Missouri High Court Narrows Medical Malpractice Limits

The Missouri Supreme Court has slightly narrowed the scope of a 2005 state law limiting how much money can be awarded to people in medical malpractice cases.

The high court’s March 23 ruling provided a victory for those injured before the law took effect. But the court’s majority avoided the broader issue of whether the lawsuit limits are a violation of other constitutional rights.

The 2005 “tort reform” law was a priority of then-Gov. Matt Blunt and the Republican-led Legislature. They said it was needed to hold down liability insurance premiums for doctors, thus ensuring that health care was available and affordable for Missouri residents.

One of the law’s main provisions lowered the cap for non-economic damages such as pain and suffering in medical malpractice cases to a flat $350,000 per lawsuit, effective for any case filed after Aug. 28, 2005. Missouri’s previous limit of $579,000 had been adjusted annually for inflation and had been interpreted by courts to apply to multiple parties in a lawsuit.

At issue was the case of James and Mary Klotz of suburban St. Louis. Their 2006 lawsuit alleged that James Klotz contracted a staph infection – which led to other health problems – when a pacemaker was implanted in March 2004.

A jury awarded James Klotz more than $2 million and Mary Klotz more than $500,000, with non-economic damages comprising more than half their combined total. But a trial judge reduced James Klotz’s non-economic damages to the cap imposed by the 2005 law and eliminated them for Mary Klotz because the 2005 law required that they be counted under her husband’s total.

The Supreme Court said the Missouri Constitution’s prohibition on retroactive laws means those new limits cannot be applied to the Klotzes, nor to anyone else whose injuries occurred before the 2005 law took effect.

The decision means several hundred thousand more dollars for the Klotzes.

“I’m glad I won, but I’m in pain all the time,” James Klotz said in an interview with The Associated Press. “I’d gladly give up all the money just to have my whole life back together.”

It’s unclear how many other plaintiffs stand to gain money as a result of the ruling, but attorneys in the case said that pool could be relatively small. A separate Missouri law generally requires malpractice cases to be filed within two years of an injury.

The Klotzes’ attorneys had urged the Supreme Court to strike down the 2005 limits for all medical malpractice cases, not just those involving injuries that occurred before then.

In a concurring opinion, Supreme Court Judge Michael Wolff said he believes the jury award limits should be stricken for violating a person’s constitutional right to a jury trial.

In another concurring opinion, Judge Richard Teitelman agreed with Wolff’s rational and added that the 2005 limits also should be overturned for violating constitutional equal-protection guarantees.

Teitelman said the limits on non-economic damages disproportionately affect the young, elderly, disabled and poor people who don’t earn enough to win large jury verdicts for economic damages.

“The caps operate on a perverse irony – those with relatively minor injuries are permitted full recovery, while the most severely injured among us are denied,” Teitelman added.

Attorneys involved in the case said the concurring opinions essentially invited a broader challenge of the 2005 medical malpractice limits.

“The current caps are going to continue to apply to cases that are pending until somebody else takes this issue up and perhaps gets a different ruling,” said attorney Tad Eckenrode, who represented the defendants, Dr. Michael Shapiro and the Metro Heart Group of St. Louis.