Medical Malpractice Caps Unconstitutional Illinois Supreme Court

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ILLINOIS SUPREME COURT DECLARES MEDICAL MALPRACTICE CAPS UNCONSTITUTIONAL

For the third time, the Illinois Supreme Court has declared arbitrary caps on non-economic damage awards in medical malpractice cases unconstitutional. The most recent case, Lebron v. Gottlieb Memorial Hospital, relates to a 2005 law passed by the Illinois General Assembly which capped an injured plaintiff's recovery of non-economic damages (disability, pain and suffering, disfigurement and loss of society) in medical malpractice cases to $500,000 in cases against a physician and $1,000,000 in cases against a hospital. This cap would be imposed on every medical malpractice case, regardless of the severity of the injury or the age of the injured plaintiff.

Under the law, the jury would not be informed of the cap. As such, a jury could return a verdict against a doctor for $2,000,000 and after the trial the trial court would be required to reduce the verdict to $500,000.

In the Supreme Court, the caps were opposed not just by the injured plaintiff, but by the American, Illinois State, Cook County, and Chicago Bar Associations, all of which comprise of attorneys who work on behalf of injured persons and also those who work on behalf of doctors, hospitals and insurance companies. Additionally, the caps were opposed by the Woman's Bar Association, the National Association for the Advancement of Colored People (NAACP), and the Illinois Alliance for Retired Americans. These groups opposed the caps in part because caps on non-economic damages disproportionately affect women, racial minorities and older individuals.

Finally, the AFL-CIO and the Chicago Federation of Labor filed briefs in opposition to the caps, as well as a group of almost 25 law and social sciences professors who provided statistical evidence undermining the alleged "health care crisis" and "doctor flight" from Illinois. Conversely, the only groups who supported the caps were associations of doctors and hospitals. Not a single independent or bi-partisan group filed supporting briefs in the Supreme Court supporting the caps.

At the time the Act was passed but before it was signed by then-Governor Blagojevich, this column featured an article arguing that the Governor should not sign the bill into law because it was unconstitutional, and because it would not solve the problem of increasing insurance premiums on the medical profession. This article will discuss the LeBron case and future articles will discuss the validity of criticisms of the decision.

Abigaile LeBron

Shortly, after the medical malpractice caps were passed by the General Assembly and signed into law, Abigail Lebron was born. As a result of alleged medical errors during her delivery, Abigail suffers from a severe brain injury, cerebral palsy, abnormal neurological function and needs to be fed through a tube in her stomach. Abigail's mother filed suit against the doctor and hospital involved with Abigail's care, and filed a motion requesting that the trial court find the cap on non-economic damages unconstitutional.

After extensive briefing a Circuit Court judge found that the caps violated the separation of powers clause of the Illinois Constitution because it acts as a legislative remittitur. A remittituris the right of a judge to reduce a jury verdict if they feel it is unreasonably high. The judge will either reduce the verdict to an amount he feels is appropriate or order that a new trial as to the amount of damages be conducted with a new jury. The only limitation on the judge is that they order a remittitur based on the facts and circumstances of the particular case before him.

Caps on non-economic damages operate as a legislative remittitur. In other words, rather than having a judge who has viewed the evidence and heard testimony from witnesses decide whether a verdict in a particular case is too high, the legislature has arbitrarily capped damages at a certain amount. Because a remittitur is a function given to the judicial branch (the courts), having the legislature impose a remittitur is a violation of separation of powers. Therefore, the judge ruled that the Act was unconstitutional and could not be applied.

The Supreme Court's Decision

Under Illinois law, if a judge finds a state law unconstitutional, the parties are allowed an automatic and immediate appeal to the Supreme Court of Illinois. As described above, prior to issuing its decision, the Supreme Court received briefs not just by the parties to the LeBroncase, but from over 20 entities who submitted "friend of the court" briefs, as well as a brief from the Illinois Attorney General, who is allowed to intervene in cases where a state law is found unconstitutional.

After extensive briefing and oral argument, the Supreme Court affirmed the trial court's finding that the statute was unconstitutional. The Court noted that in 1997 it held in the Best case that a $500,000 cap on non-economic damages was unconstitutional because it violated the separation of powers clause of the Illinois Constitution and violated the Illinois' Constitutions prohibition on "special legislation." The special legislation clause prohibits arbitrary legislative classifications that discriminate in favor of a select group without a sound, reasonable basis. The Court found the cap on non-economic damages penalized the most severely injured individuals, and thus was special legislation.

Likewise, in 1976, the Supreme Court invalidated a similar medical malpractice cap in another case. Thus, the LeBron decision is the third time the Supreme Court has found that non-economic damage caps in medical malpractice cases was unconstitutional.

In LeBron, the Supreme Court reiterated that legislatively imposed caps on non-economic damages violates the separation of powers clause. It is first and foremost the role of a jury to assess the nature and extent of an individual's injuries. It is then the role of the trial judge, who has had an opportunity to see the particulars of a case to decide whether the jury's verdict is excessive. It is not the legislature's role to impose an arbitrary one size fits all cap on damages.

The Court also addressed the fact that several other states do have medical malpractice caps that have withstood constitutional scrutiny in those states. However, the Court rejected "everybody is doing it" as the test for determining the constitutionality of an Illinois state law.

Since the Supreme Court's decision, the same rhetoric that fueled the caps imposition has again re-surfaced as criticism of the decision. Next month we will discuss whether doctors are really leaving the state, whether the filings or verdict amounts of medical malpractice cases are rising, and whether malpractice claims have a significant effect on the cost of health care.


By: Martin Healy, Jr.
Dennis M. Lynch