A Billion Dollar Judgment Cannot Buy Justice Without Money -By Fransiscus Nanga Roka

A child may have been catastrophically injured in a court can still leave her family staring into financial ruin. Steward Health Care is getting the most expensive judgment ever for a Connecticut medical malpractice suit, but we still face an unacceptable hole in American medicine, justice doesn’t mean much if you can’t pay to power your care.

A jury in August 2025 ordered damages to Anyssa Zancanella, her partner and daughter Azaylee after a botched delivery at Jordan Valley Medical Center’s West Valley campus in October 2019 when the hospital was owned by Steward. The award was extraordinary. Another issue was whether the family would be able to collect.

The family’s lawyers depicted in the lawsuit guiltless nurses giving dangerously high doses of Pitocin, and an unresponsive on-call physician who was asleep while fetal distress went ignored. After over 30 hours in the hospital, a c-section was performed. Azaylee has hypoxic-ischemic brain injury and needs 24-hour care. The allegations paint multiple failed safeguards, not just one bad judgment call.

The procedural distinction matters. It was a default judgment after Steward stopped participating, and then its lawyers quit. Before awarding damages, Corum nevertheless heard a wealth of testimony. The ruling did not simply create a billion-dollar judgment against them for which they had failed to show up in court.

Asset creation is not a remedy for a damages judgment. Bankruptcy usually prevents litigation or collection against a debtor, except as authorized by the court. It may still be possible to establish liability and obtain a judgment, but unless this is paid the only remedy will come through available assets, insurance policies or consequential bankruptcy orders.

The insurance arrangements of Steward add to the worry. In August, 2024, The Boston Globe published an investigation of TRACO (an acronym for the company), its Panama-based captive insurer which then possessed just $3.5 million cash while facing 517 pending or unpaid malpractice claims. The books had significant amounts of loans and receivables payable by Steward. These are historical figures; not a validated current balance sheet. Yet they demonstrate the risk that comes when a hospital group scrapes together funds to defend itself from injured patients.

hospital fails there will be little protection in its ability to repay. And when the two fail in concert, it is the family who pays.

Patients never negotiated that exposure. They go to a hospital for treatment, not the company balance sheet of its solvency. Whether corporate promising survives liquidation should not determine whether any child with a debilitating condition has care for life.

Five reforms should follow.

Hospital licensing should start by requiring proper malpractice protection, independently verified and funded, in relation to the risk they cover–it should not be diluting this later with a claim following a sale or closure.

Second, regulators should limit loans and transfers by malpractice insurers to associated hospital enterprises. Reserves should remain available for claims, substantiated by independent actuarial reviews and enforceable requirements to maintain sufficient liquidity.

Third, distressed hospital deals should disclose malpractice liabilities and indicate who will pay existing and future claims. Transfer of ownership should not render accountability impossible to trace.

Fourth, lawmakers must also create provisions within the patient-compensation backstop that would make reasonably crucial care available, funded by appropriately useful marketplace efforts, if beneficial suppliers and insurers neglect to fund them.

Fifth, only retain investigators authorized to pursue recoverable transfers and executive misconduct where the evidence reasonably supports such claims. Responsibility must be earned; no corporate status, and neither professional title, should protect a person from accountability.

Supervised staffing, safe fetal-monitoring escalation and rapid access to senior obstetric decision makers clinical prevention will still be required.

What is larger than judgment, is Azaylee’s life. The only test of justice is if she is supported permanently and whether another family escapes the same avoidable injury. A record award is a headline. Funded care is accountability.

Fransiscus Nanga Roka

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