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FMG Law Blog Line

Florida Supreme Court Strikes Down Damage Caps in Med Mal Cases

Posted on: June 9th, 2017

By: Melissa A. Santalone

Almost a year to the day after hearing oral argument on the case of North Broward Hospital District v. Kalitan, the Florida Supreme Court finally issued its decision striking caps on noneconomic damages in medical malpractice cases, holding they violate the Equal Protection Clause of the Florida Constitution. The Court reviewed and agreed with the Fourth District Court of Appeal’s ruling that also found Fla. Stat. § 766.118(2) and (3) violate the Equal Protection Clause. Many in the Florida legal community anticipated this outcome, since in 2014, the Court stopped just short of striking all noneconomic damage caps in med mal cases in Estate of McCall v. U.S., 134 So.3d 894. In McCall, the Court limited its holding that noneconomic damage caps were unconstitutional to wrongful death medical negligence suits.

Section 766.118, originally enacted in 2003, imposed caps on noneconomic damages in medical malpractice personal injury lawsuits ranging from of $500,000 to $750,000 per claimant for non-catastrophic injuries, depending on whether they were caused by a “practitioner” or “nonpractitioner,” as defined by the statute. It also limited noneconomic damages to between $1 million and $1.5 million for catastrophic injuries, which includes things like the loss of a limb, severe burns, or severe brain injuries, and those injuries resulting in a permanent vegetative state. 

In the Kalitan case, the plaintiff had undergone surgery for carpal tunnel syndrome, wherein her esophagus was perforated during intubation. After awaking from surgery and complaining of chest and back pain, she was examined by a doctor, who failed to discover her injury, and she was released from the hospital. The next day she was found unresponsive and rushed back to the hospital, where she underwent emergency surgery and spent weeks in a drug-induced coma. The plaintiff underwent a long course of rehabilitation, including additional surgeries, to be able to eat again and alleged she continues to suffer from physical pain and emotional trauma from the incident. At trial, the jury awarded the plaintiff $4 million in noneconomic damages; however, the plaintiff’s recovery was reduced by close to $2 million due to the damage caps.

Section 766.118 was initially enacted under the rationale that it was necessary to combat a medical malpractice crisis where ever-escalating insurance premiums were driving doctors out of state or into retirement, effectively limiting Floridians’ access to healthcare. The 4-justice plurality of the Court found the statute’s effect was arbitrary and unreasonable. It compared the hypothetical outcomes to claimants with varying degrees of injury, and determined the statute arbitrarily limited the recovery of the most seriously injured. Moreover, the plurality concluded, it did so without any rational relationship to the stated objective of decreasing medical malpractice premiums, since there was no mechanism to ensure savings were passed from insurance companies to doctors.  The dissent opinion, signed by 3 justices, found a rational relationship did exist between the statute and the legitimate state interest of decreasing medical malpractice premiums, and argued the plurality misapplied the proper test used in equal protection challenges.

This decision is a win for the Plaintiffs’ bar, which has always been vehemently opposed to caps, and it will likely send shockwaves through the Florida medical and insurance realms. Insurers will need to reevaluate whether the premiums they charge are adequate in light of the increased risk they now face and will need to be prepared to see an increase in the number of suits they must defend against. Likewise, those working in the medical field must decide if the coverage they currently have will adequately protect their personal assets if the worst should happen.

For any questions regarding the Florida Supreme Court’s decision, please contact Melissa A. Santalone at [email protected].


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