Missouri, Georgia Supreme Courts Rule On Challenges To Noneconomic Damages Caps

(Mealey’s) The Missouri Supreme Court on March 23 held that caps on noneconomic damages in medical malpractice cases cannot be applied to cases filed before a law setting the limits took effect in 2005; the ruling came a day after the Georgia Supreme Court declared that state’s caps unconstitutional (James Klotz, et al. v. St. Anthony’s Medical Center, et al., No. SC90107 Mo. Sup.; Atlanta Oculoplastic Surgery, P.C. v. Nestlehutt, et al., No. S09A1432, Ga. Sup.). 

The Missouri case restored the full amount of noneconomic damages that a jury had awarded to James and Mary Klotz, who sued St. Anthony’s Medical Center, Dr. Michael Shapiro and Metro Heart Group in December 2004, alleging medical malpractice.  James Klotz developed a staph infection in April 2004, a month after Shapiro inserted a pacemaker in Klotz at St. Anthony’s.  Klotz suffered sepsis, organ failure and other complications as a result of the infection.  Mary Klotz asserted a claim for loss of consortium. 

A St. Louis Circuit Court jury in July 2008 awarded James Klotz damages totaling nearly $2.1 million and awarded Mary Klotz $513,000.  However, the trial court judge reduced James Klotz’s noneconomic damages against Shapiro and Metro Heart Group from $509,200 to $234,500 and reduced Mary Klotz’s noneconomic damages from $220,430 to zero, citing Revised Statutes of Missouri Section 538.10.  Section 538.10 had been amended in 2005 by the Missouri Legislature; the amended law caps noneconomic damages against health care providers to $350,000 per occurrence for all cases filed after Aug. 28, 2005.

The Klotzes appealed, arguing that Section 538.10 violates the Missouri Constitution’s prohibition against retrospective legislation because their claim arose before Section 538.10 took effect, among other arguments.  Shapiro and Metro Heart Group responded that the amendment is not unconstitutional because although James Klotz was injured before August 2005, the “right” of noneconomic damages did not occur until the jury found that he was entitled to those damages.

In reversing and remanding to the trial court for entry of a judgment consistent with the jury’s verdict, the Missouri Supreme Court called the issue “straightforward.”  “When the malpractice accrued, the legislature had an established cap on noneconomic damages of $579,000, and both Mr. and Mrs. Klotz were entitled to their own noneconomic damages up to that cap amount,” the en banc Supreme Court said in its per curiam opinion.

In the Georgia case, Betty Nestlehutt and her husband sued Atlanta Oculoplastic Surgery, d/b/a Oculus, for medical malpractice after complications from a laser resurfacing and full facelift in 2006 caused her permanent disfigurement.  A jury awarded $115,000 for medical expenses, $900,000 in noneconomic damages for Betty Nestlehutt’s pain and suffering and $250,000 for her husband’s loss of consortium.

The Nestlehutts then moved to have Official Code of Georgia Annotated Section 51-13-1 — which would have reduced the jury’s noneconomic damages award to the statutory limit of $350,000 — declared unconstitutional.  The trial court granted the motion and entered judgment for the couple in the full amount awarded by the jury.  Oculus appealed.

In affirming the trial court, the Georgia Supreme Court held Monday that the cap violates the state Constitution’s guarantee of the right to trial by jury.

“By requiring the court to reduce a noneconomic damages award determined by a jury that exceeds the statutory limit, OCGA § 51-13-1 clearly nullifies the jury's findings of fact regarding damages and thereby undermines the jury's basic function,” the court said.

[Editor's Note:  Full coverage will be in the April issue of Mealey’s Litigation Report: Punitive Damges.  In the meantime, the opinions are available at or by calling the Customer Support Department at 1-800-833-9844.  Missouri Supreme Court opinion.  Document #67-100416-003Z.  Georgia Supreme Court opinion.  Document #67-100416-004Z.  For all of your legal news needs, please visit]
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