Medical malpractice cases can be among the most challenging legal matters to navigate, and Missouri is no exception. Families who believe they have been victims of medical negligence often face a maze of legal, medical, and procedural hurdles. Understanding why these cases are so complex can help patients and their families make informed decisions when pursuing justice.

1. A High Standard of Proof

One reason medical malpractice cases are complicated in Missouri is the high standard of proof required. To win a case, the plaintiff must demonstrate that a healthcare provider's negligence directly caused injury or harm. This often requires expert testimony from medical professionals who can explain how the standard of care was breached. For example, if a patient suffers complications after surgery, the plaintiff would need a qualified doctor to testify that the surgeon did not meet accepted standards of care and that this failure caused the injury. 

2. Short, Strict Statutes of Limitations

Strict statutes of limitations add to the complexity. Missouri operates under a restrictive medical malpractice statute of limitations framework governed by Mo. Rev. Stat. § 516.105. The general rule requires all medical malpractice actions to be brought within two years from the date of occurrence of the alleged negligent act.  The statute provides only three narrow exceptions: (1) respecting foreign objects left in the body, the limitations period does not begin to run until the object is discovered; (2) claims of negligent failure to inform patients of medical test results are also subject to the discovery rule; and (3) minors under 18 have until their 20th birthday to sue.  In addition, Missouri courts recognize a continuing care exception that tolls the limitations period until the care ceases or the physician-patient relationship ends.  

Outside of these limited circumstances, missing the statutory deadline precludes the case from being heard.  This tight deadline adds another layer of pressure, especially when one considers that the plaintiff will have to be fully prepared and have a medical expert ready to certify the legitimacy of the claim at the beginning of the litigation.

3. Rare and Expensive Expert Witnesses

The involvement of expert witnesses is central to the process. In Missouri, courts require plaintiffs to provide an affidavit from a medical expert to certify medical malpractice cases. For instance, someone alleging a hospital's failure to diagnose cancer would likely need an oncologist to provide a sworn statement about how the care departed from accepted standards. 

Codified in Mo. Rev. Stat. § 538.225, the requirement mandates that plaintiffs file an affidavit within 90 days of filing their petition (extendable to 180 days for good cause) stating they have obtained a written opinion from a legally qualified health care provider (1) that the defendant failed to use reasonable care and (2) that such failure directly caused or contributed to the claimed damages. A separate affidavit must be filed for every defendant named in the petition.  Failure to comply results in mandatory dismissal without prejudice.  

The dependency on technical expert input distinguishes malpractice cases from other types of personal injury lawsuits.  Deepening the problem is the fact that the required expert is another physician.  Professionals are reluctant to speak out against their colleagues, so these experts are not easy to find.  Their rarity, coupled with their pedigree, also makes them very expensive to retain.

4. The Legal and Medical Jargon

In addition, the intersection of complex medical terminology and procedural rules compounds the difficulty. Plaintiffs must grasp not only their underlying medical condition but also litigation practices such as depositions and discovery. For example, a patient pursuing a malpractice claim after a prescription error would need to navigate both pharmacy records and legal procedures for obtaining evidence.

5. Trust Factor for Physicians and Nurses

Furthermore, in making a medical malpractice claim one is suing doctors and/or nurses, who, according to decades of Gallup Polling, are the professionals most trusted by the public.  That means before a plaintiff ever walks into the courtroom, his opponents, the defendant medical personnel, are probably starting out more than just a little bit ahead in terms of credibility with the jury.  The credibility bias in favor of doctors and nurses is unique to medical malpractice lawsuits, very hard to overcome, and, as many plaintiffs painfully learn, bleeds into every aspect of the litigation through jury deliberations.

6. Caps on Non-Economic Damages

Last, but certainly not least, awards for non-economic damages (essentially pain and suffering) in verdicts and judgments for Missouri medical malpractice cases are capped under Mo. Rev. Stat. § 538.210, which operates on a tiered system. For standard personal injury cases arising from medical malpractice, no plaintiff may recover more than $400,000 for noneconomic damages regardless of the number of defendants. For catastrophic personal injury cases, the cap increases to $700,000.  Death cases arising from medical malpractice also carry the higher $700,000 cap.

Except for the increase for catastrophic injury cases, the statute does not really account for the severity of the non-economic injuries.  Plaintiffs who suffer lifelong agony and loss of enjoyment of life resulting from paralysis or loss of limbs, for example, are treated the same as those with minor, temporary injuries.  The former will have to consider the possibility that what would normally be a multi-million dollar award could be reduced to a fraction.

Conclusion

In summary, Missouri medical malpractice cases are complicated due to:

• high proof standards necessitating expert testimony;
• strict and sometimes unforgiving filing deadlines; 
• mandatory and challenging expert witness requirements; 
• the need to master both legal and medical complexities; 
• the burden of overcoming the elevated trust and respect the public and juries have for doctors and nurses; and
• caps on non-economic damages

Families pursuing these claims need knowledgeable legal representation to navigate these challenges effectively. If you or a loved one believe you have experienced medical negligence, consulting with an experienced Missouri medical malpractice attorney as soon as possible can ensure your rights are protected.  Our Missouri trial lawyers are here to help. Reach out to us at www.bautistaleroy.com or 816-221-0382 for a free consultation.