Nevada Governor, Lawmakers Reach Compromise on Legislation to Cap Awards in Medical Malpractice Lawsuits

To ease Nevada's malpractice insurance crisis, Gov. Kenny Guinn (R) and state legislative leaders on July 29 drafted compromise legislation that would place a $350,000 cap on jury awards for non-economic damages in liability lawsuits, the Las Vegas Review-Journal reports. The lawmakers met on July 30 for the first day of a special legislative session to address the state's malpractice insurance crisis, which came to light last fall when insurers began increasing premiums for physicians three- and fourfold. Many physicians opted to leave the state, retire early, eliminate services or stop accepting new patients. The "mass resignations" of surgeons also led to the temporary closure of Las Vegas' only trauma center at University Medical Center. Assembly Majority Leader Barbara Buckley (D) said that lawmakers in both chambers plan to introduce and pass identical versions of the same bill. The following are among the provisions of the bill:

• Non-economic damages, such as awards for pain and suffering, would be capped at $350,000. The cap would contain exemptions for cases involving death, brain damage, paralysis, total blindness, amputation or sterility. Incidents involving "gross malpractice" and "clear and convincing evidence that an award in excess of $350,000 for non-economic damages is justified under the circumstances" would also be exempted.
• Civil liability for surgeons at public trauma centers would be capped at $50,000 "if the care is given in good faith and does not amount to gross negligence."
• Physicians who are "partly responsible" for malpractice could still be held liable for all economic damages, which include the costs of additional medical care and lost wages.
• The state's Medical Dental Screening Panel, which reviews all malpractice lawsuits before they proceed to court, would be eliminated and all malpractice cases would instead proceed directly to court.
• Medical facilities and health professionals would be required to report physician misconduct to the state Board of Medical Examiners.
• Reports to the governor and the Legislature would be required regarding disciplinary actions against doctors, lawsuits or claims submitted to arbitration and judgments or settlements against doctors.

Reaction
Although lawmakers were "pleased" with the bill and hoped that it would lower the cost of medical malpractice coverage, many doctors criticized the number of exceptions to the jury award cap. Lonnie Hammargren, a Las Vegas neurosurgeon and former lieutenant governor of Nevada, said that neurosurgeons "would gain nothing from the agreement because all of their surgeries can potentially result in brain damage or paralysis." Dr. Donald Palmisano, president-elect of the American Medical Association, added that states "with effective caps" on jury awards do not have exemptions to the caps. He said that exemptions contained in Nevada's proposal "would hinder the state's attempt to stabilize the liability market and discourage insurance companies from writing new policies." But many lawmakers remained confident that the proposal would help doctors. "This will guarantee, insofar as possible, that there will be medical coverage for those who are most in need of it, particularly those areas of OB/GYN, trauma doctors and orthopedic surgeons," state Senate Majority Leader Bill Raggio (R) said (Whaley/Vogel, Las Vegas Review-Journal, 7/30).