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ANNAPOLIS — The Maryland Court of Appeals affirmed the state's caps on malpractice awards in a ruling Tuesday, overturning a decision by a Montgomery County Circuit Court judge.

The case involved Silver Spring dermatologist Dr. Norman A. Lockshin, who was sued for malpractice in 2008 by a family of a Rockville lawyer, Richard Semsker, who died of skin cancer. The jury awarded the family $5.8 million, a figure that according to the caps, should have been reduced to $3.5 million.

Lockshin's attorney was not immediately available for comment.

Circuit Court Judge John W. Debelius III ruled the caps applied only to cases that have first gone through arbitration. That didn't happen in this case, and he allowed the jury award.

His decision, in effect, invalidated caps that were part of a 2004 special session of the General Assembly called to resolve a crisis in medical malpractice. Insurance rates were climbing and doctors were threatening to leave Maryland. The tightened caps were seen as a way to lower insurance rates.

The appeals court ruled the caps applied to all malpractice cases.

"I think we have had a real good case, but we had an uphill battle politically," said Patrick Malone, the Washington, D.C., lawyer representing the Semsker family.

"We had the entire Maryland medical establishment against us. While we have the better of the issue on the moral ground — damage caps are a terrible imposition upon victims of proven malpractice — on the other hand the establishment was against us on that."

"The court's ruling is a victory for both patients and physicians. It upholds the obvious legislative intent to control the impact of huge damage awards on Maryland's health care delivery system," Dr. Murray A. Kalish, MedChi's president, said in a statement. "We would have fought the original ruling to the end and were so vigorous in filing the amicus brief, because the ramifications would have been cataclysmic to all Marylanders," Kalish added.