The state House Judiciary Committee approved a bill yesterday that could lead to additional caps on noneconomic damages in medical malpractice claims against doctors in five specialties vulnerable to lawsuits.

The vote was a significant hurdle for doctors and other supporters of malpractice reform, since similar bills have died before the committee in the past. The bill was drafted as a compromise to get House approval and to encourage talks with the state Senate, where many senators are opposed.

Advocates believe the bill addresses one key reason for the flight of some doctors from the Islands. Yesterday's action positions the bill for a full House vote after several years where malpractice reform has idled.

The bill would create a medical malpractice task force that would recommend caps on non-economic damages, such as emotional distress and loss of companionship, to lawmakers before the 2010 session. A separate medical malpractice insurance rate commission would recommend reasonable market-price malpractice insurance rates.

Lawmakers, responding to a request from the Hawai'i Medical Association, chose to cover doctors who practice emergency medicine, neurological surgery, obstetrics and gynecology, orthopedic surgery and general surgery.

The bill would expire in 2014, when it is hoped that data will show whether caps on damages reduce malpractice insurance rates and help persuade specialists to practice in Hawai'i.

"We really wanted to make the bill workable. Hopefully, we can talk to the Senate and see what they like and don't like," said state Rep. Jon Riki Karamatsu, D-41st (Waipahu, Village Park, Waikele), the committee's chairman. "I had to adjust it in order to get it out of the House. There were concerns from some of my members. They felt that caps wouldn't affect doctor retention."

The bill initially would have placed a $250,000 cap on non-economic damages in each speciality. It would have set a $3 million award limit on non-economic damages in cases of gross negligence.

TARGET OF CRITICISM

Karamatsu, who took over the committee this session, had promised to try to move a malpractice reform bill. The committee's former chairman — Tommy Waters, who declined to seek re-election last year — was the target of attacks by doctors, conservatives, talk radio hosts and newspaper editorial pages for refusing to hear malpractice reform last session after a bill died in committee in 2007.

Many state Capitol insiders thought Waters unfairly received the brunt of the criticism when it was clear there were not enough votes in the House and Senate to pass malpractice reform.

Doctors, many lawmakers say, have yet to prove that caps on damages lower malpractice insurance premiums or keep doctors from leaving the state. The state already has a $375,000 cap on pain and suffering, but doctors argue that lawyers can get around that cap by pursuing claims for emotional distress or loss of companionship.

The bill passed in committee yesterday seeks to address a complaint from trial lawyers that caps would unfairly limit victims of malpractice from recovering the full costs of medical errors. The bill would lift the caps on noneconomic damages if a victim's economic damages, such as lost wages and benefits, are less than $1.5 million.

Bob Toyofuku, a lobbyist for the Hawai'i Association for Justice, which includes trial lawyers, points out that the number of doctors in Hawai'i has increased. The shortage of specialists in rural areas and the Neighbor Islands is due to several factors, he said, including low reimbursement rates from state and private insurers and quality of life issues.

"All of our information shows that doctors have increased in Hawai'i rather than decreased," Toyofuku said. "So they have to show who is leaving, why they're leaving. And as far as we know, it's not because of medical malpractice."

Kathy Campbell of Kailua, a grandmother and advocate with Save Our Doctors, told lawmakers yesterday that malpractice reform would help keep doctors in Hawai'i. She said it is the patients who suffer from the shortage of specialists.

"We are the ones who lose out when doctors leave the state," she said.