Missouri has caps on noneconomic damages in medical malpractice lawsuits. There is no cap on economic damages. Here are the caps under § 538.210:
| YEAR | Non-Catastrophic | Catastrophic Cap |
| 2020 | $435,176 | $716,558 |
| 2021 | $442,547 | $774,504 |
| 2022 | $450,098 | $787,671 |
| 2023 | $457,749 | $801,061 |
| 2024 | $465,531 | $814,679 |
| 2025 | $473,445 | $828,529 |
Difference Between Catastrophic and Non-Catastrophic Injury
Missouri distinguishes between catastrophic and non-catastrophic injuries in the context of medical malpractice lawsuits. This distinction is relevant because, as you can see, it affects the cap on noneconomic damages that can be awarded to a plaintiff in such cases.
Catastrophic Injury
In Missouri, a catastrophic injury is defined as an injury that involves one or more of the following:
- Quadriplegia: Complete paralysis of all four limbs (both arms and both legs).
- Paraplegia: Complete paralysis of both lower limbs (both legs).
- Loss of Two or More Limbs: The amputation or loss of use of two or more limbs, such as arms or legs.
- Significant and Permanent Cognitive Impairment: Severe and irreversible cognitive impairment that substantially impairs the individual’s ability to think, reason, or function.
- Irreversible Failure of a Major Organ: The complete and permanent failure of a major organ, such as the heart, lungs, or kidneys.
- Significant Loss of Vision: A substantial and permanent loss of vision.
For injuries that fall into any of these categories, the cap on noneconomic damages in medical malpractice cases is typically higher.
Non-Catastrophic Injury
Non-catastrophic injuries, by contrast, do not meet the criteria outlined above. These injuries may still be severe and result in significant pain and suffering, but they do not fall into the catastrophic category.
For non-catastrophic injuries in Missouri, there is a lower cap on noneconomic damages that can be awarded to the plaintiff.
What Is the Loss of Consortium Cap in Missouri?
A claim for loss of consortium is combined with the plaintiff’s claim, treating them as a single entity and applying a single cap. There is a single cap regardless of the number of defendants involved. This means that in any medical negligence case, the maximum limit for non-economic damages remains at $700,000, regardless of whether there is a loss of consortium claim (or multiple defendants in the case).
Velazquez v. University Physician Associates
In 2021, the Missouri Supreme Court ratified the cap in Velazquez v. University Physician Associates, et al., No. 98977, setting significant legal precedents pertaining to noneconomic damages caps outlined in § 538.210, RSMo., concerning lawsuits against healthcare providers for personal injury arising from healthcare services.
Cap Fully Affirmed
Firstly, the Court upheld the noneconomic damages caps in their entirety, affirming that the Missouri Legislature’s 2015 amendment, which replaced a common law medical malpractice cause of action with a statutory one, was constitutionally sound. The Supreme Court emphasized the General Assembly’s authority to abolish common law causes of action and made clear it did not think that capping noneconomic damages for statutory causes of action violated the Missouri Constitution. So that puts that issue to bed.
Trial Date Is the Date for Cap
Unlike most states, the determination of the applicable noneconomic damages cap in Missouri is based on the trial date, not the date of injury. The court in Valazquez explicitly stated that the cap applies to the damages awarded during the trial, not the underlying malpractice incident.
This means that the caps are applicable to damages awarded on or after the statute’s effective date, even if the malpractice occurred prior to that date. The Court justified this interpretation by highlighting the legislature’s intent to safeguard a plaintiff’s noneconomic damages award from inflation, requiring the cap to be applied at the time of the trial, not the date of the alleged malpractice.
- Another law firm’s summary of Valazquez
History in the Cap in Missouri
In 2005, the Missouri Legislature passed HB 393, which placed a $350,000 cap on non-economic damages in medical negligence claims.
Watts
In 2012, in Watts v. Cox Medical Center, the Supreme Court of Missouri struck down § 538.210 — the state’s medical malpractice noneconomic damage caps that became law in 2005 — for violating the Missouri Constitution’s right to trial by jury.
The majority held that because the state constitution safeguards the “right of trial by jury as heretofore enjoyed,” the legislature lacked the authority to impose restrictions on common-law claims, including those related to medical negligence, which had been accessible since the constitution’s inception in 1820.
Try Again
The Watts ruling prompted a swift reaction from state lawmakers. The new version of the Missouri cap explicitly excludes medical malpractice claims from the realm of English common law. So malpractice law became a statutory creation to get around the problem in Watts.
The revised version of § 538.210 established a $400,000 cap on noneconomic damages in medical malpractice cases, subject to an annual increase of 1.7%. This cap applies solely to the overall injury and not to each individual incident or defendant, as we talked about above.