March 25, 2010 - Missouri Supreme Court Issues Limited Ruling in Medical Malpractice Case

Damage caps on pain and suffering in medical malpractice awards cannot be applied retroactively, the Missouri Supreme Court ruled Tuesday in a widely watched case involving an Arnold, Missouri, couple.

Bucking a recent trend among other state courts, the Missouri court did not overturn caps state lawmakers put on malpractice awards back in 2005 but said that they didn't apply to James and Mary Klotz because their case involved injuries that occurred before the law changed.

"It is settled law in Missouri that the legislature cannot change the substantive law for a category of damages after a cause of action has accrued," the court wrote.

On Monday, the Georgia Supreme Court had declared similar caps in that state unconstitutional, ruling that a cap on awards limits the right to a fair trial, because the jury's ability to reach an award has been hampered by the Legislature. On different grounds, the Illinois Supreme Court overturned medical malpractice caps in that state in February.

Lawyers on both sides of the politically charged issue found something to cheer in the Missouri ruling.

"The good news for doctors and defendants in this case is that the majority of the court recognizes that caps are good law," said the attorney who represented the defendants, physician Michael Shapiro and the Metro Heart Group. "There aren't going to be too many cases that will be subject to this ruling."

His clients were sued by the Klotzes in December 2006, because they alleged malpractice in the failure of James Klotz's pacemaker. The damage occurred in 2004, they alleged, before the new malpractice caps of $350,000 for pain and suffering were enacted.

The lower malpractice caps were part of Gov. Matt Blunt's push in 2005 to change various laws to make the state more friendly to the health care industry. At the time, doctors were leaving the state, and Blunt and other Republicans blamed the costs of malpractice lawsuits.

While the court only issued a narrow ruling on the issue of retroactivity, attorneys who work in the malpractice field said they were encouraged by the concurring opinions written by judges Mike Wolff and Richard Teitelman, both of whom wrote that the malpractice caps are unconstitutional.

Wolff wrote that the caps limit the right to a trial by jury, while Teitelman questioned whether the caps discriminate against the poor, because there is no cap on economic damages.

"I think they point out that questions remain," said a St. Louis attorney who was involved in the Klotz case.

He and his partner represent another client who has challenged the constitutionality of the damage caps.

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