30 June 2017

Florida Supreme Court Strikes Down “Unconstitutional” Cap On Medical Malpractice Damages

The Florida Supreme Court has struck down the State’s pain-and-suffering damages cap, holding that the limits, which only impacted medical malpractice lawsuits, violated Florida’s Constitution. The case, North Broward Hospital District v Kalitan, was filed by a woman whose esophagus was punctured as she received anesthesia.

Law Restricting Malpractice Damages Violates Equal Protection

In a 4 to 3 ruling issued on Thursday, June 8, 2017, Florida’s highest court settled a long-standing debate within the State’s legal and medical communities. Florida’s legislature initially passed a cap on medical malpractice damages in 2003, citing a so-called “crisis” of negligence claims filed against doctors.

Florida Supreme Court Building

That year, the State’s GOP lawmakers forcefully argued that an “epidemic” of malpractice lawsuits was driving insurance premiums to unsustainable highs, forcing physicians to leave for cheaper jurisdictions. The only problem? Florida’s Supreme Court could find little evidence that the State’s damages cap had any effect on insurance premiums, doctor retention rates or other aspects of the malpractice insurance situation.

No Evidence Of Beneficial Impact On Doctor Insurance Premiums

Severely-injured patients, the Supreme Court says, are being used as guinea pigs. The damages cap is an experiment, put in place by Florida’s legislature, to see whether or not arbitrarily lowering a plaintiff’s award will affect insurance premiums. There’s just no way to justify such an experiment, seeing that individual patients will be hurt and no one has provided sufficient evidence that Florida’s damages cap is working. In fact, the Court wrote that “there is no evidence [none at all] of a continuing crisis” in medical malpractice insurance premiums.

In effect, Florida’s legislators had passed an ineffective law to solve a nonexistent problem.

The Court wasn’t really interested in how well Florida’s noneconomic damages cap worked, though. Long before considering the law’s effects, the Supreme Court had already decided that Florida’s cap on non-economic damages violates the equal protection clause of the State’s Constitution, which holds that all “natural persons” (excluding legal entities, like corporations) are “equal before the law.”

Limiting Non-Economic Awards Is Arbitrary & Irrational

While some infringements of a citizen’s rights are warranted, they must be justified by a compelling and legitimate state interest. Moreover, legal standards that limit rights cannot be “arbitrary or capricious.”

The recent ruling builds on precedent set in a 2004 case, Estate of McCall v. United States, in which Florida’s Supreme Court held that non-economic damages caps in wrongful death cases were unconstitutional. In both McCall and Kalitan, Florida’s high court found that non-economic damages were, in fact, arbitrarily imposed, since the cap would come into effect automatically, regardless of whether the jury’s verdict was reasonable and fair.

Some high jury awards, the majority argued, are entirely justified and we shouldn’t be limiting them as a rule in all cases. Even if there was evidence that malpractice damages caps lowered insurance premiums, the cap would still be unconstitutional, because it would be “saving a modest amount for many by imposing devastating costs on a few” – those plaintiffs who suffer severe damages due to medical negligence.

Damages Caps Discriminate Against Patients & Doctors

In its opinion, Florida’s Supreme Court asked readers to consider three hypothetical patients: A, B and C:

  • Patient A suffers moderate injuries. Her damages, under Florida’s old law, would be capped at $500,000.
  • Patient B loses their hand, which would qualify as a “catastrophic injury,” limiting his full recovery to a maximum of $1 million.
  • Patient C, however, suffers a “drastic” injury and is left in a permanent vegetative state. Despite the extreme damage caused in Patient C’s case, her family’s potential recovery would still be limited to $1 million.

As the Court notes, only Patient A has a good chance of securing full compensation. Patient C, on the other hand, has no chance of getting full compensation. The problem with this scheme is obvious. Even though Patient C has lost everything, her award has been arbitrarily limited, with no consideration of malpractice’s dramatic effect on her life.

In this small example, we can also see why the Florida Supreme Court held that non-economic damages caps discriminate against medical professionals, too. Imagine Doctors A, B and C, who injured their respective patients by acting negligently. With the cap in place, Doctor A, whose negligence resulted only in moderate harm, may well receive a financial punishment appropriate to her wrongdoing. Doctor C, though, gets off with a slap on his wrist. Despite ruining someone’s life, along with the lives of her loved ones, Doctor C is only on the hook for $1 million, the same amount as Doctor B. And that doesn’t make much sense.

House Considers National Damages Cap

More than half of states now have some form of medical malpractice award cap on the books, NPR reports, even though these limits have met with questionable results. Meanwhile, a bill now being considered in the US House of Representatives hopes to impose a non-economic damages cap nationwide, limiting awards for pain and suffering to $250,000. While it faces stiff resistance, from both liberals and conservatives, President Trump has come out in support of law. If passed, a federal damages cap for malpractice claims would supersede the Florida Supreme Court’s decision, putting an arbitrary limit back in place.


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