Missouri Cap on Non-Economic Damages Unconstitutional; Discretion Abused Setting Long-Term, Low-Interest Periodic Payments for Brain-Injured Infant

A near-term pregnant woman sought medical care because she had experienced cramping and noticed decreased fetal movement. The medical treatment she received did not meet the standard of care and caused her son to be born with catastrophic brain injuries.


The woman sued the medical center and its associated physicians for providing negligent health care services. After a trial, the jury returned a in favor of the plaintiff and awarded $1.45 million in non-economic damages and $3.371 million in future medical damages. The trial court entered a judgment reducing the non-economic damages to $350,000 as required by state law and establishing a periodic payment schedule pursuant to another state law. The periodic payment schedule required immediate payment of half of all net future medical damages with the other half paid in equal annual installments over the next 50 years with an interest rate of 0.26 percent.


Both parties appealed. The plaintiff argued the state law cap on non-economic damages violated the right to trial by jury and that the periodic payment schedule was arbitrary and unreasonable because it does not assure full compensation due to the low interest rate and 50-year payment schedule.


The defendants argued that the trial court erred in requiring immediate payment of half of all net future medical damages. Specifically, the defendants argued that the applicable state law prohibits a lump sum payment of a portion of future medical damages and, instead, requires that all future medical damages be paid pursuant to a periodic payment schedule.


The Supreme Court of Missouri held that the state law cap on non-economic damages violates the Missouri Constitution’s right to trial by jury because it infringes on the jury's purpose of determining the amount of damages sustained by an injured party. The court also held that the trial court abused its discretion because the periodic payment schedule did not assure full compensation due to the interest rate and 50–year payment schedule. The court clarified that the state law pursuant to which the judge set the periodic payment schedule gives the judge the authority to determine the manner in which future damages shall be paid, including what portion should be paid in future installments as to both medical and other future damages.


See: Watts v. Lester E. Cox Medical Centers, 2012 WL 3101657 (Mo., July 31, 2012) (not designated for publication).