After hours of testimony, state lawmakers yesterday deferred action on a series of proposals aimed at placing a cap on monetary damages patients can be awarded in medical malpractice lawsuits.

The House Judiciary Committee considered several bills that would address medical malpractice lawsuits and the amount of damages patients can claim. After more than six hours of testimony, the committee deferred action at 8:10 last night ahead of another hearing March 3.

State Rep. Jon Riki Karamatsu, D-41st (Waipahu, Village Park, Waikele), chairman of the House Judiciary Committee, proposed the package of bills designed to recruit and retain doctors and to reduce their medical malpractice insurance liability.

Karamatsu proposed a $250,000 cap on noneconomic damages in malpractice claims, such as for emotional distress and loss of companionship.

The state already has a $375,000 cap on pain and suffering.

The proposal also would limit monetary awards for noneconomic damage caused by gross negligence to $3 million and requires a healthcare provider to disclose to patients adverse events relating to their medical treatment.

The measure would also require the Hawai'i medical board to collect and publish information about physicians licensed in the state to allow consumers to make informed decisions in selecting physicians.

Another proposal would set a $1 million cap on noneconomic damages for specialists such as neurologists and neurosurgeons.

"We're taking a look at amending the bills," Karamatsu said. "The arbitrary cap concerns a number of us."

Similar proposals died last year after state lawmakers decided that doctors did not conclusively link caps on damages to lower malpractice insurance premiums or an easing of the shortage of specialists in poor and rural areas.

"I'm open to us continuing the discussion. I'm still skeptical to whether this is going to do anything," said House Majority Leader Blake Oshiro, D-33rd ('Aiea, Halawa Valley, 'Aiea Heights). "I still have a lot of questions about whether caps are what we need to do."

Doctors want a cap on noneconomic damages, such as for emotional distress and loss of companionship, in malpractice lawsuits by patients to contain unpredictable jury awards.

"Tort reform will increase reimbursements and lower malpractice premiums, and a major reason why is the factor of defensive medicine" Dr. Gary A. Okamoto, president of the Hawaii Medical Association, said in written testimony submitted to the committee. "Defensive medicine ... is providing medical services that are not expected to benefit the patient but that are undertaken to minimize the risk of a subsequent lawsuit."

Doctors say a cap on noneconomic damages will lower malpractice insurance premiums and reduce some of the uncertainty about malpractice lawsuits, which could help persuade more doctors to practice in rural areas or work on-call and emergency room shifts.

Attorneys who often represent plaintiffs in medical malpractice suits oppose the caps, saying that the chance for a large payday is needed for the small percentage of victims who suffer catastrophic, life-altering injuries.

Doctors are not deterred by malpractice premiums, as evidenced by the 873 doctors who have become licensed in Hawai'i from 2000 to 2008, marking a 30 percent increase.

Collin M. "Marty" Fritz, a Honolulu attorney who represents medical malpractice victims, said there were only 40 malpractice complaints filed in Hawai'i last year, and that the likelihood of malpractice awards driving doctors from the state is overstated.

Victims who suffer devastating injuries and require permanent, expensive medical attention would be hurt by award caps, he said.

"The Hawai'i (insurance) premiums are low, comparatively (to the Mainland)," Fritz said. "The caps take away the ability for a jury to look at it on a case-by-case basis."