Malpractice Caps “Offend” The Concept of Justice: Florida Supreme Court

The Florida Supreme Court has thrown out the state’s cap on damage awards in medical malpractice lawsuits, indicating that limiting the amount that juries can award after reviewing the evidence offered at trial is incompatible with the concept of equal justice. 

In a 5-2 ruling in Estate of McCall v. United States (PDF), the Florida Supreme Court found that the state’s statutory cap on noneconomic damages violates the equal protection clause of state’s constitution. The ruling strikes down a $1 million cap as unconstitutional.

At issue in the case was an award returned by a Florida jury in a wrongful death lawsuit filed by the family of Michelle McCall, who died of cardiac arrest due to blood loss in February 2006, after a botched delivery at a U.S. Air Force medical facility in Florida. The jury determined that the family should be awarded $2 million in damages, including $500,000 for her son, who was born healthy, and $750,000 for each of her parents.

Under the Florida cap on medical malpractice damages, the court slashed the verdict in half to the arbitrary $1 million limit enacted by the state legislature, which overrides the decision of a jury without any review of the evidence or circumstances of the case. The Florida Supreme Court ruled that the action and the state’s malpractice cap was unfair.

The court noted that the reduction meant that every one of the surviving members of the family got less from the jury award. The justices pointed out, however, that had she been survived just by her son, he would have received the full $500,000; thus the malpractice cap is unfair to people survived by large families.

Medical Malpractice Caps Offensive to Justice

The court ruled that the malpractice cap “has the effect of saving a modest amount for many by imposing devastating costs on a few — those who are most grievously injured, those who sustain the greatest damage and loss, and multiple claimants for whom judicially determined noneconomic damages are subject to division and reduction simply based on the existence of the cap,” the opinion states. “Under the Equal Protection Clause of the Florida Constitution…we hold that to reduce damages in this fashion is not only arbitrary, but irrational, and we conclude that it ‘offends the fundamental notion of equal justice under the law.’”

The court received the case after it was appealed to the Eleventh Circuit Court of Appeals, which upheld the cap under federal law, but handed state law issues off to the Florida Supreme Court.

The decision strikes down a key provision of tort reform laws passed instituted in Florida in 2003, by then-Governor Jeb Bush, and ratified by a Republican-led state legislature, who said that the caps were necessary to keep down insurance rates and prevent doctors from fleeing the state.

Similar logic has been used to put in place caps in a number of states, but the Florida Supreme Court noted that more and more state courts are striking those malpractice caps down as anathema to equal protection laws, citing a similar ruling recently in Illinois that led to the downfall of medical malpractice caps in that state as well.

About 30 states currently have damage caps of some form, but they have been increasingly challenged in recent years.

State Supreme Courts in Illinois, Missouri and Georgia have thrown out similar damages caps in recent years, saying that the imposition of caps by the state legislatures violated the plaintiffs’ rights to a trial by jury, since the cap overrode the jury’s judgment on what the compensation for those cases should be.

California was the first state to enact a damage cap in 1975, specifically limiting the non-economic damages in medical malpractice lawsuits. According to the National Conference of State Legislatures, as of 2005 ten states capped recoveries specifically on medical malpractice cases and another 22 have caps that are not limited to medical malpractice. About a dozen states also have caps on punitive damages.