House Votes To Cap Damages For Medical Malpractice
In Suits, Punitive Awards Could Not Exceed $250,000

By Juliet Eilperin
Washington Post Staff Writer
Friday, March 14, 2003; Page A04

The House voted yesterday to limit the monetary damages that courts can award in medical malpractice cases, a top goal of doctors, hospitals, many businesses and the Bush administration.

The measure, approved 229 to 196, would cap punitive awards in malpractice suits at $250,000. It would apply to suits filed against doctors, hospitals, health maintenance organizations and manufacturers of drugs and medical devices.

President Bush has pushed aggressively for the bill, and Senate Majority Leader Bill Frist (R-Tenn.), a former heart surgeon, has pledged to bring it to a vote. Its fate in the Senate is uncertain, however, because many Democrats oppose the bill, and supporters likely will need 60 votes to overcome a potential filibuster in the 100-member chamber.

Some GOP senators also have voiced doubts. Sen. Lindsey O. Graham (R-S.C.) is circulating a letter citing a private poll that showed the cap on damages "is particularly unpopular with Republicans" and "doesn't seem to excite the interest or support of more than about one-fourth of respondents."

Proponents say the measure would curb the escalating costs of malpractice insurance, which has prompted many doctors and some hospitals to close. Opponents say it would simply benefit powerful health care groups while preventing citizens from claiming their due in court if they are harmed by wrongful medical actions.

Yesterday's vote fell almost entirely along party lines: Sixteen Democrats voted in favor of the measure; nine Republicans opposed it.

GOP leaders said the health care system's problems will worsen without the proposed malpractice limits. "It's not just doctors who are feeling the crunch," said Rep. Thomas M. Reynolds (R-N.Y.). "Hospitals and other producers are also reaching their breaking point."

But Democrats said the legislation would not guarantee lower insurance rates or an end to unjustified lawsuits. The bill, said Rep. Max Sandlin (D-Tex.), "is nothing but a sham."

The day-long debate capped a fierce lobbying effort that pitted doctors, hospitals and insurers against trial lawyers and consumer advocacy groups. Both sides have spent weeks publicizing their cause, and have brought in victims to highlight the bill's purported virtues or flaws.

These horror stories surfaced on the House floor yesterday, as lawmakers recounted medical tragedies.

Rep. Ric Keller (R-Fla.) spoke of how the Orlando Regional Medical Center's trauma center is poised to close, and how a constituent died of a head injury when he had to be transported miles from an accident site.

"We don't have to guess what the consequences are of shutting down these facilities," Keller said.

Later in the debate, however, Rep. Joseph M. Hoeffel III (D-Pa.) cited the case of Linda McDougall, who underwent an unnecessary double mastectomy after a hospital mixed up her lab results. "The good news is Linda McDougall doesn't have breast cancer," Hoeffel said. "The bad news is she doesn't have breasts any more."

Mary Alexander, president of the American Trial Lawyers Association, stood outside the House chamber with a group of lawyers, greeting legislators as they approached the floor. "The proposal will hurt those who are most severely impaired by medical malpractice, and it does nothing to bring down insurance premiums for doctors," she said. "What we need is insurance reform."

Richard E. Anderson, an oncologist who chairs the Doctors Company, a malpractice insurer, questioned Alexander's assumptions.

"Those are tired arguments," Anderson said. "Failure to address this crisis translates into a failure of access to care."