Challenges to medical liability caps go before Georgia, Maryland high courts
side note: State Supreme Courts in Georgia and Maryland will rule on non-economic damages for liability cases, will they overturn legislation?
High courts in Georgia and Maryland will decide the fate of caps on non-economic damages in medical liability cases in each state, two of the latest attempts to undo such award limits.
The Georgia Supreme Court case stems from a February trial court decision rejecting the constitutionality of the state’s $350,000 cap. Oral arguments began Sept. 15 in Atlanta Oculoplastic Surgery v. Nestlehutt.
Maryland’s Court of Appeals is set to hear arguments Nov. 5 on whether the state’s caps apply only to cases that are arbitrated.
Because of the constitutional and public policy issues at play, the two cases went to their respective high courts. Physicians in both states are pledging to defend the caps, which they credit with easing liability insurance costs and keeping doctors in practice.
The cases involve high stakes for patients and physicians, and undermining the reforms “would be a step backward” in access to care gains, said Rebecca J. Patchin, MD, chair of the AMA’s Board of Trustees. The Litigation Center of the American Medical Association and State Medical Societies joined the Medical Assn. of Georgia and MedChi, the Maryland State Medical Society, in filing separate friend-of-the-court briefs in their respective state cases. Liability insurance premiums in Georgia declined by 18% after the state capped noneconomic damages in 2005.
MedChi CEO Gene M. Ransom III said the cases also highlight the need for federal endorsement of tort reform as part of national health system reform, particularly for states struggling to pass measures to contain unaffordable liability costs. In light of the legal threats to caps, “federal health reform that includes tort reform becomes even more crucial,” he said.
But trial lawyers argue that the caps come at patients’ expense.
“The appropriate place for decisions on liability and fair compensation is the courthouse, not the Legislature,” said Georgia Trial Lawyers Assn. President Chris Clark. The trade organization is considering filing a brief in the Georgia case.
Questioning Georgia’s cap
In February, Fulton County Judge Diane E. Bessen ruled that Georgia’s noneconomic damage cap infringed on judges’ and juries’ power to determine awards and violated patients’ equal protection rights, with the greatest impact on those severely injured. “The cap so interferes with the determination of the jury that it renders the right of a jury trial wholly unavailable,” Bessen wrote in the opinion.
Clark said the award limit precludes legitimate medical liability claims, whose costs often exceed the value of the cap. And judges already have the ability to strike down excessive verdicts, he said.
But doctors say the law strikes a balance between patients’ legal rights and ensuring the availability of medical care.
“All patients suffer when you have an access-to-care crisis, so the Legislature said, ‘We have to address this problem,’ ” said Donald J. Palmisano Jr., MAG general counsel and director of government relations. He added that the cap still entitles patients to unlimited compensation for economic damages, such as medical expenses.