NMSC: Medical Malpractice Cap Not Unconstitutional


Today the New Mexico Supreme Court decided in Siebert v. Okun that the cap on damages in the Medical Malpractice Act (“MMA”) was not unconstitutional. The court of appeals had previously decided this in a 2013 case, Salopek v. Friedman. However, in a controversial 2016 decision, a judge on the Second Judicial District disregarded Salopek and found the cap to be unconstitutional. Today’s opinion clarified why the caps are in fact constitutional and serves as an important reminder of the different roles played by the district and appellate courts in our common law system.


The relevant facts of this case are simple. A patient sued her doctor for malpractice, and a jury awarded $2.6 million in damages. The doctor, however, was subject to the Medical Malpractice Act, which (subject to certain limitations not relevant here) limits the amount of damages to $600,000.

Defendants sought to reduce the ruling in accordance with the cap. After a hearing, the district court refused to do so, instead ruling that the cap was unconstitutional.

District Courts Are Bound by Appellate Decisions

In ruling that the cap was unconstitutional, the district court was not writing on a clean slate. The court of appeals had already held that the act was not unconstitutional. In our common law system, the district court was bound by that holding. As the Supreme Court stated:

“The general rule is that a court lower in rank than the court which made the decision invoked as a precedent cannot deviate therefrom and decide contrary to that precedent, irrespective of whether it considers the rule laid down therein as correct or incorrect.”

It is fundamental to our common law system that lower courts are bound by the decisions of higher courts. A district court has wide discretion in many areas. But once a higher court has decided a question of law, the lower court may not disregard it in favor of its own, different conclusion.

The district court was aware of the binding precedent establishing that the cap was constitutional. It was, no doubt, aware that it lacked authority to overrule the court of appeals. It is therefore surprising that it would reach a contrary result. It is a reminder, however, of why as lawyers we always counsel clients that nothing is certain at trial. Courts can and do do unexpected things.

Not surprisingly, the defendants appealed the lower court’s decision. The court of appeals could easily have summarily reversed. Instead, it chose to “certify” the case to the supreme court. Certification is a process where a court can ask the supreme court to decide the issue (rather than deciding it and letting the parties seek an appeal). In this instance, the supreme court accepted certification, so the matter bypassed the court of appeals and proceeded directly to the state’s highest court.

A Cap Does Not Deprive Patients of the Right to a Jury

The Supreme Court reached the same result as the court of appeals, albeit by a different route. The constitutionality of the cap depended on two questions: (1) whether there is a right to trial by jury in MMA cases, and (2) whether that right is violated by a law limiting the amount of money a jury may award.

There Is a Right to a Jury in MMA Cases

In Salopek, the court of appeals answered the first question in the negative, ruling that there right to a jury trial did not attach to an action under the medical malpractice act. The supreme court did not agree. To determine whether there is a right to trial by jury for a particular action, the court looks to whether that general type of action would have been tried to a jury at the time the New Mexico Constitution was adopted.

The Salopek court, focusing on procedural differences between the MMA and common law medical malpractice, concluded that the MMA was distinguishable from the causes of action that would have been tried to a jury. The Court explained that the focus on procedural matters was error: the correct analysis was to look at the substantive requirements, and the substance of the MMA was nearly identical to common law medical negligence.

The earliest New Mexico medical negligence case the Court find was from 1954. Accordingly, there was no direct evidence of whether medical negligence was tried to a jury prior to 1911. Looking to other jurisdictions, the Court noted that medical negligence was tried to a jury in other states as early as 1794. It therefore concluded that such a case would have been tried to a jury in New Mexico.

The MMA’s Cap on Damages Does Not Violate the Right to Trial by Jury

Having concluded that the right to a jury attaches to an MMA case, the Court next had to answer whether the cap violated that right. The plaintiffs had argued that any limitation on damages invaded the jury’s right to set an award. But the Court declined to read the right to a jury trial so broadly.

Instead, the Court concluded that the right to a jury was subject to reasonable regulation so long as the core right was undisturbed. By the time the New Mexico Constitution was adopted, the jury’s role had been reduced to that of a fact finder. The right to trial by jury therefore required only that the evidence is presented to a jury, which deliberates and returns a verdict based on its factual findings. But the “legal consequence” of that verdict is a question of law, not of fact, and the legislature has the power to shape it.

The legislature did just that with the MMA cap. Though the jury makes a finding on damages, the law restricts those damages to a maximum amount. But nothing in the MMA restricts a plaintiff’s right to present evidence before a jury for “a fair and equitable resolution” of the facts of the case. Accordingly, the cap was not unconstitutional, and the district court’s ruling to the contrary was reversed.

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