Title: MARGARET JENKINS V JAYESH KUMAR PATEL
Citation: N/A
Docket Number: 123957
State: Michigan
Issuer: Michigan Supreme Court
Date: July 26, 2004

_______________________________ 
 
 
 
 
 
 
 
 
 
 
 
 
 
Michigan Supreme Court 
Lansing, Michigan 
Chief Justice:  
Justices: 
Maura D. Corrigan  
Michael F. Cavanagh 
Elizabeth A. Weaver 
Marilyn Kelly 
Opinion 
Clifford W. Taylor 
Robert P. Young, Jr. 
Stephen J. Markman 
FILED JULY 26, 2004 
MARGARET JENKINS, as Personal
Representative of the ESTATE OF
MATTIE HOWARD, DECEASED, 
Plaintiff-Appellee, 
v 
 
No. 123957 
JAYESH KUMAR PATEL, M.D., and
COMPREHENSIVE HEALTH SERVICES,
INC., a Michigan Corporation,
doing businsess as THE WELLNESS
PLAN, Jointly and Severally, 
Defendants-Appellants. 
BEFORE THE ENTIRE BENCH 
MARKMAN, J.  
We granted leave to appeal to consider whether the 
medical 
malpractice 
noneconomic 
damages 
cap, 
MCL 
600.1483(1), applies to a wrongful death action where the 
underlying claim is medical malpractice. 
The jury awarded 
plaintiff $10 million in noneconomic damages. 
The trial 
court denied defendants’ motion for remittitur or a new 
trial, concluding that the medical malpractice noneconomic 
 
 
 
 
 
  
 
 
 
damages cap does not apply to wrongful death actions. 
The 
Court of Appeals affirmed. 
Because we conclude that the 
medical malpractice noneconomic damages cap does apply to 
wrongful death actions where the underlying claim is 
medical malpractice, we reverse the judgment of the Court 
of Appeals and remand this case to the Court of Appeals for 
consideration of the constitutional issues raised by 
plaintiff that were not resolved by the Court of Appeals in 
light of its analysis of the statutory issue. 
I. FACTS AND PROCEDURAL HISTORY 
Plaintiff brought this wrongful death action against 
defendants, seeking to recover damages for the death of her 
mother that allegedly resulted from defendants’ medical 
malpractice. 
Plaintiff’s decedent began treating with 
defendant Dr. Jayesh Patel shortly after being hospitalized 
for 
a 
stroke. 
Plaintiff 
contends 
that 
Dr. 
Patel 
negligently managed the decedent’s renal disease and 
hypertension, which ultimately led to her death. Plaintiff 
sought damages for the loss of society and companionship 
sustained by the decedent’s seven children and seven 
siblings. 
The jury awarded plaintiff $10 million in 
noneconomic damages. 
Defendants filed a motion for remittitur or for a new 
trial, arguing that the medical malpractice noneconomic 
2  
 
 
 
                                                 
damages cap, MCL 600.1483(1), requires a reduction in the 
damage award, and, in the alternative, that the award is 
excessive. 
The 
trial 
court 
held 
that 
the 
medical 
malpractice noneconomic damages cap does not apply to 
wrongful death actions. The trial judge further held that, 
although the award is excessive, he could not determine an 
appropriate amount of damages because he was not personally 
present at the trial to hear the testimony of the witnesses 
and judge their credibility.1  Therefore, he let the jury’s 
$10 million verdict stand. 
In a published decision, the 
Court of Appeals affirmed the trial court’s decision that 
the medical malpractice noneconomic damages cap does not 
apply to wrongful death actions.2
 The Court of Appeals, 
however, remanded the case to the trial court, holding that 
the trial court, having found the award to be excessive, 
must either set a remittitur amount or grant a new trial on 
damages only.3
 One of the judges on the panel wrote a 
1 The judge who presided over the jury trial was
subsequently appointed to a federal judicial position and
was no longer on the trial court at the time the motion for
remittitur or for a new trial was heard. 
2 256 Mich App 112; 662 NW2d 453 (2003). 
3 The Court of Appeals further instructed the trial
court that it could revisit its ruling concerning whether
the verdict was excessive if it acknowledged that its
(continued…) 
3  
 
 
 
 
 
 
 
                                                 
concurring opinion to emphasize her belief that the 
language of the wrongful death act precludes application of 
the medical malpractice noneconomic damages cap. 
We 
granted defendants’ application for leave to appeal.4 
II. STANDARD OF REVIEW 
Whether the medical malpractice noneconomic damages 
cap, MCL 600.1483(1), applies to a wrongful death action 
where the underlying claim is medical malpractice is an 
issue of statutory interpretation, which is a question of 
law that this Court reviews de novo. Morales v Auto-Owners 
Ins Co, (After Remand), 469 Mich 487, 490; 672 NW2d 849 
(2003). 
III. ANALYSIS 
MCL 
600.1483, 
also 
referred 
to 
as 
the 
medical 
malpractice noneconomic damages cap, provides, in pertinent 
part: 
(1) In 
an 
action 
for 
damages 
alleging
medical malpractice by or against a person or
party, 
the 
total 
amount 
of 
damages 
for 
noneconomic loss recoverable by all plaintiffs,
resulting from the negligence of all defendants,
shall not exceed $280,000.00 unless, as the 
result of the negligence of 1 or more of the
defendants, 1 or more of the following exceptions 
(…continued) 
previous ruling was "nondefinitive" in light of its concern 
at the time that it had not been present at trial.  
4 469 Mich 958 (2003). 
4  
 
 
 
 
 
 
 
 
 
 
 
apply as determined by the court pursuant to
section 
6304, 
in 
which 
case 
damages 
for 
noneconomic loss shall not exceed $500,000.00: 
(a) The plaintiff is hemiplegic, paraplegic,
or quadriplegic resulting in a total permanent
functional loss of 1 or more limbs caused by 1 or
more of the following: 
(i) Injury to the brain. 
(ii) Injury to the spinal cord. 
(b) The plaintiff has permanently impaired
cognitive capacity rendering him or her incapable
of making independent, responsible life decisions
and 
permanently 
incapable 
of 
independently
performing 
the 
activities 
of 
normal, 
daily
living. 
(c) There has been permanent loss of or
damage to a reproductive organ resulting in the
inability to procreate. 
(2) 
In 
awarding 
damages 
in 
an 
action 
alleging medical malpractice, the trier of fact
shall itemize damages into damages for economic
loss and damages for noneconomic loss. 
(3) As used in this section, “noneconomic 
loss” 
means 
damages 
or 
loss 
due 
to 
pain,
suffering, inconvenience, physical impairment, 
physical 
disfigurement, 
or 
other 
noneconomic 
loss. 
The 
wrongful 
death 
act, 
MCL 
600.2922, 
provides, 
in 
pertinent part: 
(1) Whenever the death of a person or 
injuries resulting in death shall be caused by 
wrongful act, neglect, or fault of another, and
the act, neglect, or fault is such as would, if
death had not ensured, have entitled the party
injured 
to 
maintain 
an 
action 
and 
recover 
damages, the person who or the corporation that
would have been liable, if death had not ensued, 
5  
 
 
 
 
 
 
 
 
shall be liable to an action for damages,
notwithstanding the death of the person injured,
and 
although 
the 
death 
was 
caused 
under 
circumstances that constitute a felony. 
(2) Every action under this section shall be
brought by, and in the name of, the personal
representative of the estate of the deceased 
person . . . . 
 
 
 
* * * 
(6) In every action under this section, the
court or jury may award damages as the court or
jury shall consider fair and equitable, under all
the circumstances including reasonable medical,
hospital, funeral, and burial expenses for which
the estate is liable; reasonable compensation for
the 
pain 
and 
suffering, 
while 
conscious,
undergone by the deceased person during the 
period intervening between the time of the injury
and death; and damages for the loss of financial
support 
and 
the 
loss 
of 
the 
society 
and 
companionship of the deceased. 
There is no common-law right to recover damages for a 
wrongfully caused death. 
Instead, the wrongful death act 
provides the exclusive remedy under which a plaintiff may 
seek damages for a wrongfully caused death. 
Courtney v 
Apple, 345 Mich 223, 228; 76 NW2d 80 (1956). That does not 
mean, however, that the wrongful death act is the only act 
that is applicable in a wrongful death action. 
For 
instance, the medical malpractice statute of limitations, 
MCL 600.5838a, applies to wrongful death actions where the 
underlying claim is medical malpractice because “in all 
actions brought under the wrongful death statute, the 
6  
 
 
   
                                                 
limitations period will be governed by the provision 
applicable to the liability theory of the underlying 
wrongful act.” 
Hawkins v Regional Medical Laboratories, 
PC, 415 Mich 420, 436; 329 NW2d 729 (1982); Waltz v Wyse, 
469 Mich 642; 677 NW2d 813 (2004). 
Additionally, actions 
brought under the wrongful death act “accrue as provided by 
the statutory provisions governing the underlying liability 
theory . . . .” 
Hawkins, supra at 437. Accordingly, when 
the underlying claim is medical malpractice, the medical 
malpractice accrual statute, MCL 600.5838a, applies to a 
wrongful death action. 
Further, this Court has recently 
applied 
the 
medical 
malpractice 
notice 
of 
intent 
requirement of MCL 600.2912b, the medical malpractice 
tolling 
provision 
of 
MCL 
600.5856(d), 
the 
medical 
malpractice 
affidavit 
of 
merit 
requirement 
of 
MCL 
600.2912d, and the medical malpractice expert witness 
qualification 
requirements 
of 
MCL 
600.2169(1)(a) 
to 
wrongful death actions. 
Waltz, supra; Grossman v Brown, 
470 Mich __; __ NW2d __ (2004); Halloran v Bhan, 470 Mich 
__; __ NW2d __ (2004).5 
5 The dissent is correct that neither this Court nor 
the parties in these cases addressed whether these medical
malpractice provisions apply to wrongful death actions;
their application was just assumed. Post at 7-8. 
(continued…) 
7  
 
 
 
                                                 
Clearly, the wrongful death act is not the only act 
that is pertinent in a wrongful death action. 
“The mere 
fact that our legislative scheme requires that suits for 
tortious conduct resulting in death be filtered through the 
so-called ‘death act’, MCL 600.2922; MSA 27A.2922, does not 
change the character of such actions except to expand the 
elements of damage available.” 
Hawkins, supra at 436. 
That is, a wrongful death action grounded in medical 
malpractice is a medical malpractice action in which the 
plaintiff is allowed to collect damages related to the 
death of the decedent. 
The statute at issue here, MCL 600.1483, specifically 
provides that it applies to “an action for damages alleging 
medical malpractice . . . .”6  Plaintiff’s action is clearly 
(…continued) 
See also Anthony v Forgrave, 126 Mich App 489, 493;
337 NW2d 546 (1983), in which the Court of Appeals held
that “in a wrongful death action, venue is determined
through 
application 
of 
the 
venue 
statutes 
governing
personal injury actions; focus is on the cause of action
which underlies the wrongful death claim.” 
6 The dissent contends that "the limitation on non­
economic damages does not always apply in an ‘action 
alleging medical malpractice,’” post at 7, as indicated by
MCL 
600.6098(1), 
which 
provides, 
“If 
the 
limitation 
applies, 
the 
court 
shall 
set 
aside 
any 
amount 
of 
noneconomic damages in excess of the amount specified in
section 1483.” 
[Emphasis added.] 
We agree that the cap
does not always apply in an action alleging medical 
(continued…) 
8  
 
 
 
 
 
 
                                                 
 
an 
“action 
for 
damages 
alleging 
medical 
malpractice 
. . . .” 
Section 1483(1). 
This fact is undisputed. 
Although the Court of Appeals recognized that “§ 1483 
applies 
in 
an 
action 
for 
damages 
alleging 
medical 
malpractice, and that the case before us, with respect to 
the subject matter from which the negligence arose, is such 
an action,” Jenkins v Patel, 256 Mich App 112, 122; 662 
NW2d 453 (2003), it went on to conclude that “the 
Legislature did not intend [§ 1483’s noneconomic] damages 
cap to limit those damages in a wrongful-death, medical­
malpractice action.” 
Id. at 125-126. 
It reached this 
conclusion on the basis that § 1483(3)’s definition of 
“noneconomic loss” does not specifically include losses 
related to wrongful death, such as loss of society and 
companionship. 
Section 1483(3) defines “noneconomic loss” as “damages 
or loss due to pain, suffering, inconvenience, physical 
impairment, physical disfigurement, or other noneconomic 
loss.” 
The 
wrongful 
death 
act, 
MCL 
600.2922(6), 
(…continued)
malpractice. 
Instead, the cap applies only in medical
malpractice actions in which the plaintiff is awarded an
amount of noneconomic damages that exceeds the pertinent
cap. The Legislature’s use of the word “if,” however, does
not, as the dissent contends, indicate that the cap never 
applies in a wrongful death action. 
9  
 
 
 
specifically provides that “the loss of the society and 
companionship of the deceased” is an available remedy in a 
wrongful death action. The Court of Appeals concluded that 
the damages referred to in § 1483(3) “relate to damages 
sustained by an individual surviving plaintiff rather than 
damages sustained by next of kin in a wrongful-death action 
. . . .” 
Jenkins, supra at 124. 
Thus, the Court of 
Appeals concluded that § 1483 is not meant to limit damages 
that a next of kin would seek for his own suffering, such 
as loss of society and companionship. 
The Court of Appeal’s reasoning is flawed, in our 
judgment, because it fails to give meaning to all the words 
of the statute and “[c]ourts must give effect to every 
word, phrase, and clause in a statute and avoid an 
interpretation that would render any part of the statute 
surplusage or nugatory.” 
State Farm Fire & Cas Co v Old 
Republic Ins Co, 466 Mich 142, 146; 644 NW2d 715 (2002). 
If the definition of “noneconomic loss” in § 1483(3) does 
not encompass damages sought by a next of kin under the 
wrongful death act for his own suffering, as the Court of 
Appeals concluded, then such definition also would not 
encompass such damages when sought by a next of kin of a 
plaintiff who survived the medical malpractice. If that is 
so, then the Legislature’s specific directive that § 1483 
10  
 
 
 
 
 
 
 
limits the total damages recoverable by “all plaintiffs” 
means nothing. 
However, this language has to mean 
something. 
In our judgment, the “all plaintiffs” language 
means that the plaintiff who most directly suffered from 
the medical malpractice is not necessarily the only 
plaintiff in a medical malpractice action. 
Rather, the 
“plaintiff’s” next of kin may also be plaintiffs in a 
medical malpractice action and they may seek damages for 
the losses that they have suffered as a result of the 
medical malpractice, such as the loss of society and 
companionship. Blackwell v Citizens Ins Co of America, 457 
Mich 662 , 664 n 1; 579 NW2d 889 (1998)(a plaintiff’s 
husband’s loss of consortium claim is derivative of the 
plaintiff’s medical malpractice claim). 
Furthermore, § 1483(3)’s definition of “noneconomic 
loss” is not limited to “damages or loss due to pain, 
suffering, 
inconvenience, 
physical 
impairment, 
[and] 
physical disfigurement . . . .” 
Rather, § 1483(3) 
specifically includes within the definition of “noneconomic 
loss” all the things mentioned above and “other noneconomic 
loss.” Therefore, just because a noneconomic loss, such as 
loss of society, is not specifically listed under § 
1483(3), does not mean that it is not a covered noneconomic 
loss. 
Section 1483(2) directs the trier of fact to 
11  
 
 
 
 
 
  
 
                                                 
“itemize damages into damages for economic loss and damages 
for noneconomic loss.” 
Noneconomic damages are subject 
either to the $280,000 cap or the $500,000 cap, while 
economic damages are not subject to either of these caps.7 
Damages awarded in an action for medical malpractice can 
obviously only be economic or noneconomic. 
The damages 
awarded in this case for loss of society and companionship 
are clearly noneconomic damages. Rusinek v Schultz, Snyder 
& Steele Lumber Co, 411 Mich 502, 504-505; 309 NW2d 163 
(1981)(loss of consortium, which is defined as including 
loss of society and companionship, is a noneconomic loss). 
This fact is undisputed. 
Accordingly, we agree with 
defendants 
that 
§ 
1483’s 
definition 
of 
“noneconomic 
losses,” which includes “other noneconomic loss,” includes 
noneconomic losses not specifically listed, including those 
sought by plaintiff’s next of kin for their own pain and 
suffering. 
Otherwise, a plaintiff’s next of kin would not 
be able to recover for such things as loss of consortium, 
7 Pursuant to MCL 600.1483(4), “[t]he state treasurer
shall adjust the limitation on damages for noneconomic loss
set forth in subsection (1) by an amount determined by the
state treasurer at the end of each calendar year to reflect
the cumulative annual percentage change in the consumer
price index.” 
The 2004 limitations are $366,000 and 
$653,500. 
See 
http://www.michigan.gov/documents/
nonecolimit101_3658_7.pdf. 
12  
 
 
 
 
 
 
 
loss of society, and loss of companionship in a medical 
malpractice action, and, as discussed above, a medical 
malpractice plaintiff’s next of kin can most certainly 
recover such damages. See Blackwell, supra. 
Further support for our conclusion that the medical 
malpractice noneconomic damages cap applies to a wrongful 
death 
action 
where 
the 
underlying 
claim 
is 
medical 
malpractice can be found in the allocation of liability 
statute, MCL 600.6304. Section 1483(1) refers expressly to 
§ 6304, stating that if the court determines, pursuant to § 
6304, that one of the enumerated exceptions apply, then the 
$500,000 cap, rather than the $280,000 cap, is applicable. 
Section 6304 provides, in pertinent part: 
(1) In an action based on tort or another 
legal theory seeking damages for personal injury,
property damage, or wrongful death . . . the 
court, unless otherwise agreed by all parties to
the action, shall instruct the jury to answer
special interrogatories or, if there is no jury,
shall make findings indicating both of the 
following: 
(a) The total amount of each plaintiff’s
damages. 
(b) The percentage of the total fault of all
persons that contributed to the death or injury
. . . . 
* * * 
(3) The court shall determine the award of 
damages to each plaintiff in accordance with the
findings under subsection (1), subject to any 
13  
 
 
 
 
reduction under subsection (5) . . . and shall
enter judgment against each party, including a
third-party defendant . . . . 
* * * 
(5) 
In 
an 
action 
alleging 
medical 
malpractice, the court shall reduce an award of
damages in excess of 1 of the limitations set
forth in section 1483 to the amount of the 
appropriate limitation set forth in section 1483.
The jury shall not be advised by the court or by
counsel for either party of the limitations set
forth in section 1483 or any other provision of
section 1483. [Emphasis added.] 
Section 6304(1), requiring the jury to allocate fault among 
all persons, expressly applies to wrongful death actions, 
because it explicitly states, “In an action based on . . . 
wrongful death . . . .” 
Section 6304(3) then requires the 
court to reduce the plaintiff’s award in all subject 
actions, including wrongful death actions, according to the 
jury’s allocation of fault and subject to any reduction 
required under subsection 5. 
As noted above, subsection 5 
is the subsection requiring the court to apply the 
noneconomic damages cap of § 1483. Thus, subsection 3 of § 
6304 incorporates the noneconomic damages cap of § 1483 
into wrongful death actions by ensuring that in any action 
subject to § 6304, expressly including wrongful death 
actions, the court will reduce the plaintiff’s verdict both 
on the basis of the allocation of fault and on the basis of 
14  
 
 
 
                                                 
 
  
§ 1483—the noneconomic damages cap for medical malpractice 
cases.8 
Plaintiff argues that the wrongful death act expressly 
precludes 
application 
of 
the 
medical 
malpractice 
noneconomic damages cap to wrongful death actions. 
As 
noted above, MCL 600.2922(6) provides, in pertinent part: 
In every action under this section, the 
court or jury may award damages as the court or
jury shall consider fair and equitable, under all
the circumstances including reasonable medical,
hospital, funeral, and burial expenses for which
the estate is liable; reasonable compensation for
the 
pain 
and 
suffering, 
while 
conscious,
undergone by the deceased person during the 
period intervening between the time of the injury
and death; and damages for the loss of financial 
8 The 1986 version of § 1483 provided, in pertinent
part: 
(1) In an action for damages alleging 
medical malpractice against a person or party
specified 
in 
section 
5838a, 
damages 
for 
noneconomic loss which exceeds $225,000.00 shall
not be awarded unless 1 or more of the following
circumstances exist: 
(a) There has been a death. 
The 1986 version of § 1483 capped noneconomic damages at
$225,000 unless one of seven exceptions, including death,
applied. Section 1483 was amended in 1993 to adopt a two­
tiered cap system. 
Under this two-tiered cap system, the
lower cap applies unless one of three exceptions, not
including death, applies. While the 1986 version of § 1483
specifically provided that the noneconcomic damages cap
does not apply to wrongful death actions, the current
version does not specifically provide that the cap does not
apply to wrongful death actions. 
15  
 
 
   
 
                                                 
support 
and 
the 
loss 
of 
the 
society 
and 
companionship of the deceased. 
Plaintiff argues that this provision governs damages in 
wrongful death claims, in such a manner that other 
provisions are rendered inapplicable. 
However, this Court 
has held that other statutory and common-law limitations on 
the amount of damages apply to wrongful death actions. For 
instance, 
comparative 
negligence 
principles 
and 
the 
collateral source setoff rule, MCL 600.6303(1), apply to 
wrongful death actions. 
Solomon v Shuell, 435 Mich 104; 
457 NW2d 669 (1990); Rogers v Detroit, 457 Mich 125; 579 
NW2d 840 (1998), overruled on other grounds by Robinson v 
Detroit, 462 Mich 439; 613 NW2d 307 (2000).9 
Contrary to plaintiff’s contention, § 1483 and § 
2922(6) are not incompatible. 
Notwithstanding § 1483, in 
accordance with § 2922(6), “[i]n every action under” the 
wrongful death act, “the court or jury may award damages as 
the court or jury shall consider fair and equitable,” 
including 
“reasonable 
compensation 
for 
the 
pain 
and 
suffering, while conscious, undergone by the deceased 
person during the period intervening between the time of 
9 The dissent is correct that neither this Court nor 
the 
parties 
in 
these 
cases 
addressed 
whether 
these 
limitations 
apply 
to 
wrongful 
death 
actions; 
their 
application was just assumed. Post at 8. 
16  
 
 
      
 
 
the injury and death; and damages for the loss of financial 
support and the loss of the society and companionship of 
the deceased.” 
Only after the court or jury has, in its 
discretion, awarded damages as it considers fair and 
equitable does the court, pursuant to § 6304(5), apply the 
noneconomic damages cap of § 1483. This is made explicitly 
clear in § 6098(1), which states: 
A judge presiding over an action alleging
medical malpractice shall review each verdict to
determine 
if 
the 
limitation 
on 
noneconomic 
damages provided for in section 1483 applies. If 
the limitation applies, the court shall set aside
any amount of noneconomic damages in excess of 
the amount specified in section 1483. 
Section 6304(5) similarly provides: 
In an action alleging medical malpractice,
the court shall reduce an award of damages in
excess of 1 of the limitations set forth in 
section 1483 to the amount of the appropriate
limitation set forth in section 1483. The jury
shall not be advised by the court or by counsel
for either party of the limitations set forth in
section 1483 or any other provision of section
1483. 
Although § 1483 reduces the damages awarded by the trier of 
fact, it does nothing to impinge upon the trier of fact’s 
ability 
to 
determine 
an 
amount 
that 
is 
“fair 
and 
equitable.” 
That is, § 1483 does not diminish the ability 
of the trier of fact to render a fair and equitable award 
of damages; it merely limits the plaintiff’s ability to 
recover the full amount awarded in cases where the cause of 
17  
 
 
 
 
 
 
action is based upon medical malpractice and the amount 
exceeds the cap. 
See Phillips v Mirac, Inc, 470 Mich 415; 
__ NW2d __ (2004). 
As the Court of Appeals in Zdrojewski v Murphy, 254 
Mich App 50, 76; 657 NW2d 721 (2002), quoting Phillips v 
Mirac, Inc, 251 Mich App 586, 594; 651 NW2d 437 (2002), 
aff’d 470 Mich 415; __ NW2d _(2004), explained when it held 
that the noneconomic damages cap does not violate a 
plaintiff’s right to a jury trial, the noneconomic damages 
cap “‘does not impinge on a jury’s right to . . . 
determine[e] . . . the amount of damages . . . incurred.’” 
Instead, it “‘only limits the legal consequences of the 
jury’s finding.’” 
That is, “‘[o]nce the jury has reached 
its verdict, the trial judge merely enters a judgment on 
the verdict that is consistent with the law.’” 
Id. at 76­
77. 
“Plaintiff was able to try this case in front of a 
jury that rendered a verdict awarding plaintiff damages. 
Because MCL 600.6304(5) prohibits the trial court from 
informing the jury of the noneconomic damages limitation of 
MCL 600.1483, the jury rendered its damages award on the 
basis of the facts of the case, unaware of the limitation 
of the statute.” 
Id. at 77. 
Accordingly, the noneconomic 
damages cap does not violate a plaintiff’s statutory right 
18  
 
 
 
 
 
                                                 
 
 
to have the court or jury “award damages as the court or 
jury shall consider fair and equitable.” Section 2922(6). 
IV. CONCLUSION 
We conclude that the medical malpractice noneconomic 
damages cap does apply to wrongful death actions where the 
underlying claim is medical malpractice.10  Accordingly, we 
reverse the judgment of the Court of Appeals and remand 
this case to the Court of Appeals for consideration of the 
constitutional issues raised by plaintiff, which were not 
resolved by the Court of Appeals in light of its analysis 
of the statutory issue.11 
Stephen J. Markman
Maura D. Corrigan
Elizabeth A. Weaver 
Clifford W. Taylor
Robert P. Young, Jr. 
10 Because no allegation has been made that plaintiff
was 
hemiplegic, 
paraplegic, 
quadriplegic, 
or 
had 
permanently impaired cognitive capacity, or that there had
been permanent loss of or damage to a reproductive organ
because of defendants’ medical malpractice, we conclude
that the lower cap applies. 
Cf. Shinholster v Annapolis
Hosp, 471 Mich __; __ NW2d __ (2004). 
11 Because we conclude that the medical malpractice
noneconomic damages cap applies to actions filed under the
wrongful death action where the underlying claim is medical
malpractice, and because defendants have not argued that an
award so capped is excessive, noneconomic damages in this
case must be reduced in accordance with § 1483, consistent
with this opinion. 
19  
 
 
 
 
 
 
 
 
 
 
 
_______________________________ 
 
 
 
 
v 
S T A T E O F M I C H I G A N  
SUPREME COURT  
MARGARET JENKINS, as personal
representative of the Estate
of Mattie Howard, deceased, 
Plaintiff-Appellee, 
No. 123957 
JAYESH KUMAR PATEL, M.D., and
COMPREHENSIVE HEALTH SERVICES,
INC., a Michigan Corporation,
d/b/a THE WELLNESS PLAN,
jointly and severally, 
Defendants-Appellants. 
KELLY, J. (dissenting). 
I disagree with the majority's conclusion that the 
medical malpractice noneconomic damages cap applies to 
wrongful death actions. 
The Court of Appeals analysis and 
decision concerning this issue were correct and should be 
affirmed. 
Statutory Interpretation 
This Court has often repeated the proper approach to 
interpreting statutes. We recently stated: 
"The 
paramount 
rule 
of 
statutory
interpretation is that we are to effect the 
intent of the Legislature. 
Tryc v Michigan
Veterans' Facility, 451 Mich 129, 135; 545 NW2d
642 (1996). To do so, we begin with the statute's 
 
 
 
                                                 
language. If the statute’s language is clear and
unambiguous, 
we 
assume 
that 
the 
Legislature
intended its plain meaning and we enforce the
statute as written. 
People v Stone, 463 Mich
558, 562; 621 NW2d 702 (2001). 
In reviewing the
statute's language, every word should be given
meaning, and we should avoid a construction that
would render any part of the statute surplusage
or nugatory. Altman v Meridian Twp, 439 Mich 623,
635; 487 NW2d 155 (1992)." [Omelenchuk v City of 
Warren, 466 Mich 524, 528; 647 NW2d 493 (2002),
quoting Wickens v Oakwood Healthcare Sys, 465
Mich 53, 60; 631 NW2d 686 (2001).]
The Wrongful Death Act 
The wrongful death act1 is the exclusive remedy in 
wrongful death cases. Courtney v Apple, 345 Mich 223, 228; 
76 NW2d 80 (1956). The Court of Appeals correctly reasoned 
that the medical malpractice noneconomic damages cap found 
in MCL 600.1483 does not apply to actions brought under the 
act. Jenkins v Patel, 256 Mich App 112; 662 NW2d 453 
(2003). 
Furthermore, the Court of Appeals concurring 
opinion of Judge Kelly underscores that a plain language 
reading of the act precludes the application of the MCL 
600.1483 cap. 
The wrongful death act was passed to ensure the 
preservation of claims that, at common law, would have 
terminated with the death of the victim or the tortfeasor. 
Hawkins v Regional Medical Laboratories, PC, 415 Mich 420, 
1 MCL 600.2922. 
2  
 
 
 
                                                 
428-429; 329 NW2d 729 (1982). To ensure the survival of a 
claim, a wrongful death claim must be filed in conformity 
with the provisions of the act. 
An injured plaintiff may file suit under other 
statutory provisions. However, if he dies in the course of 
litigation, to recover damages for the death, his estate 
must file a claim under the wrongful death act. MCL 
600.2921. The act contains no cap on the damages available. 
See MCL 600.2922. It was not amended by tort reform 
legislation.2 
In this case, the decedent's estate sought damages for 
losses sustained by the decedent's seven children and seven 
siblings. A malpractice action brought on behalf of the 
decedent had she been alive would not have survived her. 
Plaintiff had no alternative but to file suit under the 
wrongful death act. 
The act contains the substance, procedures, and the 
measure of damages in an action brought against one who has 
caused the death of another. 
2 The most recent amendment to the wrongful death act
occurred in 2000. This amendment made modifications to the 
statute in conformity with the Estates and Protected 
Individuals Code. 
MCL 700.1101 et seq. 
Before that, the
statute was amended in 1985. It was not amended in 1995,
when tort reform legislation was passed. 
3  
 
 
 
MCL 600.2922(6) provides: 
In every action under this section, the
court or jury may award damages as the court or
jury shall consider fair and equitable, under all
the circumstances including reasonable medical,
hospital, funeral, and burial expenses for which
the estate is liable; reasonable compensation for
the 
pain 
and 
suffering, 
while 
conscious,
undergone by the deceased person during the 
period intervening between the time of the injury
and death; and damages for the loss of financial
support 
and 
the 
loss 
of 
the 
society 
and 
companionship of the deceased.
Indisputably, plaintiff's action is governed by the 
specific provisions of the act. I agree with the Court of 
Appeals majority that 
standing alone, the [wrongful death act]
mandates recovery in any amount, limited only by
the requirement that the amount be fair and 
equitable, 
for 
noneconomic 
losses, 
including
those for loss of society and companionship.
Without taking into consideration the damages cap
. . . the [act] clearly and unambiguously governs
a medical-malpractice action involving death and
the accompanying request for damages. This was
clearly the Legislature's intent in enacting the
[act]. Tort-reform legislation, which included 
the damages cap, did not result in any amendment
of the [act]. [Jenkins, supra at 119-120.]
In 
short, 
the 
only 
limitation 
intended 
by 
the 
Legislature on noneconomic damages under the wrongful death 
act is that the amount be fair and equitable. 
The Medical Malpractice Noneconomic 
Damages Cap Statute 
I agree with Court of Appeals Judge Kelly that the 
wrongful death act and the medical malpractice damages cap 
4  
 
 
statute need not be read in pari materia. The statutes 
serve different purposes. The medical malpractice damages 
cap serves to limit liability in a medical malpractice 
action. As stated above, the wrongful death act provides 
for the survival of an action once the victim dies. It 
allows the estate to recover damages for the value to the 
estate of the life of the deceased. While the Legislature 
could have made the medical malpractice damages cap 
expressly applicable to wrongful death actions, it chose 
not to do so. 
The wrongful death act specifically provides for 
damages in actions filed in accordance with its provisions. 
See MCL 600.2922(6). 
Just as this Court should not expand 
the remedies available under the act, it should not narrow 
them, absent an explicit indication that the Legislature 
intended it. 
If the Legislature wanted the medical malpractice 
damages cap statute to apply in wrongful death actions, 
some indication of that intention would be present in the 
language of the wrongful death act. Furthermore, although 
the 
Legislature 
was 
aware 
of 
the 
exclusive 
damages 
provision in the wrongful death act, it made no reference 
to a limitation on damages in the medical malpractice 
noneconomic damages cap statute. 
5  
 
 
 
 
The Legislature is presumed to have knowledge of 
existing laws. 
It is assumed to have measured the effect 
of new laws on all existing laws. Walen v Dep't of 
Corrections, 443 Mich 240, 248; 505 NW2d 519 (1993). It is 
presumed to know that the wrongful death act provides 
specifically and exclusively for damages in wrongful death 
claims. 
Therefore, it is significant that the Legislature 
declined the opportunity to list death as an injury subject 
to the damages cap in either the wrongful death act or the 
medical malpractice noneconomic damages cap statute. The 
inference is strong that the damages cap does not apply in 
wrongful death cases arising from underlying medical 
malpractice claims. 
Other Legislation 
The Legislature has specifically addressed death in 
other legislation. In the products liability cap act, MCL 
600.2946a, 
a statute analogous to the damages cap, the 
Legislature 
not 
only 
specifically 
addressed 
death, but identified death as one of the two
injuries that results in the second-tier cap: 
"In an action for product liability,
the total amount of damages for noneconomic loss
shall not exceed $280,000.00, unless the defect
in the product caused either the person's death
or permanent loss of a vital bodily function, in
which case the total amount of damages for 
6  
 
 
 
noneconomic loss shall not exceed $500,000.00."
[MCL 600.2946a(1).]
Thus, while the Legislature was clearly
aware that death is a possible injury in medical­
malpractice claims just as in products-liability
claims, it chose not to identify it as an injury
subject to the damages cap. 
[Jenkins, supra at 
135-136 (Kelly, J., concurring).] 
MCL 600.6098(1) lends support to the plaintiff's 
argument. The language of this section requires a judge 
presiding over an action alleging medical malpractice to 
determine 
if the limitation of noneconomic damages
provided for in section 1483 applies. If the
limitation applies, the court shall set aside any
amount of noneconomic damages in excess of the 
amount specified in section 1483.
The Legislature's use of the word "if" in MCL 
600.6098(1) suggests that the limitation on noneconomic 
damages does not always apply in an "action alleging 
medical malpractice." This language supports the conclusion 
that the medical malpractice damages cap does not apply in 
wrongful death actions. 
The majority claims that this section means that the 
cap is applicable only where the amount of a damage award 
exceeds the damages cap. It believes that the limitation 
does not apply if the jury award is less than the damages 
cap amount. I disagree. The cap is applicable even in that 
case. 
When it has not been necessary to reduce the award, 
the cap is unapplied, not inapplicable. 
7  
 
 
 
 
                                                 
 
 
The majority references cases in which, it says, this 
Court has applied other statutes to the wrongful death act. 
Ante at 7. See Halloran v Bhan 470 Mich ___; ___ NW2d ___ 
(2004); Grossman v Brown, 470 Mich ___; ___ NW2d ___ 
(2004). 
This is accurate; however, the issue was not 
raised in those cases. The issue in Halloran and Grossman 
was not whether the statutes mentioned were properly 
applied to claims made under the wrongful death act. 
The 
parties in those cases raised questions involving medical 
malpractice expert witness's qualifications to testify. The 
parties did not question whether the statutes in question 
applied to the wrongful death act. 
Likewise, contrary to the majority's characterization 
of Solomon3 and Rogers,4 this Court did not hold "that other 
statutory and common-law limitations on the amount of 
damages apply to wrongful death actions." Ante at 15-16. 
Again, those cases involved different issues. 
Rogers 
involved 
questions 
of 
governmental 
immunity, 
attorney 
misconduct, and various evidentiary claims. The only 
reference to wrongful death is in the factual background of 
the case. Solomon involved whether certain evidence was 
3 Solomon v Shuell, 435 Mich 104; 457 NW2d 669 (1990). 
4 Rogers v Detroit, 457 Mich 125; 579 NW2d 840 (1998). 
8  
 
 
 
                                                 
admissible under an exception to the hearsay rule. It also 
involved the application of the rescue doctrine. Again, 
reference to the wrongful death nature of the case is 
mentioned only in the factual background. While the Court 
assumed the application of these statutes, that is a far 
cry from deciding an issue raised by the parties. 
Furthermore, whether the savings provision in the 
wrongful death act5 applies to medical practice actions6 has 
little bearing on whether the Legislature intended that the 
damages cap statute applies. 
The wrongful death act 
specifically references the relevant statute of limitations 
provision of the underlying claim. 
MCL 600.5852; Waltz v 
Wyse, 469 Mich 642, 658-659; 677 NW2d 813 (2004) (Cavanagh, 
J., dissenting). 
Conclusion 
The Legislature made no mention in the wrongful death 
act to there being a cap on damages available under it. No 
other act, including MCL 600.1483, makes the medical 
malpractice damages cap applicable to wrongful death 
actions. 
I conclude that the Legislature did not intend 
5 MCL 600.5852.  
6 See Waltz v Wyse, 469 Mich 642; 677 NW2d 813 (2004).  
9  
 
 
 
 
that the medical malpractice damages cap should be applied 
to wrongful death actions. 
Therefore, the Court of Appeals analysis and decision 
regarding this issue should be affirmed. 
Marilyn Kelly
Michael F. Cavanagh 
10