Malpractice Damage Cap Thrown Out in Missouri

The Supreme Court of Missouri voted 4 – 3 to overrule the cap on noneconomic damages in medical malpractice cases on July 31, 2012.  The court ruled that damage caps are unconstitutional and violate the right of trial by jury.  A prior decision in 1992 had upheld the cap as constitutional, and in 2005 a tort reform bill was passed that lowered the amount from $579,000 to $350,000.

Other parts of Missouri’s medical malpractice tort reform remain unchanged, and the noneconomic damage cap in wrongful death cases still applies.



In this case, Watts v. Lester E. Cox Medical Centers, the family of a baby born with brain injuries was awarded $1.45 million in noneconomic damages at trial, but the trial court limited that award to the maximum allowed by the 2005 cap.  The Supreme Court’s opinion was that the plaintiff was entitled to have a jury determine the claim for noneconomic damages caused by medical negligence. The Supreme Court also found that the lower court abused its discretion regarding a periodic payment schedule for future damages because it did not assure the plaintiff full compensation considering the length of time involved and rising costs of health care.



Because the damage caps were found to be unconstitutional, the only way this decision can be changed is by a constitutional amendment. The 3 ways to amend the Missouri constitution are by proposal from the General Assembly put to a statewide vote, an initiative petition put forth by voters, and Constitutional Convention.



The response to the damage cap being thrown out has been varied.  The president of the Missouri Association of Trial Attorneys says this decision is a victory for individual rights. Others consider it devastating news for physicians and health care providers. Do not expect any immediate rate reaction from medical malpractice insurance companies.



Most malpractice insurance companies have been watching this case closely and, considering the current political climate in Missouri,were not surprised by the decision.  The larger companies have been preparing for this possibility by building reserves and a healthy surplus. It is recommended physicians and hospitals look carefully at their insurance company and make sure coverage is with a strong, financially stable company.


We will be following events related to this decision and will make updated information available.