when the plaintiffs settled their claims for the $100,000 cap against Dr. Barrow and sought the remainder of the statutory cap from the PCF. The case then proceeded pursuant to the provisions of La.Rev.Stat. § 40:1299.44(0, which set forth the procedure when a claimant demands an amount in excess from the PCF after settlement with the health care provider:
If the insurer of a health care provider or a self-insured health care provider has agreed to settle its liability on a claim against its insured and claimant is demanding an amount in excess thereof from the patient’s compensation fund for a complete and final release, then the following procedure must be followed:
(1) A petition shall be filed by the claimant with the court in which the action is pending against the health care provider, if none is pending in the parish where plaintiff or defendant is domiciled seeking (a) approval of an agreed settlement, if any, and/or (b) demanding payment of damages from the patient’s compensation fund.
(2) A copy of the petition shall be served on the board, the health care provider and his insurer, at least ten days before filing and shall contain sufficient information to inform the other parties about the nature of the claim and the additional amount demanded.
(8) The board and the insurer of the health care provider or the self-insured health care provider as the case may be, may agree to a settlement with the claimant from the patient’s compensation fund, or the board and the insurer of the health care provider or the self-insured health care provider as the case may be, may file written objections to the payment of the amount demanded. The agreement or objections to the payment demanded shall be filed within twenty days after the petition is filed.
(4) As soon as practicable after the petition is filed in the court the judge shall fix the date on which the petition seeking approval of the agreed settlement and/or demanding payment of damages from the fund shall be heard, and shall notify the In claimant, the insurer of the health care provider or the self-insured health care provider as the case may be, and the board thereof as provided by law.
(5)(a) At the hearing the board, the claimant, and the insurer of the health care provider or the self-insured health care provider, as the case may be, may introduce relevant evidence to enable the court to determine whether or not the petition should be approved if it is submitted on agreement without objections. If the board, the insurer of the health care provider or the self-insured health care provider, as the case may be, and the claimant cannot agree on the amount, if any, to be paid out of the patient’s compensation fund, then the trier of fact shall determine at a subsequent trial which shall take place only after the board shall have been given an adequate opportunity to conduct discovery, identify and retain expert witnesses, and prepare a defense, the amount of claimant’s damages, if any, in excess of the amount already paid by the insurer of the health care provider or self-insured health care provider. The trier of fact shall determine the amount for which the fund is liable and render a finding and judgment accordingly. The board shall have a right to request trial by jury whether or not a jury trial has been requested by the claimant or by any health care provider.
(e) In approving a settlement or determining the amount, if any, to be paid from the patient’s compensation fund, the trier of fact shall consider the liability of the health care provider as admitted and established where the insurer has paid its policy limits of one hundred thousand dollars, or where the self-insured health care provider has paid one hundred thousand dollars.

La.Rev.Stat. § 40:1299.44(C)(emphasis added).

Once plaintiffs settled their dispute against the health care provider for the statutory cap of $100,000, liability for the malpractice and for damages of at least $100,000 was established. La.Rev.Stat. § 40:1299.44(C)(5)(e)(“In approving a settlement ..., the trier of fact shall consider the liability of the health care provider as admitted and established where the insurer has paid its policy limits of one hundred thousand dollars....”) However, as this Court stated in Graham, plaintiffs still had to prove the malpractice caused damages in excess of $100,000 at trial against the PCF under La.Rev.Stat. § 40:1299.44(C)(5)(a):

... We now conclude that the legislative intent of “liability” in Section 1299.44 C(5) was that the payment of $100,000 in settlement | ^establishes proof of liability for the malpractice and for damages of at least $100,000 resulting from the malpractice, which is a very significant benefit to the medical malpractice victim. However, at the trial against the Fund, the plaintiff has the burden of proving that the admitted malpractice caused damages in excess of $100,000.

Graham, 699 So.2d at 372.

In Hall v. Brookshire Bros., Ltd., 02-2404 (La.6/27/03), 848 So.2d 559, we explained the rationale for this rule:

Liability implies some damage, but not specifically which damage or how much. Moolekamp v. Rubin, 531 So.2d 1124, 1126-1127 (La.App. 4 Cir.1988). Having proven that defendant’s fault caused damage, a plaintiff must further prove what damage, by kind and seriousness, was caused by defendant’s fault before the court can render an appropriate award. Id.

A defendant is only liable for that damage caused by his or her fault. Fault is a broad concept, encompassing all conduct falling below a proper standard. Weiland v. King, 281 So.2d 688, 690 (La.1973), citing Langlois v. Allied Chemical Corporation, 258 La. 1067, 249 So.2d 133 (1971).

When a defendant stipulates to liability, that defendant acknowledges that his or her fault (substandard performance of a legal duty owed to plaintiff for the protection from certain risks of harm) caused the plaintiff to sustain some damage (in the case of the qualified health care provider under the Medical Malpractice Act, that defendant stipulates that the damage he or she caused is at least $100,000).

However, there can be, and frequently is, more than one cause of a plaintiffs damages. Graves v. Page 96-2201 (La.11/7/97), 703 So.2d 566, 570; Syrie v. Schilhab, 96-1027 (La.5/20/97), 693 So.2d 1173, 1179. Because a defendant is liable only for that damage caused by his or her fault, when a defendant stipulates to liability for fault, he or she does not thereby necessarily concede responsibility for 100% of the fault.

In the same vein, when a health care provider tenders payment of $100,000.00, thereby admitting and establishing “liability,” that admission of liability is an admission of fault and causation of damages of at least $100,000.00. It is not an admission of the percentage of fault attributable to the health care provider; nor is it an admission as to the extent of the claimant’s damages beyond $100,000.00. Louisiana Revised Statute 40:1299.44(0(5) speaks directly and exclusively to the liability of the health care provider; it is silent with respect to the responsibility of any other actor.

| mHall, 02-2404 at pp. 11-12, 848 So.2d at 567-68.

Clearly, when the PCF and claimant dispute the remaining amount due, the PCF is entitled to full discovery and a trial at which, under the statutory provisions and in accord with our jurisprudence, the claimant must prove his damages, if any, attributable to the malpractice in excess of the amount already paid by the defendant physician. Prior to the trial provided for in La.Rev.Stat. § 40:1299.44(C)(5)(a), only the liability of the defendant physician for the malpractice and damages up to $100,000 is conclusively established by the settlement in accordance with La.Rev.Stat. § 40:1299.44(C)(5)(e). See Gn-aham, 699 So.2d at 372. It follows, therefore, summary judgment as to his fault and causation, to which only the defendant physician and claimant were parties, can likewise only establish the liability of the defendant physician up to $100,000. The burden of proof for the remainder of the statutory cap remains on the claimant as explicitly contemplated by the above emphasized provisions of La.Rev.Stat. § 40:1299.44(C)(5)(a). Otherwise, the parties in the underlying proceeding could potentially negotiate the PCF’s liability as part and parcel of the settlement agreement, as alleged herein given Dr. Barrow’s agreement not to oppose the partial summary judgment on fault and causation, thus depriving the PCF of its statutorily granted right to “conduct discovery, identify and retain expert witnesses, and prepare a defense,” in conjunction with its ability to limit its exposure to excess damages at trial.

While we are mindful the MMA is in derogation of established rights and is to be strictly construed, Sewell v. Doctors Hosp., 600 So.2d 577, 578 (La.1992), we are nevertheless obligated to apply the Act in a manner which is consistent with logic and the presumed fair purpose and intention of the Legislature in passing it. |14La. Civ.Code art. 10; Hall, 02-2404 at p. 13, 848 So.2d at 568. In this instance, our interpretation and application of the relevant statutory provisions is consistent with the Legislature’s clear intention to hold the PCF liable only for acts constituting medical malpractice. See La.Rev.Stat. § 40:1299.41(I)(cautioning “[n]othing in this Part shall be construed to make the [PCF] liable for any sums except for those arising from medical malpractice”); Hall, 02-2404 at pp. 13-14, 848 So.2d at 568. Similarly, it coincides with legislative intent in granting the PCF the ability to limit its liability by demonstrating, through full discovery and trial on the merits, the extent of damages, if any, occasioned by the malpractice at issue, all the while maintaining the “significant benefit” the plaintiff receives “in that the fault of the qualified health care provider is admitted as is causation of damages of at least $100,000.00 in value.” Hall, 02-2404 at p. 14, 848 So.2d at 568; Graham, 699 So.2d at 372. Therefore, in accordance with the above emphasized language of La.Rev. Stat. § 40:1299.44(0(5) and our holding in Graham as well as our reasoning in Hall, we find the partial summary judgment against Dr. Barrow on the issue of causation is not binding on the PCF in plaintiffs’ claim for damages exceeding the $100,000 MMA cap.

Contrary to plaintiffs’ argument, our position is further supported by the principles of res judicata set forth in La. Rev.Stat. § 13:4231, which provides:

Except as otherwise provided by law, a valid and final judgment is conclusive between the same parties, except on appeal or other direct review, to the following extent:
(1) If the judgment is in favor of the plaintiff, all causes of action existing at the time of final judgment arising out of the transaction or occurrence that is the subject matter of the litigation are extinguished and merged in the judgment.
(2) If the judgment is in favor of the defendant, all causes of action existing at the time of final judgment arising out of the transaction or occurrence that is the subject matter of the litigation are extinguished and the judgment bars a subsequent action on those causes of action.
| ]S(3) A judgment in favor of either the plaintiff or the defendant is conclusive, in any subsequent action between them, with respect to any issue actually litigated and determined if its determination was essential to that judgment.

La.Rev.Stat. § 13:4231 (emphasis added). Under these provisions, a previous judgment can only preclude an issue against a party that actually participated in the litigation, and the PCF neither participated in nor was a party to this litigation until after the settlement, when it took the status of a statutory intervenor. See Hanks, 04-1485 at p. 9, 904 So.2d at 667; Williams, 449 So.2d at 458, n. 16. Plaintiffs also mistakenly rely on our opinion in Hanks, even though we expressly found therein:

In the instant case, nothing in the record indicates the existence of an agreement between the health care providers and the plaintiff to settle their liability in exchange for anything. This case simply does not involve a settlement liability. Rather, it involves a payment in satisfaction of an adverse judgment. Consequently, the provisions of La. R.S. 40:1299.44(0, including subsection (C)(5)(e), do not apply to this case.

Hanks, 04-1485 at p. 7, 904 So.2d at 666. Therefore, we find Hanks is clearly distinguishable from the instant case and its holding is, likewise, inapplicable.

Accordingly, we reverse the judgment of the Court of Appeal finding the partial summary judgment binding on the PCF and now turn to the manifest error doctrine to review the jury’s factual conclusions on the issue of causation.

Manifest Error Review

In accordance with well-established law, much discretion is left to the judge or jury on determinations of fact. Guillory v. Lee, 09-0075, p. 14 (La.6/26/09) 16 So.3d 1104, 1116; Wainwright v. Fontenot, 00-0492, p. 6 (La.10/17/00), 774 So.2d 70, 74.

[T]he reviewing court must give great weight to factual conclusions of the trier of fact; where there is conflict in the testimony, reasonable evaluations of credibility and reasonable inferences of fact should not be disturbed upon review, even though the appellate court may feel 11fithat its own evaluations and inferences are as reasonable. The reason for this well-settled principle of review is based not only upon the trial court’s better capacity to evaluate live witnesses (as compared with the appellate court’s access only to a cold record), but also upon the proper allocation of trial and appellate functions between the respective courts.

Guillory, 09-0075 at p. 14, 16 So.3d at 1116-17 (quoting Perkins v. Entergy Corp., 00-1372 (La.3/23/01), 782 So.2d 606). An appellate court, in reviewing a jury’s factual conclusions, must satisfy a two-step process based on the record as a whole: there must be no reasonable factual basis for the trial court’s conclusion, and the finding must be clearly wrong. Kaiser v. Hardin, 06-2092, pp. 11-12 (La.4/11/07), 953 So.2d 802, 810; Guillory v. Insurance Co. of North America, 96-1084, p. 5 (La.4/8/97), 692 So.2d 1029, 1032. The issue to be resolved on review is not whether the jury was right or wrong, but whether the jury’s fact-finding conclusion was a reasonable one. Rosell v. ESCO, 549 So.2d 840, 844 (La.1989); Canter v. Koehring Co., 283 So.2d 716, 724 (La.1973).

Notably, reasonable persons frequently disagree. Guillory, 09-0075 at pp. 15-16, 16 So.3d at 1117. However, where there are two permissible views of the evidence, the factfinder’s choice between them cannot be manifestly erroneous or clearly wrong. Rosell, 549 So.2d at 844. “[W]here there is conflict in the testimony, reasonable evaluations of credibility and reasonable inferences of fact should not be disturbed upon review, even though the appellate court may feel that its own evaluations and inferences are as reasonable.” Canter, 283 So.2d at 724. Simply stated,

When findings are based on determinations regarding the credibility of witnesses, the manifest error-clearly wrong standard demands great deference to the trier of fact’s findings; for only the factfinder can be aware of the variations in demeanor and tone of voice that bear so |17heavily on the listener’s understanding and belief in what is said. Where documents or objective evidence so contradict the witness’s story, or the story itself is so internally inconsistent or implausible on its face, that a reasonable fact finder would not credit the witness’s story, the court of appeal may well find manifest error or clear wrongness even in a finding purportedly based upon a credibility determination. But where such factors are not present, and a factfinder’s finding is based on its decision to credit the testimony of one of two or more witnesses, that finding can virtually never be manifestly erroneous or clearly wrong.

Rosell, 549 So.2d at 844-45 (citations omitted). With these principles in mind, we must review the record evidence and determine if the jury erred in its factual conclusions regarding causation.

To establish causation in a medical malpractice action, the plaintiffs bore the burden of proving “[t]hat as a proximate result of [Dr. Barrow’s] lack of knowledge or skill or the failure to exercise this degree of care the plaintiff suffered injuries that would not otherwise have been incurred.” La.Rev.Stat. § 9:2794(A)(3). Moreover, while medical testimony is not always necessary, our long standing jurisprudence has held, “because of the complex medical and factual issues involved, a plaintiff will likely fail to sustain his burden of proving his claim under La.Rev.Stat. § 9:2794’s requirements without medical experts.” Pfiffner v. Correa, 94-0992 (La.10/17/94), 643 So.2d 1228, 1234; see also Samaha v. Rau, 07-1726, pp. 5-6 (La.2/26/08), 977 So.2d 880, 883-84.

Following a three-day trial during which five physicians testified on the issue of causation, the jury concluded the plaintiff had not proven Dr. Barrow’s actions or inaction caused plaintiffs injuries. After careful review of the evidence, we cannot say the jury manifestly erred.

As the record shows, the majority of physicians who testified conceded that, even if surgery had been done two days before Dr. Barrow first saw Mr. Kham-mash, he “can’t claim that that would solve his weakness” and the damage to | ^plaintiffs nerve root most likely resulted from an acute disc herniation or extrusion that occurred during his physical therapy session. Dr. Waguespack, who performed the surgery to remove the disc fragments at the L3-4 level, was the first expert to testify. Although he admitted prolonged length of nerve impingement or pressure can cause the nerve fiber to die and in such cases he tends to want to treat early, he could not say “more probably than not” the outcome, ie., plaintiffs weakness, “would have been any different with a surgery done on July the 5th or August 20th.” He would, however, have “been willing to try.” Dr. Clark, Mr. Kham-mash’s treating physician, next testified as an expert in the field of physical medicine and rehabilitation. He opined Mr. Kham-mash’s acute herniation occurred on July 1 in physical therapy and was time sensitive, such that plaintiffs best chance at recovery was “if he had had the surgery the day of the event.” However, he could not say if plaintiff would have recovered or that more probably than not surgical intervention would have changed the outcome on July 1, even though he did agree plaintiff had a greater chance of recovery if surgery had been done sooner.

Dr. Robert Franklin, a member of the medical review panel, also testified as an expert in physical medicine and rehabilitation. He opined, if plaintiff had been referred for surgical consult on July 7, then “more likely than not” that would “have given him his best chance” as the earlier the insult to the nerve root is removed, the potential for improvement increases. But, he could not say “more probable than not that he would have recovered” or with any medical certainty that had the surgery occurred any sooner “the result would have been any different.”

The next expert witness to testify on causation was Dr. Louis Blanda, an orthopedic surgeon. He opined “the unkindly delay in relieving the nerve compression probably caused the nerve not to recover,” and a surgical referral on 113July 7, 2008, would have made “the probability” of preventing permanent injury better. Dr. Bert Bratton, a neurosurgeon, was the last expert to testify on causation, and he presented three theories for plaintiffs present condition in the order of probability: (1) initial disc rupture was so traumatic it damaged the nerve at that point; (2) “significant delay to the ultimate decompression of the nerve”; or (3) still some compression of the L-4 nerve root at the adjacent L4-5 level. In his opinion, the damage to plaintiffs nerve root was such that the ultimate result was set by July 5, and he would not have performed surgery until the nerve decreased swelling of which the pain was indicative. Therefore, he concluded Dr. Ban*ow properly administered steroids to decrease the swelling, and there was no causal connection between his treatment or failure to perform a physical exam and plaintiffs current condition.

From this testimony, the jury could reasonably conclude: (1) plaintiffs injury was sustained during his physical therapy session; (2) the disc rupture at that time was so violent the nerve was permanently damaged; and (3) Dr. Barrow’s failure to examine and refer plaintiff for sui’gical consult on July 7 would not have resulted in any change in plaintiffs permanent condition. Therefore, the record evidence does reasonably show Dr. Barrow’s inaction did not cause plaintiffs injuries. Based on this evidence, the jury could reasonably conclude causation had not been proven. Thus, because the jury’s factual conclusions are reasonably supported by the record evidence, we must affirm the District Court’s ruling on the issue of causation.

CONCLUSION

In summary, we find the partial summary judgment on causation rendered against Dr. Barrow is not binding on the PCF in plaintiffs’ claim for damages exceeding $100,000. Reviewing the record in its entirety, we further find noj^manifest error in the jury’s factual conclusions on causation. Accordingly, we reversed the judgment of the Court of Appeal and reinstate the judgment of the District Court in its entirety.

DECREE

For these reasons, we reverse the judgment of the Court of Appeal and hereby reinstate the judgment of the District Court in its entirety.

REVERSED; JUDGMENT OF THE DISTRICT COURT REINSTATED.

CLARK, Justice, concurs in part, dissents in part for reasons to be assigned.

HUGHES, Justice, dissents with reasons.

HUGHES, J.,

dissenting.

hi respectfully dissent. Although appeals are favored in the law, I agree with plaintiffs position that based on notice of judgment dated May 17, 2013, the application for rehearing in the court of appeal and subsequently the writ application to this court of the Patient’s Compensation Fund were untimely, and thus this court does not have jurisdiction to modify as requested the judgment of the court of appeal.

      . The MMA limits the liability of a single qualified health care provider to $100,000; any damages in excess of $100,000 may be recovered from the PCF, but may not exceed $500,000. Williamson v. Hospital Service Dist. No. 1 of Jefferson, 04-0451 (La. 12/1/04), 888 So.2d 782, 785-86.

      . At that time, Dr. Clark noted the right L4-5 disc herniation and free disc fragment — Mr. Kliammash's previous 2000 injury — had largely resolved itself.

      . Plaintiffs named as defendants: John E. Clark, M.D.; John E. Clark, M.D., Ltd., a professional medical organization; Louisiana Spine and Sports Medicine, L.L.C., the facility with which both Dr. Clark and Dr. Barrow were associated; Gloria Wall, the physical therapist who treated Mr. Khammash; Heather B. Landry, another physical therapist who treated Mr. Khammash; and MC2 Enterprises, L.L.C. operating as Capitol City Physical Therapy, and then J.E.C. Consultants, L.L.C. d/b/a Capitol City Physical Therapy, the facility with which both Wall and Landry were affiliated.

      . The petition expressly noted, although some of the named defendants were qualified healthcare providers for whom claims first had to be reviewed by a medical review panel, other defendants were not such qualified providers, and the petition was filed against all out of an abundance of caution.

      . On September 15, 2010, the plaintiffs filed another motion for summary judgment, asserting: (1) the only issue remaining was the extent of damages and (2) it would be an abuse of discretion to fail to award the full $500,000 allowable under MMA, subject to the $100,000 credit for Dr. Barrow and his insurer's settlement, given the lack of any genuine issue regarding Mr. Khammash’s injuries and disability. In October 2010, the plaintiffs also filed a Motion in Limine seeking to exclude the testimony of Dr. Bert R. Bratton, the PCF’s expert, intending to testify regarding causation and liability because the prior, unappealed partial summary judgment rendered those two issues final. Both of the foregoing motions were heard by the District Court on December 6, 2010, at which time the court denied both motions. On August 12, 2011, the plaintiffs filed a motion in li-mine to limit the jury verdict form and preclude causation as an issue. Plaintiffs also filed objections to the proposed jury charges pertaining to either liability or causation. Again, these motions were denied.

      . Effective July 1, 2003, Act No. 882 of 2003 amended and reenacted La.Rev.Stat. § 40:1299.44(C)(5), moving the substance of the quoted provision from La.Rev.Stat. § 40:1299.44(0(5) to La.Rev.Stat. § 40:1299.44(C)(5)(e). Significantly, as Section 2 of Act 882 provides, the enactments of La.Rev.Stat. § 40:1299.44(C)(5)(a) and (e) were merely "procedural and interpretative in nature and ... intended to clarify and codify existing law.”

      . This decision was superceded on other grounds by an amendment to La.Rev.Stat. § 23:1032 as recognized in Walls v. American Optical Corp., 98-0455, p. 3 (La.9/8/99), 740 So.2d 1262, 1265.


source: Caselaw Access Project

author: KNOLL, J.

license: Public Domain

text:
    In re Judge Janice CLARK, 19th Judicial District Court East Baton Rouge Parish State of Louisiana.
    No. 2014-O-0188.
    Supreme Court of Louisiana.
    May 7, 2014.

      John Eric Keeling, Assistant Special Counsel, for applicant.
    Stanley, Reuter, Ross, Thornton & Alford, LLC, Richard Charles Stanley, William M. Ross, Gina M. Palermo, Due, Price, Guidry, Piedrahita & Andres, PA, Robert deLoney Downing, for respondent.
   KNOLL, J.

| ,This matter comes before us on the recommendation of the Judiciary Commission of Louisiana (the “Commission”) that Respondent, Judge Janice Clark, of the 19th Judicial District Court, Parish of East Baton Rouge, be publicly censured for an alleged ethical violation and be ordered to reimburse the Commission the costs incurred in the investigation and prosecution of this matter. The Commission conducted an investigatory hearing, made findings of fact and of law, and determined that the Respondent violated Canons 1, 2A, and 3A(1) of the Code of Judicial Conduct, concluding that Judge Clark’s actions in Ms. Reed’s case constituted an egregious legal error sufficient to rise to the level of judicial misconduct for which a judge may be publicly disciplined under Article V, Section 25(C) of the Louisiana Constitution. After thoroughly reviewing the record before us, we disagree with the Commission’s conclusions and reject its recommendation of discipline.

FACTUAL BACKGROUND

The complaint forming the basis of the Formal Charge now before us was lodged with the Commission by Marie Reed, who appeared before Judge Clark as the plaintiff in Marie Reed v. East Baton Rouge Sheriff Dept, No. C592351, 19th Judicial District Court, Division “D,” Parish of East Baton Rouge. Specifically, the | ^Formal Charge at issue centers on a colloquy which took place in open court between Judge Clark and Ms. Reed while Ms. Reed’s lawyer was absent and on Judge Clark’s order dismissing Ms. Reed’s suit without prejudice after Ms. Reed was unable to prove her eligibility to proceed in forma pauperis. In order to understand the nature of this charge, it is necessary to understand what transpired in the Reed proceedings.

Ms. Reed initiated Reed when she filed a petition pro se on July 7, 2010, seeking damages for allegedly false and defamatory statements made about her by the defendants. With this petition, Ms. Reed filed an affidavit requesting the court’s leave to proceed to forma pauperis. Judge Clark signed an order granting Ms. Reed pauper status on July 9, 2010.

On January 12, 2011, defendants sought to traverse Ms. Reed’s pauper status, contending that she had sufficient net monthly income to pay court costs and that she had abused the legal system by filing five lawsuits in a one-month period. Although Ms. Reed had proceeded in proper person up until this point, Jarrett Ambeau filed a motion to enroll as counsel of record on January 20, 2011. Even after obtaining counsel, Ms. Reed was not discouraged from attempting to act as her own attorney. Mr. Ambeau testified before the hearing officer in the instant disciplinary matter that he himself did not always know whether Ms. Reed was acting as a lawyer or as a client: “She acted like an attorney a lot by filing her own motions, by going to the clerk’s office, by going to the judge’s office. I mean, she — I actually had to specifically instruct Ms. Reed to stop going to the courthouse on her own because she did that a lot.”

Notably, even after Mr. Ambeau enrolled as counsel, Ms. Reed filed pro se a “Motion to Schedule Hearing.” Mr. Am-beau testified at a deposition, noticed by counsel for Judge Clark at which all counsels of record were present, that he had no idea she was filing this motion and he had never before seen the document. |sAlso, notable, is the “Objection to Transfer of Pauper Status” filed by Ms. Reed on January 31, 2011. Although Ms. Reed filed this response without Mr. Ambeau’s knowledge after she had retained him to represent her, Mr. Ambeau later cited the pro se filing in his March 22, 2011 answer to, inter alia, defendants’ motion to deny plaintiffs pauper status, referring to Ms. Reed’s pro se response as a “submission that is sufficient to answer any challenge to her pauper status.”

At a hearing on February 16, 2011, on defendants’ motion to rescind pauper status and exceptions of lack of procedural capacity, no cause of action, vagueness, and ambiguity, Judge Clark sustained defendants’ exceptions, but gave Mr. Ambeau seven days to attempt to amend the defects in the petition. Over the objection of defense counsel, Judge Clark also gave the plaintiff ten days to file an updated to forma pauperis affidavit.

Following this hearing, Mr. Ambeau failed to file this amended petition within the seven day time period ordered by Judge Clark. Further, although Mr. Am-beau instructed Ms. Reed to file an updated pauper affidavit with the court, the court received no updated affidavit from Ms. Reed within the time alotted. On March 9, 2011, defendants filed a motion to revoke Ms. Reed’s pauper status and to strike her petition for damages. Judge Clark set the motions for hearing on April 11, 2011. Mr. Ambeau moved to continue this hearing, and Judge Clark granted the motion, continuing the hearing until April 18, 2011.

In the interim, Mr. Ambeau moved to stay the proceedings on March 22, 2011, arguing judicial economy and the interests of justice militated in favor of a stay as the plaintiffs civil claim was based on the same events and related facts as a criminal action which was then pending against Ms. Reed. On March 24, 2011, Judge Clark denied this motion on the showing made.

At the outset of the hearing on April 18, 2011, Judge Clark denied ^defendants’ motion to strike, finding Mr. Ambeau’s filing of the petition one day late did not prejudice the defendants and commenting that striking the petition “would certainly reek at the very heart of justice.” Turning to the defendants’ challenge of Ms. Reed’s pauper status, Judge Clark noted Ms. Reed had failed to properly update the affidavit concerning her finances. Mr. Ambeau acknowledged his client may have misunderstood what she was supposed to file and requested another opportunity to complete an updated affidavit. Over the objection of defense counsel, Judge Clark granted Ms. Reed a further extension:

[A]n additional twenty-four hours in which to file a full and complete affidavit with the clerk, with the court, and with opposing counsel. Thereafter, the court will render its decision based on the evidence before it. If there’s any information to the contrary that you have, counselor, that you bring to the attention of the court, the court will likewise consider it.

Mr. Ambeau then mentioned he had a motion to stay he wished to file. Judge Clark instructed Mr. Ambeau to file a formal motion to stay with the clerk of court and indicated she would take up the issue of the stay when she considered the pauper affidavit the following day:

THE COURT: The court will take up the motion to stay on tomorrow when it takes up the forma pauperis status. There will be no additional notice.
MR. AMBEAU: Thank you, Your Hon- or. Your Honor, what time is that proceeding tomorrow? 1 o’clock?
THE COURT: Whenever I get to it. No, it might be earlier than that.
MR. AMBEAU: Thank you, Your Hon- or.

After the April 18th hearing was concluded, Mr. Ambeau remembered he had a scheduling conflict and was required in court in Ascension Parish the following morning. After informing opposing counsel of this conflict, Mr. Ambeau told an unidentified male member of Judge Clark’s staff that he would be running late the following day. He did not, however, speak personally with Judge Clark or file a formal motion to continue. Instead, he instructed Ms. Reed to be in Judge IsCIark’s courtroom at 9:00 a.m. the following day — April 19, 2011 — as he was concerned Judge Clark would call the case before he arrived. Mr. Ambeau and Ms. Reed also went to the clerk’s office to file the updated pauper affidavit and the motion to stay, and they delivered these pleadings to Judge Clark’s chambers. Critically, not only was the pauper affidavit filed by Ms. Reed facially defective, as Mr. Ambeau, her attorney, served as the third party affiant in violation of the Louisiana Code of Civil Procedure, see La. C.C.P. art. 5183(A)(2) (requiring the pauper application to include “[t]he affidavit of a third person other than his attorney ... ”), but the motion to stay filed by Mr. Ambeau was also substantively the exact same motion Judge Clark “denied on the showing made” on March 24, 2011.

Later that afternoon, in chambers, Judge Clark reviewed the updated pauper affidavit and the motion to stay. She then signed an order denying the motion to stay and dismissing Ms. Reed’s suit without prejudice.

The next morning, April 19, 2011, Ms. Reed was present in Judge Clark’s courtroom, but neither Mr. Ambeau nor defense counsel was present. At 10:07 a.m., Judge Clark asked her clerk to call the docket, and Ms. Reed’s case was the first matter called. The following exchange took place on the record:

THE COURT: All right. Where is the lawyer?
MS. REED: He’s still in court. He’s on his way. He told y’all he had a pleading this morning. So he told me to make sure I’m here.
THE COURT: He had a what?
MS. REED: Pleading this morning. He had told the court yesterday that he — that he had a pleading this morning, and he is coming as soon as he finished because we never had a time. We never knew what time so that’s why I came at 9:00. We did everything yesterday, the pauperis form before we left, and I brought that in this morning, too, to add with the pauperis form. We did the pauperis form, him and I, before we left, the affidavit before we left the courthouse.
THE COURT: Well, this one is the same.
|fiMS. REED: No, he walked it through yesterday to your office.
THE COURT: Is there an additional—
MS. KNIGHT [Judge Clark’s employee]: That was on your desk this morning.
THE COURT: This?
MS. KNIGHT: Yes. And you — this was where you denied—
THE COURT: All right.
MS. KNIGHT: If you look at it, and that was attached to it, the pauper thing.
THE COURT: All right.
MS. KNIGHT: That was just laying on my desk.
THE COURT: What is your total monthly income?
MS. REED: $768 — Actually, they decreased it, but it’s $768 a month for disability, and I am on six breathing treatments a day. So the medicine— that’s why I gave you—
THE COURT: I’m asking you about your income, ma’am.
MS. REED: Oh, $768. They decreased it to $674 this last month.
THE COURT: $674.
MS. REED: They just decreased it because I got to now pay for Medicare because Medicaid couldn’t cover it.
THE COURT: And your car note is $360?
MS. REED: Yes, ma’am, a month.
THE COURT: You pay a car note every month?
MS. REED: Yes, and insurance. I have to pay insurance.
THE COURT: And you’re asking this Court to stay these proceedings?
MS. REED: Yes, ma’am.
THE COURT: What would be the point in staying them?
MS. REED: Because the law allow— because of my Fifth Amendment right because of that criminal proceeding. I would incriminate myself with the criminal proceedings.
|7THE COURT: All right. Well, what I would do is I will go ahead and dismiss the claim without prejudice so you can refile it at any time.
MS. REED: Okay.
THE COURT: All right. Thank you.

Shortly after the conclusion of the above colloquy, Mr. Ambeau arrived at the courthouse and learned of the dismissal. Mr. Ambeau testified both he and Ms. Reed were upset by what had occurred but, in his view, Judge Clark had not been discourteous or insulting and had not interfered with the attorney-client relationship between him and Ms. Reed.

The next day, April 20, 2011, Ms. Reed promptly re-filed her suit in proper person under a new docket number.

PROCEDURAL HISTORY

Ms. Reed filed a complaint with the Office of Special Counsel (“OSC”) against Judge Clark, alleging, inter alia, that Judge Clark had acted wrongfully in addressing her on the record on April 19, 2011 without her lawyer present. On June 14, 2011, the OSC forwarded Ms. Reed’s complaint to Judge Clark and requested that Judge Clark respond to Ms. Reed’s allegations. Cooperating with this request, Judge Clark submitted a brief, informal letter in which she addressed Ms. Reed’s allegations, but did not detail with specificity all of her actions on April 19, 2011. On May 22, 2012, the Judiciary Commission filed a Formal Charge against Judge Clark, alleging Judge Clark violated Canons l, 2A, and 3A(1) of the Code of Judicial Conduct and engaged in willful misconduct relating to her | sofficial duty in violation of the Louisiana Constitution, Article V, Section 25(C), when she “questioned Ms. Reed about issues under the Motion to Stay and the Motion for Forma Pauperis Status, which were the reasons for the hearing and therefore dealt with substantive matters or issues on the merits.”

A hearing was held on April 12, 2013, at which time Judge Clark fully explained her actions on April 19, 2011. Although she agreed that during the April 18, 2011 hearing she had left the record open for twenty-four hours so that Ms. Reed could submit an updated pauper affidavit, Judge Clark denied she had any intention of having any further hearing in the matter other than “to look at whatever affidavit was submitted,” which in fact she did in her chambers on the afternoon of April 18, 2011. After reviewing the updated affidavit and finding it to be facially defective, Judge Clark signed an order dismissing Ms. Reed’s case without prejudice. Judge Clark testified that, on April 19, 2011, she intended only to announce the prior day’s ruling on the record in order to memorialize it in the court minutes — a process Judge Clark called “spreading the minutes” of the case. Although Judge Clark did provide the parties with record notice on April 18, 2011, she did not necessarily expect anyone to be there. Judge Clark defended her brief questioning of Ms. Reed outside of her lawyer’s presence by noting she was simply considering whether or not she should vacate the order she had signed on April 18, 2011, dismissing the case without prejudice. Judge Clark also observed Louisiana Code of Civil Procedure article 5183(B) requires the trial court to “inquire into the facts” before deciding whether to grant a litigant the privilege of proceeding as a pauper. Concerning her questions to Ms. Reed about the motion to |sstay filed by Mr. Ambeau, Judge Clark testified that although she had already denied the motion and dismissed Ms. Reed’s case, she “reserved an opportunity to vacate my ruling on reconsideration.”

Following a hearing on this matter, the hearing officer proposed a number of factual and legal conclusions to the Commission. Among these conclusions was the following:

[T]he hearing officer cannot conclude that Judge Clark engaged in willful misconduct relating to her official duty in violation of La. Const. Art. V, § 25C. Judge Clark thought her actions were of assistance to Ms. Reed. Further, Ms. Reed’s status as a litigant was somewhat ambiguous because she filed many pleadings pro se even when she was represented by an attorney. Mr. Am-beau basically left Ms. Reed to her own devices in connection with her pauper status because he was admittedly uncomfortable with that status since he stood to gain financially from the Lawsuit. Due to this unusual set of circumstances, the hearing officer does not find intentional or willful misconduct.

In making its recommendation to this Court, the Commission specifically rejected the hearing officer’s finding Judge Clark did not act willfully or intentionally. Instead, the Commission issued “Findings of Fact, Conclusions of Law, and Recommendation of Discipline” indicating its position that the Formal Charge had been proven by clear and convincing evidence and that Judge Clark’s conduct on April 19, 2011 constituted a violation of Canons 1, 2A, and 3A(1) of the Code of Judicial Conduct. The Commission recommended that Judge Clark be publicly censured and ordered to pay the costs associated with the investigation and prosecution of this matter.

DISCUSSION

This Court has original jurisdiction in judicial disciplinary proceedings. La. Const, art. V, § 25(C). Therefore, this Court has the power to make original determinations of fact based upon the evidence in the record and is not bound by, nor required to give any weight to, the findings and recommendations of the Judiciary Commission. In re Quirk, 97-1143, pp. 3-4 (La.12/12/97), 705 So.2d|10172, 176. The grounds for disciplinary action against a judge are set forth in Article V, Section 25(C) of the Louisiana Constitution which provides:

On recommendation of the judiciary commission, the supreme court may censure, suspend with or without salary, remove from office, or retire involuntarily a judge for willful misconduct relating to his official duty, willful and persistent failure to perform his duty, persistent and public conduct prejudicial to the administration of justice that brings the judicial office into disrepute, conduct while in office which would constitute a felony, or conviction of a felony. On recommendation of the judiciary commission, the supreme court may disqualify a judge from exercising any judicial function, without loss of salary, during the pendency of proceedings in the supreme court. On recommendation of the judiciary commission, the supreme court may retire involuntarily a judge for disability that seriously interferes with the performance of his duties and that is or is likely to become permanent. The supreme court shall make rules implementing this Section and providing for confidentiality and privilege of commission proceedings.

Under our supervisory authority over all lower courts, this Court adopted the Code of Judicial Conduct, effective January 1, 1976. The Code of Judicial Conduct is binding on all judges, and violations of the Canons contained therein may serve as the basis for the disciplinary action provided for by Article V, Section 25(C) of the Louisiana Constitution. Quirk, 97-1143 at 4, 705 So.2d at 176; In re Marullo, 96-2222, p. 3 (La.4/8/97), 692 So.2d 1019, 1021; In re Decuir, 95-0056, p. 7 (La.5/22/95), 654 So.2d 687, 692. The standard of proof in judicial discipline cases is the clear and convincing standard. Quirk, 97-1143 at 4, 705 So.2d at 176; In re Johnson, 96-1866, p. 7 (La.l1/25/96), 683 So.2d 1196,1199; In re Huckaby, 95-0041, p. 6 (La.5/22/95), 656 So.2d 292, 296. This standard requires that the level of proof supporting the Commission’s factual findings must be more than a mere preponderance of the evidence but less than beyond a reasonable doubt. Id.

The Commission found Judge Clark violated Canons 1, 2A, and 3A(1) of the Code of Judicial Conduct. Specifically, the Commission alleges Judge Clark committed judicial misconduct (1) by questioning Ms. Reed outside the presence of her attorney and (2) by dismissing Ms. Reed’s claim without a proper legal |nbasis. Underlying both of these allegations is the assertion Judge Clark committed legal error on April 19, 2011. As we recognized in In re Quirk,

Our three-tiered system of judicial review necessarily exists, in part, to reverse legal errors made below. In this manner, the vast majority of legal errors are more properly addressed on appeal and do not amount to judicial misconduct. Where mere legal error is involved, “the disciplinary process should not be used as a substitute for appeal.” Jeffrey M. Shaman, Judicial Ethics, 2 Geo. J. Legal Ethios 1, 8 (1988); Judicial Conduct and Ethics, supra, § 2.02 p. 32 (“[T]he usual safeguard against error or overreaching lies in the adversary system and appellate review.”). In order to maintain an independent judiciary, mere errors of law or simple abuses of judicial discretion should not amount to judicial misconduct. Harrod v. Illinois Courts Commission, 69 Ill.2d 445, 14 Ill.Dec. 248, 372 N.E.2d 53, 65 (1977).

97-1143 at 7, 705 So.2d at 178. However, as we also acknowledged in Quirk, “[a] singe instance of serious, egregious legal error, particularly one involving the denial to individuals of their basic or fundamental rights, may amount to judicial misconduct.” Id. at 8, 705 So.2d at 178. Ever mindful of the need to carefully balance the dual purposes of preservation of the independence of the judiciary and protection of the public from the abuse of judicial power, we have held “a judge may be found to have violated La. Const. Art. V, Sec. 25 by a legal ruling or action made contrary to clear and determined law about which there is no confusion or question as to its interpretation and where this legal error was egregious, made in bad faith, or made as part of a pattern or practice of legal error.” Quirk, 97-1143 at 11-12, 705 So.2d at 180-81.

Neither the Commission nor the facts presented to us suggest Judge Clark acted in bad faith on April 19, 2011. Further, there is no suggestion Judge Clark’s conduct was part of a pattern or practice of legal error. Therefore, the only question before us is whether any of Judge Clark’s conduct on April 19, 2011 constituted egregious legal error warranting this Court’s sanction under Quirk.

First, the Commission argues, by questioning Ms. Reed outside the presence of her attorney, Judge Clark failed to uphold high standards of conduct in order to 1 ^preserve the integrity of the judiciary, in violation of Canon 1; failed to respect and comply with the law and to act in a manner that promotes public confidence in the integrity and impartiality of the judiciary, in violation of Canon 2A; and failed to be faithful to the law and to maintain professional competence in it, in violation of Canon 3A(1). We disagree. As the hearing officer correctly acknowledged in her findings, there is no Louisiana authority prohibiting a judge from speaking to a civil litigant when the civil litigant’s lawyer fails to appear in court after notice. Thus, on its face, the unclear and undetermined nature of this question makes Judge Clark’s conduct unworthy of sanction. Quirk, 97-1143 at 11-12, 705 So.2d at ISO-81.

Further, contrary to the Commission’s assertions, the record clearly establishes Judge Clark’s exchange with Ms. Reed did not interfere with her attorney-client relationship with Mr. Ambeau. The Commission goes to great lengths in its attempt to characterize the brief colloquy on April 19, 2011 between Judge Clark and Ms. Reed as a “hearing” which occurred outside of the presence of Ms. Reed’s lawyer. While we believe the transcript of the April 18, 2011 proceeding is consistent with Judge Clark’s testimony that she had no intention of conducting any kind of hearing the following day, we find this debate over whether or not a “hearing” occurred on April 19, 2011, to be completely irrelevant under the facts before us. However one characterizes the exchange which occurred between Judge Clark and Ms. Reed, we find Judge Clark did nothing warranting sanction from this Court when she addressed Ms. Reed on April 19, 2011. Indeed, as the hearing officer found, Ms. Reed had an unusual history of continuing to act many times as her own lawyer, even after Mr. Ambeau enrolled as her counsel of record. Mr. Ambeau himself testified he was often not sure whether Ms. Reed was acting as a client or as a lawyer. The record shows Ms. Reed even went so far as to file a pro se “Motion to Schedule Hearing” without Mr. Ambeau’s knowledge. | ^Although Mr. Ambeau seemed frustrated with Ms. Reed’s persistent attempts to interfere with his representation of her, when faced with defense counsel’s charge that plaintiff had not answered defendants’ motion to traverse plaintiffs pauper status, Mr. Ambeau cited a pro se filing Ms. Reed made without his knowledge after he enrolled as her attorney as a “submission that is sufficient to answer any challenge to her pauper status.” From Judge Clark’s perspective, the attorney-client relationship between Mr. Am-beau and Ms. Reed was anything but clear. As the record reflects, Ms. Reed presented herself before the court heedless of her attorney’s advice and of the consequences of her actions, whenever it suited her.

We find because Judge Clark had signed an order dismissing Ms. Reed’s case without prejudice on April 18, 2011, the brief exchange she had with Ms. Reed on April 19th was of no substantive moment. Judge Clark testified, as the written order confirms, that she denied the motion to stay and dismissed the case without prejudice the prior day. She took the bench only to announce her ruling on the record — an oral entry which would have been made even if no one associated with the case had been present that morning. If Mr. Ambeau wished to be present, it was his responsibility to notify Judge Clark personally of his scheduling conflict or file a motion to continue the matter. We find it is clear from the record that Judge Clark’s only motivation in speaking with Ms. Reed on April 19th was to help her. Ms. Reed had submitted a facially defective pauper application the prior day and her attorney had submitted substantively the same motion to stay that Judge Clark had previously denied on the showing made. After Mr. Ambeau and Ms. Reed filed the motion to stay and the defective pauper affidavit with the clerk’s office and delivered these documents to chambers, Judge Clark made her decision in chambers to dismiss the case without prejudice on the afternoon of 114April 18, 2011. By questioning Ms. Reed on April 19th, she offered Ms. Reed one more chance — a third chance — to change her mind. Under these circumstances, we find nothing worthy of sanction in Judge Clark’s brief questioning of Ms. Reed.

The Commission also alleges Judge Clark committed ethical misconduct when she dismissed Ms. Reed’s claim without prejudice. Essentially, the Commission argues Judge Clark had no legal authority for dismissing Ms. Reed’s claim because there was no motion to dismiss before her and Louisiana Code of Civil Procedure article 1672 provided her with no authority to dismiss the matter sua sponte. Judge Clark testified before the Commission that she dismissed Ms. Reed’s suit without prejudice as a result of Ms. Reed’s failure to qualify for pauper status. Judge Clark’s counsel also pointed out at oral argument that article 5188 of the Louisiana Code of Civil Procedure is silent on what the appropriate remedy is when a judge revokes pauper status in the middle of a case. While we make no judgment as to the propriety of Judge Clark’s actions, we reiterate what we made clear in Quirk: “Where mere legal error is involved, ‘the disciplinary process should not be used as a substitute for appeal.’ ” Quirk, 97-1143 at 7, 705 So.2d at 178 (quoting Jeffrey M. Shaman, Judicial Ethics, 2 Geo. J. Legal Ethics 1, 8 (1988)). Ms. Reed had the right to appeal both Judge Clark’s denial of the privilege to proceed in forma pau-peris and Judge Clark’s dismissal of her case. Both the First Circuit and this Court denied writs on the pauper issue. The appellate courts, not the Judiciary Commission, were the proper arena for this discussion concerning the propriety of Judge Clark’s good faith decision to dismiss Ms. Reed’s case without prejudice for her failure to prove her entitlement to pauper status. Every day, we review the work of judges in the lower courts, and often we exercise our | ^authority to correct legal errors that have been made by the lower courts. This is our function. Based on the record before us, we are fully persuaded that nothing with which the Commission charges Judge Clark warrants this Court’s sanction for judicial misconduct.

RECOMMENDATION REJECTED.

      . Notably, this hearing was originally set for February 14, 2011. Mr. Ambeau moved to continue the hearing, Judge Clark granted his motion, and the hearing was continued to February 16, 2011.

      . Canon 1 of the Code of Judicial Conduct provides: "An independent and honorable judiciary is indispensable to justice in our society. A judge should participate in establishing, maintaining, and enforcing, and shall personally observe, high standards of conduct so that the integrity and independence of the judiciary may be preserved. The provisions of this Code are to be construed and applied to further that objective. As a necessary corollary, the judge must be protected in the exercise of judicial independence.”

      . Canon 2A of the Code of Judicial Conduct provides: "A judge shall respect and comply with the law and shall act at all times in a manner that promotes public confidence in the integrity and impartiality of the judiciary. As used in this Code, ‘impartiality’ or 'impartial' denotes absence of bias or prejudice in favor of, or against, particular parties or classes of parties, as well as maintaining an open mind in considering issues that may come before the judge.”

      . Canon 3A(1) of the Code of Judicial conduct provides: "A judge shall be faithful to the law and maintain professional competence in it. A judge shall be unswayed by partisan interests, public clamor, or fear of criticism.”

      . During her appearance before the Commission, Judge Clark testified, "Once the in forma pauperis motion is denied, it can’t proceed without payment of costs. It would have to be dismissed.... So at the time, I knew that the case could not proceed without the payment of costs. And she did not preponderate on her right to use the in forma pauperis status, so it had to be dismissed. That’s what I thought. You — there was no need to stay it. It was dismissed without prejudice. And ... as I said, I want to avoid like the plague any suggestion that I violated somebody's Civil Rights because I’ve been a Civil Rights worker all of my life. And if it appears that I violated somebody’s Civil Rights, that is anathema to me. And I am trying to rectify that.”

      . Consistent with Judge Clark’s testimony in this regard, defense counsel also testified at the hearing that she did not think her presence was required in court on April 19, 2011.

      . As the record evinces, Judge Clark had been very accommodating of Mr. Ambeau’s schedule in the past. Mr. Ambeau testified he could not recall a time when Judge Clark denied a motion to continue he filed. He appeared before Judge Clark twice in this matter. Prior to each appearance, Mr. Am-beau moved to continue the original hearing date, and each time Judge Clark granted his motion.

      . Louisiana Code of Civil Procedure article 1672 provides, in pertinent part: "The court, on its own motion, may dismiss an action without prejudice when all the parties thereto fail to appear on the day set for trial; however, when a case has been dismissed pursuant to this provision and it is claimed that there is a pending settlement, either party may reinstate the suit within sixty days of receipt of the notice of dismissal, and any cause of action which had not prescribed when the case was originally filed shall be fully reinstated as though the case had never been dismissed.” La. C.C.P. art. 1672(A)(2).