Caps on Noneconomic Damages in Medical Malpractice Cases in Missouri

Published by Niki McCormick on

Missouri’s statutory cap on noneconomic damages for personal injury is once again headed to the Missouri Supreme Court.

On February 16, 2021, the Western District Court of Appeals granted the plaintiff’s request to transfer the plaintiff’s challenge to the constitutionality of Missouri’s cap on non-economic damages in medical malpractice cases pursuant to Section 538.210. Velazquez v. Reeves, M.D., WD 83485 (Mo. App. W.D. 2021). Assuming the Missouri Supreme Court accepts transfer, the Supreme Court will once again decide if Missouri’s attempts to cap non-economic damages for personal injury run afoul of Missouri’s constitutional protections for the right to a jury trial.

In Velazquez, the plaintiff in a medical malpractice case obtained a jury verdict awarding economic damages of $30,000, and non-economic damages of $1,000,000. In response to the defendant’s motion to apply the statutory cap, the plaintiff argued the damages limitations contained in Section 538.210 are unconstitutional. The trial court refused to declare Section 538.210 unconstitutional and decreased the damages award to $748,828, the amount of the relevant cap for catastrophic personal injuries.

On appeal, the plaintiff argued Section 538.210 violates the right to trial by jury guaranteed by Article I, § 22(a) of the Missouri Constitution, which provides “[t]hat the right of trial by jury as heretofore enjoyed shall remain inviolate…” The plaintiff asked the Western District to transfer the appeal directly to the Missouri Supreme Court based on the Supreme Court’s exclusive appellate jurisdiction over all cases involving the constitutionality of a statute. Following oral arguments on February 4, 2021, the Western District ordered the case transferred to the Supreme Court to decide the constitutional issue.

Background
The Missouri Supreme Court originally upheld the constitutionality of statutory caps on noneconomic damages in medical malpractice actions in 1992. In 2005, the Missouri Legislature enacted additional tort reforms that included revisions to the statutory cap on noneconomic damages. The Plaintiff’s Bar used the amendment of the statutory caps as an opportunity to renew their constitutional challenges to caps on noneconomic damages.

In Sanders v. Ahmed, 364 S.W.3d 195 (Mo. banc 2012), the Missouri Supreme Court upheld the constitutionality of the cap on noneconomic damages for wrongful death medical malpractice cases under the pre-2005 statute. In Sanders, the Missouri Supreme Court focused on the fact a wrongful death cause of action did not exist in common law when Missouri adopted its constitution in 1820.

Instead, the Missouri Legislature created a statutory cause of action for wrongful death in 1855. The Missouri Constitution adopted the common law of England as it existed in 1820, and Article I, section 22(a) of the Missouri Constitution provides “[t]hat the right of a trial by jury as heretofore enjoyed shall remain inviolate.” (emphasis added). The Court interpreted this provision to mean if a cause of action existed at common law before adoption of the Constitution in 1820, the Legislature lacked the power to “violate” the right to trial by jury by imposing statutory caps on damages. By contrast, if the cause of action did not exist in 1820 and the Legislature created the cause of action (and right to trial by jury) after 1820, the Legislature did have the authority to place caps on damages. Applying this logic, the Missouri Supreme Court held the Legislature created a wrongful death cause of action after 1820 and, therefore, the Legislature had the constitutional authority to enact damages caps on wrongful death medical malpractice cases.

The Sanders opinion was a precursor to the Missouri Supreme Court’s decision in Watts v. Lester E. Cox Med. Ctr., 376 S.W.3d 633 (Mo. banc 2012), which held damages caps on common law medical malpractice claims were unconstitutional. In Watts, the Missouri Supreme Court noted the common law cause of action for medical malpractice existed when Missouri adopted its constitution in 1820, and therefore the right to trial by jury on medical malpractice claims was “heretofore enjoyed.” Therefore, placing caps on noneconomic damages interfered with the plaintiff’s right to trial by jury and was unconstitutional.

In response to the Watts decision, in 2015 the Missouri Legislature enacted a new statutory scheme that abrogated Missouri common law for medical malpractice claims and replaced the common law with a statutory claim for medical malpractice. Section 538.210 declares “[a] statutory cause of action for damages against a health care provider for personal injury or death arising out of the rendering of or failure to render health care services is hereby created, replacing any such common law cause of action.” The Legislature also amended Section 1.010.1, which generally provides that the common law of England “[is] the rule of action and decision in this state.” The Legislature amended the statute to state “[t]he general assembly expressly excludes from this section the common law of England as it relates to claims arising out of the rendering of or failure to render health care services by a health care provider, it being the intent of the general assembly to replace those claims with statutory causes of action.” Section 1.010.2.

Velazquez v. Reeves
In Velazquez, the Western District recognized the Missouri Supreme Court has distinguished between common law and statutory causes of actions. The legislature cannot impose damages limitations on common law causes of action without violating the right to a jury trial “heretofore enjoyed.” The legislature can impose damages limitations on statutory causes of action because they do not impact a right to a jury trial “heretofore enjoyed.”

In granting transfer, the Western District noted the Supreme Court has not yet addressed the precise question raised in Velazquez: whether the legislature can constitutionally limit the damages recoverable for a cause of action that did exist at common law, but that has now been replaced by a statutory cause of action.

Assuming the Missouri Supreme Court accepts the case, the Court will once again decide whether Missouri’s caps on non-economic damages for personal injury are constitutional.

Who to Contact:
Please reach out to your Lashly & Baer attorney if you have any questions about this information.