## Facts

- Elliot Kaplan underwent evaluation and treatment at Mayo Clinic for suspected pancreatic cancer.
- Kaplan alleged that surgeon Dr. David Nagorney told him he would perform a biopsy before proceeding with major surgery, and that Kaplan relied on that assurance.
- Mayo performed a Whipple procedure on Kaplan.
- After surgery, Mayo determined that Kaplan did not have pancreatic cancer.
- Kaplan and his wife, Jeanne Kaplan, sued Mayo and Nagorney alleging negligent failure to diagnose and breach of contract based on the alleged promise to perform a biopsy.
- In earlier proceedings, the district court granted Nagorney summary judgment and granted judgment as a matter of law for Mayo on the breach-of-contract claim; a jury later returned a defense verdict for Mayo on negligence.
- The Eighth Circuit affirmed the defense verdict on negligence but revived the breach-of-contract claim against Mayo, holding a reasonable jury could find a contract formed from the alleged biopsy promise and a breach when no biopsy was performed.
- On remand to the District of Minnesota, Mayo filed a motion in limine to bar the Kaplans from presenting evidence of emotional distress, pain, and suffering as damages on the contract claim.

## Issues

1. Under Minnesota law, may a plaintiff recover emotional distress and pain-and-suffering damages for breach of an alleged physician–patient contract promising a specific pre-surgical biopsy?
2. Do any recognized exceptions allowing emotional-distress damages in contract apply to the alleged biopsy-promise agreement in this medical-treatment setting?

## Decision

- The court granted Mayo’s motion in limine.
- The court held that Minnesota contract law generally does not allow recovery for emotional distress or pain and suffering for breach of contract.
- The court concluded the narrow exceptions permitting such damages did not apply to the alleged promise to perform a biopsy before surgery.
- The Kaplans were prohibited from offering evidence or seeking an award of emotional distress, pain, and suffering as contract damages at the remanded proceedings on the breach-of-contract claim.

## Legal Principles

- Contract damages in Minnesota are ordinarily limited to economic losses measured by the injured party’s contract interest (such as expectancy or reliance), not mental anguish.
- Emotional-distress damages are generally unavailable in contract actions, even when emotional harm was foreseeable.
- A narrow exception may allow emotional-distress damages when the contract’s object is the plaintiff’s emotional well-being or freedom from emotional disturbance, and breach is especially likely to cause serious emotional disturbance (often referenced in Restatement (Second) of Contracts § 353).
- A medical-treatment agreement to perform (or not perform) a clinical step is not treated as a contract whose central object is emotional tranquility, so the exception does not extend to pain-and-suffering damages in this setting.
- Courts may limit contract remedies to avoid using contract law to obtain tort-type noneconomic damages after related malpractice claims have been tried and resolved.

## Conclusion

In this post-remand damages ruling, the District of Minnesota held that, even if a jury could find Mayo breached an alleged contractual promise to perform a biopsy before proceeding with surgery, Minnesota contract law does not permit recovery of emotional distress and pain-and-suffering damages on that contract claim, and the court therefore barred the Kaplans from presenting such damages evidence at trial.


Kaplan v. Mayo Clinic, 947 F. Supp. 2d 1001 (2013)