BACKGROUND PAPER TORT REFORM. Dennis Neilander, Senior Research Analyst Research Division Legislative Counsel Bureau

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1 BACKGROUND PAPER TORT REFORM Dennis Neilander, Senir Research Analyst Research Divisin Legislative Cunsel Bureau

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3 TABLE OF CONTENTS I. Intrductin... 1 II. Overview f Trt Refrm Issues... 1 III. Trt Refrm Cmpnents A. Jint and Several Liability... 3 B. Limitatins n Nnecnmic Damages C. Cllateral Surce Rule D. Punitive Damages E. Prduct Liability... 6 F. Prejudgment Interest G. Limitatins n Attrney Fees... 7 H. Peridic Payments... 8 I. Medical Malpractice... 8 IV. Cmparisn f Nevada and Califrnia Trt Laws A. Arbitratin Prvisins... " 10 B. Attrney Fee Limits... " 10 C. Limitatins n Nnecnmic Damages... " 10 D. Limitatins n Punitive Damages E. Cllateral Surce Rule... " 10 F. Peridic Payment f Awards G. Medical Malpractice Screening Panels V. Cnclusin VI. Selected References VII. Appendices Appendix A Trt Refrm Recrd, The American Trt Refrm Assciatin, December Appendix B Limits n Damages, The American Trt Refrm Assciatin, February

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5 I. INTRODUCTION In recent years, the United States system f Civil Justice has been the fcus f much natinal debate. During the early 1980s the s called "insurance crisis" gave rise t a mvement cmmnly referred t as trt refrm. At the natinal level, the Reagan Administratin frmed an executive Trt Plicy Wrking Grup and the subject f trt refrm was declared a majr public plicy cncern. While interest has cntinued t ebb and flw at varying levels thrughut the Bush and Clintn administratins, the serius plicy actins have ccurred at the state level. As with many issues, the states have been the labratries fr experiments in trt refrm. In Nevada, trt refrm appears t be f substantial interest t state legislatrs in This interest is due t a number f factrs including allegatins f rising csts f insurance (particularly malpractice insurance), escalating health care csts, and reprts f increasing jury awards. Similar cncerns in the late 1980s led Nevada legislatrs t adpt limits n punitive damages and establish a medical malpractice screening panel. Trt refrm was a relatively quiet issue in the early 1990s but nw appears t be ebbing and peaking in terms f legislative and public interest. This backgrund paper prvides legislatrs with a basic guide t trt refrm and its many cmpnents. It analyzes the trt refrm mvement generally and discusses the status f varius trt refrm cmpnents in Nevada and ther states. The paper als highlights medical malpractice as it relates t trt refrm. The varius parts f trt refrm are cmplex and this paper des nt attempt t advcate r ppse them. The purpse f this paper is t make these cmplex issues understandable. II. OVERVIEW OF TORT REFORM ISSUES There is n useful definitin f a "trt," which will allw all trtius cnduct t be distinguished frm all nn-trtius cnduct. Black's Law Dictinary defines trt as a "civil wrng r injury, ther than a breach f cntract, fr which the curt will prvide a remedy in the frm f an actin fr damages." The verall purpse f trt law is t cmpensate a plaintiff fr an injury sustained as a result f the unreasnable cnduct f anther. The main cncept that distinguishes trt law frm ther laws, particularly cntract law, is that the law is nt based n the idea f cnsent. The bulk f trt law can be divided int three majr categries relating t the nature f the defendant's cnduct. Trts can be categrized as: (1) intentinal; (2) negligent; r (3) strict liability. Intentinal trts can be generally described as cnduct by a defendant that is intended t bring abut sme srt f physical r mental affect upn anther persn, but des nt 1

6 require a desire t harm that persn. Intentinal trts include assault, battery, false imprisnment, inflictin f mental distress, and varius frms f trespass. The mst cmmn type f trt actin in the United States is negligence. The essence f the trt f negligence is that the cnduct f the trt feasr impses an unreasnable risk upn thers. In cntrast t intentinal trts, where the trt feasr's mental state is an element f the trt, in negligence cases the trt feasr's mental state is irrelevant. In rder t establish a claim fr negligence, the plaintiff must shw that the defendant wed a duty t cnduct himself accrding t certain standards, that the defendant failed t cnfrm his cnduct t thse standards, that the plaintiff's harm is prximately caused by the defendant's act f negligence, and that the plaintiff has suffered actual damages. Strict liability is a frm f trt actin which is nt based upn intent r negligence. Rather, it is based upn the ntin that thse wh engage in certain kinds f activities d s at their wn peril and must pay fr any damages which result, even if the activity has been carried ut in the mst careful pssible manner. Strict liability is mst ften impsed in cases invlving abnrmally dangerus activities and prduct liability. Hwever, certain prduct liability claims are als funded upn theries f negligence rather than strict liability. In additin t the three majr categries f trts, ther miscellaneus trts include defamatin, interference with certain advantageus relatins, invasin f privacy, misrepresentatin, misuse f legal prceedings, and nuisance. There are tw mainstream theries that are used t ratinalize the trt system in America. First, the trt system is designed t cmpensate plaintiffs fr unreasnable harm. Secndly, the American trt system attempts t act as a deterrent fr certain kinds f cnduct. This thery is funded n the ntin that sciety must limit an excess f harm-causing behavir by impsing liability fr the negligent inflictin f harm. Trt law can induce peple wh are thinking f behaving negligently t recnsider their behavir. These arguments have bth ecnmic and scietal cmpnents. The structure f American trt law, and the theries behind its existence, create the backdrp upn which the substantive refrm in recent years has been played ut. Fr the past 2 decades, there has been steadily increasing criticism f the trt litigatin system--primarily because litigatin is an expensive mechanism fr cmpensating injured parties. Arguably, utcmes are randm and unpredictable. This unpredictability may defeat the system's intended gals f cmpensating plaintiffs, spreading the risk fairly, and mtivating safer behavir. The first wave ftrt refrm was triggered by a dramatic increase in the number and size f medical malpractice and prduct liability claims in the 1970s. This was fllwed by a mre general crisis f insurance availability and affrdability in the mid-1980s. 2

7 Many states have cnsidered and enacted varius trt refrm measures since that perid. The effectiveness f enacted refrms varies greatly and n ne state has cmprehensively addressed all cmpnents f s-called trt refrm. III. TORT REFORM COMPONENTS This sectin describes varius trt refrm measures that have been cnsidered by the U.S. Cngress and state legislatures in recent years. In additin t an explanatin f the varius cmpnents, this sectin discusses the status f such cmpnents in Nevada law and the trt laws f ther states. (See Appendix A fr a series f charts and lists that summarize state trt refrm cmpnents.) A. Jint and Several Liabilitv The rule f jint and several liability attempts t address the issue that arises where tw r mre defendants are liable fr a plaintiffs injury. Pure jint and several liability makes each f the defendants liable fr the entire amunt f damages regardless f their degree f respnsibility. Trt refrmers argue that this prduces an unfair utcme since a defendant wh is nly minimally respnsible fr a plaintiffs harm may have t pay the entire award because the defendant wh is principally respnsible is inslvent. The rule als creates the effect fr turning sme lawsuits int a search fr "deep pckets." Advcates f the trt system argue that jint and several liability is necessary because it increases the prbability that a seriusly injured r damaged plaintiff will be fully cmpensated. Trt refrmers prpse t ablish the rule f jint and several liability and adpt a rule f pure several liability. This rule wuld prvide that a party wuld be liable fr damages nly in an amunt prprtinate t his/her respnsibility fr a plaintiffs harm. Anther ptin prpsed by trt refrmers wuld hld a defendant jointly and severally liable fr a plaintiffs ecnmic damages (actual damages), but prprtinately liable fr a plaintiffs nnecnmic damages (emtinal distress, lss f cmpaninship, and pain and suffering). Flrida prvides an example f a state that has ablished joint and several liability as t nnecnmic damages. Other states, such as Hawaii and Illinis, have ablished the rule fr lw-fault defendants. Varius ther states have taken this apprach and the limitatins vary depending upn the percentage f fault attributed t the defendants. Utah and Wyming are examples f states that have ttally ablished jint and several liability. Nevada has ablished the rule f jint and several liability except in the fllwing cases: Cases invlving intentinal trts; Cases invlving txic waste; 3

8 Cases where the defendants are fund t have acted in cncert; and Prduct liability cases. The apprach taken by Nevada in ablishing jint and several liability, but creating certain exceptins appears t be the mst ppular refrm taken amng the states. B. Limitatins n Nnecnmic Damages Damages fr nnecnmic lsses are damages fr pain and suffering, emtinal distress, and lss f cnsrtium r cmpaninship. These damages are characterized as having n precise cash value. Trt refrmers argue that it is very difficult fr juries t assign a dllar value t these lsses and, as a result, awards tend t be erratic and, because f the highly-charged envirnment f persnal injury trials, excessive. Supprters f the current trt system argue that stripping r limiting the ability f the jury t determine damages is cntrary t the fundamental principles f a jury system. Currently, 14 states have placed dllar limits n recveries f nnecnmic damages in medical malpractice cases. Sme states have applied the nnecnmic damage cap in a manner t exclude cases f disfigurement r severe physical impairment frm the cap. Other states have limited the applicability f nnecnmic damage caps t persnal injury claims (see Appendix B fr a list f the varius limitatins n damages that states have impsed). The State f Nevada has n caps r restrictins n nnecnmic damages. C. Cllateral Surce Rule The cllateral surce rule has its rigins at cmmn law and prvides that evidence may nt be admitted at trial t shw that a plaintiffs lsses have been cmpensated frm ther surces. The American Trt Refrm Assciatin (ATRA) estimates that 35 percent f ttal payments t medical malpractice claims are fr expenses already paid frm ther surces. Trt refrmers argue that the cllateral surce rule has the effect f allwing a plaintiff duble recvery. They als argue that jurrs are ften mtivated t return a verdict in favr f the plaintiff, irrespective f the merits f the plaintiffs claims, if they are uncertain whether the plaintiff has the means t pay the bills cnnected with his injury. Supprters f the current trt system argue that the cllateral surce rule shuld be preserved since the right f subrgatin permits recupment f duplicative payments. Fr example, an insurance cmpany that has made payments t an insured wh has a persnal injury cause f actin is entitled t recup thse payments under the thery f subrgatin frm either the trt feasr r the insured. Als, insurance payments are a cntractual benefit that a plaintiff has bargained and paid fr and shuld nt be interfered with by the judicial system. 4

9 Accrding t the ATRA, 20 states have amended the cllateral surce rule since States have traveled dwn tw different avenues in refrming the cllateral surce rule; ne is t allw the evidence t be cnsidered and the ther is t mandate an ffset. First, sme states, such as Clrad and Kentucky, permit evidence f cllateral surce payments t be admitted at trial and cnsidered by the jury. Cllateral surce payments may then be ffset in certain circumstances, but it is nt mandatry. Secnd, states such as Flrida and New Yrk require the curt t reduce jury verdicts by the amunts f such cllateral payments. The State f Nevada fllws the cmmn law cllateral surce rule which prvides that evidence f cllateral surces may nt be admitted at trial. D. Punitive Damages Punitive damages are awarded nt t cmpensate a plaintiff, but t punish a defendant fr intentinal r malicius miscnduct and t deter similar future miscnduct. Prpnents f trt refrm argue that the frequency and severity f punitive damages has grwn in recent years. They argue that the impssibility f predicting damages that may be awarded in a particular case, and the trend tward excessive amunts when they are awarded, have seriusly distrted settlement and litigatin prcesses and have led t incnsistent utcmes amng similar cases. Twenty-nine states have recently amended their punitive damage laws. Five additinal states generally prhibit punitive damages except in very limited cases. States have taken varying appraches t punitive damage refrm. Illinis and Minnesta d nt permit a claim fr punitive damages in the plaintiffs cmplaint, but allw amendment befre trial n a shwing that there is a reasnable prspect they will be awarded. Other states require that awards be based n a "clear and cnvincing" evidence standard, rather than the usual prepnderance f the evidence standard. Califrnia requires a bifurcated trial in which the jury hears evidence supprting a claim fr punitive damages nly after it has fund the defendant liable fr cmpensatry damages. Eleven states have placed caps r limits n the amunt f punitive damage awards. Several states require that part f a punitive damages award be depsited in a state fund. The cnstitutinality f this apprach is currently being cnsidered by the U.S. Supreme Curt. The 1989 Nevada Legislature enacted SUbstantial amendments t the punitive damages prvisins. The Nevada law limits punitive damage awards t $300,000 in cases in which cmpensatry damages are less than $100,000. Punitive damage awards in cases where cmpensatry damages are $100,000 r mre are limited t three times the amunt f cmpensatry damages. The law creates a number f exceptins t the punitive damage cap. The limitatins d nt apply in cases against a manufacturer, distributr, r seller f a defective prduct; an insurer wh acts in bad faith; a persn wh vilates husing discriminatin laws; a persn invlved in a case fr damages caused by txic, radiactive r hazardus wastes; and a persn fr defamatin. 5

10 In additin, the revisin requires the higher standard f liability f "ppressin, fraud r malice." The law als requires punitive damages be established by "clear and cnvincing evidence." Finally, the revisins bifurcate trials, allwing financial evidence nly after a finding f liability. E. Prduct Liability As discussed earlier, the law f strict prduct liability is meant t cmpensate persns injured by unreasnably unsafe prducts withut regard t negligence r intent. Prpnents f trt refrm argue that this kind f trt liability is unfair because it hlds manufacturers liable even thugh they culd have dne nthing t avid a plaintiffs injury. States have taken a brad range f steps in the area f prduct liability refrm. Appendix A prvides a state-by-state and issue-by-issue summary f the status f trt refrm measures in state legislatures. Beginning n page 19, the publicatin prvides a listing f varius measures enacted by state legislatures t refrm prduct liability law. The American Trt Refrm Assciatin has an agenda which sets frth its views as t the necessary elements f any effective prduct liability refrm measure. It calls fr the fllwing: The measure will gvern all prduct liability actins, irrespective f the thery n which they are brught. It will permit a plaintiff t recver damages nly upn prf that the prduct was defective and that the defect was the cause f the harm. The statute shuld set ut clear rules fr determining when a prduct is defective, and clear standards fr establishing liability based n manufacturing defects, design defects, and warning defects. The fllwing clear rules shuld be included regarding prf f causatin: 1. A prduct has been defectively manufactured if it fails in relevant respects t cmply with the manufacturer's wn prduct specificatins. A prduct has been defectively designed nly if there was a feasible alternative design which wuld have avided the injury in questin withut materially altering the cnsumer's expected use and enjyment f the prduct. Als, the csts f incrprating the new precautin in the design must nt utweigh the human and financial harms preventable by the design; and 2. A prduct is defective fr failure t warn nly if the manufacturer failed t prvide infrmatin that a reasnable persn wuld have prvided based upn a risk identifiable at the time f manufacture. The statute shuld nt hld the manufacturer liable fr harm caused by a prduct that cannt be made entirely safe where the risk f using is knwn r shuld be knwn t prduct users. 6

11 The statute shuld nt hld the prduct sellers liable fr harm caused by a prduct unless they have cntrl ver the prduct's manufacture, its design, r the safety warnings that accmpany it. Finally, it will nt hld the manufacturer liable fr harm caused by a prduct after it has been ut f the manufacturer's cntrl fr sme perid f time (fr example, 10 years). F. Prejudgment Interest Nine states have enacted either a prhibitin f, r limitatins n, prejudgment interest. Iwa, Michigan, Minnesta, and Texas, have prhibited prejudgment interest n awards fr future damages. Luisiana, Maine, Nebraska, and Rhde Island have tied prejudgment interest and pst-judgment interest t certain gvernment rates (fr example, the U.S. Treasury Bill rate r the prime lending rate with flrs and caps). The State f Texas has limited the perid during which prejudgment interest may accrue if the defendant has made an ffer t settle. The State f Nevada has prhibited prejudgment interest n amunts representing future damages. Other interest n damages in trt cases, if nt established by the curt, are set by law at the prime lending rate plus 2 percent. G. Limitatins n Attrney Fees Under the traditinal American system, a plaintiffs attrney is paid n a cntingency basis in mst trt cases. Attrneys cllect an average f 33 percent f the plaintiffs award. Since financial incentives playa rle in lawyers' decisins whether r nt t accept trt cases, refrmers argue that limiting fees may reduce the number f cases filed and reduce frivlus cases. They als argue that since a paramunt gal f the trt system is t fully cmpensate plaintiffs, attrney fees that cme ut f the award shuld be limited. Supprters f the system argue that such limitatins are unnecessary and unfairly limit the parties' ability t cntract. Apprximately ne-half f the states either specify a limit n attrney fees r authrize the curts t set attrney fees. In mst cases, attrney fees are nt direct limits n the amunt attrneys can charge their clients. Rather, there are limits n the prtin f the damage award that may be applied tward attrney fees. Sme states make attrney fee limits nly applicable in medical malpractice cases and nt trt claims in general. Indiana, Michigan, Oklahma, Tennessee, and Utah place abslute limitatins n the percentage f the damage award that may be claimed by an attrney. These percentages range frm 15 percent in Indiana t 50 percent in Oklahma. Sme states have established a sliding scale that caps attrney fees. Fr example, in Califrnia, attrney fees are limited t 40 percent f the first $50,000, 33.3 percent f the next 7

12 $50,000, 25 percent f the next $50,000, and 15 percent f damages that exceed $600,000. The State f Nevada has n statutry limits n attrney fees in trt cases. H. Peridic Payments One trt refrm measure enacted in sme states requires that certain large damage awards r damages based n expenses that will be incurred ver a lifetime, be paid peridically. The argument in favr f this apprach is that it helps reduce the impact f large awards n defendants and insurers by allwing damages t be awarded accrding t a schedule f peridic payments. This apprach als reduces the risk that the plaintiff will deplete funds that are intended t be used t pay future medical and ecnmic csts. Oppnents f this apprach argue that it hinders the fundamental gal f trt law that plaintiffs be fully cmpensated fr damages in a timely manner. Apprximately 14 states have prvisins mandating peridic payments f future ecnmic damages, if damages exceed a threshld level. In mst cases, the threshld level is between $100,000 and $250,000. Anther 16 states allw fr, but d nt mandate, peridic payments. In these states, peridic payments can be requested by the parties; in thers, it can be impsed at the curt's discretin. The State f Nevada has n statutry prvisins addressing peridic payment f awards. Hwever, it appears the curt may have the judicial discretin t apprve such an arrangement, if agreed t by the parties. The curt may even have the authrity t rder such an arrangement under certain circumstances. The statutry law is silent in this regard. I. Medical Malpractice The issue f medical malpractice refrm has been pervasive in the late 1980s and early 1990s, due in part t the rising csts related t health care. With the exceptin f punitive damages and prduct liability, the majrity f the refrm measures discussed in this memrandum that apply t trts in general wuld als apply t medical malpractice claims. Punitive damages are nt awarded frequently in medical malpractice cases since they require prf f malicius cnduct n the part f the physician. Prduct liability refrm wuld apply t certain prducts manufactured within the health care field. Cllateral surces, jint and several liability, nnecnmic damages, peridic payments, and prejudgment interest are all applicable in medical malpractice cases, as they are t trts in general. All f these measures have been cnsidered t ne degree r anther, as they impact medical malpractice. Alternative dispute reslutin has received a great deal f attentin with regard t medical malpractice. Almst every state in the Natin has a 8

13 general arbitratin prvisin that can be applied t medical malpractice claims. Sixteen states have specific prvisins that require the use f arbitratin in medical malpractice prceedings. Nevada has established a mandatry pretrial screening panel. The purpse f this panel is t eliminate nn-meritrius suits. The panel's judgment des nt preclude the parties frm ging t curt. Hwever, findings f the screening panel are admissible in curt, and if the curt agrees with the screening panel's recmmendatins, the judgment must be issued accrdingly. Als, attrney fees and curt csts may be awarded against parties wh lse in curt after the screening panel has issued a nn-favrable decisin. The screening prcess in Nevada was first established in 1985 and appeared t have the effect f stabilizing bth the frequency and severity f medical malpractice claims. Hwever, in 1992 and 1993, the medical malpractice screening panel reprted a 40 percent increase in the frequency f claims. Accrding t reprts by Nevada's Divisin f Insurance, within the Department f Business and Industry, the severity f claims has als increased. Nevada dctrs paid apprximately $16 millin in medical malpractice insurance premiums in 1993 and the divisin's recrds indicate that fur large judgments against different Nevada dctrs during 1993 exceeded the ttal amunt f premiums paid by all Nevada dctrs in that year. IV. COMPARISON OF NEVADA AND CALIFORNIA TORT LAWS Many Nevada legislatrs have inquired abut the trt refrm cmpnents utilized in Califrnia, particularly with regard t medical malpractice. The fllwing chart prvides a summary cmparisn f trt refrm measures in Nevada and Califrnia. Attrney Caps n Caps n Cllateral Peridic Arbitratin Fee Nnecnmic Punitive Surce Payment Screening State Prvisins Limits Damages Damages Offset f Awards Panel NV Nne Nne Nne Yes Nne Nne Mandatry CA Yes Yes Yes N Discretinary Mandatry Nne The current trt refrm package in Califrnia was first enacted in 1975 and is cmmnly referred t as MICRA (Medical Injury Cmpensatin Refrm Act). What fllws is an explanatin and cmparisn f Nevada and Califrnia trt refrm elements with an emphasis n medical malpractice. 9

14 A. Arbitratin Prvisins All states have vluntary binding arbitratin prvisins in general, including Nevada and Califrnia. Hwever, sme states have enacted arbitratin prvisins specific t medical malpractice. Califrnia Cde f Civil Prcedure (CCCP), Sectin 1295, allws written cntracts fr medical services t include a mandatry binding arbitratin clause. The law prvides fr a limited right f appeal. Nevada des nt specifically address arbitratin because f the mandatry pretrial screening prcedure. B. Attrney Fee Limits Abut half f the states place a limitatin n the amunt r percentage f the damage award that may be cllected by a plaintiff's attrney in a medical malpractice case. In Califrnia, CCCP, Sectin 6146, limits cntingent fees t: 40 percent f the first $50,000; 33.3 percent f the next $50,000; 25 percent f the next $50,000; and 15 percent f damages that exceed $600,000. Other states prvide a maximum percentage regardless fthe amunt f the award. Nevada has n statutry limitatins. C. Limitatins n Nnecnmic Damages Sme states have placed a cap n nnecnmic damages such as payments fr disfigurement, emtinal distress, lss f cmpaninship, lss f enjyment, mental anguish, physical and emtinal pain, suffering, and ther nnpecuniary lsses. In Califrnia, CCCP, Sectin , limits nnecnmic damages t $250,000. Cmpensatry damages are nt limited. Nevada des nt place limitatins n nnecnmic damages. D. Limitatins n Punitive Damages The 1989, the Nevada Legislature limited punitive damages in mst civil cases, including medical malpractice, t $300,000 r three times the amunt f cmpensatry damages, whichever is greater. Because punitive damage awards require a finding f fraud, malice, r ppressin, they are rare in medical malpractice cases. Califrnia des nt limit punitive damages in medical malpractice cases. E. Cllateral Surce Rule Under traditinal rules f evidence, a defendant may nt intrduce evidence f the plaintiff's cllateral surces (e.g., insurance) that may cver sme f the plaintiff's lsses. Sme states have amended the cllateral surce rule regarding medical malpractice cases t either require the jury t ffset the award against cllateral surce payments r allw the defendant t intrduce cllateral surce evidence and allw the jury the discretin f ffsetting the award. In Califrnia, CCCP, Sectin , prvides the jury with the discretin t ffset damages against cllateral surces f 10

15 payments. Nevada fllws the traditinal cllateral surce rule and des nt allw cllateral surce evidence. F. Peridic Payment f Awards If a victim is severely injured, damages are based n medical and ther expenses that will be incurred ver a lifetime. Allwing peridic payments f such expenses ver time lessens the impact f large awards n malpractice carriers. In Califrnia, CCCP, Sectin 667.7, requires the curt, if requested by either party, t rder peridic payments fr any award f future damages in excess f $50,000. The curt may cnditin the payment schedule t accmmdate predictable variatins in the plaintiff's needs. Nevada law des nt prvide fr peridic payments, althugh it appears a judge may have the inherent authrity t apprve such an arrangement. G. Medical Malpractice Screening Panels Sme states, including Nevada, have established pretrial screening panels t review the merits f a case and assist in weeding ut nn-meritrius suits. (Discussed in detail in Sectin III f this paper). Certain states, like Nevada, require the use f screening panels while thers prvide that the use f the panels is vluntary. Califrnia des nt utilize pretrial screening panels. v. CONCLUSION Trts and trt refrm are cmplex and difficult issues. There are numerus arguments fr and against each f the cmpnents f trt refrm. Nevada legislatrs can expect t hear cntradictry evidence and zealus and frceful arguments frm the many different parties interested in these issues. Fllwing is a list f additinal materials that may be f assistance in cnsidering the varius trt refrm measures that may appear befre the Nevada Legislature. 11

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17 VI. SELECTED REFERENCES Adams, Edward A. "Tracking Jury Awards; Trt Refrm Grups Dispute Dwnward Trend," New Yrk Law Jurnal, Vl. 209, p. 5, January 14, American University Law Review, Vl. 42, Summer (Entire vlume devted t sympsium n civil justice refrm.) DeBenedictis, Dn J. "Punitives Under Cntrl; But Trt Refrm Bsters See Bias in Study Findings," ABA Jurnal, May Frankel, Jnathan J. "Medical Malpractice Law and Health Care Cst Cntainment: Lessns fr Refrmers frm the Clash f Cultures," Yale Law Jurnal, Vl. 103, pp , March Gldsmith, Lee S. "Medical Malpractice: Trt Refrm Unnecessary," Natinal Trial Lawyer, Vl. 5, p. 77, May Kanazawa, Sidney K. "Tward a Reasnable Basis fr Prduct Liability," Jurnal f Prducts and Txics Liability, Vl. 15, pp , Fall San Dieg Law Review, Vl. 30, Spring (Entire vlume devted t sympsium n trt refrm.) University f Hawaii Law Review, Vl. 15, Fall (Entire vlume devted t American Law Institutes Study f accident cmpensatin refrm.) Walthers, Dan. "Let a Millin Trt Actins Blssm" (Trial lawyers ppsitin t trt refrm), Califrnia Lawyer, Vl. 14, p. 39, February Majr Advcacy Grups Alliance f American Insurers American Trt Refrm Assciatin Natinal Trial Lawyers Assciatin 13

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19 VII. APPENDICES Page N. A. Trt Refrm Recrd, The American Trt Refrm Assciatin, December B. Limits n Damages, The American Trt Refrm Assciatin, February

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21 APPENDIX A Trt Refrm Recrd, The American Trt Refrm Assciatin, December

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