Fate of Missouri's liability cap before state Supreme Court

Missouri's stabilizing medical liability climate could come undone if a legal challenge to the state's noneconomic damage cap is successful, physicians warned.

The Missouri Supreme Court will hear a constitutional challenge to the $350,00 award limit in medical liability cases. Oral arguments are set to begin Jan. 14, 2010.

The case stems from a $1 million jury verdict in 2008 to James Klotz, who experienced a brain hemorrhage and other complications after his pacemaker became infected. The physician and hospital involved denied any wrongdoing.

A trial court rejected arguments from plaintiff lawyers that the cap and other reforms violated patients' equal protection and jury trial rights when the judge reduced the jury award to the state's cap.

The high court directly took up Klotz's appeal of the ruling, and the case has rallied the medical community in defense of the 2005 cap.

Physicians, hospitals and medical liability insurers credit the statute with lowering insurance premiums and lawsuit filings, and helping doctors remain practicing in the state.

A recent report by state insurance regulators showed that in 2008, medical liability lawsuit filings hit some of the lowest rates in decades. The study found that 1,215 new claims were filed in 2008, the lowest number since 1999. Another 3,017 claims remained open, the lowest number in the 30 years the state has tracked the data.

"Money that would otherwise be spent on doctors' insurance premiums now goes to help patient care," said Jeffrey Howell, general counsel to the Missouri State Medical Assn. The organization, along with the Litigation Center of the American Medical Association and State Medical Societies, filed a friend-of-the-court brief in the case, Klotz v. Shapiro.

Howell also noted that a prior cap -- which stood at $640,000 before it was adjusted to $350,000 in the 2005 tort reform effort -- was upheld by the state Supreme Court in a 1992 decision, Adams v. Children's Mercy Hospital.

But Mary Coffey, Klotz's attorney, pointed to several differences in the newer law, which no longer includes inflation adjustments and limits noneconomic damages to $350,000, regardless of the number of injured plaintiffs or defendants in a case.

"What this does is cut the really catastrophic injury cases at their knees," Coffey said. The Missouri Assn. of Trial Attorneys is assisting Klotz's case.