MONTGOMERY, Ala. (Legal Newsline) - The Alabama Supreme Court upheld a record $10 million in punitive damages against a hospital where a carpenter who went in for a severed thumb ended up dying after being administered dangerously high doses of intravenous opioid painkillers.
The court left intact a much-criticized 1995 decision striking down Alabama’s $1 million punitive-damages cap in medical malpractice cases, although one justice described that as a “high watermark of judicial activism” that should be overruled.
John Dewey West went to Springhill Memorial Hospital in 2014 after cutting off the tip of his thumb in a table saw. Dr. John McAndrew, an orthopedic surgeon, cleaned up the wound and prescribed two pain medications, Percocet pills and Dilaudid, a powerful opioid. His order said to dispense 4 milligrams intravenously every three hours for “increased pain.”
Hospital records indicate Nurse Jane Elenwa administered two 4-milligram doses to West, although she denied doing so, saying it would have been “egregious and a gross violation of the standard of care.” SMH agreed the doses were administered, however, because records included a report showing Elenway accessed a locked cabinet that requires a fingerprint or passcode, and scans of West’s wrist bracelet show he received the drugs.
Early the next morning a nurse’s aide found West unresponsive and efforts to revive him failed. His wife Patricia sued the hospital and a jury awarded $35 million in punitive damages, which the judge reduced to $10 million, still a record for a medical malpractice case in Alabama.
On appeal, SMH argued the damage award was excessive and urged the court to restore the $1 million cap on punitive damages. The Alabama Supreme Court left both in place in a recently published decision.
The damages were justified given the “egregious,” “unacceptable” dosage of Dilaudid, the majority said. The court rejected complaints that the award grossly exceeded the previous record of $6.5 million in 2021, saying SMH had the “available assets and liability insurance” to pay it and “the size of the award matters in relation to the particular defendant's financial position.”
The court also rejected calls to “revive” the $1 million statutory cap on punitive damages, which it declared unconstitutional in 1995. A plurality of the court in 2001 held that the decision was “wrongly decided” to the extent it meant the right to jury trial includes the right to impose punishment.
The problem for SMH is two decades later the court hasn’t chosen to revive the punitive-damages cap, “and that choice has not been for a lack of parties asking that we do so,” the majority said. Alabama legislators, presumably taking into account the state Supreme Court’s prior ruling, enacted a punitive-damages cap in 1999 that excluded wrongful-death actions.
Justice William B. Sellers partially dissented, saying defendants should have “fair notice” not only of the conduct that will subject them to penalties, but the severity of that penalty.
“The defendant here could not have anticipated a punitive-damages award in this amount,” he wrote, based on prior damages awards in the state.
Justice Jay Mitchell also dissented in part, saying the court’s 1995 decision striking down the punitive-damages cap “represented a high watermark of judicial activism” in Alabama when “several members of Alabama's judiciary believed themselves to have `almost limitless discretion in striking down duly enacted laws’ by recasting their own policy preferences as `constitutional rights,’" he wrote, citing a dissent in that case. The law is still on the books, ready to be enforced if the court overturns that decision, he wrote.
Justice Greg Cook also dissented in part, saying the U.S. Supreme Court had placed limits on punitive damages as a multiple of compensatory damages. While Alabama’s wrongful-death statute provides for only punitive, not compensatory damages, the Alabama Supreme Court still could have declared the $10 million judgment in this case too high compared to prior awards including the previous record of $6.5 million two years before.