Through a statute enacted over a decade ago, North Carolina law limits medical-malpractice defendants’ liability for noneconomic damages (such as pain and suffering) to a statutory maximum. The limit applies unless the claimant proves gross negligence, recklessness, fraud, intentional conduct, or malice. That maximum amount, which is adjusted every three years for inflation, is set at $656,730 through the end of 2025.

In recent years, however, similar statutes in other states have faced legal challenges, typically based on arguments that the so-called “damages caps” are unconstitutional under state law.

Recently, the North Carolina statute faced just such a challenge. In Mohebali v. Hayes, a medical-malpractice plaintiff argued that the statutory cap on her noneconomic damages violated her constitutional right to have a jury determine damages.

Rejecting that argument and holding the cap to be constitutional, the North Carolina Court of Appeals sided with the majority of states that have considered this question. And because the deadline for the plaintiff to appeal the Court of Appeals’ decision to the state Supreme Court has now passed, North Carolina’s medical community can move forward with more clarity as to the constitutionality of the statute limiting their liability in court.

That said, because the North Carolina Supreme Court has not yet weighed in on this issue and because future plaintiffs could challenge the statute using other constitutional theories, this remains an area worth watching.

Background on the Case

The case involved a medical malpractice claim against an obstetrician and his medical practice. A jury awarded the plaintiff $7.5 million in noneconomic damages. The trial court, however, applied the legislative cap to reduce her award to the current statutory maximum of $656,730. The plaintiff appealed, arguing the cap violated her right under Article I of the North Carolina Constitution to have a jury determine her damages.

The Ruling & How Other States Have Approached This

The case proceeded to the Court of Appeals. After pausing briefly over the fact that the plaintiff did not pursue any exceptions to the cap that would seem to have applied to her circumstances, the Court of Appeals addressed the sole question before it — whether the cap violates Article I of the North Carolina Constitution. The three-judge panel unanimously held that it did not.

"Many state supreme courts have recognized the authority of their respective legislatures to enact such caps as not violative of the right to a jury trial in common law actions," the court wrote. It cited rulings in Alaska, Idaho, Maryland, Massachusetts, Michigan, Nebraska, Utah, Virginia, and West Virginia in making that point, while noting that supreme courts in Georgia and four other states reached the opposite conclusion.

The court also quoted from the North Carolina Supreme Court, which has instructed appellate courts considering challenges to state laws to "presume that [the law] is constitutional" and strike it down "only if it violates the express constitutional text and its unconstitutionality is demonstrated beyond a reasonable doubt." The Court of Appeals concluded, "Our General Assembly generally has the power to determine when a remedy is legally cognizable without impairing the right to a jury trial."

Is This the Final Word in North Carolina?

Noting in its ruling the issue "appears to be one of first impression in North Carolina," the Court of Appeals itself invited the state Supreme Court to weigh in. However, the plaintiff in this case chose not to seek that court’s review.

That sets the case as binding precedent in the state’s trial courts, at least for now. It remains possible that a different plaintiff, in a future case, could eventually bring the issue before the Supreme Court, which would not be bound by the Court of Appeals' decision in Mohebali. And future plaintiffs could challenge the legislative cap (or a similar statute) on other constitutional grounds.

Bottom Line

For the foreseeable future, the medical community remains protected by the legislative cap on noneconomic damages.

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