Georgia Supreme Court Keeps Non-Economic Damages Uncapped in Medical Malpractice Cases

The Supreme Court of Georgia issued two significant decisions confirming that awards of non-economic damages for personal injuries in medical malpractice cases remain uncapped in Georgia.

These recent rulings reinforce the Court’s 2010 decision in Atlanta Oculoplastic Surgery v. Nestlehutt, which held that statutory caps on non-economic damages violate the state constitution.

While the decisions preserve uncapped non-economic damages in injury claims involving pre-death pain and suffering, the legality of damages caps on pure wrongful death claims remains unresolved. Health care providers, insurers and litigators should be aware that Georgia continues to allow juries to award substantial non-economic damages, including for pain and suffering and wrongful death claims.

Background

In 2005, the Georgia General Assembly put a $350,000 cap on non-economic damages in medical malpractice cases. Five years later, in Nestlehutt, the Supreme Court of Georgia held that the cap violated the Georgia Constitution’s guarantee of a trial by jury, reasoning that the cap infringed on the jury’s role as factfinder by limiting the damages they could award.

Nestlehutt was a medical malpractice personal injury case. The issue of whether non-economic damages caps were also unconstitutional in wrongful death cases has not been expressly decided by the Georgia Supreme Court. However, two recent cases address the constitutionality of non-economic damages caps in mixed personal injury and wrongful death medical malpractice verdicts.

The Court’s Reasoning

1. Clark v. Leigh

April Clark died following complications from an ovarian cyst removal. Her family sued two physicians who they alleged botched the procedure and failed to identify a bowel perforation. A Bibb County jury later awarded the family $33 million, including over $29 million in non-economic damages for both a wrongful death claim and Clark’s pre-death pain and suffering. The defendants persuaded the trial court to apply the damages cap, arguing that wrongful death claims did not carry a jury-trial right at common law, meaning a damages cap didn’t violate the Georgia Constitution.

The Court’s reasoning: The Court declined to overturn Nestlehutt and reaffirmed its holding that Georgia’s Constitution protects a jury’s role in determining damages, including non-economic damages, such as pain and suffering. The Court also addressed how the statute functions. Since the statute combines all non-economic damages into a single total and then caps the amount, the Court held it cannot be applied at all if any portion of the award is for pre-death personal injury, and thus, constitutionally protected. Applying the cap would improperly reduce damages that a jury has the right to determine.

2. Cayamcela v. Advocacy Trust

Holly Baumstark died from complications following a C-section in 2019 in an Atlanta-area hospital. Her family sued seven of the physicians who were involved in her care and Hospitalist Services of Georgia. Of the providers, six settled prior to trial, leaving only Dr. Luis Cayamcela and Hospitalist Services of Georgia. A jury awarded Baumstark’s family a $42 million verdict, including $32 million in non-economic damages for the wrongful death claim and $10 million for Baumstark’s pre-death pain and suffering. Defendants argued that the wrongful death claim fell outside of Nestlehutt, or, alternatively, that Nestlehutt should be overruled.

The Court’s reasoning: Relying on Clark, the Court upheld the full $42 million verdict. It emphasized that the statute provides no viable way to apply a cap to only part of a jury’s award. If even one category of damages is protected by the right to a jury trial, the cap cannot be applied to the verdict as a whole.

What Do These Rulings Mean?

These decisions reinforce three key points:

• • The constitutional right to a jury trial protects the jury’s right to not only decide liability, but also its right to determine the amount of non-economic damages to be awarded for personal injuries in medical malpractice suits.
  • When a statute aggregates damages into a single capped amount, it cannot be applied if any portion of the award is constitutionally protected.
  • The issue of whether Georgia’s non-economic damages cap applies to pure wrongful death claims without an award for a decedent’s pre-death pain and suffering is still unresolved.

Implications Going Forward

Higher Exposure for Providers and Insurers
Georgia remains a jurisdiction with no effective cap on non-economic damages in medical malpractice cases. Large verdicts are likely to continue, especially in wrongful death and catastrophic injury cases.

Increased Settlement Pressure
Without a cap limiting downside risk, settlement values may rise, especially in high-severity cases where juries may award significant amounts for non-economic harm.

Legislation
The Court’s reasoning leaves little room for a statutory fix. An effort to implement a damages cap would likely require a constitutional amendment. This amendment would require a two-thirds majority of the legislature and a simple majority of voters at the next general election.

Litigation Strategy
Defense counsel should continue framing constitutional arguments carefully while preparing for trial in an environment where seven- and eight-figure verdicts remain a possibility.

Takeaways for Health Care Providers and Insurers

The Supreme Court of Georgia has reaffirmed that non-economic damages for personal injuries in medical malpractice cases are not subject to a statutory cap, even when commingled with a wrongful death award. This means that Georgia remains a jurisdiction with high exposure for large non-economic damages awards in medical malpractice cases and in which early evaluation and resolution remain paramount.

Please contact Maggie Arellano, Anderson Blackmon, Annette Kinderman, George Morris or any member of Phelps’ insurance and health care teams with questions.