Plaintiff accuses Medical Professional Vincent J.Keiser and Employer Toledo Radiological Associates Inc.of Medical Malpractice

In a gripping legal battle that questions the limits of legislative power over personal injury compensation, Thomas R. McNalley has taken his case against Dr. Vincent J. Keiser to the Court of Appeals of Ohio. On December 12, 2025, McNalley filed a complaint in Lucas County, challenging the constitutionality of Ohio’s cap on noneconomic damages in medical malpractice cases as applied to him after suffering catastrophic injuries due to alleged negligence by Dr. Keiser.

The case stems from an incident where McNalley accused Dr. Keiser, a radiologist employed by Toledo Radiological Associates, Inc., of failing to diagnose a critical blood clot near his intestine. This oversight led to severe medical consequences for McNalley, including the death and removal of a significant portion of his gut, resulting in short gut syndrome. A jury awarded McNalley $5,152,000 in total damages—$652,000 for economic losses and $4,500,000 for noneconomic damages such as pain and suffering. However, Dr. Keiser sought to enforce Ohio Revised Code 2323.43(A)(3), which caps noneconomic damages at $500,000 for plaintiffs with permanent injuries like McNalley’s.

McNalley’s legal team argued that this statutory cap is unconstitutional when applied to him because it unjustly limits compensation for those most severely injured by medical malpractice while allowing full recovery for similar injuries caused by other types of torts. They contended that the statute violates due process rights as it lacks a rational basis connecting damage caps with reduced insurance rates or improved public welfare—a connection required under constitutional scrutiny.

Despite these arguments and referencing similar past rulings where courts found such caps unconstitutional in specific contexts (e.g., Brandt v. Pompa), the trial court initially sided with McNalley but was later reversed on appeal. The appellate court found that McNalley’s challenge was more akin to a facial challenge rather than an as-applied one since he failed to present clear evidence specific to his circumstances demonstrating how the statute was unreasonable or arbitrary solely in his case.

Ultimately seeking reversal of the trial court’s decision and enforcement of the statutory cap, Dr. Keiser’s defense highlighted legislative findings supporting the cap’s purpose: stabilizing healthcare costs and ensuring access to affordable medical services across Ohio—a justification upheld in prior cases like Arbino v. Johnson & Johnson.

The appellate court concluded that without specific factual evidence showing unconstitutionality in application solely to McNalley’s situation—as opposed to all catastrophically injured plaintiffs—the challenge could not succeed under either standard of review (facial or as-applied). Thus reversing the lower court’s ruling and remanding for application of R.C. 2323.43(A)(3).

Representing Thomas R. McNalley were attorneys Chad M. Tuschman, Peter O. DeClark, and Jacob J. Hamilton; representing Vincent J. Keiser were Steven J. Hupp, Ronald A Margolis, and Douglas G Leak before Judges Thomas J Osowik Christine E Mayle Charles E Sulek under Case ID L-25-00106.