An Ohio doctor has lost on appeal his bid to sue a former patient for posting a negative online review.

In September 2010, Kelly Turkoly, a resident of Glen Cove, Ohio, had plastic surgical procedures on her head and neck done by Dr. Richard Gentile which she contends she didn’t give permission and resulted in multiple infections, scarring and nerve damage.

Turkoly sued Gentile and in April 2013 a Mahoning County, Ohio, jury awarded Turkoly a $5.1 million verdict against the doctor for performing procedures for which she didn’t give her consent and for her scarring and nerve damage, the court noted.

The award was later reduced by the court to $600,000 and in September 2013 Turkoly wrote a highly detailed—and negative—report on healthcare ratings and review site Vitals.com about Gentile and her experience. “I was much disoriented and have very little memory for days after surgery,” Turkoly wrote. “He never told me that he didn’t do the procedures I paid him to do, and that he did procedures I knew nothing about. I had to discover this all on my own, each day as bandages and stitches were removed.”

In the review Turkoly also wrote that Gentile was not a board-certified plastic surgeon. “I chose Dr. Gentile because all the research I did on him before paying him to do my surgery said he was an expert plastic surgeon with years of experience on the head and neck,” Turkoly wrote in her Vitals.com review, which was cited in the ruling handed down by the Mahoning County court of appeals, district seven. “Little did I realize that meant he was board-certified as an ENT (ears, nose and throat), and not board-certified as a plastic surgeon. There is a big difference in those two certifications, but how is the common patient to know this?” In the review Turkoly also called Gentile “unscrupulous.”

After the review was published another patient cancelled a procedure, which prompted Gentile to sue Turkoly in 2015 over the negative review.

Gentile sued Turkoly on the grounds that the negative review violated the terms of the business contract between the two of them. A March 2016 jury trial resulted in a decision in favor of Gentile, with the jury citing “tortious interference with a contract.” That refers to one person intentionally damaging someone else’s contractual or business relationships with a third party, causing economic harm, according to FindLaw.com.

But now a three-judge appeals court has overturned the verdict from the Gentile trial and ruled that Turkoly’s negative review didn’t violate any contracts and didn’t prove malice and therefore did not show an intent to hurt the doctor. “The Vitals.com review does not demonstrate actual malice; the review was based on her experience and opinion,” the appeals court says in its final opinion. “There was no showing of actual malice, and no evidence of damages.”

Lawyers for Turkoly noted they were pleased with the decision. “The court of appeals’ ruling validates the rights of Ohioans to express themselves about their experiences with professionals online, and to honestly review them and state their opinions without fear of liability,” Christopher J. Regan, an attorney with the law firm of Bordas & Bordas told Law360.com.

Gentile and his law firm Roth Blair Roberts & Lodge have yet to say if they will file for appeal or comment on the verdict.