Nebraska Med Mal Cap Survives 7th, 5th & 14th Amendment Attacks

The US Court of Appeals for the Eighth Circuit has upheld Nebraska’s statutory medical malpractice limit, rejecting attacks that were based on the Seventh, Fifth, and Fourteenth Amendments of the US Constitution.

After a federal court jury awarded $17 million to a child born with severe brain damage, the court applied Nebraska’s statutory limit of $1.75, for a reduction of almost 90%. The plaintiff appealed on several grounds, including four based on the US Constitution.

The court rejected the Seventh Amendment argument that the cap amounted to a denial of right to trial by jury, ruling that it is the jury’s role to determine the extent of a plaintiff’s injuries but not to determine the legal consequences of its findings.

The court also rejected the argument that the cap amounted to a “taking” without just compensation under the Fifth Amendment, ruling that the plaintiff never had a vested property right in uncapped damages.

Similarly, the court rejected two Fourteenth Amendments arguments. First, the court held that the cap doesn’t deny equal protection to those with damages above the cap, as compared to those with damages below the cap (an argument that persuaded the Florida Supreme Court to strike down that state’s cap on June 8 in N. Broward Hosp. Dist. v. Kalitan, No. SC15-1858).

The court noted that the legislature enacted the cap for the express purpose of curbing meritless med mal claims and efficiently resolving meritorious claims. When enacted, the cap bore a rational relationship to that purpose. That is the only applicable standard, and the cap passes it. An argument that the cap is unnecessary or imprudent or has outlived its usefulness is irrelevant.

Last, the court rejected the argument that the cap denies a right of substantive due process by failing to provide a just substitute remedy for uncapped damages.


The case is Schmidt v. Ramsey, Nos. 16-1022, 16-1024 (8th Cir., June 22, 2017).

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