The Supreme Court of Missouri, in its opinion issued on July 22, 2021, upheld Missouri’s cap on nonecnomic damages in Missouri medical malpractice cases, stating, “Because 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 … Accordingly, 538.210’s non-economic damages caps do not violate article I, § 22(a) of the Missouri Constitution..”
The Underlying Facts
The Missouri medical malpractice plaintiff alleged that the defendant physicians acted negligently in the Caesarean delivery of her child and in her postpartum care at Truman Medical Center in Kansas City. The plaintiff averred that the defendants’ alleged negligence caused her to undergo multiple surgeries, including a total abdominal hysterectomy, and suffer major injuries including cardiac arrest, massive internal bleeding, a transverse bladder laceration, abdominal scarring, permanent leakage of urine through the vagina, and pain during urination and sexual intercourse. The plaintiff also alleged she suffered a loss of capacity of enjoyment of living, mental anguish, general discomfort, loss of sleep, depression, anxiety, and other emotional distress.
The Missouri medical malpractice jury found that the defendants were 100% at fault and awarded the plaintiff $30,000 in past economic damages (including past medical damages), $300,000 in past non-economic damages, and $700,000 in future non-economic damages. The circuit court applied § 538.210.2(2)’s higher non-economic damages cap for catastrophic personal injury and reduced the jury’s non-economic damages award from $1,000,000 to $748,828.
The plaintiff appealed and challenged the constitutionality of Missouri’s cap on noneconomic damages in medical malpractice cases as set forth in Section 538.210.2.
Section 538.210.2(1) provides, “In any action against a health care provider for damages for personal injury arising out of the rendering of or the failure to render health care services, no plaintiff shall recover more than four hundred thousand dollars for noneconomic damages irrespective of the number of defendants.”
Section 538.210.2(2) provides: “Notwithstanding the provisions of subdivision (1) of this subsection, in any action against a health care provider for damages for a catastrophic personal injury arising out of the rendering or failure to render hea[l]th care services, no plaintiff shall recover more than seven hundred thousand dollars for noneconomic damages irrespective of the number of defendants.”
The Supreme Court of Missouri stated in the case it was deciding: “At trial, Dr. Hawkins testified Ordinola suffered a complete, irreversible failure to her bladder and urinary organ system. In rebuttal, Dr. Burk suggested multiple surgeries may prove effective in repairing Ordinola’s fistula, thereby reversing the alleged organ system failure. The circuit court’s finding that Ordinola’s injuries were catastrophic is supported by competent evidence in the record. The circuit court, therefore, did not abuse its discretion in overruling the Physicians’ motion for remittitur.”
The Supreme Court of Missouri held: “The Physicians argue the circuit court may not apply § 538.210.8 retrospectively. The issue, however, is to which event does § 538.210.8 apply—the malpractice, or the trial arising out of the malpractice? Notably, § 538.210.8 does not reference the conduct from which liability arises. Rather, as in Tipler, the subsection affects procedure regarding the award, specifically referencing the “limitations on awards for noneconomic damages.” Therefore, the relevant event is the award, not the underlying malpractice, and § 538.210.8 applies only prospectively to damages awarded on or after its effective date.”
Source Maria del Carmen Ordinola Velazquez v. University Physician Associates, No. SC98977.
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