The Missouri Supreme Court on Tuesday struck down the centerpiece of a highly-touted Republican effort to curb liability lawsuits, opening the way for injured patients and their families to win unlimited amounts of money from the doctors and hospitals that treated them.
In a 4-3 decision, the high court said that a 2005 Missouri law capping noneconomic damages at $350,000 in medical malpractice case violates a right to a jury trial that has been embedded in the Missouri Constitution since in 1820.
Republicans reacted with outrage that the Supreme Court overturned its own precedent set two decades ago, when justices ruled that a previous cap on monetary damages did not infringe on a jury's duties. The state physicians' association predicted dire consequences for the cost and availability of health care. And some supporters of the law said the ruling could lend momentum to a campaign to change the way Missouri's Supreme Court judges are appointed.
But the ruling was praised by plaintiffs' attorneys, who had opposed the 2005 law while warning that it could leave injured, ill and disabled residents without enough money to compensate them for their dramatically altered lifestyles.
"Everyone who believes in the constitution should be thrilled with this decision," said Kansas City attorney Tim Dollar, president of the Missouri Association of Trial Attorneys.
The monetary limit had been the focal point of a "tort reform" law championed by the Republican-led Legislature and enacted by then-Gov. Matt Blunt as a means of reining in medical malpractice premiums for doctors and, hopefully, improving the availability of health care. Blunt said in a telephone interview with The Associated Press that the Supreme Court ruling undermines a key provision of what he considers one of his primary accomplishments during his four years in office.
"It's devastating news, quite frankly, for health-care providers and patients and job-creators in the state," said Blunt, who now lives in Virginia and is president of the American Automotive Policy Council.
Tom Holloway, executive vice president of the Missouri State Medical Association, asserted that - prior to the 2005 law - rising medical malpractice premiums had caused some physicians to leave Missouri and others to cut back on staff and equipment or quit performing risky procedures. He pointed to state figures showing Missouri had 15,663 licensed physicians last year, up almost one-fifth from a decade ago.
The Supreme Court ruling is "going to set off a powder keg of uncertainty in the professional liability insurance market," Holloway said. "The whole thing conjures up the ominous specter of another lawsuit crisis like the one that gripped the state 10 years ago."
Many Democrats and plaintiffs' attorneys contested the assertion that Missouri faced a crisis when Republicans enacted the lawsuit limits, noting that the number of medical malpractice claims filed in the state had been declining for several years before the 2005.
Missouri previously had an inflation-adjusted cap of $579,000 for noneconomic damages, such as pain and suffering, in medical malpractice cases. The 2005 law lowered that to a flat $350,000 and applied the cap to the total amount owed by all defendants, rather than against each defendant for each act of negligence as had been permitted under the old law.
The Supreme Court's majority pointed to the Bill of Rights of the Missouri Constitution, which states "that the right of a trial by jury as heretofore enjoyed shall remain inviolate." The court wrote that when the constitution was enacted in 1820, Missourians had a common law right to seek damages for medical malpractice claims. Therefore, "any limit on damages that restricts the jury's fact-finding role violates the constitutional right to trial by jury," the court said in a majority opinion written by Chief Justice Richard Teitelman.
In a dissenting opinion, Judge Mary Russell said the ruling "reflects a wholesale departure from the unequivocal law of this state and leaps into a new era of law." She said the right to a jury trial can be met when a jury awards damages and a judge latter applies a law capping those damages.
In this particular case, a jury awarded $1.45 million in noneconomic damages to Deborah Watts, who alleged that her son Naython had suffered brain damage when he was born in 2006 because of the negligence of Cox Medical Centers and its associated physicians.
A judge reduced that award to $350,000 in compliance with Missouri's cap. In addition to overturning the limit on noneconomic damages, the Supreme Court ordered the judge to reconsider the schedule for paying Watts nearly $3.4 million she was awarded for future medical damages.