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Missouri Supreme Court strikes down noneconomic damage caps in med mal cases

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Jarrett Dieterle
Legal Intern, Manhattan Institute's Center for Legal Policy

Yesterday, in the case Watts v. Cox Medical Centers, the Supreme Court of Missouri struck down noneconomic damage caps in medical malpractice cases. In 2005, the Missouri legislature passed, and then-Governor Matt Blunt signed, a law that limited noneconomic damages in medical malpractice cases to $350,000.

The state Supreme Court struck down this cap in a 4-3 decision (all four members of the majority were appointed by Democratic governors). Chief Justice Richard B. Teitelman, writing for the majority in Watts, held that the damage caps violated a jury trial right that Missourians had enjoyed since the common law era:

As such, section 538.210 directly curtails the jury's determination of damages and, as a result, necessarily infringes on the right to trial by jury when applied to a cause of action to which the right to jury trial attaches at common law. Because the common law did not provide for legislative limits on the jury's assessment of civil damages, Missouri citizens retain their individual right to trial by jury...

Prior to the 2005 legislation, Missouri capped noneconomic damages at $579,000; the 2005 law lowered this amount to $350,000 and made the cap apply to the total amount owed by all the defendants instead of merely having the cap apply to each defendant individually. The majority in Watts overruled a previous state Supreme Court ruling in Adams By and Through Adams v. Children's Mercy Hosp., which had held damage caps constitutional under state law.

The dissent argued that Adams should be followed in adherence to the doctrine of stare decisis, as well as pointing out that, even if the absence of precedent, Missourian's right to a jury trial was not undermined by damage caps:

The jury serves no function other than providing an individual his right to a trial by jury. As such, the jury's "constitutional task" is to provide one with his or her "individual right" to a trial by jury. Section 538.210 does not prevent the jury from assessing damages. It is only after the jury assesses damages that the trial court applies section 538.210. When the jury performs its "constitutional task," the plaintiff is afforded his or her "individual right" to a trial by jury.

The trial lawyers cheered the Watts decision as a great victory for victims of medical malpractice. Importantly, however, Missouri's cap applied only to noneconomic damages, such as "pain and suffering," and did not cap the cost of future medical care a patient might need as a result of a doctor's inadequate care. The Republican controlled legislature is considering plans to place a constitutional amendment on the ballot in November as a way to circumvent the court's ruling.

[UPDATE: Carrie Severino of National Review's Bench Memos suggests that Missouri's method for selecting judges - eponymously named the Missouri Plan - may have contributed to the outcome in Watts:

The [Watts] decision doesn't come as a surprise. Critics of the Missouri Plan for selecting judges, myself included, have long argued that it allows trial lawyers to hand-pick judges, dramatically increasing the probability that the state's jurisprudence will mirror the trial bar's priorities. The trial bar's influence appeared evident in the majority opinion's reasoning.

The Missouri Plan model consists of a "non-partisan" committee that sends a list of potential judicial candidates to the state Governor for selection. Critics of the plan have suggested that such selection committees are often dominated by trial lawyers, leading to judges who are sympathetic to the trial lawyers' agenda.]

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