In 2012, the Supreme Court of Missouri handed a significant victory to plaintiffs seeking damages in medical malpractice cases. In Watts v. Lester E. Cox Medical Centers, the court ruled that Missouri’s statutory cap on non-economic damages was unconstitutional because this cap violated a citizen’s constitutional right to a trial by jury.
A Missouri mother filed a medical malpractice action against a hospital and its associated physicians, claiming that their negligent medical services caused her newborn son to suffer catastrophic brain injuries. The jury awarded the mother $1.45 million in non-economic damages. Pursuant to the statutory cap, however, the trial judge reduced that amount to $350,000.
The jury also awarded the plaintiff $3.371 million in future medical damages, in which they paid half up front with the remaining divided over a 50-year period. The trial judge allowed the hospital and physicians to pay one-half of the future damages in one lump sum and the other one-half over 50 years with the statutorily required interest rate of 0.26 percent.
In finding the statutory cap unconstitutional, the court wrote that non-economic damages must be determined by juries. The right to a jury trial cannot remain “inviolate” as required by the Missouri constitution if a medical malpractice plaintiff remain deprived of a jury assigning damages based on the facts of a case.
Additionally, the court found that the interest-based formula for payment of future damages would not ensure that the baby’s future medical bills would be covered because the formula did not factor in healthcare inflation. As a result of this decision, the trial judge must enter a new and proper payment schedule.
New legislation in 2015 made malpractice damages statutory, including caps, and are regularly upheld by the Missouri Supreme Court. The Missouri Department of Insurance increases the non-economic medical malpractice caps annually, currently up to the year 2050. The courts have applied the cap date as the judgment date, not the injury date.
The cap for catastrophic injuries is significantly higher than for non-catastrophic injuries. Under the new statute, catastrophic injuries are defined as those resulting in quadriplegia, paraplegia, the loss of two or more limbs, significant and permanent cognitive impairment, irreversible failure of a major organ, significant loss of vision, and wrongful death. As the skin is a major organ, the courts have also included failure of the skin as a catastrophic injury.
The 2012 decision overruled a 1992 Missouri Supreme Court decision that upheld the constitutionality of the medical malpractice statutory cap, saying that the 1992 decision was based on flawed reasoning. The Watts decision is in line with four other states that also concluded that any limit on non-economic damages violates the constitutional right to trial by jury.
