Background
Emily Cowan sued Dr. Guy Slann and CHI St. Alexius Health Williston for medical malpractice arising from a surgery performed in August 2018, during which Dr. Slann operated on her uninjured right foot instead of her injured left foot. Dr. Slann settled and was dismissed before trial. After an eight-day trial, the jury returned a verdict for Cowan against CHI in November 2024, awarding $265,000 in past economic damages, $360,000 in past noneconomic damages, $2,000,000 in future economic damages, and $2,000,000 in future noneconomic damages. The jury found CHI 65% at fault and Dr. Slann 35% at fault.
Following the verdict, CHI moved to reduce the noneconomic damages award pursuant to North Dakota’s statutory cap under N.D.C.C. § 32-42-02, which limits noneconomic damages in health care malpractice claims to $500,000. The district court upheld the cap’s constitutionality and reduced the noneconomic damages accordingly, entering an amended judgment on August 18, 2025, totaling $2,299,512.61, including damages, pre- and post-verdict interest, and costs. CHI paid the full amended judgment plus post-judgment interest, and Cowan’s attorney signed and filed a satisfaction of judgment in district court on September 11, 2025, certifying the amended judgment had been “fully satisfied.” The filed satisfaction, however, was not notarized as required by N.D.C.C. § 28-20-24, and Cowan’s counsel declined CHI’s later request to file a compliant version.
Cowan then filed a notice of appeal on October 15, 2025, challenging the constitutionality of the noneconomic damages cap under the North Dakota Constitution’s right-to-jury-trial guarantee. CHI filed a conditional cross-appeal, arguing Cowan had waived her appellate rights by accepting full payment of the judgment without reserving any issues for appeal. The North Dakota Supreme Court ordered briefing on appealability before addressing the merits.
The Court’s Holding
The Supreme Court dismissed both Cowan’s appeal and CHI’s conditional cross-appeal. Although the filed satisfaction was technically noncompliant with the notarization requirement of N.D.C.C. § 28-20-24—meaning the judgment had not been formally satisfied of record—the Court held that Cowan nonetheless waived her right to appeal by voluntarily accepting substantial benefits under the amended judgment. The satisfaction’s plain language expressly acknowledged “full payment” and certified the judgment “fully satisfied,” without any reservation of issues for appeal or indication of a partial satisfaction.
The Court rejected Cowan’s argument that her acceptance covered only undisputed amounts or that her appeal could only increase the judgment. Because granting Cowan’s requested relief would require reversing the entire amended judgment, and because CHI’s cross-appeal placed the amount she received at potential risk of reduction, Cowan could not claim her accepted benefits were “separate and independent” from the disputed issues or wholly insulated from reversal. The Court found the voluntary-acceptance-of-benefits doctrine barred the appeal on these facts.
To provide clarity going forward, the Court adopted a bright-line rule: in non-divorce cases, a party’s voluntary acceptance of the full amount of a judgment, without reserving any issues for appeal, waives that party’s right to appeal from the judgment. The Court expressly abrogated its 1894 decision in Tyler v. Shea to the extent it recognized a conflicting exception. Having dismissed Cowan’s appeal on this basis, the Court found it unnecessary to address CHI’s conditional cross-appeal.
Key Takeaways
- Accepting full payment of a judgment in a non-divorce case, without expressly reserving the right to appeal or limiting the scope of the satisfaction, constitutes a waiver of appellate rights — even if the filed satisfaction document is technically defective for lack of notarization.
- The Court adopted a new bright-line rule for non-divorce cases: voluntary acceptance of the full judgment amount forfeits the right to appeal, abrogating the prior exception from Tyler v. Shea (1894) that had allowed appeals where the accepted benefit could not be affected by reversal.
- Plaintiffs who intend to appeal a reduced damages award — such as one subject to a statutory cap — must expressly reserve their appellate rights before accepting any payment and should not file a satisfaction of judgment that certifies the case “fully satisfied” without qualification.
- The Court’s favorable acceptance-of-benefits rule for divorce cases (established in Fercho v. Fercho) has no application outside the domestic relations context.
Why It Matters
This decision creates a significant procedural trap for plaintiffs in North Dakota medical malpractice and other civil cases who wish to collect a judgment while simultaneously challenging a statutory cap or other reduction on appeal. By adopting a bright-line rule and abrogating the Tyler v. Shea exception, the Court eliminated what had been a potential avenue for plaintiffs to argue their accepted benefits were insulated from appellate reversal. Plaintiffs’ counsel must now take affirmative steps — such as expressly reserving appeal rights in any satisfaction document or negotiating a conditional payment arrangement — before accepting judgment proceeds when an appeal is contemplated.
The ruling also leaves unresolved the underlying constitutional question of whether North Dakota’s $500,000 noneconomic damages cap for health care malpractice claims violates the state constitution’s right-to-jury-trial guarantee. That question, which drew amicus participation from the State of North Dakota, the North Dakota Hospital Association, the North Dakota and American Medical Associations, and the American Tort Reform Association, will need to await a future case where the plaintiff has properly preserved the right to appeal.