## Facts

- Elnora R. Pulliam sought treatment in an emergency department with symptoms of serious illness.
- An emergency room physician, employed by Coastal Emergency Services of Richmond, Inc., negligently failed to diagnose and properly treat bacterial pneumonia and bacteremia.
- Mrs. Pulliam died, and her estate filed a medical malpractice and wrongful death action against the physician and Coastal.
- A jury found for the estate and awarded $2,045,000, plus interest from the date of death.
- The circuit court reduced the recoverable amount to $1,000,000 under Virginia’s medical malpractice damages cap, Va. Code § 8.01-581.15.

## Issues

1. Whether Va. Code § 8.01-581.15’s cap on total recovery in medical malpractice actions violates constitutional protections, including the right to jury trial, due process, equal protection, takings, or separation of powers.
2. If the cap is constitutional, whether the trial court correctly applied it to reduce the jury’s award to the statutory maximum.

## Decision

- The Supreme Court of Virginia affirmed.
- The court held that Va. Code § 8.01-581.15 is constitutional and reaffirmed its prior decision upholding the cap.
- The court held that reducing the verdict to the statutory maximum did not impermissibly alter the jury’s fact-finding, but limited the legal remedy available.
- The court concluded that the cap survives due process and equal protection review because it is rationally related to legitimate legislative objectives concerning medical malpractice and healthcare availability.
- The court rejected takings and separation-of-powers challenges, treating the cap as a legislative definition of the available remedy rather than a judicial reexamination of factual findings.
- A concurring justice agreed the statute was constitutional but noted it can produce unfair results in individual cases, which is a policy matter for the legislature.

## Legal Principles

- A statutory damages cap may limit the amount recoverable on a jury verdict without violating the jury-trial guarantee when the jury remains free to find liability and determine the uncapped amount of damages.
- Under rational-basis review, a damages cap satisfies due process and equal protection if it bears a reasonable relation to legitimate governmental interests, including stabilizing malpractice insurance and maintaining access to healthcare.
- Applying a damages cap is not a taking when the statute defines, from the outset, the maximum legal remedy available for the claim.
- Setting limits on recoverable damages is a legislative function and does not violate separation of powers so long as the courts retain their ordinary adjudicative roles within the statutory framework.

## Conclusion

The court upheld Virginia’s medical malpractice damages cap against multiple constitutional challenges and affirmed the reduction of the jury’s wrongful-death verdict to the statutory maximum, treating the cap as a lawful legislative limit on recovery rather than an interference with jury fact-finding.


Pulliam v. Coastal Emergency Servs. of Richmond, Inc., 257 Va. 1, 509 S.E.2d 307 (Va. 1999)