After being injured by a doctor, nurse or other medical provider in the State of Maryland, patients often wonder whether they can sue for punitive damages. This article will cover the basics of punitive damages claims in Maryland healthcare malpractice cases. The attorney responsible for this content is Benjamin A. Schwartz and the content was accurate as of the date this article was written (May 23, 2024).

What are Punitive Damages?

“Punitive damages” is a technical legal term for money awarded to the plaintiff in a lawsuit to punish the defendant. Sometimes, punitive damages are also called “exemplary damages”, because they seek to make an example of the defendant’s wrongdoing. Punitive damages are not designed to compensate the injury victim. “Compensatory damages” are designed to compensate the injury victim for her or his losses. Compensatory damages may include medical expenses, lost wages, pain and suffering, and other things.

What does Maryland law say about punitive damages in healthcare malpractice cases?

Injured patients often feel betrayed after being injured as a result of the wrongdoing, negligence, or incompetence of a doctor, nurse or other healthcare provider. A serious injury at the hands of a medical treatment provider is different from an injury from another type of incident such as a car accident or slip-and-fall or dog bite. In cases involving injuries caused by a medical professional, the patient gave the medical professional their trust. In return, the medical professional’s wrongdoing violated that trust. As a result, it is very common to feel like a medical professional who caused injury should be punished by the law. And plaintiffs in healthcare malpractice cases often wonder if they can pursue a claim for punitive damages.

Unfortunately, Maryland law sets a very high bar for making a claim for punitive damages in a healthcare malpractice case. In 1975, the Court of Appeals of the State of Maryland issued a decision in a case called H&R Block, Inc. v. Testerman, 275 Md. 36, 338 A.2d 48. That was not a medical malpractice case. It set a rule for punitive damages in Maryland lawsuit cases. The rule is that “where the tort [the wrongful conduct leading to the lawsuit] is one arising out of a contractual relationship, actual malice is a prerequisite to the recovery of punitive damages”.

In 1991, the Court of Appeals issued a decision in the case of Schaefer v. Miller, 322 Md. 297, 587 A.2d 491. The Court extended the “Testerman rule” to healthcare malpractice cases. The Court reasoned that when the patient hires a doctor provide treatment such as a surgical operation, that’s a contract. If the doctor commits an error while providing the treatment, then that’s a tort arising out of a contractual relationship. And so now, to sue and recover an award of punitive damages in a Maryland healthcare malpractice case, the Plaintiff must plead and prove actual malice.

“Actual malice” is defined in the Testerman decision as “the performance of an act without legal justification or excuse, but with an evil or rancorous motive influenced by hate, the purpose being to deliberately and willfully injure the plaintiff”. Actual malice is not merely wrongful, careless conduct. Under the definition given in the Testerman case, it would be conduct where the doctor or nurse is actually trying to cause harm to the patient.

Is every State the same when it comes to punitive damages in medical malpractice cases?

Each state has its own rules and standards for punitive damages, and for healthcare malpractice cases. Accordingly, the law in one state may differ greatly in another state. Maryland’s next-door neighbor is Delaware. Let’s look at Delaware law to see how it compares.

In a Delaware medical malpractice case, the plaintiff may be awarded punitive damages if she or he pleads and proves that the defendant maliciously intended the injury. In this regard, the law in Delaware is very similar to the law in Maryland.

Additionally, a plaintiff in a Delaware medical malpractice case could be awarded punitive damages where the defendant did not actually intend to cause the harm, but the defendant’s actions constituted “wilful and wanton misconduct”. See 18 Del.C. § 6855.

Under Delaware law, “wilful and wanton misconduct” refers to conscious indifference or disregard for the rights of others and has commonly been referred to as an “I don’t care” attitude. See, for example, the Delaware Superior Court’s decision of 9-12-2005 in Pattanayak v. Khan, 2005 Del. Super. LEXIS 358.

As a result, under Delaware law, a plaintiff could be awarded punitive damages where the doctor or nurse did not actually intend the injury, but recognized a substantial and unjustifiable risk of injury and acted or failed to act to protect the patient’s life or health. But that would not be enough to prevail on a punitive damages claim in Maryland.

Is the Maryland punitive damages rule fair?

I do not feel that the Maryland punitive damages rule is fair to victims of healthcare malpractice. In my mind, there are three categories of cases:

First, there are cases where the doctor or nurse did not intend to harm the patient, did not understand the risk of harm connected to what they were doing, but ended up harming a patient because they were simply careless or negligent. If you unintentionally harm someone as a result of a simple mistake or accident, then you should not be punished. The key here is that you did not intend to cause harm.

Second, there are cases on the other end of the spectrum, where the doctor or nurse intended to harm or kill the patient. Those folks should be put in prison. And of course, punitive damages should be available to their victims.

But there is a third category of cases in the middle. These are cases where the doctor or nurse realized that there was a significant risk to the patient of injury or death, and just recklessly ignored that risk and proceeded without taking appropriate precautions. Those are the cases where you can claim punitive damages in Delaware but not in Maryland. I believe punitive damages should be available for plaintiffs harmed by doctors and nurses who took unreasonable and unjustifiable risks on behalf of patients who trusted them to make reasonable, sensible decisions on their behalf.

What should you do if you have been injured due to the wrongdoing of a doctor or nurse in Maryland?

If you have been injured as a result of the careless, reckless, or intentional wrongdoing of a doctor, nurse, or other healthcare provider in the State of Maryland, you should contact an attorney that handles Maryland medical malpractice lawsuit cases. In our Law Firm, we have multiple attorneys that handle Maryland malpractice claims. We don’t charge a fee to review prospective medical malpractice cases. And if we do accept your case, we will likely offer to handle it on a contingency fee basis (meaning you don’t pay an attorney’s fee unless and until we win or settle your case).