Missouri High Court Addresses Medical Malpractice Caps - April 05, 2010

The Missouri Supreme Court handed down a long anticipated decision regarding medical malpractice caps on March 23rd, 2010. This decision was anticipated by lawyers, insurance companies and legislators. The case, styled Klotz v. St. Anthony's Medical Center, was handed down after many groups filed briefs (arguments in written form) advocating different positions on the issue. The Padberg & Corrigan Law Firm filed an amicus brief on behalf of the AFL-CIO advocating the repeal of the non-economic damage caps.
The central issue in the case involved the constitutionality of caps on non-economic damages in cases against healthcare providers. In 2005 the Missouri legislature, lead by a conservative coalition of Republicans, passed legislation that capped non-economic damages in medical malpractice cases at $350,000.00. This legislation superseded previous legislation in 1986 that capped non-economic damages at $300,000.00. However, the 1986 legislation was different in several important respects. First, it applied a yearly cost of living escalator. In 2005, the cap, by inflation, had risen to over $650,000.00. Second, the 1986 cap applied to each defendant in the case, not the case as a whole. Thus, if two healthcare providers negligently caused a patient some harm, two caps were applied. The 2005 caps have no inflation adjuster and apply regardless of the number of defendants.
Advocates for patients claimed the caps were unreasonably restrictive, and caused unfair outcomes. Severely injured patients would receive no more than less severely injured patients. Younger patients who would have to live with painful outcomes would be treated the same as older patients with much shorter life expectancies. Advocates for patients felt the legislature had violated patients' rights to trial by setting damages regardless of the severity of injury, a job for juries. Advocates for the caps argued that escalating insurance premiums would be held at bay with the caps.
Arguments for both sides of the debate were only partly answered by the Supreme Court in Klotz v. St. Anthony's. Many technical evidence questions were resolved by the Court before it turned its attention to the question of caps. On that issue, the Court held that the new caps could not be applied retrospectively. In other words, the Court felt the legislature improperly imposed the 2005 caps on cases that had accrued (arisen before) before the 2005 caps were put into place. The Court declared this portion of the 2005 legislation unconstitutional. For cases where the negligent treatment occurred before the new caps were put into place, the old caps applied. This was agreed by the entire seven member court.
On the issue of the constitutionality of the caps themselves, the Court did not rule. By ruling as it did on the constitutionality of the retroactive application of the 2005 caps, the Court felt the Klotz case was resolved, and did not address the constitutionality of the new caps. However, two members of the Court, Justice Teitleman and Justice Wolff, both wrote concurring opinions. Each Justice felt, for different reasons, that the caps on noneconomic damages violated the Missouri Constitution.
The concurring opinions do not change the law, but they do signal where some of the Court members are on this issue. Certainly the Court will be presented with this issue again in the near future, and the question of damage caps will be answered. The Padberg & Corrigan Law Firm will continue to advocate for the rights of injured patients, and will assist in this fight until its final decision.