Senate Rejects Cap on Malpractice Awards : Congress: Lawmakers approve some restrictions. But they turn down a measure that would have set a $500,000 limit for victims’ ‘pain, suffering.’

The Senate approved several modest restrictions on medical malpractice awards Tuesday, but rejected a strict, California-style cap on the amount that can be received by victims of botched operations or bungling by doctors and hospitals.

So far, the Senate is steering a somewhat more moderate course than the House as it heads toward a vote on what would be the first-ever national rules for personal-injury lawsuits. But backers of the broad liability bill are still not sure that they have the 60 votes needed to shut off debate in the Senate.

The answer likely will come later this week.

In March, the Republican-led House started with a modest bill that limited lawsuits dealing with defective products and quickly expanded it to cover all civil damage suits. Punitive damages--which are awarded to punish and deter wrongdoing--were limited in all cases to three times the victim’s economic losses, while medical malpractice awards for “pain and suffering” were capped at $250,000.

But that measure, especially the cap on malpractice awards for pain and suffering, was seen as too radical to win passage in the Senate.

On Tuesday, the upper chamber, on a 56-44 vote, turned down a measure that would have set a $500,000 limit for pain and suffering by malpractice victims.

However, the senators approved a package of changes that would reduce malpractice awards by the amount already covered by the victim’s insurance and make clear that doctors, hospitals and drug makers need pay for only their share of the liability.

While punitive damages in medical cases are rare, the Senate also voted to limit these awards to no more than twice the amount awarded to compensate a malpractice victim.

The mixed result was greeted with dismay by physicians, but it won applause from a coalition representing hospitals, drug makers, medical specialists and insurers.

James S. Todd, president of the American Medical Assn., said he was “disappointed” with the defeat of the cap on pain-and-suffering awards, but he pledged that his group would “aggressively lobby” to revive the proposal when a House-Senate conference committee takes up both versions of the bill.

“For the first time in our nation’s history, elements of health care and medical malpractice liability reform have won passage in both the House and Senate,” said Martin J. Hatlie, chairman of the Health Care Liability Alliance, the medical coalition.

While the proposed restrictions on medical liability were seen as a stark change in the law for much of the nation, California already has adopted most of them, including the limit on pain-and-suffering awards.

Critics said the limit, adopted in 1975, has not helped cap inflation in health care costs but has blocked some horribly injured persons from receiving adequate compensation for suffering caused by doctors or hospitals.

Consumer advocate Ralph Nader denounced the Senate’s restrictions on malpractice awards and cited studies showing that more than 80,000 people die every year as a result of negligence in hospitals. Only a small fraction of those injured by medical bungling ever file lawsuits, he added.

After completing work on the medical section of the bill, the Senate took up an amendment by Majority Leader Bob Dole (R-Kan.) that would limit punitive-damage awards in all civil cases to twice the amount given to compensate the plaintiffs. The House has already approved a similar limit, but Sen. John D. (Jay) Rockefeller IV (D-W. Va), a co-sponsor of the bill to limit punitive awards in product-liability cases, said he fears that an across-the-board limit will drive away votes needed for final passage.

Because it takes 60 votes to shut off debate in the Senate, a minority of the body can block legislation.