Fein v. Permanente Medical Group

Decision Date15 October 1985
Docket NumberNo. 85-19,85-19
PartiesLawrence FEIN v. PERMANENTE MEDICAL GROUP
CourtU.S. Supreme Court

The appeal is dismissed for want of a substantial federal question.

Justice WHITE, dissenting.

California Civ.Code Ann. § 3333.2 (West Supp.1985) establishes a $250,000 maximum limitation in medical malpractice actions for "noneconomic losses to compensate for pain, suffering, inconvenience, physical impairment, disfigurement, and other non-pecuniary damage." This statute is part of the Medical Injury Compensation Act of 1975, enacted by the California Legislature in response to the dramatic rise in consumer medical costs caused by the increase in both monetary awards in medical malpractice actions and medical malpractice insurance premiums. See 1975 Cal.Stats., 2d Ex.Sess., ch. 2, § 12.5(1)(b), p. 4007.

Appellant brought a medical malpractice action against appellee, Permanente Medical Group, a partnership of physicians, for failing to diagnose and prevent a myocardial infarction. The jury awarded appellant total damages of $1,287,783, including $500,000 for noneconomic losses. The trial judge, however, pursuant to § 3333.2, reduced the amount of noneconomic damages to $250,000.

The California Supreme Court affirmed, rejecting appellant's challenge that § 3333.2 contravenes both the Due Process and Equal Protection Clauses of the Federal Constitution. 38 Cal.3d 137, 211 Cal.Rptr. 368, 695 P.2d 665 (1985). The court found no due process violation based on the theory that "the Legislature retains broad control over the measure, as well as the timing, of damages that a defendant is obligated to pay and a plaintiff is entitled to receive, and . . . the Legislature may expand or limit recoverable damages so long as its action is rationally related to a legitimate state interest." Id., at 158, 211 Cal.Rptr., at 383, 695 P.2d, at 680 (emphasis in original). The court then reasoned that the limitation imposed by § 3333.2 was a rational response to the problem of rising medical malpractice insurance costs.

Similarly, the court found that § 3333.2 did not improperly discriminate either between medical malpractice plaintiffs and other tort plaintiffs, or within the class of medical malpractice plaintiffs by denying full recovery to those with noneconomic damages exceeding $250,000. The legislature's decision to limit the application of § 3333.2 to medical malpractice cases, and within those cases to those with large noneconomic damages awards, the court reasoned, was a rational response to escalating malpractice insurance rates.

California thus joins Indiana as the only two States to uphold the constitutionality of this type of medical malpractice damages limits. See Johnson v. St. Vincent Hospital, Inc., 273 Ind. 374, 404 N.E.2d 585, 598-601 (1980). Four other States which have addressed similar damages limitations have invalidated the challenged provisions on federal constitutional grounds. Baptist Hospital of Southeast Texas v. Baber, 672 S.W.2d 296, 298 (Tex.App.1984) ($500,000 limit on damages other than medical expenses); Carson v. Maurer, 120 N.H. 925, 941-943, 424 A.2d 825, 836-838 (1980) ($250,000 limit on "noneconomic" damages); Arneson v. Olsen, 270 N.W.2d 125, 135-136 (N.D.1978) ($300,000 limit on total damages); Simon v. St. Elizabeth Medical Center, 3 Ohio Op.3d 164, 166, 355 N.E.2d 903, 906-907 (Com.Pl.1976) ($200,000 limit on "general" damages).*

One of the reasons for the division among the state courts is a question left unresolved by this Court in Duke Power Co. v. Carolina Environmental Study Group, Inc., 438 U.S. 59, 98 S.Ct. 2620, 57 L.Ed.2d 595 (1978). In that case, the Court upheld the provisions of the Price-Anderson Act, 42 U.S.C. § 2210, which place a dollar limit on total liability that would be incurred by a defendant in the event of a nuclear accident. One of the objections raised against the liability limitation provisions was that they violated due process by failing to provide those injured by a nuclear accident with an adequate quid pro quo for the common-law right of recovery which the Act displaced. The Court noted: It is not at all clear that the Due Process Clause in fact requires that a legislatively enacted compensation scheme either duplicate the recovery at common law or provide a reasonable substitute remedy. However, we need not resolve this question here. . . ." 438 U.S., at 88, 98 S.Ct. at 2638 (footnote omitted).

The North Dakota Supreme Court in Arneson, supra, followed Duke Power Co., and refused to hold that the legislature may not limit a pre-existing right without providing a quid pro quo. 270 N.W.2d, at 134-135. Nevertheless, the...

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