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Caps on medical malpractice lawsuits signed into law

Ray Howze
St. Louis Public Radio

Limits on monetary damages in medical malpractice lawsuits have been reinstated in Missouri.

Gov. Jay Nixon signed Senate Bill 239 into law Thursday at SSM Health St. Mary's Hospital in Jefferson City. The state's Supreme Court overturned the previous limits three years ago. Since 2005 they had been at $350,000.

Commonly known as tort reform, the bill places caps of $400,000 on damages for personal injury and $700,000 for a catastrophic injury – death, paralysis or loss of vision for example – in a medical malpractice lawsuit. It also includes a clause to increase the limits by 1.7 percent each year.

Without caps on damages, insurance companies can charge doctors a range of premiums to insure their practice. Nixon said the Supreme Court's decision created a level of uncertainty. 

"This decision resulted in a new problem by creating a climate of financial uncertainty for health care providers," he said.

Noneconomic damages, as the bill defines them, include everything except the medical costs and lost wages as a result of the injury.

Ravi Johar, an OBGYN at Mercy Hospital in St. Louis and president-elect of the Missouri State Medical Association, joined other doctors and the governor in Jefferson City on Thursday. He said insurance costs are a doctor's single biggest expense.

"Physicians have to be able to keep their doors open," Johar said. "If you have to pay out more, it's not like a grocery store or gas station where as their costs increase, they can pass it on. We have set reimbursement. If our costs increase and our reimbursements stay the same, you just can't keep your doors open."

Many supporters of the bill warned that without setting limits on damages, doctors would leave the state because it would be too expensive to practice. Johar said he saw a lot of colleagues leave the state after the court's ruling.

The measure passed the Senate in March by a vote of 28-2 and the House in April by a vote of 125-27. Many Democrats opposed the bill in previous years, but some agreed to it this year after the higher limits and 1.7-percent increase were included.

"Together we are marking the successful completion of a bipartisan effort to ensure that our health care providers can continue to do what they do best, help and heal Missourians in need," Nixon said. "This is a day many years in the making and a result of a lot of hard work by many people and organizations."

Sen. Jill Schupp, D-Creve Coeur, was one of the "no" votes in the Senate. She said monetary damages shouldn't be limited by a state law.

"We need to take a look at each situation individually and make a decision based upon those facts," Schupp said. "By pre-empting that ability by putting a cap on these damages, I think we've done a disservice to the people of the state of Missouri."

Schupp cited the case of Regina Turner of St. Louis. Doctors at St. Clare Health Center in Fenton operated on the wrong side of Turner's brain in 2013 and caused cognitive and neurological problems.

"You tell me what the right amount is in punitive damages to compensate that woman for the loss of all kinds of skills and for needing care the rest of her life," she said. "Sure, that care is going to be taken care of, but her quality of life is diminished forever."

In the court's 2012 ruling, it said a restriction on damages was in violation of the Sixth Amendment – a right to a jury trial. This year's bill does not contain any severability clauses, so if a court does find the bill unconstitutional, all parts would be invalid.

Follow Ray Howze on Twitter: @RayHowze