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Appeals court OKs higher cap for burn injury

The Missouri Court of Appeals Western District ruled Aug. 23 that a woman who severely burned herself in an attempted suicide could claim the higher of two caps on the noneconomic damages in her medical negligence case.

The case is among a handful of appellate opinions to examine a 2015 Missouri law that limits the amount of noneconomic damages available in most suits against health care providers to about $400,000. However, it applies a higher cap of $700,000 to cases involving catastrophic injuries.

Although the plaintiff, Katherine Harned, survived, she sustained third-degree burns on 42 percent of her body after dousing herself with hairspray and lighting herself on fire. While some of the damage was repaired with skin grafts, the Western District said she also continues to suffer permanent mobility issues, increased sensitivity to the sun and other issues. As a result, she met the statutory requirement of “irreversible failure of one or more major organ systems.”

“We reject Defendants’ contention that the skin grafts ‘healed’ Harned’s skin,” Judge Cynthia L. Martin wrote for the court. “Rather, the evidence established that a major organ [system] — Harned’s skin — irreversibly failed and could not heal itself, but that Harned was able to survive due to life-saving medical intervention that accommodated for the irreversibly failed major organ system.” Judges Lisa White Hardwick and W. Douglas Thomson concurred.

Tim Cronin of The Simon Law Firm, who represented Harned, noted that the case is the first to examine the noneconomic damage caps since the Missouri Supreme Court affirmed their constitutionality last year.

“I think the takeaway from this appellate opinion is you do not need to have magic-word language from a doctor saying, quote, ‘irreversible failure of an organ system,’” Cronin said. “If it’s an organ system with evidence to support a permanent injury, it’s within the trial judge’s discretion to decide which of the two caps is appropriate.”

T. Michael Ward of Brown & James, who argued for the defense, didn’t return a request for comment.

The ruling allows Harned to retain the entirety of the $806,000 a Clay County jury awarded her last year. Harned, who had a long history of psychiatric care that included previous suicide attempts, was hospitalized after she attempted to overdose on prescription medication. The jury found Dr. Daniel V. Spurlock and his employer, Meritas Health, at fault for sending Harned home from a local hospital without a proper plan to keep her safe from her suicidal thoughts and ideations.

The award included $560,000 in past and future noneconomic damages. Had the lower cap been used, that portion of the award would have been reduced to about $442,000, as the caps are adjusted for inflation each year. Cronin had asked the trial judge to increase Harned’s noneconomic damages to the full $774,500 available under the statute, but the motion for additur was denied, which wasn’t appealed.

The 2015 caps were passed in response to a 2012 Supreme Court ruling that threw out the $350,000 cap then in effect. The state constitution guarantees that “the right of trial by jury as heretofore enjoyed shall remain inviolate,” and the court said the legislature could not set limits on common-law claims that were available when the constitution was first adopted in 1820.

To put the caps back in effect, the legislature repealed the common-law cause of action for medical negligence claims and replaced it with an identical statutory cause of action. The Supreme Court affirmed that approach last year in Ordinola Velazquez v. University Physician Associates.

The new statue also applies to injuries that cause loss or permanent inability to use two or more limbs, brain injuries and loss of vision. Cronin said the major organ system provision is the only one that provides any “wiggle room” to apply to serious injuries.

The case is Harned v. Spurlock, WD84990.