Morris v. Savoy

Decision Date27 August 1991
Docket NumberNo. 89-1807,89-1807
Citation576 N.E.2d 765,61 Ohio St.3d 684
PartiesMORRIS et al. v. SAVOY.
CourtOhio Supreme Court

According to plaintiff-petitioner Ralph Morris, on May 7, 1987, he suffered a broken bone in his neck in a car accident. Defendant-respondent, Dr. John A. Savoy, a neurosurgeon, operated on Morris on May 12. The operation left Morris paralyzed from the neck down. Although he has since regained some use of his limbs following extensive rehabilitation therapy, it is very limited. He faces a lifetime of medical and nursing care with no possibility of ever functioning normally again.

Morris and his wife, Shirley, sued Savoy in United States District Court. Malpractice liability was admitted and the case was tried only on the issue of damages. The jury returned a verdict awarding Morris and his wife the following amounts:

                Past lost wages ......................... $   80,000
                Future lost wages .......................... 600,000
                Nursing home costs ......................... 565,000
                Pain and suffering ......................... 845,000
                Wife's loss of consortium and services ..... 126,000
                                 Total .................. $2,216,000

Judge Sam Bell withheld entry of final judgment pending certification to this court of the following questions:

"1. Whether R.C. § 2307.43, which limits recovery of general damages in any medical claim to two hundred thousand dollars ($200,000), violates the Ohio Constitution?

"2. If R.C. § 2307.43 is constitutional, does its limitations [sic ] on awards of general damages apply to limit the aggregate recovery by all claimants for general damages arising out of a single medical claim to $200,000?

"3. If R.C. § 2305.27 is constitutional, does it compel the reduction of an award of damages in a medical claim by the amount of collateral benefits as defined in R.C. § 2305.27 that are payable in the future[?]"

Jeffries, Kube & Monteleone Co., L.P.A., J. Michael Monteleone and Richard A. Vadnal, Cleveland, for petitioners.

Jacobson, Maynard, Tuschman & Kalur Co., L.P.A., Robert C. Maynard, Jerome S. Kalur, Thomas H. Terry III and Robert C. Seibel, Cleveland, for respondent.

Jeffrey R. White and John K. Fitch, urging unconstitutionality for amici curiae, Association of Trial Lawyers of America, Consumer Federation of America and Dissatisfied Parents Together.

Frank A. Ray, Michael S. Miller and Jeffrey L. Maloon, Columbus, urging unconstitutionality for amicus curiae, Ohio Academy of Trial Lawyers.

Weisman, Goldberg, Weisman & Kaufman, Fred Weisman, Greene & Hennenberg, William Martin Greene and Jean M. McQuillan, Cleveland, urging unconstitutionality for amicus curiae, National Spinal Cord Injury Ass'n.

Dinsmore & Shohl, John E. Schlosser and Frank C. Woodside III, Cincinnati, urging constitutionality for amici curiae, Children's Hosp. Medical Center and St. Elizabeth Medical Center.

Thompson, Hine & Flory, Gerald L. Draper, Robert D. Monnin and Margaret R. Carmany, Columbus, urging constitutionality for amicus curiae, Defense Research Institute, Inc.

Lee I. Fisher, Atty. Gen., and Simon B. Karas, Columbus, urging constitutionality for amicus curiae, Ohio Attorney General.

WRIGHT, Justice.

This court has not considered either of the statutes challenged by petitioners in this case--a remarkable fact given the age of the statutes and the limits they place on recovery by medical malpractice victims. The statutes were part of the General Assembly's response in 1975 to a perceived health care crisis prompted by escalating medical malpractice insurance premiums.

For the reasons set forth below, we hold that that response was unconstitutional in R.C. 2307.43, by setting a $200,000 cap on general damages that may be awarded for medical malpractice. This answer will serve as a response to the first and second questions posed by the district court.

Question three requires a threshold determination of constitutionality of R.C. 2305.27 regarding limits on the collateral source rule followed by a specific finding as to the intent of the legislature in its application to future payments. 1 We find that the statute is constitutional and that it was intended to reach future payments capable of being calculated with reasonable certainty.


The Ohio Medical Malpractice Act ("Act") was passed as a result of the turmoil that swept the nation in the early 1970s with the medical fraternity predicting dislocation of medical care as the result of soaring malpractice rates. The Act, finally enacted by Am.Sub.H.B. No. 682, 136 Ohio Laws, Part II, 2809, 2813, was introduced in the General Assembly on April 15, 1975, in H.B. No. 682. 136 House Journal, Part I, 687. As introduced, the bill did not contain any limit on the amount of general damages recoverable from either physicians or hospitals. It did provide for abrogation of the collateral source rule. H.B. No. 682, lines 199 to 201, proposed R.C. 2743.02(C). Just two months later, on June 17, a bill much altered in committee and now containing a $200,000 cap on general damages for any medical claim was passed by the House and sent to the Senate. 136 House Journal 1217; Sub.H.B. No. 682, lines 469 to 472, proposed R.C. 2743.161. While the bill was in a Senate committee, the Ohio State Medical Association informed the legislature on July 1 that "within the next several days, the number of physicians unable to continue medical practice in Ohio because of lack of adequate malpractice coverage will reach crisis proportions." Gongwer News Service, Inc., Ohio Report (July 1, 1975) 3. There was an attempt, while the bill was in the Senate, to place a cap on all damages at $500,000, but the amendment was defeated by a vote of eighteen to fourteen. 136 Senate Journal 889. Also during Senate consideration, R.C. 2305.27 was added to require a reduction in a plaintiff's recovery by the amount received from collateral sources. 136 Senate Journal 888. In its final form, the abrogation of the collateral source rule did not affect payments resulting from policies or contracts paid for by plaintiffs or their employers. 136 Senate Journal 950; 136 House Journal 1643-1644. On July 28, the Act was signed into law by Governor James A. Rhodes. The emergency nature of the Act was posited as follows: "The reason for such necessity lies in the fact that immediate action is necessary to insure a continuance of health care delivery to the citizens of Ohio." Am.Sub.H.B. No. 682, Section 8; 136 Ohio Laws, Part II, 2843-2844.

The Act amended ten sections of the Ohio Revised Code and created twenty-six new statutes. The sweep was broad. Among the changes were provisions for compulsory (though nonbinding) arbitration, R.C. 2711.21, and an altered statute of limitations, R.C. 2305.11, principally to eliminate the actuary's nightmare, "long-tail liability." The legislature also established limits on the amounts recoverable in general, or noneconomic, damages and required a setoff for payments from collateral sources. In the last fifteen years, this court has had occasion to rule on the constitutionality of only three statutes in that Act, upholding two, 2 but finding portions of a third unconstitutional. 3


Following the events that produced the malpractice damage caps, there has been a lengthy convalescence with the remedy being examined for any unconstitutional side effects. It has been found wanting in the majority of instances where the issue has been litigated, though the rationale for overturning damage caps has varied widely.

State supreme court cases that have found such violations include:

Kansas Malpractice Victims Coalition v. Bell (1988), 243 Kan. 333, 757 P.2d 251 (violates rights to trial by jury, adequate remedy, and due course of law); Lucas v. United States (Tex.1988), 757 S.W.2d 687 (violates constitution's open courts guarantee); Smith v. Dept. of Ins. (Fla.1987), 507 So.2d 1080 (violates right of access to courts); Carson v. Maurer (1980), 120 N.H. 925, 424 A.2d 825 (violates equal protection guarantee); Arneson v. Olson (N.D.1978), 270 N.W.2d 125 (violates equal protection); Jones v. State Bd. of Medicine (1976), 97 Idaho 859, 555 P.2d 399 (remanded to apply heightened equal protection standard); and Wright v. Central Du Page Hosp. Assn. (1976), 63 Ill.2d 313, 347 N.E.2d 736 (violates constitutional prohibition against special privilege).

Those that have upheld malpractice injury caps include:

Etheridge v. Medical Ctr. Hospitals (1989), 237 Va. 87, 376 S.E.2d 525; Williams v. Kushner (La.1989), 549 So.2d 294; Fein v. Permanente Medical Group (1985), 38 Cal.3d 137, 211 Cal.Rptr. 368, 695 P.2d 665, appeal dismissed (1985), 474 U.S. 892, 106 S.Ct. 214, 88 L.Ed.2d 215 (White, J., dissenting); Johnson v. St. Vincent Hosp., Inc. (1980), 273 Ind. 374, 404 N.E.2d 585; and Prendergast v. Nelson (1977), 199 Neb. 97, 256 N.W.2d 657.

The determination of constitutionality needs to be tempered by the fact that, in two of the five cases cited, the courts noted the existence of an insurance fund that acted as a quid pro quo for plaintiffs' loss of unlimited recovery for pain and suffering.

Our standards for review of this statute, challenged on due process and equal protection grounds, are the same as we used in Mominee v. Scherbarth (1986), 28 Ohio St.3d 270, 28 OBR 346, 503 N.E.2d 717, and in Schwan v. Riverside Methodist Hosp. (1983), 6 Ohio St.3d 300, 6 OBR 361, 452 N.E.2d 1337. In Mominee, we held that: "A legislative enactment will be deemed valid on due process grounds ' * * * if it bears a real and substantial relation to the public health, safety, morals or general welfare of the public and if it is not unreasonable or arbitrary.' " Id., 28 Ohio St.3d at 274, 28 OBR at 349-350, 503 N.E.2d at 720-721, quoting Benjamin v. Columbus (1957), 167 Ohio St. 103, 4 O.O.2d 113, 146 N.E.2d 854, paragraph five of the syllabus. In Schwan, we agreed to an...

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