Missouri Supreme Court Hears Challenge to Malpractice Limits

Missouri’s top judges questioned Jan. 14 whether a 2005 law limiting medical malpractice lawsuits is being wrongly applied to people retroactively and is discriminating against the spouses of those injured.

Attorneys for patients argued to the state Supreme Court that the law violates numerous provisions of the Missouri Constitution and that lawmakers had no rational basis to reduce the amount of money that people who had been harmed could win from medical providers.

The law was a priority of the Republican-led Legislature and then-Gov. Matt Blunt. They claimed “tort reform” was essential to curtail rising liability insurance premiums for doctors and to ensure that health care was available and affordable for Missouri residents.

A main change in the 2005 law lowered the cap for non-economic damages such as pain and suffering in medical malpractice cases to a flat $350,000 per lawsuit. Missouri’s previous limit of $579,000 had been adjusted annually for inflation and had been interpreted by courts to apply to multiple parties in a lawsuit.

Specifically at issue was the case of James and Mary Klotz of suburban St. Louis, who sued after James Klotz had a pacemaker implanted in March 2004 and subsequently contracted a staph infection that contributed to other health problems.

Although the Klotzes originally sued in December 2004, they dismissed that case and re-filed a lawsuit in December 2006. A jury awarded James Klotz more than $2 million and Mary Klotz more than $500,000, with non-economic damages comprising more than half their combined total.

The trial judge then reduced James Klotz’s non-economic damages to the cap imposed by the 2005 law and eliminated them for Mary Klotz because the law required that they be counted under her husband’s total.

Several judges focused their questioning of attorneys on a section of the state constitution that prohibits laws from being applied retroactively – something the court enforced earlier this week in a challenge to laws imposing new requirements on sex offenders.

The Legislature applied the medical malpractice caps to lawsuits filed after the Aug. 28, 2005, effective date of the law – even if the alleged malpractice occurred before then.

Chief Justice William Ray Price Jr. asked how that was any different than the Legislature responding to a hypothetical bridge collapse by voting the next day to limit lawsuit damages against to state to $100 for each family who lost a loved one – something he implied would be unconstitutional.

Attorney Tad Eckenrode, who represented Dr. Michael Shapiro and the Metro Heart Group of St. Louis, responded that the legal philosophy was different and that in the case of the Klotzes, “there is no reason for these people to have believed that the law wouldn’t change.”

Supreme Court judges also followed up another of the Klotzes’ arguments by questioning whether the 2005 law effectively limited spouses’ constitutional right to access the courts by placing their damages for “loss of consortium with their spouse” under the same non-economic damages cap as that of their husbands or wives.

The Klotzes, who listened from the front row of the Supreme Court’s seating gallery, said afterward that they were encouraged by the judges’ questions.

“Mine’s an example case basically,” James Klotz said. “There’s a lot of injustice, I think, by having the caps.”

Also watching the arguments was state Sen. Jason Crowell, R-Cape Girardeau, an attorney who was a chief advocate for the 2005 limits. Crowell said lawmakers limited what spouses could win because their claims were dependent on injuries to their husbands or wives.

“What we wanted was a hard $350,000, non-stackable, non-split-up-able, non-multipliable” limit, Crowell said. “We only did that in the medical malpractice field because (lawmakers had) figures that say there will be savings to the health care system if these lawsuits go away.”

The case attracted extraordinary attention. Legal briefs were filed on behalf of 25 groups – with businesses, insurers and medical professionals generally arguing to uphold the law and attorneys for the elderly, disabled, minorities and unions arguing it should be struck down because they would be disproportionately affected by the limits.