More than four years after a post-surgery infection led to the loss of vision in his left eye, 94-year-old Concord Township resident John Paganini is challenging a state limit on noneconomic damages for medical malpractice cases. Trial and appeals courts in Cuyahoga County both sided with Paganini. His case has now gone before the Ohio Supreme Court, which held oral arguments on Feb. 10. Paganini had left cataract eye surgery in late 2021, according to a judgment entry from Cuyahoga County Common Pleas Court Judge Timothy McCormick. It “appeared to have gone well,” but he called the office the next morning because of “eye pain and other symptoms.” A third-party answering service took his call and relayed information to the on-call doctor. Paganini then went to the Cataract Eye Center facility, where he was evaluated by a technician and diagnosed by Dr. Gregory Louis with a form of bleeding called vitreous hemorrhage. Paganini was referred to a specialist the next day when the pain did not improve, and he was diagnosed with an infection, the judge added. Vision in that eye could not be saved. He later sued Louis, the Cataract Eye Center of Cleveland and CEI Physicians for negligence for not diagnosing the infection. A Cuyahoga County jury awarded Paganini more than $1.4 million in damages in 2024. State law puts a maximum of $500,000 on noneconomic damages for medical damage that includes “permanent and substantial physical deformity, loss of use of a limb or loss of a bodily organ system.” McCormick wrote that the law was passed in 2001. There were concerns about the rising medical malpractice insurance rates and fewer doctors willing to work in states with high malpractice awards. The judge found that the law was unconstitutional as applied to Paganini’s case, violating the “due course of law clause” of Article I, Section 16 of the Ohio Constitution. McCormick wrote that while “the goal of lowering medical malpractice insurance rates is related to the general welfare of the public,” the legislature did not demonstrate “a real and substantial relationship between malpractice insurance rates and capping noneconomic damages for catastrophic injuries.” “There is no evidence from the legislature that cutting a plaintiff like Paganini’s award, or the awards of the one or two similarly situated people a year, cuts rates in a meaningful way beyond other reform efforts,” he wrote later. McCormick also found the law to be “unreasonable and arbitrary” as applied to Paganini. He referred to a 2018 case from Franklin County that found that the law “still burdens those most severely injured by medical malpractice to benefit to the general public.” Louis and Cataract Eye Center appealed the decision to award the full $1.4 million to Paganini, but Ohio Eighth District Court of Appeals Judge Eileen Gallagher upheld McCormick’s ruling in 2025. The defendants then appealed to the Ohio Supreme Court. At the Supreme Court, attorney Brad McPeek presented the arguments for Louis and the eye center. He said that the appeals court “played actuary” when it used one 2019 study and took one part of that study to say there was no clear “link between lower medical malpractice insurance rates in Ohio and this particular noneconomic damage cap.” McPeek also argued that using the cap to “make that number for non-economic damages more predictable” resulted in more cases settling, with “more plaintiffs and defendants getting together and able to really rationally evaluate their cases.” Attorney Susan Petersen represented Paganini. She said that an important factor in this case was the fact that he was only awarded noneconomic damages. When the jury awarded him the damages in 2024, he was 92 years old. “This was not a situation that the legislature anticipated and included in its legislative findings, where there would be available lost economic damages or future medical costs,” Petersen said. Attorney John Kerkhoff, representing Attorney General Yost’s office, asked the court to reconsider a broader constitutional question. He argued that Article 1, Section 16 of the Ohio Constitution provides “no free floating substantive power to strike down the General Assembly’s laws.” Kerkhoff added that that clause includes no “substantive due process,” which he said “would go toward striking down any type of policy decision of the General Assembly that is not procedural.” He later described substantive due process within that clause as the “ability of courts to review the rationality of the General Assembly’s laws that go to things like economic regulation or the substance of the law that creates rights, and those types of things that the General Assembly makes policy decisions on.” Petersen said that Yost’s office “wants to overturn nearly 150 years of how this court applied Article 1, Section 16 of our constitution.” She also said that additional parties “do not get to frame or expand the issues,” and the defendants never brought that larger issue to the case. The Feb. 10 oral arguments can be viewed at ohiochannel.org. The court’s website said that several months usually pass before a case is decided. ...read more read less