Punitive damages are an amount of money awarded by the jury designed to punish the defendant for misconduct that was particularly bad. In other words, punitive damages are not intended to compensate the victim, but to punish the bad guy. Most medical malpractice cases do not involve the possibility of punitive damages because the case only involves simple negligence and not intentional or gross misconduct. One of the few types of medical malpractice cases that may allow punitive damages are cases involving sexual misconduct by the doctor or nurse. Some states have caps on punitive damages and in some states, all or part of the punitive damages are payable to the state rather than to the injured person. Punitive damages are also subject to federal income tax, while regular damages in an injury or death case are not.