California Cap on Noneconomic Damages Applies to PAs, Even If Physician Provides No Supervision

​​A young child died of metastatic malignant melanoma after two physician assistants (PAs) at a dermatology clinic misdiagnosed a cancerous skin lesion as benign. In a lawsuit brought by the patient's mother, the Supreme Court of California upheld reduction of the noneconomic damages award from $4.25 million to $250,000 per the state cap on noneconomic damages in medical malpractice cases. The cap applies to lawsuits against PAs when the PA has a legally enforceable agency relationship with a supervising physician and provides services within the scope of that relationship, even if the physician provides no or minimal actual supervision, the supreme court held.

The decision focused on the care provided by two PAs, Freesemann and Hughes. PA Freesemann had entered into a delegation-of-services agreement (DSA) with the dermatologist who owned the clinic. However, by the time of the events at issue, the dermatologist was no longer actively practicing...