North Broward Hospital District, etc. v. Susan Kalitan
219 So. 3d 49
| Fla. | 2017Background
- Plaintiff Susan Kalitan suffered catastrophic injuries (esophageal perforation during intubation) after outpatient carpal tunnel surgery, resulting in prolonged coma, multiple surgeries, chronic pain, and mental disorders.
- Jury awarded $4,718,011 in total damages, including $2M past and $2M future noneconomic damages; trial court reduced noneconomic awards pursuant to section 766.118 caps and further reduced hospital liability by sovereign-immunity limits.
- Kalitan appealed the application of the statutory caps on noneconomic damages in personal-injury medical negligence actions, arguing they violate the Equal Protection Clause of the Florida Constitution.
- The Fourth District held the caps unconstitutional, relying on this Court’s prior decision in Estate of McCall v. United States (which invalidated the caps in wrongful-death cases) and ordered reinstatement of the jury award.
- The Florida Supreme Court granted review and affirmed the Fourth District: it held the personal-injury noneconomic-damage caps in sections 766.118(2) and (3) violate article I, section 2 because they are arbitrary and bear no rational relationship to the Legislature’s stated purpose of addressing a medical-malpractice insurance crisis.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Constitutionality of § 766.118 caps on personal-injury noneconomic damages (Equal Protection) | Caps arbitrarily reduce compensation for the most grievously injured and discriminate among victims; McCall controls and requires invalidation | Caps are a rational legislative response to a medical-malpractice insurance crisis and pass rational-basis review | Held unconstitutional: caps arbitrarily diminish awards for the most seriously injured and fail rational-basis review |
| Applicability of McCall (wrongful-death context) to personal-injury cases | McCall’s reasoning about arbitrariness and lack of rational relation to legislative goal applies equally to personal-injury caps | McCall was limited to wrongful-death context and should not control personal-injury cases | Held McCall applies: the same arbitrary classifications exist in personal-injury caps and invalidate them |
| Whether caps bear a rational relationship to a legitimate state interest (malpractice insurance crisis) | No evidence connects caps to reduced premiums or continued crisis; even if once justifiable, changed conditions negate the rationale | Legislature’s factual findings and comprehensive legislative process provide a conceivable rational basis; courts should defer | Held no rational relationship: evidence does not support that caps alleviate the malpractice-insurance problem and conditions changed since enactment |
| Remedy / disposition | Reinstate full jury award reduced by statute | Uphold statutory reduction | Held: affirm Fourth District; statutory caps invalidated; remand for proceedings consistent with opinion |
Key Cases Cited
- Estate of McCall v. United States, 134 So.3d 894 (Fla. 2014) (plurality and concurring-in-result holdings that § 766.118 wrongful-death noneconomic caps violate Florida Equal Protection)
- St. Mary’s Hosp., Inc. v. Phillipe, 769 So.2d 961 (Fla. 2000) (equal protection and due-process principles guiding review of liability-limiting legislation)
- Univ. of Miami v. Echarte, 618 So.2d 189 (Fla. 1993) (discussion of caps and rational-basis considerations in medical-malpractice context)
- Mizrahi v. N. Miami Med. Ctr., Ltd., 761 So.2d 1040 (Fla. 2000) (acknowledging legislative role and the possibility that statutory validity may change as conditions change)