Florida Supreme Court Rejects Cap On Malpractice Awards


ABOVE VIDEO: WESH 2 News reports on the Florida Supreme Court ruling that caps on non-economic awards in wrongful death medical malpractice cases are unconstitutional.

EDITOR’S NOTE:  Yesterday, the Florida Supreme Court ruled that the medical liability caps on non-economic damages for wrongful death cases in Florida Statute 766.118, which passed in 2003, were unconstitutional as a violation of the Equal Protection Clause of Florida’s Constitution.

The statute was passed after a rancorous battle between proponents of the Florida Trial Bar and healthcare provider organizations, including the Florida Medical Association and the Florida Hospital Association, at a time in 2003 when the Florida healthcare industry was in the throws of a crisis in which the number of medical malpractice cases and malpractice insurance premiums were skyrocketing, and there was widespread concern that the unchecked explosion  of medical malpractice costs would force physicians to leave Florida or stop providing high-risk services.

Since then, the battle has been waged in the courts, culminating after 11 years in the ruling documented by The News Service of Florida’s Jim Saunders in the article below.

I suspect that the legal assault on the statute will continue on a broader scope in an attempt to legislate, through the courts and ultimately from the bench, the unconstitutionality of other aspects of the law related not just to wrongful death, but also other types of “personal injury.”  

It appears that the floodgates may be about to open again on massive “pain and suffering” medical malpractice awards in Florida.

— Dr. Jim Palermo, Editor-in-Chief

THE NEWS SERVICE OF FLORIDA — Siding with the family of a Panhandle woman who died of complications after giving birth, the Florida Supreme Court on Thursday ruled that a 2003 law limiting damages in medical-malpractice lawsuits is unconstitutional.

The 5-2 ruling rejected a damage cap that emerged from months of political fighting in the Legislature more than a decade ago. In doing so, justices gave a huge victory to plaintiffs’ lawyers who fiercely opposed limits on so-called “non-economic” damages — and dealt a huge blow to physicians, who have made a priority of reining in medical-malpractice lawsuits.

Supreme Court of Florida. From left to right: sitting–Justice Pariente, Chief Justice Polston and Justice Lewis; standing–Justices Labarga, Quince, Canady and Perry

“At the present time, the cap on non-economic damages serves no purpose other than to arbitrarily punish the most grievously injured or their surviving family members,” Justice R. Fred Lewis wrote. “Moreover, it has never been demonstrated that there was a proper predicate for imposing the burden of supporting the Florida legislative scheme upon the shoulders of the persons and families who have been most severely injured and died as a result of medical negligence.”

But Chief Justice Ricky Polston, who was joined in dissent by Justice Charles Canady, pointed to legislative findings that indicated the state was in the midst of a medical-malpractice insurance “crisis” in 2003 that threatened the quality and availability of health care. Those findings were based, at least in part, on high insurance costs for doctors.

“This court has previously recognized the existence of a medical malpractice insurance crisis as a legitimate state interest,” Polston wrote. “Further, it is undisputed that increasing the quality, availability, and affordability of health care for Floridians is a legitimate state interest. And the Legislature’s policy choice of enacting a cap on non-economic damages in medical malpractice cases is rationally related to these state interests.”

After heavy lobbying by doctors, hospitals and insurance companies, lawmakers and then-Gov. Jeb Bush in 2003 approved a compromise bill that included capping non-economic damages at $1 million in malpractice cases involving wrongful-death claims. Non-economic damages typically relate to issues such as pain and suffering, rather than issues such as lost wages.

Thursday’s ruling stemmed from the February 2006 death of 20-year-old Michelle McCall, who gave birth to a son at Fort Walton Beach Medical Center but died days later because of complications from severe bleeding. McCall’s estate sued the federal government because she was part of a military family and was treated by Air Force medical staff.

A federal judge agreed with the family’s arguments that McCall had not received proper care and found that her survivors should receive $2 million in non-economic damages. But because of the state law limiting such damages, the award was reduced to $1 million.

The 11th U.S. Circuit Court of Appeals in Atlanta ruled that the damage limits applied to the McCall case did not violate the federal constitution, but the Florida Supreme Court overturned that ruling, declaring caps on non-economic damages in this wrongful death case violated the Equal Protection Clause of Florida’s Constitution.

The 11th U.S. Circuit Court of Appeals in Atlanta ruled that the damage limits did not violate the federal constitution, but it said the Florida Supreme Court should consider state constitutional issues.

Both sides of the medical-malpractice debate have closely watched the McCall case, which, in effect, was a proxy for the larger battle over the constitutionality of damage limits. As an indication of the complexity of the issues, Thursday’s ruling came more than two years after the Supreme Court heard arguments in the case.

Paul Anderson, president of the Florida Justice Association, a trial-lawyers group that fought the limits, issued a statement praising the ruling. He said “victims and their families will have the opportunity to be fully compensated for their losses. The cap on non-economic damages unfairly punished victims whose lives were permanently altered by no fault of their own.”

But the Florida Medical Association, a physicians group that helped lead efforts to pass the cap, warned that the ruling will lead to more malpractice lawsuits, which will drive doctors to practice in other states.

“Again, this is another example of the Supreme Court legislating from the bench, and it is offensive that activist judges have taken the place of elected officials,” Florida Medical Association General Counsel Jeff Scott said.

The five justices who ruled against the law — Lewis and justices Barbara Pariente, Peggy Quince, Jorge Labarga and James E.C. Perry — found that it violated the Equal Protection Clause of the Florida Constitution. But while they agreed on the result, the justices offered two opinions that indicated differences in legal reasoning. Lewis and Labarga agreed in one opinion; the other three justices agreed in an opinion written by Pariente.

Both majority opinions, however, took issue with the Legislature’s rationale that it was addressing a medical-malpractice crisis by approving the cap. The opinions also pointed, in part, to the decision to set a $1 million cap, regardless of the number of claimants in a case. McCall’s parents were each initially awarded $750,000 in non-economic damages and her son was awarded $500,000, but those amounts were halved because of the cap.

“There is no evidence of a continuing medical malpractice crisis that would justify the arbitrary reduction of survivors’ non-economic damages in wrongful death cases based on the number of survivors,” Pariente wrote. “This arbitrary reduction punishes the survivors of victims of medical malpractice without any commensurate benefit to the survivors and without a rational relationship to the goal of reducing medical malpractice premiums.”

Present Senate Judiciary Chairman Tom Lee helped negotiate the 2003 law.

The ruling came as lawmakers prepared to finish the second week of this year’s legislative session. But it was not immediately clear whether Republican legislative leaders would try to address the medical-malpractice issues this spring.

“Disappointing, as usual, from them,” Senate Rules Chairman John Thrasher, R-St. Augustine, said when asked about the justices’ ruling. “But we’ll see what we have to do to address it.”

Senate Judiciary Chairman Tom Lee, a Brandon Republican who helped negotiate the 2003 law during an earlier stint in the Senate, said he will have to look at the details of the ruling before considering whether to try to address it. But Lee also expressed unhappiness that it took more than a decade for the courts to decide whether the cap was constitutional.

“Isn’t it a shame that it takes 11 years to get statutes litigated in the Florida court system?” he asked.