The U.S. Supreme Court will not review a ruling upholding a $28.1 million jury verdict, the first in New England, against R.J. Reynolds Tobacco Co. for a Connecticut smoker who now breathes through a hole in her throat.

The Monday decision means the case returns to the U.S. district court in Bridgeport, where additional punitive damages may be added. The U.S. Court of Appeals for the Second Circuit upheld the jury's award in October.

Barbara Izzarelli, a former Norwich resident now living in Florida, was awarded $13.6 million in damages after the jury found in 2010 that R.J. Reynolds acted with reckless disregard for the safety of consumers. The jury also found Izzarelli 42 percent at fault for smoking the cigarettes.

That reduced the initial jury award in 2010 to about $8 million. Seven months later, Judge Stefan Underhill added $4 million in punitive damages.

Reynolds turned down a settlement offer of $400,000 in 1999, meaning Izzarelli is entitled under state statute to 12 percent annual interest on that offer from 1999 to 2011. That tacks on an additional $15.7 million.

Prejudgment interest increases the total to $28.1 million.

In addition, the Second Circuit held that Underhill should re-determine the punitive damages.

According to David Golub, Izzarelli's attorney, Underhill can now award punitive damages anywhere up to two times the compensatory damages, which were $7.9 million. That could add on an additional $15.8 million.

Underhill will probably rule within the next two months, said Golub, a partner with Silver Golub & Teitell in Stamford.

Golub said in a statement and emails that the tobacco giant targeted his client when she was a child. Izzarelli, 57, began smoking Salem Kings at age 12, developed cancer and needed surgery to remove her larynx at age 36. The procedure left her with an opening through her throat to permit breathing.

Izzarelli, 57, developed larynx cancer after smoking Salem cigarettes for more than 25 years. She was forced have her larynx surgically removed, requiring her to breathe through a hole in her throat. She currently lives in Holly Hill, Florida.

Irrazelli argued Reynolds had undertaken a campaign to market Salems to minors, with nicotine levels that would give users amounts above the threshold for addiction.

A jury held that the Salem cigarettes were unreasonably dangerous and defectively designed, and that R.J. Reynolds had acted with reckless disregard for the safety of consumers.

Dr. K. Michael Cummings, professor at the Medical University of South Carolina, testified as an expert on the public health issues in the case.

In a release by Golub, Cummings said, “The tobacco companies have discounted the significance of the verdicts against them in Florida as an aberration because of the Engelclass action there,” he said. “This verdict demonstrates that the verdicts in Florida are no flukes and that the tobacco companies will be held liable in the Northeast and elsewhere. This unanimous verdict in Connecticut, with its substantial damages and punitive damages award, should send shivers down the tobacco companies' CEO's spines.”

Theodore M. Grossman of Jones Day, representing Reynolds, could not immediately be reached.

“Barbara Izzarelli has fought long and hard against R.J. Reynolds, which targeted her with a product that was specifically designed to addict her,” Golub said in a statement this week. “Although it will not bring back her health, this ruling does give her a final victory.”

Izzarelli ended the habit in her mid-30s.

Salem was sold to ITG Brands, a subsidiary of Japan-based Imperial Tobacco, in 2015.

Theodore Grossman, of counsel at Jones Day, represents Reynolds. He was out of the country and did not respond to a request for comment Wednesday.