The Cuyahoga County Court of Appeals, Eighth Appellate District, issued an opinion on January 30, 2025, that the cap on non-economic damages provided in Revised Code 2323.43(A)(3) is unconstitutional as applied in a medical matter with catastrophic injuries. While many trial courts around the State have ruled similarly, this is the first Ohio Court of Appeals decision declaring the statutory limitation on non-economic damages in catastrophic cases unconstitutional as applied.

In Paganini v. The Cataract Eye Center of Cleveland, et al., 2025-Ohio-275, a medical malpractice action against defendants – a physician and medical center – alleging that plaintiff’s eye infection was misdiagnosed resulting in loss of his eye, the trial court ruled that the statutory cap on noneconomic damages under Revised Code 2323.43(A)(3) was unconstitutional as applied to plaintiff. The ruling was affirmed on the reasoning that the statute arbitrarily burdened the most severely injured patients without a substantial relationship to reducing medical malpractice insurance costs. The Court of Appeals found the statute arbitrary and unreasonable as applied, and a violation of the Paganini’s rights under the due course of law clause of the Ohio Constitution.

An appeal to the Ohio Supreme Court has now been filed. On March 17, 2025, The Cataract Eye Center of Cleveland argued in its memorandum in support of jurisdiction that the Eighth District’s decision reads like a policy statement from a Northwest D.C. think tank – not an opinion from an Ohio court. Instead of deferring to the General Assembly’s extensive findings – which detail the many reasons why non-economic damage caps in malpractice cases lead to lower medical insurance premiums and more affordable healthcare, the court played actuary. They argue the Eighth District concluded the General Assembly was wrong when it enacted R.C.2323.43(A)(3) in 2003 based on one sentence from the Ohio Department of Insurance’s 2019 annual report to the Ohio General Assembly, summarizing Ohio medical malpractice claims, saying that it is “not clear” that the damage cap lowers insurance costs, and ruled that the statute is unconstitutional as a result.

They urge the Supreme Court to exercise jurisdiction in order to restore the General Assembly’s primacy in matters of policy. Furthermore, because the Eighth District’s decision scuttled two decades of medical malpractice case law and endangers affordable healthcare, The Cataract Eye Center of Cleveland argues the Court must intervene.

While the Ohio Supreme Court has upheld non-economic damage caps in other instances, this is its first opportunity to examine the medical negligence caps. The lack of any inflationary indexing in the many years since enactment has been a growing concern. The Court has been under Republican control since 1986. Republicans won all three races in the November 2024 election, increasing their hold on the Court from a 4-3 advantage to a 6-1 advantage. This matter will be closely watched, no doubt drawing much amicus curiae involvement, and impacting medical negligence matters in Ohio for many years to come.

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Non-Economic Damages Cap Heading to Ohio Supreme Court

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