Missouri Revised Statutes

Mo. Rev. Stat. § 538.210 (2026)

No common law cause of action

✓ current as of May 2026

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538.210. No common law cause of action — limitation on noneconomic damages — jury not to be informed of limit — limit — punitive damages, requirements — annual increase on damages limit, amount — nonseverability clause. — 1. A statutory cause of action for damages against a health care provider for personal injury or death arising out of the rendering of or failure to render health care services is hereby created, replacing any such common law cause of action. The elements of such cause of action are that the health care provider failed to use that degree of skill and learning ordinarily used under the same or similar circumstances by members of the defendant's profession and that such failure directly caused or contributed to cause the plaintiff's injury or death.

2. (1) In any action against a health care provider for damages for personal injury arising out of the rendering of or the failure to render health care services, no plaintiff shall recover more than four hundred thousand dollars for noneconomic damages irrespective of the number of defendants.

(2) Notwithstanding the provisions of subdivision (1) of this subsection, in any action against a health care provider for damages for a catastrophic personal injury arising out of the rendering or failure to render heath care services, no plaintiff shall recover more than seven hundred thousand dollars for noneconomic damages irrespective of the number of defendants.

(3) In any action against a health care provider for damages for death arising out of the rendering of or the failure to render health care services, no plaintiff shall recover more than seven hundred thousand dollars for noneconomic damages irrespective of the number of defendants.

3. This section shall also apply to any individual or entity, or their employees or agents:

(1) That provide, refer, coordinate, consult upon, or arrange for the delivery of health care services to the plaintiff; and

(2) Who is a defendant in a lawsuit brought against a health care provider under this chapter, or who is a defendant in any lawsuit that arises out of the rendering of or the failure to render health care services.

4. No health care provider whose liability is limited by the provisions of this chapter shall be liable to any plaintiff based on the actions or omissions of any other entity or individual who is not an employee of such health care provider, unless the individual is an employee of a subsidiary in which the health care provider has a controlling interest and the subsidiary does not carry a professional liability insurance policy or self-insurance covering said individual of at least one million dollars per occurrence and a professional liability insurance policy or self-insurance covering said subsidiary of at least one million dollars per occurrence.

5. The limitations on liability as provided for in this section shall apply to all claims for contribution.

6. In any action against a health care provider for damages for personal injury or death arising out of the rendering of or the failure to render health care services, where the trier of fact is a jury, such jury shall not be instructed by the court with respect to the limitation on an award of noneconomic damages, nor shall counsel for any party or any person providing testimony during such proceeding in any way inform the jury or potential jurors of such limitation.

7. For purposes of sections 538.205 to 538.230^*, any spouse claiming damages for loss of consortium of their spouse shall be considered to be the same plaintiff as their spouse.

8. Any provision of law or court rule to the contrary notwithstanding, an award of punitive damages against a health care provider governed by the provisions of sections 538.205 to 538.230^* shall be made only upon a finding by the jury that the evidence clearly and convincingly demonstrated that the health care provider intentionally caused damage to the plaintiff or demonstrated malicious misconduct that caused damage to the plaintiff. Evidence of negligence including, but not limited to, indifference to or conscious disregard for the safety of others shall not constitute intentional conduct or malicious misconduct.

9. For purposes of sections 538.205 to 538.230^*, all individuals and entities asserting a claim for a wrongful death under section 537.080 shall be considered to be one plaintiff.

10. The limitations on awards for noneconomic damages provided for in this section shall be increased by one and seven-tenths percent on an annual basis effective January first of each year. The current value of the limitation shall be calculated by the director of the department of commerce and insurance, who shall furnish that value to the secretary of state, who shall publish such value in the Missouri Register on the first business day following January first, but the value shall otherwise be exempt from the provisions of section 536.021.

11. In any claim for damages under this chapter, and upon post-trial motion following a jury verdict with noneconomic damages exceeding four hundred thousand dollars, the trial court shall determine whether the limitation in subsection 2 of this section shall apply based on the severity of the most severe injuries.

12. If a court of competent jurisdiction enters a final judgment on the merits that is not subject to appeal and that declares any provision or part of either section 1.010 or this section to be unconstitutional or unenforceable, then section 1.010 and this section, as amended by this act and in their entirety, are invalid and shall have no legal effect as of the date of such judgment, and this act, including its repealing clause, shall likewise be invalid and of no legal effect. In such event, the versions of sections 1.010 and this section that were in effect prior to the enactment of this act shall remain in force.

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(L. 1986 S.B. 663 § 5, A.L. 2005 H.B. 393, A.L. 2015 S.B. 239, A.L. 2017 H.B. 452, A.L. 2020 S.B. 591)

*Section 538.230 was repealed by H.B. 393, 2005.

CROSS REFERENCES:

Applicability of statute changes for cases filed after August 28, 2005, 538.305; for cases filed after August 28, 2020, 510.262

Time limitation to bring malpractice actions, 516.105

(2010) Application of new cap on noneconomic damages to causes of action that accrue prior to effective date of law violates constitutional prohibition of retrospective laws. Klotz v. St. Anthony's Medical Center, 311 S.W.3d 752 (Mo.banc).

(2012) Limitations on amount of non-economic damages recoverable from a health care provider under cause of action for wrongful death does not violate constitutional right to a trial by jury or principle of separation of powers. Sanders v. Ahmed, 364 S.W.3d 195 (Mo.banc).

(2012) Cap on non-economic damages violates the right to trial by jury guaranteed by Article I, Section 22(a) of the Missouri Constitution. Watts v. Lester E. Cox Medical Centers, 376 S.W.3d 633 (Mo.banc).

Notes of Decisions

Cited in 60 cases (22 in the last 5 years), 1992–2026 · leading case: Jason D. Dodson & Jason D. Dodson, Jr., a Minor, & Eva Raine Dodson-Lohse, a Minor, & August William Davis Dodson, a Minor, said Minors appearing by the duly appointed Next Friend Jason D. Dodson, Respondent/Cross-Appellant v. Robert P. Ferrara, M.D., & Mercy Clinic Heart & Vascular, LLC, Appellants/Cross-Respondents., 491 S.W.3d 542 (Mo. 2016).

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Jason D. Dodson & Jason D. Dodson, Jr., a Minor, & Eva Raine Dodson-Lohse, a Minor, & August William Davis Dodson, a Minor, said Minors appearing by the duly appointed Next Friend Jason D. Dodson, Respondent/Cross-Appellant v. Robert P. Ferrara, M.D., & Mercy Clinic Heart & Vascular, LLC, Appellants/Cross-Respondents., 491 S.W.3d 542 (Mo. 2016). · cites it 217× “On the defendant’s motion, the trial court reduced the noneconomic damages in accordance with the damages cap in section 538.210, RSMo 2000. 3 Id. On appeal, the plaintiff argued that the mandatory cap on noneconomic damages violated the right to a trial by jury under article I,…”

Klotz v. St. Anthony's Med. Ctr., 311 S.W.3d 752 (Mo. 2010). · cites it 102× “After the verdict, based on § 538.210, RSMo Supp.2008, the trial court reduced the noneconomic damages awarded to Mr.”

Watts ex rel. Watts v. Lester E. Cox Med. Centers, 376 S.W.3d 633 (Mo. 2012). · cites it 74× “The trial court entered a judgment reducing Watts’ non-economic damages to $350,000 as required by section 538.210. 1 The judgment also established a periodic payment schedule pursuant to section 538.”

Sanders v. Ahmed, 364 S.W.3d 195 (Mo. 2012). · cites it 44× “[2] Defendants referred to this defense as "setoff," which occasionally is used incorrectly instead of reduction; Defendants did so with reference to section 537.060. [3] Section 538.210 provides: "In any action against a health care provider for damages for personal injury or…”

Cook v. Newman, 142 S.W.3d 880 (Mo. Ct. App. 2004). · cites it 46× “§ 538.210, RSMo 1986. A related statute enacted at the same time provides that this limitation applies “only to causes of action arising on or after February 3, 1986.”

Wright v. Barr, 62 S.W.3d 509 (Mo. Ct. App. 2001). · cites it 12× “Finally, appellants urge in their sixth point that the trial court erred in failing to conform the judgment pursuant to § 538.210, which places a cap on noneconomic damages.”

Callahan v. Cardinal Glennon Hosp., 863 S.W.2d 852 (Mo. 1993). · cites it 9× “Section 538.210 became effective on February 3, 1986.”

Adams v. Child.'s Mercy Hosp., 832 S.W.2d 898 (Mo. 1992). · cites it 12× “The trial court reduced the judgment as directed by Section 538.210. *901 The Adamses and the Hospital filed motions for new trial and, when those were not successful, appealed.”

Jefferson ex rel. Jefferson v. Missouri Baptist Med. Ctr., 447 S.W.3d 701 (Mo. Ct. App. 2014). · cites it 16× “205(9)’s Definition of “Physician Employee” In 2005, the legislature amended Chapter 538, entitled “Tort Actions Based on Improper Healthcare,” by enacting the current section 538.210, entitled “Limitation on noneconomic damages — jury not to be informed of limit —…”

Koon v. Walden, 539 S.W.3d 752 (Mo. Ct. App. 2017). · cites it 6× “8 In 1986, the legislature passed Section 538.210, which replaced common law medical malpractice claims with a statutory cause of action against healthcare providers.”

Scott v. SSM Healthcare St. Louis, 70 S.W.3d 560 (Mo. Ct. App. 2002). · cites it 9× “Koch; (3) allowing the application of more than one statutory damage cap for non-economic damages against Hospital pursuant to § 538.210; (4) denying Hospital’s remittitur motion on the damages awarded to Josephine Scott; (5) admitting certain *563 expert testimony; and (6)…”

Dibrill ex rel. Wheeler v. Normandy Assocs., Inc., 383 S.W.3d 77 (Mo. Ct. App. 2012). · cites it 4× “Given the parties’ agreement, we have not been asked to resolve, and are therefore not resolving, whether all of the causes of action in this case with respect to the various defendants are governed by Section 538.210. We note, however, that Section 538.”

Show all 60 citing cases →

— Mo. Rev. Stat. § 538.210(1) — 4 cases

Jason D. Dodson & Jason D. Dodson, Jr., a Minor, & Eva Raine Dodson-Lohse, a Minor, & August William Davis Dodson, a Minor, said Minors appearing by the duly appointed Next Friend Jason D. Dodson, Respondent/Cross-Appellant v. Robert P. Ferrara, M.D., & Mercy Clinic Heart & Vascular, LLC, Appellants/Cross-Respondents., 491 S.W.3d 542 (Mo. 2016). “On the defendant’s motion, the trial court reduced the noneconomic damages in accordance with the damages cap in section 538.210, RSMo 2000. 3 Id. On appeal, the plaintiff argued that the mandatory cap on noneconomic damages violated the right to a trial by jury under article I,…”

Romero v. United States, 865 F. Supp. 585 (E.D. Mo. 1994).

Jason D. Dodson & Jason D. Dodson, Jr., a Minor & Eva Raine Dodson-Lohse, a Minor & August William Davis Dodson, a Minor, said Minors appearing by the Duly Appointed Next Friend Jason D. Dodson, Plaintiffs/Respondents/Cross-Appellants v. Robert P. Ferrara, M.D., & Mercy Clinic Heart & Vascular, L.L.C., Defendants/Appellants/Cross-Respondents. (Mo. Ct. App. 2015).

Nation v. Moore (W.D. Mo. 2023).

— Mo. Rev. Stat. § 538.210(2) — 1 case

Wright v. Barr, 62 S.W.3d 509 (Mo. Ct. App. 2001). “Finally, appellants urge in their sixth point that the trial court erred in failing to conform the judgment pursuant to § 538.210, which places a cap on noneconomic damages.”

— Mo. Rev. Stat. § 538.210(3) — 2 cases

Jefferson ex rel. Jefferson v. Missouri Baptist Med. Ctr., 447 S.W.3d 701 (Mo. Ct. App. 2014). “205(9)’s Definition of “Physician Employee” In 2005, the legislature amended Chapter 538, entitled “Tort Actions Based on Improper Healthcare,” by enacting the current section 538.210, entitled “Limitation on noneconomic damages — jury not to be informed of limit —…”

Collin & Courtney Jefferson, By & Through Their Nat. Father & Next Friend, Eric Jefferson & the Est. of Gloria Mitchell Moss, By & Through its Pers. Rep., Walter Moss v. Missouri Baptist Med. Ctr. & Amy Mosher, M.D., & Midwest Radiological Assocs., P.C., Defendants/Respondents. (Mo. Ct. App. 2014).

— Mo. Rev. Stat. § 538.210(8) — 1 case

Nation v. Moore (W.D. Mo. 2024).

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