Missouri Supreme Court Strikes Down Malpractice Cap

August 01, 2012

August 1, 2012 — The Missouri Supreme Court yesterday struck down a state law that caps noneconomic damages in medical malpractice cases at $350,000. It declared that the law infringed on a person's right to trial by jury, which includes the right to have a jury set damages.

The ruling, one of several recent setbacks for proponents of tough tort reform measures, illustrates the risk inherent in passing a federal law that would limit what a victorious plaintiff can receive in noneconomic (pain and suffering) damages. Such a law, supported by organized medicine and Congressional Republicans to curb supposedly frivolous suits and extravagant jury awards, theoretically could be overturned by the US Supreme Court.

To buttress its ruling, the Missouri Supreme Court went back almost 200 years to the laws that governed prestatehood Missouri when an elderly Daniel Boone, pioneer par excellence, was trapping beaver there. In the process, the court overturned a state high court ruling in 1992 that upheld the constitutionality of limiting noneconomic damages.

The case before the court involved a boy who was born with disabling brain injuries at a hospital in Springfield, Missouri. The boy's mother sued the hospital and several physicians for negligent care — specifically, the delay of a cesarean delivery necessitated by fetal hypoxia and acidosis. The jury ruled in favor of the mother and awarded her roughly $3.4 million in future medical damages and roughly $1.5 million in noneconomic damages. The judge reduced the noneconomic damages to $350,000, which was the limit set by Missouri law.

The Missouri Supreme Court analyzed the case in light of the provision in the Missouri constitution that says "the right of trial by jury as heretofore enjoyed shall remain inviolate." The court declared that before the state constitution was adopted in 1820 — Missouri became a state the following year — common law called on juries to determine how much in damages an injured plaintiff should receive.

"The right to trial by jury 'heretofore enjoyed' was not subject to legislative limits on damages," the court stated in its majority opinion.

Missouri Law Joins Others in Trash Can

Before yesterday's ruling, Missouri was one of roughly 2 dozen states with laws that cap noneconomic damages in malpractice suits at various levels, according to a tally kept by the National Conference of State Legislatures. (A few other states limit punitive damages or total damages of any kind.) Some of these laws have survived constitutional challenges, as was the case in Maryland. In contrast, cap laws in Alabama, New Hampshire, Oregon, Washington, and, most recently, Illinois and Georgia have been tossed into the unconstitutional trash basket.

For the past 10 years, Republicans in the House of Representatives have introduced bills that would limit noneconomic damages to $250,000. Their legislation has gotten nowhere in the Senate, controlled by Democrats, who tend to support plaintiffs' rights. House Republicans made their latest attempt to institute a $250,000 cap and other tort reforms in March. The bill they passed also repeals a controversial Medicare cost-control mechanism in the Affordable Care Act called the Independent Payment Advisory Board. President Barack Obama has threatened to veto the legislation in the unlikely event that it passes the Senate.


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