Verdicts

California's Noneconomic Damage Cap Held Constitutional

In an unpublished opinion, the Court of Appeal of California, Third Appellate Division, held that because the distinction drawn by the state's Medical Injury Compensation Reform Act (MICRA) between health care professionals and other tortfeasors was rationally made to further a valid state purpose, it did not violate constitutional guarantees of equal protection. Hooper v. Capobianco, C040072, 2004 Cal. App. Unpub. LEXIS 5001 (Ct. of App. Of Calif., 3d App. Dist 5/25/04).

Plaintiff was prescribed Trazodone' by the defendant doctor as a sleep aid. An uncommon but known side-effect of the use of Trazodone is priapism, a “persistent erection of the penis, accompanied by pain and tenderness, resulting from a pathologic condition rather than sexual desire.” (PDR Medical Dict. (2d ed. 2000) p. 1443.) The occurrence of priapism is a urological emergency. The window of treatment to prevent impotence extends up to 26 hours after onset. However, if the condition is not reversed within 6 hours, the risk of permanent damage and impotence becomes very high.

Plaintiff took a dose of Trazodone and awoke with an erection. He then took another dose, went back to sleep, then awakened again with a persistent erection. Because these events occurred over Memorial Day weekend and the plaintiff had no medical insurance, he chose to wait several days to seek defendant's advice rather than go to the hospital. When he did see defendant, he was sent to a hospital where he underwent several harrowing procedures that proved unsuccessful. He was finally operated on under general anesthesia. During surgery, his urethra was nicked and badly repaired. His condition has now subsided, but he is impotent and he experiences urine leakage. He also suffers from psychological injury.

The jury awarded plaintiff $3.4 million on his medical malpractice action against defendant. Of that amount, $2 million were for noneconomic damages and approximately $1.2 million were for past and future loss of earning capacity. On defendant's motion, the trial court reduced the award of noneconomic damages to $250,000 pursuant to California Civil Code ' 3333.2, which, as part of the MICRA, limits recovery of noneconomic damages in medical malpractice cases to $250,000.

Plaintiff asserted on appeal that ' 3333.2's limitation on the amount of noneconomic damages that may be awarded in a medical malpractice case violated the equal protection guarantees of both the federal and state constitutions facially and as applied to this case. He argued the statute unlawfully discriminates against victims of medical negligence by: 1) imposing an arbitrary cap on the amount of noneconomic damages that can be awarded in a medical malpractice action; 2) imposing a cap that is no longer rationally related to the statute's goal of providing a reasonable damages remedy because the cap has not been increased in over 25 years; and 3) immunizing medical tortfeasors, which allegedly is not rationally related to the statute's other goal of reducing medical malpractice insurance premiums. The court disagreed with each of plaintiff's arguments.

The court found that ' 3333.2 was rationally related to the legitimate state interest of reducing costs for malpractice defendants and their insurers and that limiting the law's application to medical malpractice cases was thus warranted. Quoting Fein v. Permanente Medical Group (1985) 38 Cal.3d 137 at p. 162, the court noted that “[j]ust as the complete elimination of a cause of action has never been viewed as invidiously discriminating within the class of victims who have lost the right to sue, the $250,000 limit – which applies to all malpractice victims – does not amount to an unconstitutional discrimination.” It also found no basis on which to hold that the $250,000 cap was arbitrary, directing the plaintiff to take to the legislature his concerns about the cap's failure to increase since its introduction in the 1970s. And, finally, as to plaintiff's assertion that ' 3333.2 violates state equal protection guarantees because it immunizes medical professionals but not other tortfeasors, the court found that the legislature could have rationally decided immunizing medical professionals but not other tortfeasors from liability would reduce medical malpractice insurance premiums. Because the distinction drawn by the law between health care professionals and other tortfeasors could rationally be made to further a valid state purpose, it did not violate constitutional guarantees of equal protection.

California's Noneconomic Damage Cap Held Constitutional

In an unpublished opinion, the Court of Appeal of California, Third Appellate Division, held that because the distinction drawn by the state's Medical Injury Compensation Reform Act (MICRA) between health care professionals and other tortfeasors was rationally made to further a valid state purpose, it did not violate constitutional guarantees of equal protection. Hooper v. Capobianco, C040072, 2004 Cal. App. Unpub. LEXIS 5001 (Ct. of App. Of Calif., 3d App. Dist 5/25/04).

Plaintiff was prescribed Trazodone' by the defendant doctor as a sleep aid. An uncommon but known side-effect of the use of Trazodone is priapism, a “persistent erection of the penis, accompanied by pain and tenderness, resulting from a pathologic condition rather than sexual desire.” (PDR Medical Dict. (2d ed. 2000) p. 1443.) The occurrence of priapism is a urological emergency. The window of treatment to prevent impotence extends up to 26 hours after onset. However, if the condition is not reversed within 6 hours, the risk of permanent damage and impotence becomes very high.

Plaintiff took a dose of Trazodone and awoke with an erection. He then took another dose, went back to sleep, then awakened again with a persistent erection. Because these events occurred over Memorial Day weekend and the plaintiff had no medical insurance, he chose to wait several days to seek defendant's advice rather than go to the hospital. When he did see defendant, he was sent to a hospital where he underwent several harrowing procedures that proved unsuccessful. He was finally operated on under general anesthesia. During surgery, his urethra was nicked and badly repaired. His condition has now subsided, but he is impotent and he experiences urine leakage. He also suffers from psychological injury.

The jury awarded plaintiff $3.4 million on his medical malpractice action against defendant. Of that amount, $2 million were for noneconomic damages and approximately $1.2 million were for past and future loss of earning capacity. On defendant's motion, the trial court reduced the award of noneconomic damages to $250,000 pursuant to California Civil Code ' 3333.2, which, as part of the MICRA, limits recovery of noneconomic damages in medical malpractice cases to $250,000.

Plaintiff asserted on appeal that ' 3333.2's limitation on the amount of noneconomic damages that may be awarded in a medical malpractice case violated the equal protection guarantees of both the federal and state constitutions facially and as applied to this case. He argued the statute unlawfully discriminates against victims of medical negligence by: 1) imposing an arbitrary cap on the amount of noneconomic damages that can be awarded in a medical malpractice action; 2) imposing a cap that is no longer rationally related to the statute's goal of providing a reasonable damages remedy because the cap has not been increased in over 25 years; and 3) immunizing medical tortfeasors, which allegedly is not rationally related to the statute's other goal of reducing medical malpractice insurance premiums. The court disagreed with each of plaintiff's arguments.

The court found that ' 3333.2 was rationally related to the legitimate state interest of reducing costs for malpractice defendants and their insurers and that limiting the law's application to medical malpractice cases was thus warranted. Quoting Fein v. Permanente Medical Group (1985) 38 Cal.3d 137 at p. 162, the court noted that “[j]ust as the complete elimination of a cause of action has never been viewed as invidiously discriminating within the class of victims who have lost the right to sue, the $250,000 limit – which applies to all malpractice victims – does not amount to an unconstitutional discrimination.” It also found no basis on which to hold that the $250,000 cap was arbitrary, directing the plaintiff to take to the legislature his concerns about the cap's failure to increase since its introduction in the 1970s. And, finally, as to plaintiff's assertion that ' 3333.2 violates state equal protection guarantees because it immunizes medical professionals but not other tortfeasors, the court found that the legislature could have rationally decided immunizing medical professionals but not other tortfeasors from liability would reduce medical malpractice insurance premiums. Because the distinction drawn by the law between health care professionals and other tortfeasors could rationally be made to further a valid state purpose, it did not violate constitutional guarantees of equal protection.