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How Wisconsin, Illinois, and federal proposals have approached limits on medical malpractice damages
Medical malpractice cases can involve devastating injuries, permanent disabilities, loss of independence, and the loss of a loved one. One of the most significant legal questions in these cases is whether a legislature can place a limit on the amount of noneconomic damages a seriously injured patient may recover. Noneconomic damages can include compensation for pain and suffering, disability, disfigurement, loss of normal life, and other harms that do not have a simple dollar value.
Wisconsin has been at the center of this debate for years. In 2017, the Wisconsin Court of Appeals ruled that the state’s $750,000 cap on noneconomic damages in medical malpractice cases was unconstitutional because it placed a disproportionate burden on catastrophically injured patients. The decision generated significant attention because the court concluded that the cap could fully compensate less seriously injured victims while substantially reducing awards for victims whose injuries were severe enough to justify more than $750,000 in noneconomic damages.
That appellate decision, however, was not the final word. In 2018, the Wisconsin Supreme Court reversed the Court of Appeals and upheld the $750,000 cap as constitutional. The Wisconsin case therefore provides an important example of how the constitutional debate over medical malpractice damages can develop through multiple levels of appellate review.
Quick Take: Illinois and Wisconsin took different paths on medical malpractice damage caps. The Illinois Supreme Court invalidated Illinois’ 2005 medical malpractice damages cap in Lebron v. Gottlieb Memorial Hospital. Wisconsin’s Court of Appeals initially found Wisconsin’s $750,000 cap unconstitutional, but the Wisconsin Supreme Court later reversed that decision and upheld the cap. Meanwhile, a proposed federal law in 2017 would have imposed a $250,000 limit on noneconomic damages in certain federally connected health-care lawsuits, but that proposal did not become law.
What Are Noneconomic Damages in a Medical Malpractice Case?
Economic damages are generally losses that can be calculated through financial evidence. Examples may include past and future medical expenses, rehabilitation costs, lost income, and diminished earning capacity. Noneconomic damages are different because they compensate for injuries that are real but more difficult to measure financially.
Economic Damages
These damages generally involve measurable financial losses, such as medical bills, future medical care, lost wages, and loss of earning capacity.
Noneconomic Damages
These damages address losses such as pain and suffering, disability, disfigurement, physical impairment, loss of normal life, and other nonfinancial consequences of an injury.
The distinction becomes particularly important in catastrophic injury cases. A person who suffers a devastating injury may have significant economic losses, but some of the most profound consequences of the injury may be noneconomic. The inability to enjoy ordinary activities, permanent physical limitations, chronic pain, disfigurement, and the loss of independence can be difficult to reduce to a simple financial calculation.
The Wisconsin Medical Malpractice Cap Controversy
Wisconsin’s $750,000 cap on noneconomic damages became the subject of a major constitutional challenge in Mayo v. Wisconsin Injured Patients and Families Compensation Fund. The case arose after a jury awarded Ascaris Mayo $15 million in noneconomic damages and awarded Antonio Mayo $1.5 million for loss of society and companionship.
The Mayos challenged the statutory cap, arguing that reducing their jury awards to $750,000 would violate constitutional protections. The circuit court concluded that the cap was unconstitutional as applied to the Mayos. The case then went to the Wisconsin Court of Appeals.
The central constitutional argument: The Wisconsin Court of Appeals reasoned that the cap affected the most severely injured victims differently from less severely injured victims. A person whose noneconomic damages were below $750,000 could receive the full amount awarded by the factfinder, while a catastrophically injured person whose noneconomic damages exceeded $750,000 would have the award reduced to the statutory maximum.
The Court of Appeals concluded in 2017 that this distinction created an equal-protection problem under the Wisconsin Constitution. The court relied in part on the Wisconsin Supreme Court’s earlier decision in Ferdon ex rel. Petrucelli v. Wisconsin Patients Compensation Fund, which had previously invalidated an earlier medical malpractice cap.
The Wisconsin Supreme Court Ultimately Reversed the Decision
The Court of Appeals decision was not the final outcome. The Wisconsin Injured Patients and Families Compensation Fund sought review by the Wisconsin Supreme Court, which issued its decision in June 2018.
The Wisconsin Supreme Court reversed the Court of Appeals and held that the $750,000 cap was constitutional both on its face and as applied to the Mayos. The Supreme Court also overruled Ferdon, concluding that the earlier decision had applied an incorrect constitutional standard and improperly intruded upon the legislature’s role.
As a result, the Wisconsin Court of Appeals decision cannot accurately be described today as establishing that Wisconsin’s $750,000 cap is unconstitutional. The case remains important, however, because the lower-court decision illustrates one constitutional argument that has been raised against statutory limits on noneconomic damages.
The jury awards damages.
In the Mayo case, the jury awarded substantial noneconomic damages based on the injuries presented at trial.
The statutory cap is challenged.
The plaintiffs argued that applying the $750,000 limit to their jury award violated constitutional protections.
The Court of Appeals rules for the plaintiffs.
In 2017, the Wisconsin Court of Appeals held that the cap was unconstitutional on its face based on equal-protection principles.
The Wisconsin Supreme Court reverses.
In 2018, the Wisconsin Supreme Court upheld the $750,000 cap and reversed the Court of Appeals.
Illinois Took a Different Approach to Medical Malpractice Damage Caps
Illinois has its own important history involving attempts to limit noneconomic damages in medical malpractice cases. In 2005, the Illinois General Assembly enacted legislation that included a cap on noneconomic damages in medical malpractice and wrongful death actions.
That legislation was challenged in Lebron v. Gottlieb Memorial Hospital. In 2010, the Illinois Supreme Court held that the medical malpractice damages cap violated the separation-of-powers provision of the Illinois Constitution because it improperly required courts to reduce jury awards that the legislature had determined should be limited by statute.
The court explained that determining whether a jury’s assessment of damages is excessive is fundamentally a judicial function. The court therefore held that the statutory provision requiring courts to reduce noneconomic damages above the statutory limit constituted an unconstitutional legislative remittitur.
Illinois today: Illinois does not currently have a general statutory cap on noneconomic damages in medical malpractice cases. The Illinois General Assembly’s current statutory materials identify the former $500,000 noneconomic-damages limitation as a provision that was held unconstitutional.
That does not mean every medical malpractice claim results in a large recovery. A plaintiff must still prove the elements of the claim, establish the applicable standard of care and breach, demonstrate causation, and prove the damages supported by the evidence. The absence of a statutory damages cap is only one part of the legal framework governing an Illinois medical malpractice case.
The Federal $250,000 Proposal Was Not a Federal Law
The original discussion of a federal $250,000 cap also requires an important clarification. In 2017, Congress considered the Protecting Access to Care Act of 2017, H.R. 1215. The proposal included a $250,000 cap on noneconomic damages in certain health-care lawsuits.
The proposed legislation was part of a broader effort to change federal medical liability rules. Among other provisions, H.R. 1215 proposed a three-year statute of limitations in covered cases, limits on attorney contingency fees, changes involving joint and several liability, and a $250,000 ceiling on noneconomic damages.
What Was Proposed
H.R. 1215 proposed a $250,000 limit on noneconomic damages in covered health-care lawsuits, along with other medical-liability reforms.
What Happened
The House passed H.R. 1215 in June 2017. The bill was then referred to the Senate Judiciary Committee and did not become law.
That distinction is important for anyone reading an older article about medical malpractice law. A proposed federal cap should not be described as an existing nationwide rule. Medical malpractice claims are generally governed by state law, although particular claims involving federal health-care programs or the federal government can involve additional federal rules.
Why a Damages Cap Can Matter in a Catastrophic Injury Case
The effect of a noneconomic damages cap can become particularly significant when an injury permanently changes a person’s life. A catastrophic injury may result in years or decades of pain, physical impairment, disfigurement, loss of independence, and inability to participate in activities the person previously enjoyed.
Economic damages may address medical treatment, rehabilitation, lost income, and future care. Noneconomic damages address a different category of harm. A statutory cap can therefore affect how much of the jury’s assessment of those nonfinancial losses can ultimately be recovered.
Pain and Suffering
Evidence may address physical pain, chronic symptoms, treatment, and the ongoing effect of the injury on daily life.
Disability and Impairment
Permanent limitations can affect a person’s ability to work, exercise, travel, care for family members, and perform ordinary activities.
Loss of Normal Life
Medical negligence can interfere with hobbies, relationships, independence, and the activities that previously made up a person’s daily life.
How Medical Malpractice Claims Are Evaluated in Illinois
Because Illinois does not currently impose a general statutory cap on noneconomic damages in medical malpractice cases, the focus in an Illinois claim remains on establishing liability and proving the full extent of the damages supported by the evidence.
Medical malpractice litigation can involve complicated medical records, expert testimony, treatment histories, imaging, laboratory results, future-care projections, employment records, and testimony from the injured patient and family members. The evidence must connect the alleged medical negligence to the injuries and losses being claimed.
A medical injury is not automatically medical malpractice.
A poor medical outcome by itself does not necessarily establish negligence. A medical malpractice claim generally requires evidence addressing the applicable standard of care, a departure from that standard, and a causal connection between the alleged negligence and the injury.
Illinois also has specific procedural requirements and deadlines that can apply to medical malpractice claims. For example, the Illinois Code of Civil Procedure contains specific limitation and repose provisions for actions against physicians, dentists, nurses, and hospitals arising from patient care. Anyone who believes they have been injured because of medical negligence should therefore investigate the claim promptly.
Why Medical Malpractice Cases Can Require Extensive Preparation
Medical malpractice cases are often more complicated than ordinary personal injury claims because the central dispute may involve technical medical questions. The parties may disagree about what a reasonably careful medical professional should have done, whether a particular diagnosis should have been made earlier, whether treatment should have been different, or whether the alleged negligence actually caused the injury.
Medical Records
Records can help establish the patient’s condition before treatment, what occurred during treatment, and the patient’s condition afterward.
Expert Testimony
Experts may be needed to explain the applicable medical standard of care, whether it was breached, and whether the breach caused the claimed injuries.
Damages Evidence
Evidence concerning medical treatment, future care, employment, physical limitations, pain, and changes to daily life can all be relevant to damages.
Frequently Asked Questions About Medical Malpractice Damage Caps
Does Illinois currently have a cap on medical malpractice noneconomic damages?
Illinois does not currently have a general statutory cap on noneconomic damages in medical malpractice cases. The Illinois Supreme Court invalidated the state’s 2005 medical malpractice damages cap in Lebron v. Gottlieb Memorial Hospital, and the Illinois General Assembly’s current statutory materials identify the former limitation as unconstitutional.
Did Wisconsin’s $750,000 medical malpractice cap get struck down?
The Wisconsin Court of Appeals struck it down in a 2017 decision, but that ruling was later reversed. In 2018, the Wisconsin Supreme Court held that the $750,000 cap was constitutional both facially and as applied to the plaintiffs in Mayo v. Wisconsin Injured Patients and Families Compensation Fund.
Was there a federal $250,000 medical malpractice cap?
A federal proposal containing a $250,000 cap was introduced in 2017 as H.R. 1215, the Protecting Access to Care Act. The House passed the bill, but it was referred to the Senate and did not become law. It therefore should not be described as an enacted nationwide $250,000 cap.
What are noneconomic damages?
Noneconomic damages generally compensate for losses that do not have a straightforward financial measurement, such as pain and suffering, disability, disfigurement, physical impairment, and loss of normal life.
What should someone do after a suspected medical error?
A person who believes they were injured because of medical negligence should preserve medical records and other relevant information and seek legal advice promptly. Illinois medical malpractice claims are subject to specific deadlines and procedural requirements, so waiting too long can affect the ability to pursue a claim.
Sources and Illinois Medical Malpractice Resources
Illinois Supreme Court — Lebron v. Gottlieb Memorial Hospital
Read the Illinois Supreme Court decision
Illinois General Assembly — 735 ILCS 5/ Code of Civil Procedure
Review the Illinois Code of Civil Procedure
Wisconsin Supreme Court — Mayo v. Wisconsin Injured Patients and Families Compensation Fund
Read the Wisconsin Supreme Court decision
Wisconsin Court of Appeals — Mayo v. Wisconsin Injured Patients and Families Compensation Fund
Read the 2017 Court of Appeals decision
U.S. Government Publishing Office — H.R. 1215, Protecting Access to Care Act of 2017
View the House-passed bill
U.S. Government Publishing Office — H.R. 1215 Referred to the Senate
View the Senate referral record
Congressional Budget Office — Medical Malpractice Damage Caps
Review the CBO discussion of a $250,000 noneconomic damages cap
Injured Because of Suspected Medical Negligence?
Medical malpractice cases can involve complicated medical evidence, expert testimony, significant damages, and strict legal requirements. The attorneys at Patel Law, PC represent clients in personal injury, medical negligence, wrongful death, and other serious injury matters.
Attorney Baku N. Patel has represented injured clients in complex personal injury matters and brings litigation experience to cases involving significant injuries and disputed liability. No matter the size of a case, understanding your rights and the evidence supporting your claim is an important first step.
