The Gourleys sued Knolla and the OB/GYN Group for medical malpractice resulting in their child's brain damage and cerebral palsy. The district court awarded them $5,625,000 in damages, but the defendants argued that the damages limitation of $1,250,000 under Neb. Rev. Stat. § 44-2825(1) is constitutional and that the jury verdict is invalid. The Nebraska Supreme Court found no constitutional violation of the legislation and rejected the argument that the cap was not justified because there was no insurance crisis and lifting the cap would have little effect on the cost of medical services. The court has determined that a cap on damages for medical malpractice is not special legislation and does not violate the equal protection clause of the Nebraska Constitution. The rational basis test applies, which requires a plausible policy reason for the classification, legislative facts that may rationally have been considered true, and a relationship between the classification and its goal that is not arbitrary or irrational. The damages cap does not limit access to the courts, and the Gourleys' interest in unlimited damages is economic. The Legislature had evidence to justify passing the Nebraska Hospital-Medical Liability Act, which provides an assured fund for the payment of malpractice claims and access to an impartial medical review panel to determine if the healthcare provider met the standard of care.

The court upheld the constitutionality of the damages cap in § 44-2825, stating that it is necessary to keep malpractice insurance rates low and prevent physicians from leaving the medical practice. The dissenting opinion failed to acknowledge that the overall cost of insurance in Nebraska is lower than in many states without damages caps. The court's role is to review the constitutionality of legislation without questioning the wisdom of legislative enactments. Prendergast is binding precedent, and the court has consistently relied on it to support legislative discrimination in malpractice actions. The majority opinion thoroughly analyzed the issue and determined that the damages cap is constitutional based on other legal authority.

The passage discusses how medical liability settlements are limited by economic and noneconomic damages, with many states enacting caps on the latter. However, one such cap on damages was overturned for unfairly restricting recovery for economic damages. Nebraska's Hospital-Medial Liability Act limits recovery to a maximum of $1,250,000 for any instance of medical malpractice, depriving injured individuals of full economic damages. A bill intended to reduce malpractice insurance premiums by capping total damages was enacted, but was not fully considered and ultimately did not lower premiums as intended, as the Excess Liability Fund provides coverage exceeding $200,000.

The Honorable Hendry agrees with Justice Gerrard that the damages cap imposed by Neb. Rev. Stat. § 44-2825(1) may violate substantive due process rights of injured persons. However, Hendry dissents from Gerrard's opinion that the Gourleys have standing to challenge the Nebraska Hospital-Medical Liability Act as unconstitutional special legislation. Hendry believes that only members of the general class of health care professionals who are not defined as "health care providers" under the act but may still be liable for malpractice or negligence have standing to assert that the statute is unconstitutional special legislation. The author reserves judgment on whether the statute violates Neb. Const, art. Ill, § 18 until the proper party with an adequate and proper record is before the court.

The case challenges the constitutionality of a statute that imposes a cap on recovery amounts. The court revisits the issue of the constitutionality of the cap, finding that the Nebraska Constitution prohibits special legislation that grants exclusive privileges, immunity, or franchise to any corporation, association, or individual, except in cases where a general law cannot be made applicable. The court applies a stringent test to determine if the cap creation has an arbitrary and unreasonable method of classification. The focus is on whether there are substantial differences in situation or circumstances in legislative classifications. The court concludes that it would be a disservice to the parties to rely on a previous case that upheld the statute's constitutionality.

Judge Carlson has a mixed opinion on the legal case. They agree with some parts of Justice McCormack's opinion and also support Justice Gerrard's analysis of substantive due process. However, they disagree with some aspects of the case.