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The Illinois Supreme Court, in an opinion issued on February 4, 2010, ruled that the Illinois law (Public Act 94-677) that placed limits on awards for noneconomic damages such as pain and suffering in medical malpractice cases is facially invalid.  The statute capped noneconomic damages at $1 million for hospitals and their personnel and $500,000 for doctors.  The Court ruled that the damage limitation violates the constitutional principle of separation of powers by interfering with the authority of the judicial branch to reduce verdicts.  The ruling, which totaled 52 pages, was written by Chief Justice Fitzgerald, with whom Justices Freeman, Kilbride and Burke concurred.  Justices Karmeier and Garman concurred in part and dissented in part, while Justice Thomas took no part in the decision.

The test case involved a baby born by Caesarean section who was found to have numerous permanent injuries. Suit was filed against Gottlieb Memorial Hospital, the doctor, and an assisting nurse.  This litigation is the lead case in a number of lawsuits consolidated in Cook County which raised the same issue.

This highly anticipated ruling, with amicus curiae briefs filed by over 20 different organizations, groups and individuals on behalf of plaintiff and defense, was the Illinois legislature’s third attempt at passing tort reform, and this version suffered the same fate as the previous two.  The limitation on noneconomic damages was one of several reforms, which were enacted due to the rising cost of medical liability insurance and the resulting impact on physicians and hospitals.  Other aspects of the act affected by this decision include portions of the Illinois Insurance Code, Medical Practice Act of 1987, the Good Samaritan Act, as well as other changes to the Code, including the “Sorry Works (program).”

The Illinois Supreme Court, while giving great deference to legislative findings on the impact of caps on noneconomic damages, stated that its task was to determine the “constitutionality of the statute (as opposed to) its wisdom.”  In doing so, the Court held that the purpose of the separation of powers clause is to ensure that “the whole power of two or more branches of government” will not “reside in the same hands.”  The Court explained the doctrine of remittitur, which allows a Court to correct a verdict and is determined on a case-by-case basis reliant on particular evidence and facts.   The Court ultimately ruled that although the legislature may statutorily limit damages recoverable in statutory actions, the limitation on non-statutory actions (such as medical malpractice claims) violated the separation of powers clause.

The above-described arguments are identical to those made in the prior case which held caps on non-economic damages to be unconstitutional. Best v. Taylor Machine Works, 179 Ill.2d 367 (1997) established the precedent relied upon by the circuit court in finding the present statute unconstitutional, and the Illinois Supreme Court’s analysis supported this finding.  The Court, though, noted that the Best damages cap applied to all actions, whether based on common law or statute, whereas the cap at issue applied only to medical malpractice actions.  The Court implicitly adopted the Best analysis, ultimately finding that any infringement on noneconomic damages represented a patent violation of separation of powers.

The Court recognized the General Assembly’s ability to alter the common law, but held it may not do so in a manner which would run afoul of the separation of powers clause.  The defendants had cited to other statutes which limit common law liability, arguing that if this section were invalidated, they too must also be declared unconstitutional.  These acts (such as the portions of the Recreational Use of Land and Water Areas Act and Good Samaritan Act), however, do not require a court to reduce a jury’s award of noneconomic damages, irrespective of the facts of the case.

The Court also examined statutes from other states which limit noneconomic damages.  The defense argued the limits in the Illinois caps were “well within the range of reasonable limits adopted by (other) states.”  However, the Court noted that such limitations vary widely (focusing on California and Florida), and that the Court refrained from deciding whether a particular limit is in fact reasonable.  Rather, the Court found that regardless of whether the limits are reasonable, this provision still runs afoul of the constitution, noting that an “everybody is doing it” standard is not the proper litmus test.

The dissent criticized the majority opinion as being rushed, contending that while it purports to defend the constitution, it stands as an obstacle to the legislature’s efforts to find an answer to the “healthcare crisis.”  The dissent implied that the majority opinion is an affront to the health-care reform efforts of the Obama Administration.  The majority denied this contention, criticizing the dissent for what it deemed to be “emotional and political rhetoric.”

In fact, the concurrence/dissent spent a significant portion of the opinion outlining the Obama administration’s efforts at passing a health care reform act.  However, it also echoed the defense’s essential arguments that (1) other states have limits, and (2) if this statute is found unconstitutional, then so must other similar acts be declared unconstitutional.  The dissent argued that this ruling represents an impermissible encroachment upon the inherent power of the judiciary to correct jury verdicts through remittitur.  The dissent also argued that the Plaintiffs lacked standing in this matter, a charge that the majority opinion stated was ineffective and decided not to address.  The dissent’s basic point with respect to standing and ripeness was that none of the Plaintiffs in any of the consolidated cases had yet prevailed in the medical malpractice claims.

In addressing the majority’s reliance on the principles found within the Best decision (i.e., the separation of powers), the dissent stated that while it is admirable not to do something just because others are doing it, “it can be no dishonor to learn from others when they speak good sense.”  The dissent acknowledged that the Court must allow the legislature to enact its constitutional powers to make, amend, alter, and abolish the laws of the state.  The dissent contended that the act limiting noneconomic damages in medical malpractice claims will in no way usurp the judiciary’s powers.  The dissent relied on the rulings of other states which have upheld the constitutionality of similar statutes.

While the central issue was of the opion the caps on non-economic damages in medical malpractice, the majority struck down the rest of the legislation on inseverability grounds, but stated that the General Assembly could reenact any other provision it deemed appropriate.  The entire act, found at section 2-1706.5 of the Code of Civil Procedure, was adopted as part of Public Act 94-677.  For purposes of this ruling, the Court issued no opinion on the other components of the Act.