August 1, 2012

In its written opinion filed on July 31, 2012, the Supreme Court of Missouri held “that section 538.210 [Missouri’s $350,000 statutory cap on noneconomic damages] is unconstitutional to the extent that it infringes on the jury’s constitutionally protected purpose of determining the amount of damages sustained by an injured party. Such a limitation was not permitted at common law when Missouri’s constitution first was adopted in 1820 and, therefore, violates the right to trial by jury guaranteed by article I, section 22(a) of the Missouri Constitution.”

The plaintiff in the Missouri medical malpractice case (Watts v. Lester E. Cox Medical Centers, et al., Case No. SC91867) filed her medical malpractice case against the defendants alleging that her son was born with disabling brain injuries because Cox Medical Centers and its physicians provided negligent health care services. The medical malpractice jury found in favor of the plaintiff and awarded $1.45 million in noneconomic damages and $3.371 million in future medical expenses. Pursuant to Missouri’s statutory cap on noneconomic damages that limited the amount of noneconomic damages to $350,000, the trial judge reduced the jury’s award for noneconomic damages from $1.45 million to $350,000. The plaintiff filed an appeal from the judge’s actions.

The Supreme Court Of Missouri’s Reasoning

The Supreme Court of Missouri held that the cap on non-economic damages (Section 538.210) violated the right to trial by jury guaranteed by Article I, Section 22(a) of its Constitution that provides in part “the right of trial by jury as heretofore enjoyed shall remain inviolate ….” The Supreme Court of Missouri stated that once the right of trial by jury attaches, as it did in this case, the plaintiff has the full benefit of that right free from legislation to the contrary.

The Supreme Court of Missouri determined that Section 538.210 curtails the determination of damages because it caps the jury’s award of non-economic damages wholly independently of the facts of the case. As such, it necessarily infringes on the plaintiff’s right to trial by jury. Statutory damage caps were not permissible when the constitution was adopted in 1820 and, therefore, remain impermissible. The right to trial by jury cannot “remain inviolate” when an injured party is deprived of the jury’s constitutionally assigned role of determining damages according to the particular facts of the case.


We commend the Supreme Court of Missouri for its analysis of the rights provided its citizens by Missouri’s Constitution and how the Missouri State Legislature’s attempt to place caps on noneconomic damages as it was applied in the case before it violated the fundamental rights of the plaintiff. As the Supreme Court of Missouri noted in its opinion, there are other states with similar constitutional language with regard to the right to trial by jury that have concluded that, because the assessment of damages is one of the factual findings assigned to the jury rather than to a judge, any limit on damages that restricts the jury’s fact-finding role violates the constitutional right to trial by jury (including Washington State, Oregon, Alabama, and Florida).

However, as the separate Opinion Concurring In Part And Dissenting In Part filed in the Missouri case points out, there are other states with similar constitutional language that have upheld as constitutional their statutory caps on noneconomic damages, including Nebraska, Idaho, Ohio, and Maryland. In general, those states reason that the role of the jury is fact-finding. This role requires the jury to determine liability and measure damages, both economic and noneconomic, as a result of liability. Once it has completed its fact-finding duty, it has completed its constitutional task. It is then the court’s duty to apply the law. Laws that establish caps on noneconomic damages establish the substantive legal limits of a plaintiff’s damage remedy. As such, it is a matter of law, not fact. The court applies the law that establishes the cap on noneconomic damages only after the jury has completed its fact-finding duty. Because the court does not apply the cap on noneconomic damages until after the jury has performed its constitutional function, the law that establishes caps on noneconmoic damages does not violate the constitutional right to a trial by jury. Some courts also reason that their legislatures are permitted to abrogate a cause of action cognizable under the common law completely and, therefore, have the power to limit recovery in the same causes of action.

If you may have a claim for medical malpractice in Missouri or in another state in the U.S., you should promptly consult with a local medical malpractice attorney regarding your legal rights.

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