Ill. High Court Rejects Med Mal Caps

An Illinois law that set caps on medical malpractice awards for "pain and suffering" has been ruled unconstitutional by the state's high court, which found legislators had overreached in attempting to restrict the judicial process.

The decision was the first instance of scrutiny by the Illinois High Court of a law signed by former Gov. Rod Blagojevich which established caps on noneconomic damages of $500,000 in cases against doctors and $1 million against hospitals.

In enacting the law, Illinois followed other states, such as California, that capped noneconomic damages years ago.

The High Court ruling upheld a decision by Cook County Circuit Court Judge Diane Larsen in Chicago, who decided that caps on malpractice awards violated the Illinois Constitution's "separation of powers" clause, in effect ruling that the state legislature can't interfere with the right of juries and judges to determine fair damages.

The first case to test the law challenging the constitutionality of the caps, LeBron v. Gottlieb Memorial Hospital, was brought prior to trial by attorneys for Abigaile LeBron, a 13-month-old girl who suffered a severe brain injury during birth at Gottlieb Memorial Hospital in Melrose Park.

Both Judge Larsen's decision and the Supreme Court's decision were based on a 1997 Illinois Supreme Court decision that overturned a 1995 law implementing caps on personal-injury cases.

The High Court decision reflected the findings in its earlier Best case decision. "Although decisions from other jurisdictions can provide guidance where precedent from Illinois is lacking, we do not write today on a blank slate," the court said.

"Our decision in Best guides our analysis," the majority said. "That the courts of other states would hold differently based on their constitutional jurisprudence applied to their statutes is of no moment."

"This court's jurisprudence of state constitutional law cannot be predicated on the actions of our sister states," the majority said in its opinion.

The Illinois Supreme Court's decision in LeBron came despite a plea voiced in a dissent filed by two judges. The dissent noted the current intense debate over health care delivery reforms in Washington, D.C., especially the concerns voiced by President Obama in his State of the Union address over the costs associated with not reining in medical liability costs.

"Although his proposal focused on expanding health insurance coverage, he also recognized that reform of medical malpractice laws might aid in reducing our nation's health care costs, while also improving the quality of care delivered by physicians and received by their patients," Justice Lloyd Karmeier said in his dissent.

"That medical malpractice reforms might have salutary effects on the delivery of affordable health care in Illinois was a view shared by our General Assembly when it enacted the law struck down by the court in 2005," Justice Karmeier continued.

Mark Behrens, a partner at Shook, Hardy & Bacon, LLP, Washington, D.C., which represents insurers in medical liability cases, voiced particular disappointment with the decision because it was crafted in an attempt to deal with concerns raised by the court in a prior decision in 1997.

"The state legislature did not try to overreach in this case," Mr. Behrens said. "It tried to fashion a bipartisan solution."

At the same time, Mr. Behrens noted that the court's majority opinion "was careful to point out that the decision does not necessarily call into question other medical liability reforms the legislature might enact."

The majority in the case said they were not persuaded by the argument that other jurisdictions are enacting such reforms.

"We are also not persuaded by defendants' arguments that the circuit court's judgment should be reversed because courts of other states, which have considered whether a limitation on noneconomic damages violates separation of powers, have rejected this argument," the majority said in its opinion.

"We have reviewed the statutes defendants cite and observe that the limitations on noneconomic damages adopted in other states vary widely, not only in the amount of the cap, but other specifics," the court said.

"We are also not persuaded by defendants' arguments that the circuit court's judgment should be reversed because courts of other states, which have considered whether a limitation on noneconomic damages violates separation of powers, have rejected this argument," the court said.

The majority also rebuked the comments in the dissent about the health care reform efforts of President Obama.

"The dissent implies that the majority opinion is somehow an affront to the health care reform efforts of the Obama administration, and expressly cautions that if we 'persist in invalidating damages caps,' dire consequences will likely follow."

Plainly, the majority said, "the Obama administration's health care reform efforts are not the backdrop against which we have decided the constitutionality" of the 2005 law, "and we express no opinion–favorable or otherwise–as to those efforts."

Rather, the court said, its decision in this case–that the 2005 law cannot stand–"is based, as it must be, on the binding provisions of our state constitution and our case law interpreting the same."

"Although we do not expect that the members of this court will always agree as to what the law is, or how to apply the law in a given case, we do expect that our disagreements will focus on the legal issues, providing a level of discourse appropriate to the state's highest court," the majority said.

"The emotional and political rhetoric that peppers the dissent is ill-suited to this pursuit," the majority concluded.

Insurance interests were not happy with the ruling. The American Insurance Association was among the critics.

"Not having a cap on noneconomic damage awards will once again subject medical malpractice insurers to excessive verdicts and settlements, setting back any progress in the Illinois market," predicted Ken Stoller, AIA senior counsel.

"We are disappointed in the ruling and fear a return to a time when the market was in crisis and some Illinois citizens were without access to health care."