Suits for nursing-home neglects sound in general negligence rather than medical malpractice, and are consequently not subject to damage caps

By Alex Stein

The West Virginia Supreme Court has recently delivered a super-important malpractice decision, Manor Care, Inc. v. Douglas, — S.E.2d —- (W. Va. 2014), holding that suits for nursing-home neglects sound in general negligence, rather than medical malpractice, and are consequently not subject to damage caps. This decision is very well reasoned and I expect it to be followed in other states that cap medical-malpractice damages. 

An eighty-seven years old woman was admitted to a nursing home. The woman suffered from Alzheimer’s dementia, Parkinson’s Disease, and other ailments, but she was able to walk with the use of a walker, recognized and communicated with her family, and was generally well-nourished, and well-hydrated. After spending nineteen days at the nursing home, the woman had become dehydrated, malnourished, bed ridden, and barely responsive. She had fallen numerous times, sustained head trauma and bruises, and suffered from sores in her mouth and throat. Shortly thereafter, the woman died as a result of severe dehydration.

The nursing home wantonly neglected the woman because it was chronically understaffed.

The West Virginia Supreme Court decided that the ensuing suit for wrongful death properly alleged corporate negligence, as opposed to medical malpractice. The Court reasoned that “the manner in which a claim is pled does not govern whether the MPLA [West Virginia’s Medical Practitioners Liability Act] ultimately will be applied to a particular claim.” Yet, the plaintiff’s allegation of corporate negligence was proper as a matter of substance. For that reason, the plaintiff’s action for damages was not capped by the MPLA.

Based on that reasoning and the state’s punitive-damage doctrine, the Court ruled that the plaintiff deserves to recover punitive damages in the amount close to $32,000,000.

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About Alex Stein

Alex Stein is a Professor of Law at Brooklyn Law School. Before joining Brooklyn, Alex was a Professor of Law at Cardozo Law School (2004-2016) and served for more than a decade at the Hebrew University of Jerusalem Faculty of Law (1991-2004). He also held visiting professorial appointments at Alabama, Columbia, Miami, and Yale Law Schools. In Fall 2016, he visited Harvard Law School, where he taught Torts and a seminar on Medical Malpractice. Alex's specialty areas include Torts, Medical Malpractice, Evidence, as well as general legal theory and economic analysis of law. He authors three books, An Analytical Approach to Evidence (with Ronald J. Allen et al.) (6th ed. 2016); Foundations of Evidence Law (2005) and Tort Liability under Uncertainty (2001, with Ariel Porat), and over sixty articles of which many have appeared in leading journals. Alex was one of the founding editors of Theoretical Inquiries in Law and is on the editorial board of the International Journal of Evidence & Proof. In 2013, he launched an e-journal STEIN on Medical Malpractice,, that covers all significant developments in medical malpractice laws across the United States. He graduated from the Hebrew University of Jerusalem and earned a Ph.D. from the University of London.