As any regular reader of this blog knows, large medical malpractice verdicts are made to be reversed or reduced. The big verdicts get lots of attention in the press and lead many doctors and their insurance companies to claim the sky is falling. Then, after the press has left and the attention of the public is focused elsewhere, the large verdict is either reduced by the trial judge or overturned on appeal. This was exactly what recently happened to the largest malpractice verdict ever in Iowa. The state supreme court reversed it and sent it back for a new trial.
As many large malpractice verdicts do, this case arose out of the birth of a child during which the child suffered significant brain injuries. The case was brought by a conservator on behalf of the child. The conservator alleged the child suffered brain injuries due to delays on the part of the hospital and obstetrician in delivering the baby when the mother’s blood pressure fell and in using forceps and a vacuum device to deliver the baby, which fractured the baby’s skull. The conservator let the obstetrician out of the case and proceeded to trial against the obstetrical group that employed her and against the hospital. The defendants denied everything.
One of the pieces of evidence submitted to the jury was the package insert for the vacuum device. A package insert is a document prepared by the manufacturer and placed in the box along with the vacuum device. Among other things it describes when to use the vacuum device and when not to use it. The package insert here advised against using the vacuum device in the way in which the obstetrician used it and warned that it could damage the baby, if used that way.
The jury found against both the obstetrical group and the hospital. It awarded total damages of $97 million, of which $53 million was cost of future care and loss of future income. The remaining $44 million was non-economic damages, such as pain and suffering and loss of bodily function.
After the trial court entered judgment on the verdict, the hospital and the conservator entered into a settlement agreement. The obstetrical group refused to settle and appealed the judgment on a number of grounds.
The Iowa Supreme Court unanimously reversed the judgment on the grounds that the package insert was impermissible hearsay and that its admission deprived the defendants of the opportunity to cross-examine the manufacturer about whether the warnings in the insert were valid and whether they applied to this case or not. The Supreme Court remanded the case to the trial court for a new trial against the obstetrical group only.
While this case was on appeal, however, the rules were changed. In large measure because of this verdict, the Iowa legislature enacted a cap that limited non-economic damages in medical malpractice cases to $2 million. So even if the jury finds in favor of the child again and awards the same economic damages of $53 million for cost of care and loss of income, the child cannot recover more than another $2 million for pain and suffering and loss of bodily function. It will also be a different trial without the hospital as a defendant. The absence of the hospital increases the chance that the jury might find everything to be the fault of the hospital and let the obstetrical group off scot free.
What happened here is pretty typical. Defendants who are on the wrong end of a large verdict will always file motions with the trial court asking for a new trial or for a reduction in the amount of the award. If they don’t win these motions before the trial court, they file an appeal and try their luck with the Court of Appeals or the Supreme Court. These appellate courts are most often pretty conservative and are receptive to appeals from large verdicts. When one of these large verdicts is overturned, that decision never gets the same breathless attention that the original verdict received. Keep that in mind the next time you read about a large malpractice verdict. There will always be more to the story.
