Ascaris Mayo v. Wisconsin Injured Patients and Families Compensation Fund
914 N.W.2d 678
Wis.2018Background
- In 2005 the Wisconsin Supreme Court in Ferdon struck down a $350,000 noneconomic-damages cap for medical malpractice; the Legislature later enacted a $750,000 cap in 2005 Wis. Act 183 (codified at Wis. Stat. § 893.55).
- Wisconsin operates a guaranteed-payment system (the Injured Patients and Families Compensation Fund) that ensures 100% payment of economic damages but limits Fund payments for noneconomic damages to $750,000 per claim.
- Ascaris and Antonio Mayo obtained a jury verdict awarding large noneconomic damages ($15,000,000 to Ascaris; $1,500,000 to Antonio) after catastrophic injuries; the Fund moved to reduce noneconomic awards to $750,000 under the statutory cap.
- The circuit court held the cap unconstitutional as applied to the Mayos; the court of appeals held the cap facially unconstitutional relying on Ferdon.
- The Wisconsin Supreme Court granted review, overruled Ferdon, held rational-basis review applies, and concluded § 893.55 is constitutional both facially and as applied to the Mayos; remanded to impose the $750,000 cap.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Facial constitutionality of the $750,000 noneconomic-damages cap under equal protection and due process | The cap unfairly burdens catastrophically injured plaintiffs (those with awards > $750,000), denying equal protection and due process; the classification is arbitrary | The cap is part of a legislative scheme (mandatory insurance + Fund) with legitimate objectives (controlling costs, preserving access), so it survives rational-basis review | Court: apply rational-basis; cap is facially constitutional (overrules Ferdon) |
| As-applied challenge by the Mayos (large reduction of jury award) | Applying the cap to the Mayos arbitrarily deprives them of constitutionally protected rights and is not rationally related to legislative objectives | Application treats all similarly situated claimants identically; the Fund/legislature rationally balanced compensation and access to care | Court: cap is constitutional as applied; Mayos were not treated differently from similarly situated claimants |
| Standard of review for damages-cap challenges | (Mayos) Some prior precedent (Ferdon) used a heightened rational-basis variant; plaintiffs rely on Ferdon analysis | State: ordinary rational-basis review applies; Ferdon’s “rational basis with teeth” is illegitimate judicial policymaking | Court: adopt ordinary rational-basis review; overrule Ferdon and reject rational-basis-with-teeth |
| Deference/presumption of constitutionality | Plaintiffs urge scrutiny of legislative record and outcomes (e.g., Fund assets, physician retention) | State emphasizes presumption of constitutionality and legislative findings supporting the cap | Court: presumption stands; challengers must prove unconstitutionality beyond a reasonable doubt in facial challenges; here challengers failed |
Key Cases Cited
- Ferdon ex rel. Petrucelli v. Wis. Patients Comp. Fund, 284 Wis. 2d 573 (2005 WI) (previously invalidated a lower noneconomic-damages cap; court overruled in this decision)
- Aicher v. Wis. Patients Comp. Fund, 237 Wis. 2d 99 (2000 WI) (articulated rational-basis factors and review principles for legislative classifications)
- Bostco LLC v. Milw. Metro. Sewerage Dist., 350 Wis. 2d 554 (2013 WI) (explains use of rational-basis scrutiny when no fundamental right or suspect class is implicated)
- League of Women Voters of Wis. Educ. Network, Inc. v. Walker, 357 Wis. 2d 360 (2014 WI) (discusses facial vs. as-applied challenges and presumption of constitutionality)
- Blake v. Jossart, 370 Wis. 2d 1 (2016 WI) (example of as-applied equal protection analysis; plaintiff must show disparate treatment of similarly situated persons)
- State v. Smith, 323 Wis. 2d 377 (2010 WI) (applies rational-basis scrutiny where no fundamental right or suspect class is implicated)