Constitutionality of Statutory Caps on Non-Economic Damages in Missouri

Prior to August 2005, the medical malpractice cap on non-economic damages in Missouri changed each year. The Missouri Department of Insurance, Financial Institutions and Professional Registration would calculate an adjusted rate each year. However, beginning with cases filed after August 28, 2005, the cap is $350,000, regardless of the number of defendants. There is no adjustment for inflation. The Missouri cap on medical malpractice damages applies to non-economic damages. There is no cap on hard economic damages such as medical expenses or lost wages.

Tort reform, such as medical malpractice damages caps are highly controversial and Missouri is no exception. The issue of whether the 2005 law violated the Missouri Constitution was recently litigated in Sanders v. Ahmed. Sanders was a wrongful death action stemming from medical negligence. The jury returned a verdict in favor of Sanders for past economic damages, past non-economic damages and future non-economic damages exceeding $10 million. Applying the cap under RSMo. § 538.210 to the non-economic damages, the trial court reduced plaintiffs’ non-economic damages to the statutory cap. Sanders appealed, contending the cap was unconstitutional. In a 5-2 decision, the Supreme Court of Missouri held the cap on non-economic damages in a wrongful death case is constitutional. The dissent would hold that the cap on non-economic damages set forth in RSMo. § 538.210 violates the right to trial by jury and the separation of powers as guaranteed by the Missouri Constitution.

The Sanders Court put emphasis on the fact that a wrongful death claim in Missouri is purely statutory, with no common law antecedent. The court reasoned that where the legislature created the cause of action, it has the power to define the remedy available. In a narrow holding, the majority ruled that because a wrongful death claim is purely a creature of statute, and not of common law, the legislature had the constitutional power to limit recovery in a wrongful death action.

Interestingly, the same majority of the Missouri Supreme Court used this reasoning earlier in the year in another 5-2 decision (Estate of Overbey v. Franklin Nat’l Auto Sales N., LLC, No. SC91369) in which it upheld the constitutionality of punitive damage caps in a cause of action under Missouri’s Merchandising Practices Act, another statutorily created cause of action.

Still pending before the Missouri Supreme Court is the Watts case (SC 91867) which involves the constitutionality of caps in the context of a medical negligence claim. In Watts, a baby was born with severe brain damage and cerebral palsy, as a result of a clotting issue which was alleged to have caused an inadequate supply of oxygen to his brain. The jury awarded Ms. Watts $4.82 million. The jury’s award was broken down as follows: $3,371,000 future medical, $250,000 past non-economic, and $1,200,000 future non-economic. It will be interesting to see how the court rules with respect to the constitutionality of statutory caps on non-economic damages in a case that is not solely a statutory cause of action.