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Are Medical Malpractice Damages Caps Constitutional? An Overview of State Litigation

Published online by Cambridge University Press:  01 January 2021

Carly N. Kelly  and
Michelle M. Mello
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Extract

The United States is in its fifth year of what is now widely referred to as “the new medical malpractice crisis.” Although some professional liability insurers have begun to report improvements in their overall financial margins, there are few signs that the trend toward higher costs is reversing itself - particularly for doctors and hospitals. In 2003-2004, the presidential election and tort reform proposals in Congress brought heightened public attention to the need for some type of policy intervention to ease the effects of the crisis.

The darling of tort reformers at both the federal and state levels has been legislation to limit, or “cap,” damages awarded to plaintiffs in malpractice cases. Health care provider groups, liability insurers, and the Bush Administration have all seized on the example of California's MICRA law, which since 1975 has capped noneconomic damages in malpractice cases at a flat $250,000, as the path to financial recovery.

Type
Article
Information
Journal of Law, Medicine & Ethics , Volume 33 , Issue 3 , Fall 2005 , pp. 515 - 534
Copyright
Copyright © American Society of Law, Medicine and Ethics 2005

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References

Anonymous, “2004 Rate Survey Indicates Rate Increases May Be Leveling but Triple-Digit Hikes Not Over,” Medical Liability Monitor 29 (2004):1–5.Google Scholar
Berges v. Lambkin-Alexander (FL. Cir. Ct., no citation available); Boggs v. Camden-Clark Mem’l Hosp. (W. VA. S. Ct., no citation available); Albert, T., “Challenges in State Courts: New Tort Reforms Under Fire,” amednews.com November 1, 2004 at <http://www.ama-assn.org/amednews/2004/11/01/prl11101.htm> (last visited June 21, 2005).+(last+visited+June+21,+2005).>Google Scholar
Judd ex rel. Montgomery v. Drezga, 103 P.3d 135 (Utah 2004).Google Scholar
Claims have also been brought alleging that caps legislation violates state constitutional provisions prohibiting “special laws,” or laws that apply to only particular persons or things of a class. See, e.g., Lucas v. United States, 757 S.W.2d 687 (Tex. 1988). Such challenges have not been successful.Google Scholar
N.C. GEN. STAT. § 1D-15 (2004).Google Scholar
OR. REV. STAT. § 31.740 (2003).CrossRefGoogle Scholar
Studdert, D. M. Brennan, T. A., “The Problems with Punitive Damages in Lawsuits Against Managed-Care Organizations,” N. Engl. J. Med. 342 (2000): 280–284.CrossRefGoogle Scholar
Studdert, D. M. Yang, Y. T. Mello, M. M., “Are Damages Caps Regressive? A Study of Malpractice Jury Verdicts in California,” Health Affairs 23 (2004): 54–67.CrossRefGoogle Scholar
See Studdert, Yang, Mello, , supra note 8.Google Scholar
Niemeyer, P. V., “Awards for Pain and Suffering: The Irrational Centerpiece of Our Torts System,” Virginia Law Review 90 (2004): 1401–1421, at 1403.CrossRefGoogle Scholar
CAL. CIV. CODE § 3333.2 (2004).Google Scholar
A.C.A. § 16-55-208 (2004).CrossRefGoogle Scholar
IDAHO CODE § 6–1603 (2004).Google Scholar
ALASKA STAT. § 09.17.010 (2004).CrossRefGoogle Scholar
MASS. GEN. LAWS ch. 231, § 60H (2004) (allows the jury to waive a $500,000 cap on noneconomic damages if it determines that the patient's injuries are so severe that the cap would deprive the patient of just compensation); NEV. REV. STAT. § 41A.031 (2004) (allows the judge to waive a $350,000 cap on noneconomic damages in cases of gross malpractice or where the court determines by clear and convincing evidence that an award in excess of $350,000 is justified).Google Scholar
NEV. REV. STAT. § 41A.031 (2004).CrossRefGoogle Scholar
BURNS IND. CODE ANN. § 34-18-14-3 (2004).CrossRefGoogle Scholar
Help Efficient, Accessible, Low-Cost Timely Healthcare (HEALTH) Act of 2003, H.R. 5.Google Scholar
Patients First Act of 2003, S. 11.Google Scholar
Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2004, H.R. 4280, 108th Cong. This bill was subsequently attached to H.R. 4279, which passed the House on May 12, 2004.Google Scholar
A bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system, S. 354, 109th Cong.; A bill to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system, H.R. 534, 109th Cong.Google Scholar
U.S. CONST. art. III § 2 restricts the federal courts (including the U.S. Supreme Court) to appellate review of cases involving questions of federal law.Google Scholar
Schuman, D., “The Right to a Remedy,” Temple Law Review 65 (1992): 1197–1227, at 1201.Google Scholar
MO. CONST. art. 1, § 14.Google Scholar
Chupkovich, P. J., Comment, “Statutory Caps: An Involuntary Contribution to the Medical Malpractice Insurance Crisis or a Reasonable Mechanism for Obtaining Affordable Health Care?” Journal of Contemporary Health Law and Policy 9 (1993): 337–375, at 364.Google Scholar
See Evans v. State, 56 P.3d 1046, 1056 (Alaska 2002).Google Scholar
See Gourley v. Nebraska Methodist Health Sys., 663 N.W.2d 43, 74 (Neb. 2003); Adams v. Children's Mercy Hosp., 832 S.W.2d 898, 905 (Mo. 1992).Google Scholar
Lucas, 757 S.W.2d, at 715 (Culver, J., concurring).Google Scholar
Adams, 832 S.W.2d, at 905.Google Scholar
Waggoner v. Gibson, 647 F. Supp. 1102 (N.D. TX. 1986).Google Scholar
Lucas, 757 S.W.2d, at 690.Google Scholar
Id. at 696–699 (Gonzalez, J., dissenting).Google Scholar
Id. at 691.Google Scholar
TEX. CONST. art. 3, § 66.Google Scholar
TEX. CIV. PRACT. & REM. § 74.301.Google Scholar
Governor's Select Task Force on Healthcare Professional Liability Insurance, Report and Recommendations (Florida: Governor's Office, 2003): At 201–211.Google Scholar
FL. CONST. Art. I, § 21.Google Scholar
Kluger v. White, 281 So.2d 1 (Fla. 1973); Lasky v. State Farm Ins. Co., 296 So.2d 9 (FL. 1974).Google Scholar
Tort Reform and Insurance Act of 1986, Laws of Florida ch. 86–160.Google Scholar
Smith v. Dep't of Insurance, 507 So.2d 1080 (FL. 1987).Google Scholar
FLA. STAT. § 766.207, 209 (2004).Google Scholar
University of Miami v. Echarte, 618 So. 2d 189 (FL. 1993).Google Scholar
U.S. CONST. amend. VII.Google Scholar
Minneapolis & St. Louis R.R. v. Bombolis, 241 U.S. 211 (1916).Google Scholar
Weiss, P. B., Comment, “Reforming Tort Reform: Is there Substance to the Seventh Amendment?” Catholic University Law Review 38 (1989): 737–767, at 744–745.Google Scholar
Lakin v. Senco Prods., Inc., 987 P.2d 463, 475 (OR. 1999).Google Scholar
Etheridge v. Med. Ctr. Hosps., 376 S.E.2d 525, 529 (VA. 1989).Google Scholar
Id.Google Scholar
Judd, 103 P.3d, at 143.Google Scholar
Adams, 832 S.W.2d, at 907.Google Scholar
Kirkland v. Blain Co. Med. Ctr., 4 P.3d 1115, 1119–1120 (ID 2000).Google Scholar
Moore v. Mobile Infirmary Assoc., 592 So.2d 156, 164 (AL. 1992).Google Scholar
Id. at 164. The Alabama and Missouri constitutions both guarantee that the right of a jury trial shall remain “inviolate.” See MO. CONST. art. I, § 22(a) and ALA. CONST. art. I, § 11.Google Scholar
Sofie v. Fibreboard Corp., 771 P.2d 711, 720–23 (Wash. 1989).Google Scholar
Id. at 723, quoted in Judd, 103 P.3d, at 146.Google Scholar
Kansas Malpractice Victims Coalition v. Bell, 757 P.2d 251, 260; but see Evans, 56 P.3d, at 1055 (Alaska Supreme Court holding that damages caps are not remittur, but a constitutionally-allowable limitation of a cause of action).Google Scholar
Hunter Dietz, L. et al., “Availability of New Trial or Remittitur,” 57B Am. Jur. 2d Negligence § 1093 (2004).Google Scholar
Dimick v. Schiedt, 293 U.S. 474, 486 (1935).Google Scholar
Id.Google Scholar
U.S. CONST. amend. XIV § 1.Google Scholar
See Regents of Univ. of Cal. v. Bakke, 438 U.S. 265 (1978) (holding demonstrates the Supreme Court's analysis of suspect classifications based on race); Harper v. Va. Bd. of Elections, 383 U.S. 663 (1966) (holding invalidating a poll tax demonstrates a law that infringed on the fundamental right to vote).Google Scholar
Willis, M. A., Comment, “Limitation on Recovery of Damages in Medical Malpractice Cases: A Violation of Equal Protection?” University of Cincinnati Law Review 54 (1986): 1329–1351, at 1334.Google Scholar
U.S. R.R. Ret. Bd. v. Fritz, 449 U.S. 166 (1980).Google Scholar
Minn. v. Clover Leaf Creamery Co., 449 U.S. 456 (1991); but see U.S. Dept. of Agric. v. Moreno, 413 U.S. 538 (1973) (striking down federal food stamp program rule that defined “household” as a group of related persons on grounds that it was “irrationally” related to the government's objective of promoting nutrition).Google Scholar
Sibley v. Bd. of Supervisors of LA. State Univ., 477 So.2d 1094, 1107 (LA. 1985).Google Scholar
Fein v. Permanente Med. Group, 695 P.2d 665, 682 (CA. 1985).Google Scholar
Id. at 670.Google Scholar
Id. at 671 (citing Medical Injury Comprehensive Reform Act, CAL. CIV. CODE § 3333.2).Google Scholar
Id. at 679.Google Scholar
Id. at 684.Google Scholar
Id. at 679.Google Scholar
Id. at 680.Google Scholar
Id. at 684.Google Scholar
Fein v. Permanente Med. Group, 474 U.S. 892 (1985).Google Scholar
Perison, M. D. Comment, , “Equal Protection and Medical Malpractice Damage Caps: The Health Care Liability Reform and Quality of Care Improvement Act of 1991,” Idaho Law Review 28 (1992): 397–419, at 412.Google Scholar
Judd, 103 P.3d, at 142.Google Scholar
Moore, 592 So.2d, at 156.Google Scholar
Id. at 169.Google Scholar
Id.Google Scholar
Carson v. Mauer, 424 A.2d 825, 830 (N.H. 1980).Google Scholar
Id. at 831.Google Scholar
Id. at 837.Google Scholar
Studdert, D. M. Mello, M. M. Brennan, T. A., “Medical Malpractice,” N. Engl. J. Med. 350 (2004): 283–292.Google Scholar
Etheridge, 376 S.E.2d, at 530.Google Scholar
Id.Google Scholar
Scholz v. Metropolitan Pathologists, P.C., 851 P.2d 901, 907 (CO. 1993).Google Scholar
As with equal protection challenges, some state courts have opted to use a higher standard of review. See Knowles v. U.S., 544 N.W.2d 183, 189 (S.D. 1996) (holding that the damages caps must bear a “real and substantial relation” to the objective to be attained).Google Scholar
See Evans, 56 P.3d, at 1055 (holding that the substantive due process question was dispensed with once the court found that the damages caps did not violate equal protection guarantees).Google Scholar
Morris v. Savoy, 576 N.E.2d 764 (Ohio 1991).Google Scholar
Id. at 770.Google Scholar
See Bell, , 757 P.2d, at 259; Lucas, , 757 S.W.2d, at 690 (holding that statutory caps were unreasonable under the state open-courts provision of the Texas constitution because they failed to provide a substitute redress for the victim).Google Scholar
Fein, 474 U.S., at 892.Google Scholar
Duke Power Co. v. Carolina Environmental Study Group, Inc., 438 U.S. 59 (1978).Google Scholar
Id. at 88.Google Scholar
Fein, 474 U.S., at 895.Google Scholar
Arneson v. Olson, 270 N.W.2d 125, 134–135 (N.D. 1978).Google Scholar
Lucas, 757 S.W.2d, at 690–691; Smith, 507 So.2d, at 1089–1090; Judd, 103 P.3d, at 138–140.Google Scholar
Scherlinck, J. M., Note, “Medical Malpractice, Tort Reform, and the Separation of Powers Doctrine in Michigan,” Wayne Law Review 44 (1998): 313–341, at 327.Google Scholar
Judd, 103 P.3d, at 145.Google Scholar
Best v. Taylor Mach. Works, Inc., 689 N.E.2d 1057, 1078–1080 (Ill. 1997).Google Scholar
Scherlinck, , supra note 98, at 340.Google Scholar
For example, see Kirkland, , 4 P.3d, at 1121 (holding that a noneconomic damages cap did not violate separation of powers because the Idaho constitution allows the legislature to “modify or abolish common law causes of action”); Pulliam v. Coastal Emergency Servs. of Richmond, Inc., 509 S.E.2d 307, 319 (VA. 1999) (holding that a medical malpractice damages cap did not violate separation of powers, because the legislature “has the power to provide, modify, or repeal a remedy”); Verba v. Ghaphery, 552 S.E.2d 406, 411 (W.Va. 2001) (holding that a medical malpractice damages cap did not violate separation of powers because the legislature has the power to limit common law remedies).Google Scholar
Judd, 103 P.3d, at 145, quoting Ritchie v. Richards, 47 P. 670, 675 (UT. 1896) (Bartch, J., concurring).Google Scholar
Schwartz, V. Behrens, M. A. Parham, M. G., “Fostering Mutual Respect and Cooperation Between State Courts and State Legislatures: A Sound Alternative to a Tort Tug of War,” West Virginia Law Review 103 (2000): 1–18, at 10–12.Google Scholar
Ohio Acad. of Trial Lawyers v. Sheward, 715 N.E.2d 1062, 1076–1079 (Ohio 1999).Google Scholar
Robinson v. Charleston Area Med. Ctr., 186 WV. 720, 730 (WV. 1991).Google Scholar
Kluger, 281 So.2d, at 4.Google Scholar
HEALTH Act of 2003, § 11(c); HEALTH Act of 2004, § 1011(c).Google Scholar
Hershkoff, H., “State Courts and the ‘Passive Virtues’: Rethinking the Judicial Function,” Harvard Law Review 114 (2001): 1833–1922, at 1888.CrossRefGoogle Scholar
Id.Google Scholar
Hershkoff, H., “Postive Rights and State Constitutions: The Limits of Federal Rationality Review,” Harvard Law Review 112 (1999): 1131–1195, at 1162–1163.CrossRefGoogle Scholar
Id. at 1168.Google Scholar
Id. at 1181.Google Scholar
Id. at 1182.Google Scholar
Blumstein, J. F., “A Perspective on Federalism and Medical Malpractice,” Yale Journal on Regulation 14 (1996): 411–427, at 425–426.Google Scholar
Studdert, Mello, Brennan, , supra note 83; Studdert, Yang, Mello, , supra note 8.Google Scholar