## Facts

- Lisa Gourley received prenatal care for a twin pregnancy from Dr. Michelle S. Knolla, an obstetrician-gynecologist with the OB/GYN Group.
- Near 36 weeks’ gestation, Lisa reported decreased fetal movement.
- Providers performed an emergency cesarean section at Nebraska Methodist Hospital.
- One twin, Colin Gourley, was born with severe brain injury, later described as cerebral palsy with major developmental and physical impairments.
- The family sued the hospital and multiple medical providers, alleging negligent prenatal care, monitoring, diagnosis, and delayed intervention caused Colin’s injuries.
- A jury awarded $5,625,000 in damages.
- Nebraska’s Hospital–Medical Liability Act capped total recoverable damages in medical malpractice actions at $1,250,000.

## Issues

1. Whether Neb. Rev. Stat. § 44-2825(1), capping medical-malpractice damages at $1,250,000, violated the Nebraska Constitution’s equal protection guarantees.
2. Whether the statutory cap violated the constitutional right to a jury trial by limiting recovery below the jury’s damages finding.
3. Whether the cap constituted impermissible special legislation, violated substantive due process, or breached separation-of-powers limits.
4. Whether asserted verdict irregularities or evidentiary errors required reversal or a new trial.

## Decision

- The Nebraska Supreme Court held the damages cap in § 44-2825(1) constitutional.
- The court reversed the district court’s ruling striking the cap and reinstated the reduced judgment of $1,250,000.
- The court rejected challenges based on equal protection, jury trial, special legislation, substantive due process, and separation of powers.
- The court did not find reversible error warranting a new trial based on the remaining verdict and evidentiary objections.

## Legal Principles

- A statutory medical-malpractice damages cap is reviewed under rational basis when it does not burden a fundamental right or target a suspect class.
- Under rational basis, the Legislature may limit recoverable damages to address perceived problems such as malpractice-insurance costs, health-care costs, and access to medical services, so long as a rational justification can be conceived.
- A damages cap does not violate the right to a jury trial when the jury remains free to determine damages as factfinding, and the cap operates as a postverdict legal limit on recovery.
- The Legislature may alter common-law remedies, including by limiting damages, consistent with substantive due process if the change has a rational basis.
- A generally applicable statutory damages limit is not an improper “legislative remittitur” and does not violate separation of powers merely because it reduces the amount collectible on a jury verdict.

## Conclusion

The court upheld Nebraska’s statutory cap on total medical-malpractice damages, concluding it rationally advanced legislative objectives and did not infringe constitutional guarantees; accordingly, the plaintiffs’ recovery was limited to $1,250,000 despite the larger jury award.


Gourley ex rel. Gourley v. Neb. Methodist Health Sys., Inc., 663 N.W.2d 43 (Neb. 2003)