In possible new trend, top West Virginia court approves malpractice caps

Courts in numerous states are grappling with the issue of lawsuit award limits in medical liability cases, and the trend may be turning toward approval of so-called “caps” that legislatures are enacting to make the medical practice environment more favorable in their states.

The West Virginia Supreme Court of Appeals ruled recently that the state’s cap on pain and suffering damages was constitutional. The court was ruling in a case where a judge reduced a lawsuit award from $1 million to $500,000 in accord with an amendment enacted by the state legislature in 2003.

Chief Justice Margaret Workman wrote in the court’s opinion that “the legislature could have rationally believed that decreasing the cap on noneconomic damages would reduce rising medical malpractice premiums and, in turn, prevent physicians from leaving the state, thereby increasing the quality of, and access to, healthcare for West Virginia residents."

The case, McDonald v. City Hospital, involved a patient with diabetes who had a kidney transplant, James D. McDonald, and was exhibiting signs of pneumonia when he presented at the hospital in 2004. He later claimed in a lawsuit against both the doctor and the hospital that a drug mixture administered to him caused rhabdomyolysis.

Jurors, who apportioned 70% fault to the physician, awarded McDonald $92,000 for medical expenses, $37,000 for lost wages, $250,000 for past pain and suffering, and $750,000 for future pain and suffering. When the judge reduced the pain and suffering award to $500,000 in accord with state law, the case was appealed.

"Our decision today places West Virginia squarely with the majority of jurisdictions in holding that caps on noneconomic damages in medical malpractice cases are constitutional,” Workman said.

Several other state courts recently have weighed in on the issue or are considering it.

A Florida appellate court on May 27 upheld the state's $500,000 noneconomic damages cap as constitutional, but the case ultimately will be decided by the Florida Supreme Court.

Pivotal cases currently are pending in Mississippi, Kansas, Louisiana, Indiana, Nevada, and California.

Last year, the Missouri Supreme Court gave approval to that state’s liability limits, but both the Georgia Supreme Court and the Illinois Supreme Court declared their state’s caps to be unconstitutional.

John H. Schmidt III, MD, president of the West Virginia State Medical Association (WVSMA), applauded the court decision in his state, saying in a statement, “The cap was the cornerstone to the reforms passed in 2003 that have worked amazingly well for the patients we care for.”

The WVSMA noted that record numbers of new physicians have been licensed in the state in recent years and that the number of lawsuits filed have dropped 50%.

Even while the caps are undergoing judicial review in some states, however, they are still being established in others. In June, Tennessee Gov. Bill Haslam recently signed into law a cap of $750,000 on medical liability awards, with the limit rising to $1 million in certain cases deemed to involve serious injury.

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