JEFFERSON CITY - When Daniel Strapman was twelve years old, he went in to St. Louis Children's Hospital for a routine hernia operation, but came out with severe brain damage after an anesthesiologist failed to reset a machine that monitored his blood pressure during the operation, according to his mother.
Seven years later, Sue Strapman sat before the House Judiciary Committee and told Missouri legislators how her son cannot walk on his own and would need round-the-clock care for the rest of his life. She said she came to urge them not to limit punitive damage awards.
"How much would be enough for your son or daughter?" Strapman said.
The issue of limiting punitive damages for lawsuits stirred emotions on both sides of the debate Wednesday as the Judiciary Committee heard testimony in a marathon hearing that went well into the night.
Victims advocates pointed to the suffering of those injured by medical malpractice, as well as the families left to deal with the aftermath of those mistakes.
But groups representing doctors and other health care providers pointed to skyrocketing malpractice insurance premiums that have forced some physicians to leave the state, or stop practicing altogether.
"This state is hemorrhaging its physicians," Dr. John Stanley, representing a group of Kansas City doctors, told the committee. "The situation is so bad, we can't even bring doctors in (to Missouri)."
Stanley said unlike other businesses, doctors "can't pass on that cost" to patients, and must absorb the higher premiums themselves. He said the rise in malpractice insurance costs -- in some cases amounting to hundreds of thousands of dollars a year for some doctors -- was driving doctors from the state, and resulting in many communities losing access to adequate health care.
"I hope it's not an omen," Stanley said, "but the last physician that testified before this committee is no longer practicing medicine in Missouri."
At issue is the room cost of those increasing premiums, and what needs to be done about it.
Doctors, hospitals, and insurance companies have been arguing that the increase in malpractice premiums are the result of frivolous lawsuits and huge damage awards being handed down by Missouri juries. Trial lawyers and victims' advocates, on the other hand, say a handful of bad doctors are driving up costs, and if the state passed laws forcing insurance companies to reform the way they do business -- separating the bad doctors from the good ones, and charging them accordingly -- then premiums would drop dramatically.
Those espousing both views testified at length before the committee Wednesday. No vote on the measure will be taken until at least next week.
The current bill being considered in the Judiciary committee deals only with lawsuits -- and includes provisions to limit the punitive damages a plaintiff can receive, as well as to restrict which venues a lawsuit may be filed in and how many cases can be filed for a specific incident.
A separate bill dealing with insurance reform is also making its way through the House, and some Judiciary committee members indicated lawmakers may try to have that bill transferred to their committee, and have both measures rolled into one.
Richard McIntosh, representing the Missouri Association of Osteopathic Physicians and Surgeons, told the committee while he thought tort reform was a "critical component" to deal with high malpractice premiums, insurance reform was necessary as well.
"They go hand in hand," McIntosh said.
McIntosh -- along with most of the doctors and hospital representatives that testified -- also stressed the need for lawmakers to act quickly and get "a bill passed and signed into law this year."
"Everyone in this room has an expectation that they will have access to a doctor when they need one," McIntosh said. "That is increasingly becoming a questionable expectation."
Dr. John Rollo, a St. Louis surgeon representing the Missouri State Medical Association, told the committee that rural areas are particularly vulnerable to the flight of doctors from Missouri.
"(Rural areas) are being hurt even more," Rollo said. "And they are already under-served and losing physicians."
The bill actually provides a raise in the current cap for non-economic damages -- calling for it to be $400,000, up from $350,000. But under current law, if someone sues more than more person or organization, that plaintiff can collect the full limit from each of those defendants, or up to $350,000 apiece. The proposed new law would allow only $400,000 total to be awarded in non-economic damages -- no matter how many people are actually being sued.