Mo. SC upholds cap on non-economic damages

Jessica M. Karmasek Apr. 4, 2012, 10:35am


JEFFERSON CITY, Mo. (Legal Newsline) - The Missouri Supreme Court ruled Tuesday that the state's cap on non-economic damages is constitutional.

Plaintiff Ronald Sanders argued that the Jackson County Circuit Court was wrong in entering a judgment providing $1.2 million in non-economic damages, instead of the $9.2 million awarded to him by a jury.

Sanders sued over the care, and eventual death, of his wife, Paulette.

On May 21, 2003, Paulette Sanders went to the emergency room at the Medical Center of Independence with complaints of numbness in her legs and difficulty walking.

Sanders, who had a long history of seizure disorders, was admitted to the hospital by her primary care physician, who requested a consultation by defendant Dr. Iftekhar Ahmed.

Ahmed, a neurologist, ordered a change in her medications from Dilantin and phenobarbitol to Depakote.

Sanders remained in the hospital. Within a week, she became lethargic. Soon after, she suffered a focal seizure, which required emergency medical intervention.

At that time, Ahmed ordered that the Depakote be discontinued.

Sanders quickly deteriorated and became unresponsive to even painful stimuli.

She was eventually transferred to a long-term care facility, where she remained bedridden. She died in August 2005.

Ronald Sanders filed a personal injury suit in May 2005. Three years later, he filed an amended petition, adding a claim for his wife's wrongful death.

During trial, Sanders argued that his wife had a defect that prevented her body from eliminating byproduct ammonia, which was produced from the Depakote ordered by Ahmed.

He also claimed that Ahmed failed to recognize and properly treat the increasing ammonia level and, as a result, his wife suffered irreversible brain damage that ultimately caused her death.

A jury later awarded Sanders $920,745.88 in past economic damages, $1.7 million in past non-economic damages and $7.5 million in future non-economic damages, for a total of $10,120,745.88.

The Jackson County Circuit Court then cut the $9.2 million in non-economic damages to $1,265,207.64, in accordance with the state's cap on such damages.

According to state code, "any action against a health care provider for damages for personal injury or death arising out of the rendering of or the failure to render health care services, no plaintiff shall recover more than $350,000 per occurrence for non-economic damages from any one defendant."

The law also allows the court to adjust the cap for inflation.

Sanders appealed, challenging the constitutionality of the cap.

Ahmed also appealed the trial court's judgment, specifically its denial of reduction and periodic payments.

Sanders argued that periodic payments violate the Missouri Constitution.

The state's high court ruled that both the cap and the periodic payments are constitutional.

As for the trial court's denial of reduction, the Court reversed and remanded the issue to the lower court.

Justice William Ray Price Jr. authored the majority's 30-page opinion.

"Provisions within section 538.210 limiting non-economic damages in wrongful death suits do not violate article I, section 22(a) of the Missouri Constitution," he wrote.

"The fact-finder -- whether judge or jury -- makes a factual determination when returning its verdict. The judge then enters judgment by applying the law to the fact-finder's determination."

The limit on damages, Price explained, interferes neither with the jury's ability to render a verdict nor with the judge's task of entering judgment. "Rather, it informs those duties," the justice wrote.

As for the trial court's denial of periodic payments, Price said the statute is "simply a limitation on a remedy."

"As the amount of noneconomic damages recoverable after applying the caps is less than the total amount of past non-economic damages determined by the jury, it is within the discretion of the trial court to assign the entire $1,265,207.64 as past noneconomic damages," he wrote.

From Legal Newsline: Reach Jessica Karmasek by email at

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