As an associate attorney in the Health Care Department, Gabriella defends healthcare entities in civil litigation matters including medical malpractice and long-term care liability. Given her strong background in healthcare, Gabriella utilizes her knowledge and skill to effectively represent medical professionals and providers, hospitals, and extended care facilities.
Gabriella received her B.S. in Microbiology from The Ohio State University and her J.D. from Case Western Reserve University. She is admitted to practice in the State of Ohio and the Northern and Southern Federal Districts of Ohio.
Published Works
•'State Constitutional Law: The Future of Abortion Rights?' Health Matrix: The Journal of Law-Medicine, Vol. 33, 2023
Thought Leadership
The Quarterly Dose
LEGAL ROUNDUP - Ohio
February 25, 2026
Ohio Appellate Courts Split on Constitutionality of Medical Malpractice Damages Cap: Sixth District Enforces LimitMcNalley v. Keiser, 2025-Ohio 5561Earlier this year, the 10th District and the 8th District in Lyon v. Riverside Methodist Hospital, 2025-Ohio-2991 (10th Dist.) and Paganini v. Cataract Eye Center of Cleveland, 2025-Ohio-275 (8th Dist.), respectively, held that Ohio’s medical malpractice non-economic damages cap is unconstitutional as applied to the plaintiff-appellees. Ohio’s 6th District in its case, McNalley v. Keiser, 2025-Ohio-5561 (6th Dist.), held that the plaintiff did not meet its burden of showing that the non-economic damages cap was unconstitutional as applied.McNalley sued radiologist Dr. Keiser and his employer after Keiser allegedly failed to diagnose a blood clot, resulting in extensive bowel loss and short-gut syndrome. At trial, a jury awarded McNalley approximately $5.15 million, including $4.5 million in non-economic damages. Dr. Keiser moved to apply the statutory cap on non-economic damages for medical claims, which limits recovery to $500,000 for plaintiffs who suffer catastrophic injuries. McNalley opposed the motion, arguing that the statute violated both due process and equal protection as applied to him, although the 6th District noted that the substance of McNalley’s arguments suggested he was arguing that the statute was unconstitutional on its face. The trial court denied the motion, holding the cap unconstitutional as applied to McNalley, but declined to find the statute unconstitutional on its face.On appeal, the 6th District emphasized the critical distinction between facial and as-applied constitutional challenges. In a rational basis analysis, as used here, to show that a statute is unconstitutional on its face, the movant must show beyond a reasonable doubt that there is no set of circumstances under which the statute may be valid. To show a statute as unconstitutional as applied, a movant must show clear and convincing evidence of a presently existing set of facts that makes the statute unconstitutional when those facts are applied. Although McNalley framed his argument as an as-applied due process challenge, the court found that he failed to present clear and convincing, case-specific facts showing that the statute was unreasonable or arbitrary as applied to him. Instead, his arguments-like those relied upon by the trial court-amounted to a broader attack on the statute’s treatment of all catastrophically injured medical malpractice plaintiffs, which constitutes a facial challenge, and he did not meet the heightened standard.The court was not persuaded by the holding in Paganini, going so far as to indicate that they would have agreed with the defendants that the challenge in Paganini was actually a facial challenge and would have held differently. Accordingly, the court held that the holding in Lyon was appropriately found, based upon articulated and specific facts as applied to the plaintiff. In this case, the court noted that both parties’ arguments were nearly devoid of facts, thereby only allowing it to view the challenge as a facial challenge.Because McNalley did not meet the heightened burden required for a facial challenge and the record lacked specific factual findings supporting an as-applied challenge, the 6th District concluded that the statutory cap must be enforced. The 6th District reversed the trial court’s judgment and remanded the case with instructions to apply the noneconomic damages cap under R.C. 2323.43(A)(3), reinstating the statutory limitation on McNalley’s recovery. The Ohio Supreme Court is scheduled to hear oral arguments in Paganini on February 10, 2026. The decision in Lyon has not been appealed to the Ohio Supreme Court.
The Quarterly Dose
LEGAL ROUNDUP - Ohio
November 1, 2025
Another Ohio District Court Rules that the Non-Economic Damages Cap on Catastrophic Medical Injuries Is Unconstitutional as AppliedLyon v. Riverside Methodist Hospital, (10th Dist.), 2025-Ohio-2991Following the 8th District Court of Appeals’ ruling in Paganini v. Cataract Eye Center of Cleveland earlier this year, the 10th District has likewise ruled that the non-economic damages cap under R.C. 2323.43(A)(3) is unconstitutional as applied.Susana Lyon filed a medical negligence complaint against Riverside Methodist Hospital, among other defendants, for failure to diagnose a thiamine deficiency, which she alleged resulted in her developing Wernicke-Korsakoff syndrome and a severe neurological injury. On April 20, 2023, a Franklin County jury awarded Lyon damages of $25,172,525.32. The breakdown of damages is as follows:Economic Damages:Past Medical Care/Expenses: $744,157.32Future Medical Expenses: $4,428,369.00Non-Economic Damages:Past Non-Economic Damages: $5,000,000.00Future Non-Economic Damages: $15,000,000.00After the trial verdict, the defendants filed a motion to enforce the non-economic damages cap of $500,000 under R.C. 2323.43(A)(3), which Lyons challenged, both facially and as applied, under due process and equal protection grounds. The trial court denied the defendants’ motion and held that the damages cap is unconstitutional. In assessing whether the trial court erred in declaring that the medical claim damages cap is unconstitutional, the 10th District considered the constitutionality of the statute both facially and as applied under both due process and equal protection grounds. Under the rational basis test, the 10th District held that the statute bears a real and substantial relation to the public interest concerns. Thus, the analysis of the statute hinges on whether the cap is unreasonable or arbitrary.Importantly, the 10th District held that under both due process and equal protection grounds, the damages cap is not facially unreasonable or arbitrary.Yet, persuaded by the 8th District’s ruling in Paganini, the 10th District held that, as applied to Lyon, the non-economic damages cap is clearly and convincingly unreasonable and arbitrary. If the cap were to be applied, Lyon’s award would be reduced by 57.4%, which the 10th District reasoned is unreasonable and arbitrary. The court also found it troubling that the statute does not adjust for inflation and calculated that the $500,000 cap that was enacted by the Ohio Legislature in 2003 would equate to only $286,475.79 as of April 2025. Thus, under due process grounds, the 10th District found that the cap is unconstitutional as applied to Lyon.Under equal protection grounds, the 10th District similarly held that, as applied to Lyon, the non-economic damages cap is unconstitutional. The court reasoned that, under Ohio law, there is no cap for non-economic damages for catastrophic injuries that are non-medical, but there is a cap for medical claims. The 10th District held: [lit is unreasonable and arbitrary that Lyon should be treated differently in this instance than an individual that suffered catastrophic injuries in a nonmedical malpractice context. If Lyon was injured by the appellants in an automobile injury, instead of in the medical negligence setting, she would have been entitled to the full award of noneconomic damages.As of May 27, 2025, Paganini v. Cataract Eye Center of Cleveland is pending in the Ohio Supreme Court (2025-0386). Riverside Methodist Hospital has not yet appealed the 10th District’s ruling. The Quarterly Dose - November 2025, has been prepared for our readers by Marshall Dennehey. It is solely intended to provide information on recent legal developments and is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. We welcome the opportunity to provide such legal assistance as you require on this and other subjects. If you receive the alerts in error, please send a note to tamontemuro@mdwcg.com. ATTORNEY ADVERTISING pursuant to New York RPC 7.1. 2025 Marshall Dennehey. All Rights Reserved.
