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July 1, 2017
Court rules med mal caps unconstitutional

Three years after finding Florida’s law limiting noneconomic damages in wrongful death cases was unconstitutional, the Florida Supreme Court has struck down the second provision of that law that limited those damages in medical malpractice actions.

In a 4-3 decision on June 8, the court majority cited the same reasons as in its 2014 ruling: The law contravenes the Florida Constitution’s equal protection clause, lacks a rational basis for meeting a state objective, and the “crisis” cited as the reason for the law no longer exists.

The case involved a Broward County woman who suffered a punctured esophagus from anesthesia procedures when she was in the hospital for carpal tunnel surgery, was sent home when the mistake was misdiagnosed, and ended up with permanent debilitating injuries.

State law limits noneconomic damages for medical practitioners to $500,000 unless the negligence causes a permanent vegetative state or a catastrophic injury where that award would be a “manifest injustice,” and in those cases, noneconomic damages are limited to $1 million. For nonpractitioners, the limits are 50 percent higher.

A jury found the woman suffered a catastrophic injury and awarded $4 million in noneconomic damages against the doctor and hospital. Because of sovereign immunity for the hospital and the caps in the statute, that award was reduced by around $3.3 million.

The Fourth District Court of Appeal, citing Estate of McCall v. United States, 134 So. 3d 894 (Fla. 2014), ruled the statute capping the noneconomic damages in medical negligence cases was unconstitutional. In McCall, the Supreme Court answered a question from the U.S. 11th Circuit Court of Appeals on whether the cap in F.S. §766.118 was legal in wrongful death cases.

The court, in a plurality opinion with a concurring opinion, said it was not, and the Fourth DCA applied the reasoning of McCall to the medical malpractice sections of the statute.

In McCall, the court noted the cap applied whether there were multiple claimants/survivors from an incident or a single claimant/survivor and also regardless of the severity of plaintiff injuries. It said that violated the Equal Protection Clause, that the Legislature failed to provide a rational basis that the law would address the crisis it said existed in medical malpractice rates, and that conditions had changed and the crisis no longer existed.

In this case, the majority found “that the caps in §766.118 violate equal protection under the rational basis test because the arbitrary reduction of compensation without regard to the severity of the injury does not bear a rational relationship to the Legislature’s stated interest in addressing the medical malpractice crisis.”

In McCall, the court found “no evidence of a continuing medical malpractice crisis justifying the arbitrary application of the statutory cap, [and] we reach the same conclusion with regard to the unconstitutionality of the caps in the present case.” The court noted that someone who lost a hand and someone left in a permanent vegetative state would receive the same maximum damages if, as specified by the law, the trial court determine a manifest injustice would occur if the higher caps were awarded.

The majority also cited McCall in noting the law possessed no mechanism to ensure savings from lower awards would be passed along to medical providers.

Chief Justice Jorge Labarga and Justices Barbara Pariente, Fred Lewis, and Peggy Quince concurred in the per curiam opinion.

Justice Ricky Polston, joined by Justices Charles Canady and Alan Lawson, dissented.

Polston, who also dissented in the McCall decision, said the majority misapplied the rational basis test, which he said under the court’s precedents must conclude that “if we can conceive of a possible factual predicate that provides a rational basis in furtherance of a legitimate state interest, the statute does not violate the constitutional guarantee of equal protection.”

He added: “The majority just discards and ignores all of the Legislature’s work and fact-finding. But, under our constitutional system, it is the Legislature, not this court, that is entitled to make laws as a matter of policy based upon the facts it finds. See art. II, §3, Fla. Const.; art. III, §1, Fla. Const. It is the Legislature’s task to decide whether a medical malpractice crisis exists, whether a medical malpractice crisis has abated, and whether the Florida Statutes should be amended accordingly. For a majority of this court to decide that a crisis no longer exists, if it ever existed, so it can essentially change a statute and policy it dislikes, improperly interjects the judiciary into a legislative function.”

The court ruled in North Broward Hospital District v. Susan Kalitan, Case No. SC15-1858.

[Revised: 12-06-2017]