Missouri Medical Malpractice Laws

In July of 2012, a decision was reached by the Missouri Supreme Court in the case of Deborah Watts v. Lester E. Cox Medical Centers, et al., 376 S.W.3d 633 (Mo 2012). The case held the cap on non-economic damages found in Mo. Rev State. § 528.10 was unconstitutional. This cap had been in place and held since August 29, 2015. The Watts case seemingly only addressed the constitutionality of the cap on non-economic damages in personal injury cases. However, the decision has still left many wondering if the cap will affect wrongful death cases of medical malpractice.

Watts v. Lester E. Cox Medical Centers (the case)

Deborah Watts filed a case on behalf of her infant son, Naython Watts, alleging he suffered brain injuries as a result of negligence committed by Cox Medical Centers and its associated physicians. Deborah Watts received prenatal care at Cox Medical Centers and was seen on October 30, 2006, due to cramping and decreased fetal movement. The jury found the treating physician failed to perform appropriate tests, failed to notify Watts of the significance of decreased fetal movement, and failed to perform further diagnostic tests. Two days later, Watts was admitted to the hospital for lack of fetal movement. While a Caesarian section was used and the delivery was started, Naython Watts was born with catastrophic brain injures due to fetal hypoxia and acidosis.

Jury Verdict

At the conclusion of the trial, the jury awarded damages of $1.45 million in non-economic damages and $3.371 million in future medical damages. The non-economic damages were reduced to $350,000 by the trial court pursuant to Mo Rev State § 538.210. The plaintiff appealed the reduction claiming the reduction and application of the cap was unconstitutional since it violated the right to trial by jury found in Article I § 22(a) of the Missouri Constitution and several other portions of the Missouri Constitution.

This is a really good day for the citizens of Missouri who believe in our Constitution,” said Kansas City attorney and president of the Missouri Association of Trial Attorneys. The high court decision “ensures that Naython will receive the benefit of the jury’s award for future medical care,” according to the ruling written by Chief Justice Richard B. Teitelman. On both sides of the fence, legislatures and attorneys alike sang the praises or the complaints about the decision, and some lawmakers quickly scrambled to write legislation to reinstate the cap on non-economic damages, including suggestions to amend the Missouri Constitution.

Court Ruled Cap on Non-Economic Damages was Unconstitutional

The Court found the non-economic damage cap of § 538.210 unconstitutional for infringing on the jury’s constitutionally protected purpose of determining the amount of damages sustained by an injured party. In the discussion of its rationale, the Court specifically referenced the long history of the inviolate right to trial by jury for actions arising under Missouri common law. An analysis of common law was done, and according to the history of Missouri common law that is based on England and that English common law, it was recognized that medical negligence is one of the five types of “private wrongs.” Civil actions for personal injury damages had long been considered personal wrongs tried by civil juries. Absent in the Court’s decision and rationale was its stance on the constitutionality of the cap on medical malpractice damages in mention of statutory causes of action such as wrongful death.

Legislatures Work to Restore Cap on Non-Economic Medical Malpractice Damages

Republican lawmakers in Missouri are reported to be working on a bill that will restore caps to medical malpractice lawsuit awards. In 2005, Governor Matt Blunt signed a law capping non-economic damages, but the cap was ruled unconstitutional in the Watts case. Republican lawmakers have long claimed that caps on non-economic damages help to curb the rising cost of medical care and health care costs. “Many other states, including Missouri before the Supreme Court’s decision, have used limits effectively to keep the cost of health care affordable for everyone. We need limits in place again to bring the kind of certainty to the system to the system that will keep insurance rates in check, “ said State Rep Eric Burlison-Republican Springfield.

What Does This Mean if I Have Been Injured Due to Medical Malpractice?

The regular legislative session started January 8 of 2014, and no doubt these laws to restore the cap on non-economic damages will be a hot topic for the legislature. Lawmakers riding on the theme of “frivolous lawsuits” and “rising medical care costs” will be loudly proclaiming the need for tort reform and caps on medical malpractice verdicts. In theory, that may sound good, and just too many. But, let’s look again at Deborah Watts and her child with catastrophic brain damage due to negligent care by her physician and hospital. If Naythan were your child, you might feel very differently about a $350,000 non-economic damage. Birth injuries are one of the most heartbreaking injuries because it is associated with the disabling of a child and loss of normalcy for a young person. How do you evaluate that cost? What is the good health and safe delivery of your child worth? I cannot put a price on the health of my children, and I do not think lawmakers should be able to institute caps and reverse the decision of a jury. When a jury determines an award, it is after many hours of evidence, testimony and consideration. Our court system is set up to put faith in the hands of 12 peers, known as the jury. I do not always like a jury’s decision, but we have to have faith in our jury system. It’s a pretty good system. Jury members are usually very reflective of the norms and beliefs of a community and can be less influenced by politics and big business.

Caps are Not Fair in Every Situation

Treating everyone the same is not always fair….it sounds fair when you say it, but when you really think about it, it is not. Every case is different and unique, thus applying one law of a cap to every situation is not fair. Treating every situation the same does not allow for many variables. As each person is unique, so is their story and their loss. Non-economic damages are meant to compensate the plaintiff (injured party) for the negative effects of medical malpractice that are not easily calculable. They include compensation for pain, suffering, stress and anxiety, loss of enjoyment of life, scarring and disfigurement, and similar losses caused by the defendant’s malpractice.

Negligence in Medical Malpractice

Few go to the doctor or hospital expected to be injured. The very act of seeking medical assistance is to seek improvement in a medical situation. However, every year as many as 98,000 people die due to estimated medical errors as determined by the IOM-Institute of Medicine. In order to bring a medical malpractice case, the following conditions must be met:

  • A duty was owed to the patient by the health care professional
  • The duty owed to the patient was deviated from or unmet altogether
  • The unmet duty can be directly related to the injury or illness that arose in the patient
  • The patient is not suffering from an injury or illness that is not related to their original ailment

As you can imagine, the above conditions can be confusing and difficult to ascertain. Medical professionals are held to a higher standard, and rightly so since they frequently deal with life and death. Birth injuries are tragic, and as a parent, you have a right to advocate on behalf of your injured child. At our firm, we understand the complexities of medical malpractice cases and the standard of care that is expected. If you are unsure whether or not you have a medical malpractice claim, we are available to discuss your information and help you determine your options. In general, most doctors work for the betterment of their patients and do not purposely do harm. But, just like any other profession, there are under-performing individuals. Unfortunately, when a doctor underperforms or is negligent, someone can be easily seriously injured or killed. For your free consultation, call (314) 276-1681 today.


Bernard, B & Young, V (2013) Medical Malpractice cap is struck down by Missouri Supreme Court. St. Louis Post-Dispatch 8/1/12

Griffin, M. (2013) Pre-Filed Bill Would Restore Caps on Medical Malpractice Damages. News for St. Louis-part of the NPR digital network. 12/12/13

Deborah Watts vs. Lester E. Cox Medical Center, no? SC91867. Opinion Issued July 31, 2012, modified on the Court’s own motion September 25, 2012.

Missouri Revised Statutes. § 528.10

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The Cagle Law Firm serves accident and injury clients throughout St. Louis and the greater St. Louis metropolitan area, including the eastern Missouri and southern Illinois communities. If you or a loved one needs legal assistance with your personal injury case, call The Cagle Law Firm at (314) 276-1681 or use our online contact form to schedule a free consultation.

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