JEFFERSON CITY — After Ronald Sanders' wife died in 2005 — because of a medicine that caused irreversible brain damage, he said — he sued.
He sued a slew of doctors for wrongful death and medical malpractice, and he dismissed or settled with all but one, neurologist Iftekhar Ahmed. At the end of the trial, the jury awarded Sanders and his daughters nearly $1 million to pay back medical bills as well as $9.2 million in non-economic damages, those that aren't related to medical or monetary costs.
There was just one problem: Ahmed's attorneys whipped out a state statute that caps the non-economic damages a jury can award in medical malpractice lawsuits. That statute knocked down Sanders' non-economic awards to $1.2 million; his attorneys responded that the statute was unconstitutional. The case was appealed and cross-appealed to the Missouri Supreme Court.
The seven justices of the state's high court heard arguments Wednesday from the attorneys on whether the legislature's cap on non-economic damages in medical malpractice lawsuits violates the Missouri Constitution.
The legislature first imposed limits on non-economic damage awards in an effort to hold down the rise in medical malpractice insurance rates.
The attorneys focused on the arguments from the plaintiff's appeal, which said that the reduced damages are unconstitutional because the statute capping the awards denies a legitimate trial by jury and violates the separation of powers between branches of the government.
Right of trial by jury
The Missouri Constitution guarantees the right of trial by jury, but plaintiff attorney Steve Hobson argued that the statute limiting the amount of damages doctors must pay the plaintiff cuts the jury's job short. The jurors aren't able to award high-dollar damages after listening to the facts of a case; instead, the jurors are prevented from awarding full damages by the statute enacted by the state legislature, Hobson said.
"My client was entitled to $10 million and the legislature, without knowing any of the facts of the case, said, 'Oh no he's not. He's only entitled to this amount,'" Hobson said in court.
Defense attorney Tim Aylward responded that the right to a trial by jury doesn't include a right to have the jury award the damages, a precedent he said was set with a 1992 case against Children's Mercy Hospital that stated the statute doesn't violate the right to trial by jury.
Aylward said even with the cap in place, the jury still serves its function of trying the facts of the case and making a judgment.
Separation of powers
The second article of the state constitution contains one paragraph comprising one sentence, which declares that the three branches of state government — legislative, executive and judicial — must remain separate and not encroach on the powers of the other branches.
To have the Missouri General Assembly create a law that caps the amount of damages jurors can award means that the legislative branch is sticking its fingers in the judiciary's business, Hobson said. And to have the legislature tell the courts to disregard jury-awarded damages could lead to a slippery slope, he added.
Aylward said that the courts operate under statutes and laws created by the legislature on a regular basis.
"Every day in this state and across the country, juries and judges decide cases within a matrix of a framework of laws that come to them by precedent and also by the legislature," he said.
It's the legislature's valid prerogative to place uniform outer limits on how much a doctor or health care provider can be required to pay, Aylward said.
The Supreme Court has not yet ruled on the case.