In March 2021, the Supreme Court of Missouri, in Rhoden v. Mo. Delta Med. Ctr., upheld a jury’s award of $ 300,000 in punitive damages against a defendant health care provider. The majority held that the facts – which occurred before the amendment to the Missouri Punitive Damages Act – satisfied the plaintiff’s burden of proving that the defendant “had shown complete indifference or conscious disregard for the safety of others ”. Fortunately, this case is expected to have limited impact, as the 2020 amendments to Missouri’s punitive damages statute in § 538.210.8, RSMo., Made it clear that the legislature intended a higher standard. applies to defendants of healthcare providers. Rather than dwelling on the underlying facts of Rhodesinstead, we will focus on the debate between majority, concurring and dissenting opinions regarding the appropriate standard for the imposition of punitive damages against health care providers.
In Rhodes, the court applied a version prior to the amendment to § 538.210 which allowed punitive damages against a health care provider only “on a demonstration by a claimant that the health care provider demonstrated willful misconduct , gratuitous or malicious ”. As indicated in our blog post of July 30, 2020, this legal standard was not defined and proved to be problematic in its application. The Rhodes The Court followed the advice of the lower courts of appeal finding that, for the purpose of punitive damages, acting “willfully, without cause or maliciously” is the legal equivalent of acting with “complete indifference or conscious disregard. the rights or safety of others ”. Thus, the Court held that it was not an error of law or other error on the part of the trial court to have instructed the jury on the standard of “indifference. total or conscious disregard for the safety of others ”as opposed to the standard of § 538.210.8. of “intentional, gratuitous or malicious”, because the two standards were equivalent and did not conflict.
Two separate dissenting opinions criticize the majority position. The first focuses on the fact that punitive damages are imposed not to compensate plaintiffs, but for the purposes of punishment and deterrence, and they should rarely be recoverable in medical negligence claims and reserved only to really extraordinary cases. A judge noted that the health care provider’s conduct may have been a negligent error, as the jury determined, but there was no credible allegation that the doctor’s conduct amounted to intentional wrongdoing or that the patient’s death was the natural and probable result of the physician’s treatment. the decisions.
A second dissenting opinion deals with Parliament’s intention to set a higher standard for health care provider defendants. With the 1986 amendments to § 538.210, the General Assembly aimed for a higher standard for punitive damages claims against healthcare providers than the lower standard applicable to defendants in general. In the opinion of this judge, it was unfortunate that the Missouri Intermediate Courts of Appeal (and the majority of the Supreme Court) failed to recognize the intentional modification of the common law by the General Assembly in adjudicating the two equivalent standards. As mentioned above, this confusion led the General Assembly to further clarify its intention by amending § 538.210 in 2020, and to specifically state that “evidence of negligence, including, but not limited to, the indifference or conscious disregard for the safety of others does not constitute willful conduct or “malicious misconduct” sufficient for punitive damages.
The 2020 amendments to § 538.210 should limit the precedent value of Rhodes. However, the solid discussion in that opinion highlights the old confusion about the appropriate standard for punitive damages in medical negligence cases and the need for greater clarity. The 2020 amendments are expected to provide that clarity, with a return to the original common law concept of willful misconduct being a prerequisite for awarding punitive damages. The new law is expected to highlight the hitherto blurred line between simply negligent conduct and conduct that warrants an award of punitive damages. This new law appears to offer important protections to defendants of health care providers, while also allowing the possibility of a claim for punitive damages, but only in the rare circumstances where the evidence would support it.