Malpractice caps crucial to good care

Without them, doctors are scared to practice.

By Nathanial Nolan

A decade ago, Missouri medicine was in crisis mode after the revocation of the state malpractice cap. In the mid-1980s, Missouri set laws that limited noneconomic damages in medical malpractice cases at $350,000 — a limit that was indexed based on inflation and thus would increase annually. In 2002, the Missouri Eastern District Court of Appeals issued a decision in Scott v. SSM Health Care that effectively nullified the cap. As part of the decision, the court set a precedent that each “occurrence” of negligence could accrue noneconomic damages, which at that time was more than $550,000. In practical terms, that meant for each person on the care team, for each day the diagnosis was missed and for each diagnostic study based on an erroneous diagnosis, the patient could receive noneconomic damages. Though each instance claimed couldn’t exceed the cap, the total “occurrences” had no limit. In essence, there was no longer a cap.

In subsequent years, the number of lawsuits and the cost of malpractice insurance dramatically increased. According to the National Practitioner Data Bank, which records physician claims, the number of claims against physicians rose by 37 percent between 2000 and 2004. In 2003, the number of frivolous claims, those that resulted in no payment, rose by 73 percent. Though no payouts occurred, the average cost of defending each claim totaled more than $11,000. For the lawsuits ended with indemnity, the average sum increased by 50 percent between 2001 and 2004.

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