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2025-2026 Points of Light

This report’s Points of Light typically comprise noteworthy actions taken by judges and lawmakers to stem abuses of the civil justice system not detailed elsewhere in the report.

No Injury, No Claim: Colorado Court Rejects Medical Monitoring Damages Theory

The Colorado Court of Appeals issued an important ruling that upholds “one of the basic principles of law,” which is that “a party may not recover damages if he has not suffered an injury.”

The case involved a class action filed on behalf of residents living near a medical sterilization plant’s facilities, claiming that ethylene oxide (EtO) emissions dating back as far as three decades placed them at a higher risk for cancer. The class action, however, did not include anyone who had developed cancer and instead sought, on behalf of healthy people, damages for the costs of ongoing medical monitoring to detect any illnesses that might be caused by the emissions in the future.

In October 2025, the Court of Appeals affirmed a lower court ruling dismissing the class action for lack of standing, finding the plaintiffs failed to allege a cognizable, actual injury. The court recognized that speculative concerns and hypothetical claims of future injuries, with no present illness or disease, do not provide a basis for a tort claim. Rather, the lawsuit alleged only “conclusory” allegations that exposure could have harmed the named plaintiff or class members without claiming that anyone experienced a “currently existing adverse effect.”

As the Court of Appeals recognized, “a trend has emerged as courts throughout the country have repeatedly held that a toxic tort claim cannot proceed in absence of a present physical injury.” The court’s decision is consistent with this approach, which reserves lawsuits for cases involving actual injuries.

Delaware Supreme Court Rejects Junk Science

In July 2025, the Delaware Supreme Court overturned a trial court ruling that allowed thousands of product liability lawsuits that had been thrown out of federal court as based on unreliable science to proceed in state court.

The Zantac litigation saga began in 2019 when Valisure, a small private lab in Connecticut, linked the drug to certain types of cancers. Zantac was voluntarily removed from the market in 2020 after a study by Valisure found that one of the medication’s ingredients, ranitidine, could possibly degrade to form a prob-able human carcinogen known as NDMA.

Valisure’s testing methodology involved heating the product to well over 200 degrees, which is clearly not a realistic scenario for how an individual would consume the drug, considering that is double the temperature of the average healthy person. Besides heating the product to temperatures it would not otherwise be subjected to, Valisure also tested the product with an artificial stomach containing unusually high amounts of salt – amounts that humans could not safely ingest.

To make matters worse, the FDA actually found that Valisure’s lab equipment created NDMA. Following the release of the Valisure report, 16 epidemiological studies were released all finding no credible evidence of Zantac being a carcinogen.

A federal court overseeing Zantac litigation dismissed thousands of these cases in 2022 after flaws behind the science of plaintiff experts’ claims were exposed by U.S. District Court Judge Robin Rosenberg. Judge Rosenberg said “there is no scientist outside this litigation,” despite extensive study of the question after the product’s voluntary withdrawal, “who concluded ranitidine causes cancer.”

As a result of the federal court ruling, Zantac cases surged in Delaware and other state courts, as mass tort lawyers looked for a different result. They filed more than 75,000 Zantac claims in Delaware state courts with 99.6% filed on behalf of out-of-state plaintiffs.

They initially succeeded, obtaining from the Delaware trial court rulings that contradicted those issued in the federal multidistrict litigation. Last summer, Delaware Superior Court Judge Vivian L. Medinilla refused to exercise her essential role as gatekeeper and permitted junk science to serve as the basis for Zantac litigation in the state. The decision threatened to create a litigation hotbed in Delaware, a state traditionally known for its fair, balanced, and predictable treatment of corporations.

In overturning the lower court, the Delaware Supreme Court found that the trial court had misapplied Delaware’s expert evidence rules in several key respects. First, the Court emphasized that Delaware’s evidentiary standard mirrors the rigorous federal framework.

Second, the Court rejected the notion that Delaware Rule of Evidence 702 carries a “liberal thrust” favoring admission of expert testimony, citing the 2023 amendments to the Federal Rule of Evidence 702—which the Delaware rule is designed to emulate—and the Advisory Committee’s Report, both of which explicitly disavow that interpretation.

Third, the Court held that the trial court improperly conflated the court’s gatekeeping responsibility to ensure that proposed expert testimony is based on sound science and is reliable, allowing its admission, with the jury’s role of assessing the evidentiary weight of expert testimony. The improperly admitted testimony, the court found, was based on “cherry-picked data,” reliance on animal and occupational NDMA studies unrelated to ranitidine, and a lack of dose-response analysis.

Finally, the Supreme Court found that the lower court failed to establish a “reliable bridge” connecting Zantac, the scientific evidence, and the alleged harms. By permitting experts to rely on generalized NDMA data divorced from ranitidine and the specific cancers at issue, the trial court fell short of the general causation standard required under Delaware law.

The Delaware Supreme Court’s ruling reenforces the responsibility of judges to act as gatekeepers over the reliability of expert testimony. It also sends a clear message to lawyers that court shopping in mass tort litigation is not a successful strategy.

Maine High Court Declines to Broaden Scope of Public Nuisance Liability

The Maine Supreme Judicial Court rejected an attempt to expand public nuisance claims and other broad theories of tort liability in connection with the opioid epidemic.

Nine Maine hospitals had sued opioid manufacturers and distributors, alleging the companies’ marketing and distribution practices created widespread addiction, which in turn, imposed significant economic burdens on hospitals tasked with treating affected individuals. The hospitals advanced claims for negligence, unjust enrichment, fraud (including negligent misrepresentation and concealment), and civil conspiracy—all of which the Court dismissed.

Most notably, the Court also declined to expand Maine’s public nuisance doctrine to apply to this case, reaffirming that private parties—here the hospitals—have standing to bring a public nuisance claim only if it has suffered a “special legal injury” from a public nuisance. The hospitals argued that their financial losses in treating opioid-related patients constituted such an injury and gave them standing.

The Court disagreed, concluding these costs were “a subset of the injuries to the public occasioned by the increase in opioid misuse” and “no different in kind from the injury to the public.” Because the court ruled the hospitals did not have standing to assert a public nuisance claim, it did not address whether the lawsuit even presented a valid public nuisance cause of action under Maine common law. The case was dismissed.

In its ruling, the court recognized the devastating toll of the opioid crisis and also made clear that extending public nuisance liability to manufacturers and distributors for the hospitals’ economic losses had no basis in Maine law. Thus, Maine joined a growing number of states in rejecting efforts to distort public nuisance doctrine.

North Carolina Court Reaffirms Legislative Authority to Limit Noneconomic Damages

In August 2025, the North Carolina Court of Appeals unanimously upheld a state law that sets a maximum amount of noneconomic damages in medical liability actions.

Since 2011, North Carolina law has limited the amount recoverable for subjective awards for noneconomic damages, such as those intended to compensate for pain and suffering, in medical liability lawsuits. That limit, which applies in cases involving ordinary negligence and is adjusted every three years for inflation, currently stands at $656,730.

In Mohebali v. Hayes, the plaintiff, who suffered injuries under the care of an at-home birthing physician, was awarded $7.5 million in noneconomic damages. The trial court reduced that award in accordance with the statutory limit, prompting the plaintiff to challenge the law’s constitutionality as an infringement on the right to a jury trial.

On appeal, the court reaffirmed the presumption of constitutionality afforded to legislative enactments, citing a 2025 North Carolina Supreme Court decision emphasizing that courts must defer to duly enacted statutes unless proven unconstitutional beyond a reasonable doubt. The court further explained that the plaintiff’s cause of action arose in 2019—seven years after the legislature adopted the damages cap—meaning no preexisting or vested right was impaired. Accordingly, the lower court’s application of the cap did not violate the plaintiff’s constitutional right to a jury trial.

ATRA submitted an amicus brief emphasizing the legislature’s effort to balance fair compensation for plaintiffs with the broader public interest in ensuring the availability and affordability of healthcare. The brief noted that the cap applies only to noneconomic damages, leaving economic damages uncapped to ensure plaintiffs can be made whole for quantifiable losses. The court appropriately recognized and upheld this legislative balance between predictability for defendants and fairness for injured patients.

Utah High Court Rejects ‘Phantom Damages’ Windfalls

The Utah Supreme Court recently addressed whether plaintiffs can recover “phantom damages”—the difference between a hospital’s list prices and the amount it receives as full payment from insurance or a third-party.

In the case at issue, the plaintiff sought to recover the hospital’s full billed charges following a car accident, even though her insurer had paid about half that amount. The trial court did not permit the jury to learn the amount actually paid for treatment, applying the collateral source rule to bar its admission. Rulings such as these lead to damage awards for medical expenses that are far more than amounts routinely paid for such care—the actual market value—leading to unjustifiably inflated awards.

In an amicus brief, ATRA explained that “[t]he usual role of the collateral source rule is not, and should not be, to authorize inflated awards for medical expenses.” The Utah Supreme Court agreed, delivering a practical and balanced ruling. The Court clarified that while the collateral source rule prevents a reduction in a plaintiff’s recovery based on third-party payments, it “does not alter the fundamental principle that special damages are limited to the actual loss resulting from the injury.”

In other words, plaintiffs may recover their actual medical costs, not hypothetical or inflated amounts that were never paid by anyone. The Court’s decision appropriately balanced the need to fully compensate plaintiffs for genuine losses while preventing unjust windfalls at defendants’ expense.

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Since its inception in 2002, the American Tort Reform Foundation’s Judicial Hellholes® program has documented in annually published reports various abuses in the civil justice system, focusing on jurisdictions where courts are radically out of balance.

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