As we reported recently in a Client Alert, the Supreme Court of New Jersey’s recent decision in Rivera v. The Valley Hospital, Inc. aligned with prior case law in confirming that punitive damages in medical malpractice actions are only available in “exceptional cases.” Although the Rivera decision does not immunize medical defendants from claims for punitive damages, it reinforces the trial bench’s obligation to rigorously apply the standards for clear and convincing evidence of willful and wanton conduct, as our analysis of the ruling explains. We also proudly note that Greenbaum attorney John Zen Jackson acted as amicus counsel for the Medical Society of New Jersey and the American Medical Association, which submitted amici briefs in support of the defense in this matter.