Damages caps in Georgia medical malpractice after Nestlehutt

Georgia’s malpractice cap statute is still in the Code, but the Supreme Court has held it cannot be enforced as written against a jury’s noneconomic award. O.C.G.A. § 51-13-1 limits noneconomic damages to $350,000 and higher totals for facilities. Atlanta Oculoplastic Surgery v. Nestlehutt (2010) held that violated the right to a jury trial, and Clark v. Leigh (2026) reaffirmed that and applied it in a wrongful death judgment. Two other limits still operate: punitive damages and claims against the state.

What § 51-13-1 says

The section still appears in the Code. It sets these limits on noneconomic damages for a single claimant.

Defendants	Limit	Subsection
One or more health care providers	$350,000 total	(b)
A single medical facility	$350,000	(c)
More than one medical facility	$350,000 per facility, $700,000 total	(d)
All of the above together	$1,050,000	(e)

Each of (b), (c), and (d) says it applies in a malpractice action “including an action for wrongful death”. Subsection (f) separately addresses periodic payments of future damages of $350,000 or more, on request.

What Nestlehutt decided

In Nestlehutt, 286 Ga. 731, a patient sued after complications from facial surgery. The Court held that the caps violated the jury trial guarantee in the Georgia Constitution because a jury’s determination of noneconomic damages was part of the right as it existed at common law. It also held the ruling applied to the case before it.

What Clark v. Leigh added

Clark, 324 Ga. 733, was decided on June 16, 2026, on appeal from the State Court of Bibb County. A jury had returned a large wrongful death award, and the trial court reduced that award to $350,000 under the statute. The defendants raised the statute after trial, and the Supreme Court said the trial court did not abuse its discretion by allowing that. On the merits, the Court:

• reaffirmed that the jury right “does not permit the application” of the § 51-13-1(b) cap “to damages for pain and suffering and loss of consortium in medical malpractice actions”;
• held that, in light of that holding, ordinary statutory construction meant the limit “cannot apply to the judgment in this case”, because Nestlehutt prevents the cap from operating the way the statute requires and a court cannot rewrite the statute; and
• vacated the reduction and remanded because the trial court had not considered an argument in the motion for new trial.

Cayamcela v. Advocacy Trust, S26A0229, decided the same day, involved a $42 million judgment: $10 million to an estate for pain and suffering and $32 million to children for wrongful death. Citing Clark, the Court said the cap “may not be constitutionally applied to the verdict in this case”, because a court can’t apply it where even part of the award is noneconomic damages covered by Nestlehutt. So the Court didn’t reach the other arguments for applying the cap to some or all of that award.

Two practical points follow. A defendant may still raise § 51-13-1 late, so a plaintiff should not treat the issue as gone. And the bare statement that “the cap is unconstitutional” leaves out the structure of the Clark reasoning, which turned in part on the award and on how the statute is built. Anyone relying on this for a particular case should read the opinion and check what happened on remand.

What does not depend on those decisions

Economic damages. Section 51-13-1(a)(4) excludes medical expenses, wages, funeral costs, and the value of services from the definition of noneconomic damages, so economic damages were never covered by these limits.

Punitive damages. Section 51-12-5.1(g) limits them to $250,000 unless the case falls within (e) or (f). Under (b), they require clear and convincing evidence of aggravated conduct. See punitive damages in wrongful death cases, where the same section is explained.

Claims against the state. The Georgia Tort Claims Act has its own limits. Section 50-21-29(b)(1) caps recovery at “$1 million because of loss arising from a single occurrence”, with a $3 million aggregate. Subsection (b)(2) creates a further rule for certain claims under Article 8 of Chapter 8 of Title 31, which ties them to § 51-13-1’s numbers as “a total cap of all damages”. A claim against a state provider therefore needs its own analysis.

Mental health care claims. A separate liability standard applies for causes of action arising on or after July 1, 2024 under § 51-1-29.7, as summarized by the Legislative Counsel.

How the 2025 reform touches the same damages

Senate Bill 68 did not create a new cap. It did change the conversation in a malpractice trial. Under the revised § 9-10-184, counsel may argue a value for noneconomic damages only after the close of evidence, at the party’s first opportunity to argue damages, and the argument must be “rationally related to the evidence”. Section 9(b) applies this part to pending actions, unless that would be unconstitutional. See non-economic damages in medical malpractice.

What a family or patient should take from this

No cap should be assumed to reduce a Georgia malpractice verdict, and no one should assume none could be raised either. Whether a state provider is involved, whether the case is for a death, and whether the defendant has argued the statute are facts that can change the analysis. Reports of a verdict in another case are not a guide. They reflect that jury and that record, and the post-trial history can change the number, as both Nestlehutt and Clark show.

Sources

• Official Code of Georgia Annotated, November 2022 public release: §§ 50-21-29, 51-12-5.1, 51-13-1
• Atlanta Oculoplastic Surgery v. Nestlehutt, 286 Ga. 731
• Clark v. Leigh, 324 Ga. 733 (2026)
• Cayamcela v. Advocacy Trust, S26A0229 (2026)
• Senate Bill 68, as passed (2025): Section 1, Section 9(b)
• Legislative Counsel, Summary of General Statutes Enacted, 2024: House Bill 1409

This page was last reviewed in November 2026 for general information. Laws and court decisions can change after that date. It is not legal advice and does not create an attorney-client relationship.