Friday, June 27, 2014

McCall: Limited Decision Or Harbinger Of The End Of All Medical Malpractice Caps?

By Charles T. Moore

The Florida Supreme Court recently issued its eagerly anticipated decision on caps on noneconomic damages in medical malpractice cases. In Estate of McCall v. U.S., 2014 WL 959180, —So. 3d— (Fla. March 13, 2014), the court held the statutory cap on wrongful death noneconomic damages under Fla. Stat. § 766.118 violates the Florida Constitution’s Equal Protection Clause. Let the argument begin: Is McCall limited to wrongful death, or has it laid the groundwork for unconstitutionality of all § 766.118 caps?

This decision will invite much dissent as to surviving sections of § 766.118 because of the opinions’ piecemeal nature. The decision was announced in an opinion written by Justice Fred Lewis in which Justice Jorge Labarga concurred. The opinion focused on the part of § 766.118 that limits all noneconomic damages in wrongful death and catastrophic injury cases against doctors to $1 million, no matter how many claimants. Justice Lewis ruled the law’s disparate treatment of multiple survivors/claimants, like a large family, versus a single survivor/claimant violates fundamental notions of equal protection. He also reasoned the Legislature failed to establish a legitimate relationship between caps and the goal of reducing medical malpractice insurance premiums.

Justice Barbara Pariente refused to endorse Justice Lewis’ “independent evaluation and reweighing” of the Legislature’s factual findings as to a medical malpractice crisis. She instead wrote a concurring opinion joined by Justices Peggy Quince and James Perry. The concurring opinion agreed that capping noneconomic damages in wrongful death cases lacks a rational relationship to the goal of reducing medical malpractice premiums. Might that same lack of rational relationship apply to personal injury medical malpractice cases? 

Justice Lewis noted the analyses for personal injury damages and wrongful death damages are different. He limited his analysis to wrongful death, rewording the certified question. He then declined to answer the other certified questions, such as whether the caps on damages violate the Florida Constitution’s Access to Courts and Right to Jury Trial protections. Answering those questions could have put to rest whether caps on damages in personal injury medical malpractice cases are also unconstitutional. The court left those questions for another day to avoid the charge of issuing an advisory opinion.

The plurality and concurring opinions give plenty of hints as to whether the analysis applies to all § 766.118 caps. The most striking example arises from the opinions’ illustration of the unfair and illogical impact resulting when caps are applied to cases with multiple “claimants/survivors” as compared with cases involving only one claimant. The same analysis used to strike down caps in wrongful death cases would apply to catastrophic cases. Imagine a catastrophic injury to a minor child in a medical malpractice case against a doctor that renders that minor child quadriplegic. The catastrophically injured child would have to share the limit of $1 million with her parent claimants. Compare that to a case where a single adult is similarly rendered quadriplegic.  She would be entitled to the full $1 million. Why is her injury worth more than the catastrophically injured child? This reflects the same unfair and illogical incongruity among claimants that led five justices to hold the cap unconstitutional in wrongful death cases. The cap in such a catastrophic injury case seems ripe for the challenge and could lead to § 766.118 being struck down in its entirety.