West Virginia has upheld a 2003 law capping damages for pain and suffering at $250,000 (or $500,000 in more serious cases), much to the delight of the state’s medical association. Former Governor Bob Wise (D-W. Va.) signed the cap into law in an effort to improve health care affordability and accessibility for state residents.

Plaintiff James MacDonald, who in 2004 was admitted to a West Virginia hospital with pneumonia, recently challenged the law. MacDonald had been taking various medications due to a previous kidney transplant and other chronic conditions, but the pneumonia medication his clinician prescribed interacted with his other medications and caused rhabdomyolysis.

MacDonald and his wife sued the hospital and treating physician, claiming that the muscle-wasting disease had lessened their enjoyment of life and caused substantial suffering. A jury agreed and found the doctor and hospital liable. They awarded damages of $129,000 for medical expenses and lost wages, $1 million for pain and suffering and an additional $500,000 in pain and suffering damages for MacDonald’s wife.


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However, a circuit court judge, citing West Virginia’s cap on non-economic malpractice damages, reduced the $1.5 million pain and suffering award to $500,000. MacDonald and his wife appealed the decision, claiming that the judge’s decision to reduce the awarded damages deprived them of their right to a jury trial.

The case then went to the West Virginia Supreme Court, which in a 4-to-1 decision ruled to keep the cap in place. “While one or more members of the majority may differ with the legislative reasoning, it is not our prerogative to substitute our judgment for that of the legislature, so long as the classification is rational and bears a reasonable relationship to a proper governmental purpose,” Chief Justice Margaret Workman (D-W. Va.) wrote in the opinion.

The state medical association applauded the decision. “The state Supreme Court has given its stamp of approval to the legislature’s effort to preserve access to quality affordable health care in West Virginia,” West Virginia State Medical Association president John H. Schmidt, III, said in a statement.

“The cap was the cornerstone to the reforms passed in 2003 that have worked amazingly well for the patients we care for. I applaud the Court’s well-reasoned decision,” Schmidt added. “From the moment the legislation was signed into law almost a decade ago, we knew the state Supreme Court would have the final word. Today is that day, and the word we’ve received from the Court is a very good one indeed.”