Heyl Royster

Missouri Supreme Court Upholds Non-Economic Cap In Medical Malpractice Action

july 26, 2021

The Missouri Supreme Court this week issued a favorable decision rejecting a medical malpractice plaintiff’s argument that the noneconomic damages cap for personal injury actions based on medical negligence was unconstitutional. In Velazquez v. University Physician Associates, the plaintiff's case stemmed from a 2017 lawsuit filed by a patient against multiple physicians and University Physician Associates, alleging medical negligence related to the delivery of her child and during postpartum care. Slip Op. SC98977, 7/22/2021. Velazquez alleged the physicians negligently performed an elective tubal litigation by failing to suture her left fallopian tube properly, resulting in cardiac arrest, massive internal bleeding, additional surgeries including a total hysterectomy, laceration of the bladder, urinary problems, and painful intercourse. In 2019, the case went to trial, where the jury awarded $300,000 in past non-economic damages and $700,000 in future non-economic damages. The defendant physicians asked the trial court to reduce the non-economic damages award pursuant to the 2015 legislation limiting noneconomic damages awards. The trial court agreed and reduced the non-economic damages award to $748,828. Plaintiff appealed the decision, claiming that the damages cap was unconstitutional. The Supreme Court disagreed and upheld the trial judge. The majority opinion noted that Missouri’s statutory caps for non-economic damages do not violate the right to trial by jury in the state constitution because medical negligence is now a statutorily created cause of action; therefore, the general assembly had the legislative authority to enact statutory non-economic damage caps on such actions.

The current noneconomic damages cap was passed in 2015. At that time, the Missouri legislature repealed the common-law medical malpractice cause of action and replaced it with a statutory medical negligence action. (Interestingly, the 2015 legislation was approved by the Republican-dominated House and Senate and signed by then-Governor Jay Nixon, a Democrat.) The 2015 legislative action was in response to the Missouri Supreme Court’s 2012 decision, Watts v. Lester E. Cox Medical Centers, 376 S.W.3d 633 (Mo. 2012). In Watts, the Missouri high court held the noneconomic damages limit violated the right to a jury trial that had existed under common law when Missouri’s original constitution was first adopted. This decision abrogated the noneconomic damages cap in medical negligence personal injury cases that were based on common law principles. The justification for the Watts’ decision stemmed from the Missouri Constitution’s guarantee of a “right of trial by jury,” which the court interpreted to bar the legislature from imposing limits on common law claims. However, in this most recent decision, the high court stated that “[b]ecause a medical negligence action is a statutorily created cause of action, the General Assembly had the legislative authority to enact statutory non-economic damage caps.” Slip op. at 7.

The Missouri Supreme Court’s action in upholding the noneconomic damages cap will help ensure that Missouri physicians, hospitals and other healthcare providers have a degree of certainty and protection in defending nebulous claims of pain and suffering and other “emotional damages.” Additional benefits include continued access to affordable professional medical liability insurance and further incentivizing physicians to keep practicing in Missouri.

Note - The 2015 legislation, codified at R.S. Mo. 538.210, implemented new caps with a two-tiered system beginning on August 28, 2015. The first tier of damage caps started at $400,000 for a typical medical negligence case, and the second tier for either “catastrophic” or a patient’s death applied a $700,000 cap. In addition, the caps grow by a cost of living adjustment of 1.7% each year.

If you have any questions, please contact Richard Hunsaker (Managing Partner – St. Louis office) or Karen Moske.

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