Williams v. Mercy Clinic Springfield Cmtys.

Decision Date15 January 2019
Docket NumberNo. SC 96547,SC 96547
Citation568 S.W.3d 396
Parties Emilee WILLIAMS, Appellant/Cross-Respondent, v. MERCY CLINIC SPRINGFIELD COMMUNITIES, f/k/a St. John’s Clinic, Inc., Respondent/Cross-Appellant.
CourtMissouri Supreme Court

568 S.W.3d 396

Emilee WILLIAMS, Appellant/Cross-Respondent,
v.
MERCY CLINIC SPRINGFIELD COMMUNITIES, f/k/a St. John’s Clinic, Inc., Respondent/Cross-Appellant.

No. SC 96547

Supreme Court of Missouri, en banc.

Opinion issued January 15, 2019
Rehearing Denied April 2, 2019


Williams was represented by Steve Garner and Grant Rahmeyer of Strong-Bauer-Garner PC in Springfield, (417) 887-4300.

Mercy was represented by William Ray Price Jr., Jeffery T. McPherson and Paul L. Brusati of Armstrong Teasdale LLP in St. Louis, (314) 621-5070; and Randy R. Cowherd, Catherin Reade and Kregg T. Keltner of Haden Cowherd & Bullock LLC in Springfield, (417) 883-5535.

Mary R. Russell, Judge

568 S.W.3d 404

Emilee Williams brought a medical malpractice action against Mercy Clinic Springfield Communities and Dr. Elene Pilapil.1 Williams alleged Dr. Pilapil, and by association Mercy, negligently failed to diagnose and treat her for Wilson’s disease, a rare genetic disorder that causes an excess of copper to slowly accumulate in the vital organs. A jury returned a verdict in favor of Williams. The circuit court entered judgment on the verdict for a total amount of $28,911,000 and allocated a portion of the future medical damages to periodic payments in accordance with section 538.220.2.2 Williams appeals, and Mercy cross-appeals.

The application of section 538.220.2 is unconstitutional as applied to Williams because payment of future medical damages at a different interest rate than the interest rate used to compute the present value of the jury’s award deprives Williams of the full value of the award and violates her due process rights. Further, because Mercy’s April 27 motion to amend the judgment to remove post-judgment interest was not filed within 30 days of the entry of judgment, the circuit court did not have authority to amend the judgment to remove post-judgment interest. The circuit court’s judgment is reversed to the extent it deprived Williams of the full value of the jury’s award, violating her due process rights, and to the extent it sustained the untimely April 27 motion to amend striking post-judgment interest. The case is remanded for entry of a new judgment in accordance with this opinion. In all other aspects, the judgment is affirmed.

Background

Williams, a 19-year-old woman, started seeing a counselor in 2011 for anxiety and depression. She also consulted with her primary care physician, who ordered lab tests showing Williams had elevated levels of liver enzymes and diagnosed her with mononucleosis. In October or November 2011, Williams began experiencing a change in her personality and an increase in anxiety and depression. Her primary care physician diagnosed her with anxiety and depression and prescribed Prozac.

Williams developed a tremor in her hand in December 2012 and first saw Dr. Pilapil, a doctor of internal medicine. Dr. Pilapil performed a neurological exam and concluded Williams did not have a neurological issue. Dr. Pilapil diagnosed her with anxiety and depression and increased her Prozac dosage.

The next month, Williams had a follow-up appointment with Dr. Pilapil. There were no changes in medication or diagnosis, and Dr. Pilapil did not perform a neurological exam. Williams visited Dr. Pilapil a third time in May 2013, after her condition had continued to deteriorate. Her tremors were worse, her voice was elevated, her fifth finger extended outward, and her lip occasionally curled up involuntarily. Dr. Pilapil lowered the Prozac dosage. At the end of May, Williams and Dr. Pilapil exchanged emails regarding Williams' worsening symptoms. Dr. Pilapil told Williams to stop taking Prozac and prescribed a different antidepressant, Celexa.

Williams visited Dr. Pilapil for the last time on June 28. At this time, Williams had trouble standing, had fatigue, could not write properly, and her fifth finger extended outward. Dr. Pilapil again stated she believed the symptoms were caused by anxiety. Dr. Pilapil continued the Celexa

568 S.W.3d 405

prescription and added Klonopin. Williams requested an MRI.

Williams and Dr. Pilapil exchanged emails during July regarding Williams' symptoms. Williams eventually asked Dr. Pilapil to schedule an appointment with a neurologist and order an MRI or CT scan. Dr. Pilapil said she would order an MRI.

Williams received an EEG at the end of the month. At this time, Williams' hands and feet were clawing, her lips were curling out, and she was unable to continue physical therapy school. Williams again contacted Dr. Pilapil and requested an MRI. At the beginning of August, Williams received an MRI, which showed significant brain trauma appearing to be Wilson’s disease.

Williams consulted doctors at the Wilson’s Disease Center for Excellence at the University of Michigan. The doctors prescribed Trientine, an aggressive chelating agent that removes excess copper from the body but can cause additional neurological degradation. Williams' health continued to decline, and the doctors ordered Williams to stop taking Trientine. Williams was essentially paralyzed for approximately two and a half years. She was not able to walk, talk, or move, and she blinked her eyes to communicate.

Since then, Williams has made significant improvements. She is able to talk and can walk with a limp. But her personality changed significantly, as she is prone to outbursts and has not been left unsupervised since August 2013. Williams filed suit, alleging Dr. Pilapil, and by association Mercy, negligently failed to diagnose and treat her for Wilson’s disease.

The jury returned a verdict in favor of Williams for the total amount of $28,911,000. The jury awarded $511,000 for past medical and wage loss, $1 million for past non-economic damages, $21 million for future medical damages, $3.2 million for future wage loss, and $3.2 million for future non-economic damages. The circuit court entered judgment, which mirrored the jury’s verdict and included post-judgment interest. Mercy moved to set aside the judgment to hear evidence about the application of section 538.220.2, seeking to have the future medical damages paid in periodic payments. Williams opposed the motion, arguing section 538.220.2 is unconstitutional as applied to her because payment of future medical damages at the statutorily required interest rate, when the jury had discounted the award to present value using a higher interest rate, effectively deprives her of the full value of the jury’s award and violates due process.

The circuit court held an evidentiary hearing regarding the periodic payment of future damages. Williams' counsel submitted a proposed judgment, which the court entered on March 20. The judgment still included an award of post-judgment interest and extracted the attorney’s fees from the amount to be paid periodically.

On April 7, Mercy filed post-trial motions to amend the judgment, for new trial, for remittitur, and for judgment notwithstanding the verdict. On April 27, Mercy filed another motion to amend the judgment, objecting to the inclusion of post-judgment interest. Williams moved to strike the April 27 motion as untimely because it was filed more than 30 days after judgment was entered. The circuit court heard argument on the pending motions.

The circuit court entered an amended judgment on June 23, sustaining Mercy’s second motion to amend and striking the post-judgment interest. It also modified the future periodic payments schedule by increasing that amount to $10 million at an interest rate of 1.2%, and it was silent as to the payment of attorney’s

568 S.W.3d 406

fees. Williams appealed, and Mercy Clinic cross-appealed.3

I. Constitutional Validity of Section 538.220.2

Williams argues the application of section 538.220.2 to her case violates her due process rights because it permits periodic payment of future medical damages at a different interest rate than was employed to compute the present value of the jury’s award.

Standard of Review

The challenge to the constitutional validity of a statute is subject to de novo review. Watts v. Lester E. Cox Med. Ctrs. , 376 S.W.3d 633, 637 (Mo. banc 2012). A statute is presumed valid and will be found constitutional unless it clearly contravenes a constitutional provision. Id. The party challenging the statute’s constitutionality has the burden of proving the statute "clearly and undoubtedly" violates the constitution. Id.

Analysis

Williams argues that allocating $10 million of her future medical damages to periodic payments at the low interest rate of 1.2% – after the damages award had been reduced to present value – violates her due process rights because it effectively deprives her of the full value of the jury’s award.

The general purpose of chapter 538 is to reduce the cost of medical malpractice, and the specific purposes of section 538.220 are to spread that cost over time, to guard against squandering the judgment, and to reduce future burdens on government social services. Watts , 376 S.W.3d at 646 (citing Vincent by Vincent v. Johnson , 833 S.W.2d 859, 867 (Mo....

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