The Missouri Supreme Court recently issued an amended opinion for Dodson v. Ferrara, Mercy Clinic Heart and Vascular, LLC. BSCR’s first post discussing the Court’s original opinion can be found here.

In Dodson, the Missouri Supreme Court heard, en banc, an appeal by both Plaintiffs and Defendants from the circuit court of St. Louis County. The case originates from a wrongful death action, brought by the family of Shannon Dodson against Defendant health care providers Dr. Robert Ferrara and Mercy Clinic Heart and Vascular, LLC, after Shannon Dodson died from a dissection of her left main coronary artery during a cardiac catheterization. The original jury verdict totaled $1,831,155 for economic damages and $9 million for noneconomic damages, but the trial court reduced the noneconomic damages to $350,000 pursuant to Mo.Rev.Stat. §538.210. On appeal, Plaintiffs argued that the statutory cap on noneconomic damages does not apply in wrongful death cases per Watts v. Lester E. Cox Medical Ctr., 376 S.W. 3d 633 (Mo. banc 2012) and that the cap violated constitutional rights of the right to trial by jury, equal protection or separation of powers provisions under both the Missouri and United States Constitutions. The Missouri Supreme Court ultimately held that noneconomic damages cap in Mo.Rev.Stat. §538.210 is, in fact, constitutional as applied in wrongful death cases, discussing the distinction of a common law claim for personal injury as opposed to a statutory claim for wrongful death.

The Court’s original opinion held that the statutory cap in Mo.Rev.Stat. §538.210 does not violate those rights provided by equal protection. Plaintiffs argued that the statutory damages cap “impacts a fundamental right because it impermissibly restricts the right to a jury trial” or, alternatively, their claims must be placed under a rational basis review to determine if the law was justified inasmuch as it was rationally related to a legitimate state interest. The Court rejected plaintiff’s first argument and, analyzing their claims under a rational basis review, found that not only was the damages cap found to be rationally related to a legitimate state interest (i.e. “reduce perceived rising medical malpractice premiums and prevent physicians from leaving ‘high risk’ medical fields”; See also Adams v. Children’s Mercy Hospital, 832 S.W.2d 898 (Mo. banc 1992), but also that the equal protection concerns presented by the plaintiffs did not apply to the outcomes stemming from the Court’s rulings (“Plaintiffs cite no cases holding that equal protection analysis is appropriate in judicial determinations.”).

In the revised opinion, which was prompted by plaintiffs’ counsel’s attempted request for a rehearing (which was denied), while the outcome of the case remained the same, the Missouri Supreme Court slightly expanded upon its original equal protection discussion. It still recognized that plaintiffs had not actually challenged the Missouri constitutional provision itself (article I, section 22(a)), but rather plaintiffs had challenged the Court’s interpretation of the provision-an argument that does not properly raise an equal protection challenge.

However, the Court replaced an existing footnote (FN 12 on p. 24 of the revised opinion), elaborating on its previous footnote that had briefly discussed the concept that an analysis of equal protection could apply to a court functioning in its administrative capacity. The revised footnote further distinguishes between common law causes of action and those created by statute, while also supporting its decision that the Mo.Rev.Stat. §538.210 damages cap did not present an equal protection violation. The new footnote states as follows: “In any event, plaintiffs whose family member was killed by medical negligence are not similarly situated to plaintiffs who – themselves – were injured by medical negligence. The former have no common law cause of action, the latter do. It is this distinction which accounts for the differences between Watts, on one hand, and Sanders and the present case on the other. Because the two classes of plaintiffs are not similarly situated with respect to Missouri’s constitutional right to a jury trial, there can be no equal protection violation either in the constitutional provision or this Court’s application of it.”

While the Court’s revised opinion does not affect the outcome of the case, the further distinction between common law and statutory causes of action could have an effect on future court discussions on the constitutionality and applicability of caps on damages. Also unchanged is the possibility of more change to non-economic damages caps through the legislature in the future, which, for now, remain constitutional in the context of a claim for wrongful death.

Recent BSCR Blog Posts Related To Statutory Caps:

March 2015 - Possibility of statutory caps making a comeback through Senate Bill No. 239.

May 2015 - Both the Senate and House Bill had passed, which limited non-economic damages in medical negligence claims to $350,000, reflecting and supporting the later Dodson decision.

May 2016- Original Dodson opinion discussed.

A summary of the Dodson case can also be found here.