A $951 Million Judgment Cannot Nurse a Child -By Fransiscus Nanga Roka

A hospital is capable of destroying a child’s future. The courts are capable of assigning a large monetary value to that destruction. When the hospital operator goes bankrupt, what happens to the money for the care? The $951 million verdict in Utah against Steward Health Care demonstrates the large disconnect between the court’s ability to hold operators accountable, and the operator’s ability to provide the compensation.

On August 2025, Judge Patrick Corum of Utah’s third district awarded damages to Anyssa Zancanella, her partner and their daughter Azaylee for the catastrophic October 2019 birth injuries that Azaylee sustained at Jordan Valley Medical Center’s West Valley Campus. Judge Corum entered the default judgment after Steward failed to appear in the litigation and he heard testimony prior to making his ruling. This was a court decision and not a negotiated settlement or payment of funds.

The family’s attorneys state that although there were indications of fetal distress, two nurses in training for their positions gave Azaylee a dangerously excessive amount of Pitocin. The physician on-call was reportedly sleeping and could not be reached. It took over 30 hours for Azaylee to be delivered by C-Section. As a result, Azaylee has experienced hypoxic ischemic brain injury and will require long-term care. All these instances illustrate that several safety nets were not put into place; including medication administration, supervision, communication and emergency services.

Institutional escape route. Reducing this catastrophe to inexperienced nurses would be an institutional escape route. Hospital assignments of personnel, establishment of supervision and determination of whether emergency calls produce action must all lead to accountability in management offices. A clinical protocol that no one can enforce is nothing more than administrative decoration.

Yet the second failure emerges after the courtroom victory.

Steward filed for Chapter 11 on May 6, 2024. Its bankruptcy counsel later confirmed that it would file a plan of reorganization in July 2025 prior to the malpractice verdict. Thus, the issue of how Steward will pay for the verdict goes beyond the headline value of the verdict and into questions about what kind of insurance Steward has, whether there are any other available assets that could be used toward payment of the verdict, and how the verdict is handled within the context of Steward’s bankruptcy case. There is no certainty that a billion-dollar verdict means a billion-dollar recovery.

The picture gets even more complicated with damage caps. The courts in Utah have set a $450,000 cap on non economic damages from medical malpractice for claims made after May 15, 2010. This is not a cap on the total amount of money awarded to a plaintiff. And commentators shouldn’t assume that default or extremely severe negligence will automatically override the statutory cap. It takes a lawyer to look at each case and determine which type of claim and what damage category applies.

Reform must make compensation dependable before disaster strikes.

State legislatures should first require hospitals to provide independent verification of their malpractice insurance coverage and reserve funds that will be adequate to cover the costs of catastrophic injuries. In addition, hospitals’ licenses to operate should be dependent on proof that any promised financial protection will remain intact if the hospital becomes bankrupt.

Second, regulators must establish that individuals administering obstetric medications have demonstrated knowledge, that they are supervised by an individual who has experience, and that there exists an emergency escalation process which can be enforced. Audits must evaluate the actual response time and actions taken to correct deficiencies rather than the presence of policy manuals.

In addition to establishing the mechanism for funding of catastrophic injuries by the industry, lawmakers also need to create mechanisms that will provide temporary care for individuals injured in accidents while the issue of liability and/or bankruptcy is being resolved. While families may still have claims against the responsible party, there must be safeguards in place to prevent them from recovering twice for the same loss.

Fourth, the bankruptcy process needs to provide adequate representation for injured patients and examine potential recoveries from fraudulent transfers. Personal liability will depend upon evidence and applicable law; simply being a corporate officer is not enough.

At last, compensation must be assessed based on the benefits provided by the compensation program such as safe and consistent nursing care, assistance with managing seizures, access to rehabilitation services, accessible housing and respite care for family members who provide care.

Azaylee’s situation requires us to go beyond being upset by a huge number. If we have a legal system that recognizes permanent damage, then it should also acknowledge the fact that those who suffer this type of damage will require support throughout their lives. Otherwise, the loudest decisions of our courts may turn out to be nothing more than costly statements about how powerless we are.

Fransiscus Nanga Roka

Faculty of Law University 17 August 1945 Surabaya and Managing Partner Law Firm Victorious Indonesia