Medical Malpractice Law In California: What Is Proposition 46?

5 February 2015
 Categories: Law, Articles


When a health care provider gives treatment that falls below acceptable practice, patients can sue for medical malpractice. These cases are increasing across the United States, with more than $3 billion in malpractice payouts paid in 2012. In California, a proposed change in legislation in 2014 could have led to increased payouts, but a ballot result rejected the proposal. Learn more about Proposition 46, and find out the main reasons people supported or opposed the change.

How Proposition 46 came about

In 2003, a hit-and-run driver killed two children, Troy and Alana Pack, in Danville, California. The police investigation revealed that the car driver was high on prescription drugs at the time of the accident. It turned out that the driver was regularly collecting multiple prescriptions, but the children's father, Bob Pack, also held doctors liable for failing to put safeguards in place to stop this kind of problem.

When Pack eventually filed a malpractice lawsuit, he discovered that he was unable to sue the doctors for more than $250,000 due to Californian legislation. In 1975, the Medical Injury Compensation Reform Act placed this cap on malpractice damages, with no increase permitted since, even with the cost of medical inflation to contend with.

Bob Pack felt that $250,000 was not enough to compensate the loss of his two children, so he mounted a campaign – Proposition 46 – to reform the law and increase the cap on malpractice damages. Pack set up the Troy and Alana Park Foundation and started to work with legal representatives to campaign for reforms.

Proposed changes under Proposition 46

Proposition 46 contained three main proposed reforms. These were:

  • Increase the cap on malpractice damages from $250,000 to $1,000,000
  • Require certain physicians to undergo random drug testing
  • Force providers to use a special online database to check for patients abusing their prescriptions

The Proposition drew a number of opponents. Every major Californian newspaper came out against the Proposition, as well as malpractice insurers and the California Medical Association.

Benefits of Proposition 46

Proposition 46 aimed to improve patient safety in California. Random drug testing could help cut down the number of physicians who abuse drugs and alcohol, decreasing the risk of traumatic malpractice incidents. Experts believe that severe penalties for healthcare professionals found abusing these drugs would have become a strong deterrent against this problem.

Crucially, the Proposition would also have offered the victims of medical malpractice more protection. A $250,000 settlement is unlikely to cover the true human cost of many tragedies, and some families go on to struggle financially as a result of this negligence. The proposed increase to $1,000,000 offers victims and their families a more reasonable level of compensation and an amount of money that can, in some way, help them adjust to disability and permanent injury.

According to an article in the LA Times, the 1975 $250,000 cap does not even serve the intended purpose and does not guarantee fair legal outcomes. The cap potentially penalizes people with more serious, life-changing injuries, while somebody with a lesser injury can still receive similar compensation. What's more, the cap potentially punishes women and children. A 2004 study shows that the average settlement for women after the cap decreased significantly compared to the amount awarded to men.

What opponents said about Proposition 46

Opponents of the Proposition argued that the legislation would unfairly increase the cost of malpractice insurance. Indeed, malpractice insurance companies largely funded the opposition campaign. The opposition argued that the change could also increase the costs of healthcare and medical insurance in California, as doctors and hospitals would immediately increase their charges.

The opposition launched a significant media campaign to oppose the measure. In the end, the ballot failed to pass in November 2014. In a statement released on November 5, 2014, Pack confirmed that he would continue to campaign for reforms in California. While the ballot result did not support the proposed changes, Pack stated that he would continue to press the authorities to increase the limit on malpractice claims.

In California, the Medical Injury Compensation Reform Act limits compensation in malpractice cases to $250,000. If you are coping with a potential malpractice injury, talk to your attorney for more advice and to learn more.


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