Columbus Appeals Court Lets a $25 Million Malpractice Verdict Stand

Published September 16, 2025 · Ohio Appeals Courts

A woman goes to the hospital again and again, unable to keep food or water down, losing weight, seeing double. No one recognizes that her body is starving for a basic vitamin. By the time another hospital diagnoses the problem, she has a permanent neurological injury. A jury hears the evidence and awards her more than $25 million. Then the defendants ask the judge to cut most of her pain-and-suffering award to fit a cap the legislature set in 2003.

On August 21, 2025, the Tenth District Court of Appeals in Columbus said no. In Lyon v. Riverside Methodist Hosp., 2025-Ohio-2991 (10th Dist.), the court held that Ohio's $500,000 cap on noneconomic damages in medical-malpractice cases was unconstitutional as applied to her. It is the second Ohio appeals court this year to reach that conclusion.

What happened

According to the opinion, Susana Lyon was treated repeatedly in late 2015 for intractable vomiting, nausea, vertigo, double vision and blurred vision, including several admissions to Riverside Methodist Hospital. In January 2016, the Ohio State University Wexner Medical Center diagnosed severe nutritional deficiency and Wernicke-Korsakoff syndrome, which led to severe peripheral neuropathy. Her lawsuit alleged a failure to diagnose a thiamine (vitamin B1) deficiency.

Most defendants settled or were dismissed before trial. In April 2023, a Franklin County jury returned a verdict of $25,172,526.32:

• about $744,000 for past medical expenses,
• about $4.43 million for future medical expenses,
• $5 million for past noneconomic damages, and
• $15 million for future noneconomic damages.

The jury found three physicians each 3 percent responsible, and their practice group jointly responsible for 9 percent.

How the cap works, and what it would have done here

"Noneconomic damages" are the losses that do not come with a bill or a pay stub: pain, suffering, loss of enjoyment of life, and the inability to do what you once did. "Economic damages" are the measurable financial losses, such as medical bills and lost wages.

For medical claims, R.C. 2323.43(A)(2) generally caps noneconomic damages at $250,000, or three times economic loss, up to $350,000 per plaintiff. For the most catastrophic injuries, such as permanent and substantial deformity, loss of use of a limb, or loss of a bodily organ system, R.C. 2323.43(A)(3) raises the limit, but only to $500,000 per plaintiff. The jury is not told about the cap; the judge applies it after the verdict.

The appeals court did the math. Without the cap, the defendants on appeal were responsible for 9 percent of the verdict, about $2.27 million. With the cap, their share fell to about $966,000, a 57.4 percent reduction.

That math also shows how fault apportionment works in Ohio. A defendant generally pays its share of the fault, not the whole verdict. We explained those rules in our 2024 post on fault apportionment. A headline verdict figure and what a particular defendant actually owes can be very different numbers.

What the court decided

The cap is not unconstitutional on its face. A "facial" challenge argues that a law is invalid in every situation. The court rejected that argument, reasoning that it could imagine cases in which a small reduction to fit the cap would be reasonable.

But it is unconstitutional as applied to Ms. Lyon. An "as applied" challenge argues that a law is unconstitutional on the specific facts of one case, and the plaintiff must prove it by clear and convincing evidence. The court held she did so on two grounds.

• Due process. The court adopted the reasoning of the Eighth District's January decision in Paganini v. Cataract Eye Ctr. of Cleveland, 2025-Ohio-275 (8th Dist.), which itself relied on the Supreme Court of Ohio's decision in Morris v. Savoy, 61 Ohio St.3d 684 (1991). Morris struck down an earlier malpractice cap because it made the most severely injured patients alone bear the cost of a benefit meant for the general public. The Tenth District added that the $500,000 figure has never been adjusted for inflation. It noted that federal inflation data put the 2003 cap at roughly $286,000 in today's dollars, making the recovery "significantly less valuable than at the time the statute went into effect."
• Equal protection. The court compared malpractice victims with everyone else. Under Ohio's general damages statute, R.C. 2315.18(B)(3), there is no cap at all on noneconomic damages for catastrophic injuries such as loss of use of a limb or loss of a bodily organ system. The malpractice statute caps those same injuries at $500,000. The court observed that if Ms. Lyon had been hurt the same way in a car crash, she would have received the full award. As applied to her, the court found the difference arbitrary, because she "is treated differently based on the nature of her victimization."

The court affirmed the full judgment.

Two appeals courts, one message

We wrote about Paganini in February, in our post on the Cleveland court's refusal to cut a malpractice award by two-thirds. In that case, a patient developed an aggressive infection after cataract surgery that was not recognized in time. He permanently lost his vision and then the eye itself, and a jury awarded $1,487,500 in noneconomic damages. Applying the cap would have taken away 66.4 percent of it.

With Lyon, two of Ohio's twelve appellate districts have now refused to apply the catastrophic-injury cap to patients whose awards would have been slashed. That does not mean the cap is gone. Each decision applies to the case in front of it, other districts have not ruled, and the Supreme Court of Ohio has not addressed the question for the current statute. Trial courts in the Second District, which includes Dayton, still start from the statute as written.

Why the record matters so much

An as-applied challenge is won or lost on the evidence. The plaintiff has to show, clearly and convincingly, how severe and permanent the injuries are, how much of the jury's award the cap would erase, and why applying it in that case is arbitrary. That record is built from the first months of a case, through medical testimony about permanence, life-care planning for future needs, and evidence of how the injury changed every part of a person's life. Our guide chapter on what your case is worth explains the categories of damages and the caps that apply to them.

What this means for you

If you or a family member suffered a permanent injury from a missed diagnosis or a medical error, the cap is not necessarily the ceiling on your recovery. But Ohio's medical-claim deadlines are short, generally one year with a limited notice extension, and the case has to be built with a cap challenge in mind from the beginning. Talk to a lawyer before you decide what your case is worth. Our personal injury page describes the kinds of serious-injury cases we handle.