Estate Awarded $1,450,000 in Punitive Damages

by David Cosgrove

Although the jury awarded only $25,000 in compensatory damages for medical negligence and a violation of the Emergency Medical Treatment and Active Labor Act (EMTALA), the Kentucky Court of Appeals upheld a punitive damage award of $1,450,000. The court upheld the award despite the fact that the jury assessed comparative fault of 25% against the Estate’s decedent.

The defendants’, a hospital and various staff members, argued that there was insufficient evidence of gross negligence to support the submission of punitive damages to the jury, and that the punitive damage award was excessive. The Kentucky Court of Appeals rejected both arguments in a decision it handed down last week.

The plaintiff was the Estate of Milford Gray. Gray went to the emergency room two times in less than 24 hours complaining of abdominal pain, constipation, nausea, and vomiting. He was discharged and transported by ambulance to a local hotel about 4 hours after his first arrival. He was indigent.

About 5 hours later, Gray returned to the emergency room after hotel staff called 911. Gray was vomiting blood. Regardless, he was discharged again about 7 hours later. He died later that same day. A duodenal ulcer had ruptured.

The Estate prevailed after two trials, two appeals, and the almost fourteen years of litigation1. There are a couple of distinct facts and procedural quirks in this case. First, the hospital staff discharged Gray the second time without stabilizing his condition, presuming him to be malingering. Indeed, they even threatened to call the police if family members returned him for a third time. Beyond demonstrating a reckless disregard for Gray’s life, the hospital violated EMTALA2. And here is the kicker—the hospital did not conduct any investigation or review of the incident. And they obviously did not settle the case. This leads me to inquire: who the heck was calling the shots for this hospital?!

Here is the procedural quirk: After the first trial, the Court of Appeals upheld the trial court’s ruling that a punitive damage award of $1,500,000 was excessive. Although it noted that the issue presented “the most difficult issue presented” in the second appeal, it upheld the punitive award of $1,450,000—despite the fact that the award was almost 60 times the compensatory damage award3.

The Cosgrove Law Group is currently working with another law firm in a case against a hospital and its staff for gross negligence. The case is set to go to trial next summer, and I really hope it doesn’t take 13 years for the court system to force the defendants to accept an appropriate degree of responsibility.


1Good grief! I at times bemoan the fact that I have a couple of cases that are in their 6th year of litigation!

2The EMTALA imposes screening and stabilization requirements upon certain federally funded hospitals.

3The court noted that there is no bright-line ratio to determine reasonableness and the ratio is only one of several facts to be considered.