Are Utah's medical malpractice damage caps constitutional? Judd v. Drezga Explained

The Utah Supreme Court faced a challenging constitutional question in Judd v. Drezga: whether legislative caps on noneconomic damages in medical malpractice cases violate fundamental constitutional rights. The case involved a severely brain-damaged child whose jury award was dramatically reduced by statute, raising important questions about the balance between legislative policy and individual rights.

Athan Montgomery suffered severe brain damage at birth due to Dr. Gregory Drezga’s incompetent use of forceps during delivery. A jury awarded Athan $1,250,000 in noneconomic damages to compensate for his diminished life experience, reduced opportunities, and shortened life expectancy. However, the trial court reduced this award to $250,000 pursuant to Utah Code section 78-14-7.1, which caps quality-of-life damages in medical malpractice cases.

The plaintiff challenged the damage cap on five constitutional grounds: violation of the open courts provision (Article I, Section 11), uniform operation of laws (Article I, Section 24), due process (Article I, Section 7), right to jury trial (Article I, Section 10), and separation of powers (Article V, Section 1). Each challenge required the court to balance legislative authority against individual constitutional rights.

The court applied the Berry test for open courts violations, requiring either a substitute remedy substantially equal to that abrogated or justification based on a clear social or economic evil addressed through reasonable, non-arbitrary means. The majority found the legislature’s stated purpose of controlling healthcare costs and ensuring continued availability of medical care constituted a legitimate governmental interest. The court emphasized judicial deference to legislative policy judgments, even when the empirical basis for those judgments remained disputed.

Chief Justice Durham’s dissent, joined by Justice Nehring, argued the majority applied the wrong standard of review and should have applied heightened scrutiny rather than rational basis review. The dissent emphasized that noneconomic damages are genuinely compensatory, not “extras,” and criticized the arbitrary burden-shifting to the most severely injured victims. The dissent also noted Utah’s historically low malpractice awards, undermining the legislature’s crisis rationale.

This decision significantly impacts medical malpractice practice in Utah. Practitioners should understand that damage caps will be strictly enforced, even in cases involving severe injuries to children. The decision also demonstrates the court’s reluctance to second-guess legislative policy determinations, even when constitutional rights are implicated, suggesting future constitutional challenges face an uphill battle without overwhelming contrary evidence.