Missouri has a reputation for protecting business interests, and the medical industry is no exception. While the state is home to some of the nation’s top hospitals and physicians, even experienced professionals can make mistakes. When those mistakes lead to serious harm, patients often feel overwhelmed and unsure of where to turn.
In recent years, legislative reforms have made it more challenging for patients to pursue medical malpractice lawsuits, particularly those without strong expert support. Missouri’s medical malpractice laws may be complex, but they’re not impossible to navigate.
Wondering whether you may have a case? In this blog, we’ll walk you through what constitutes medical practice in Missouri, what legal requirements must be met, and what steps to take if you’re considering legal action.
Standard Elements of Medical Malpractice Laws in Missouri
In Missouri, as well as the rest of the United States, medical malpractice is defined as “healthcare that falls below the accepted standard of care, resulting in injury or harm to the patient.”
To successfully prove medical malpractice in Missouri, the plaintiff (the patient) must establish four key elements:
1. Duty of Care
The healthcare provider owed a duty of care to the patient, usually established by a formal provider-patient relationship.
2. Breach of Duty
The healthcare provider failed to meet the accepted standard of care. This is often the most contested part of a malpractice case and requires expert testimony.
3. Causation
The healthcare provider’s failure or breach of duty directly caused or contributed to the patient’s injury or harm. In other words, the patient must demonstrate that the bad outcome was due to the medical provider’s negligence.
4. Damages
The patient suffered actual harm or damages. This includes past medical expenses, future medical expenses, lost wages, pain and suffering, or loss of enjoyment of life, as a result of the provider’s negligence.
Additional Legal Requirements in Missouri Malpractice Cases
In addition to these four elements, Missouri has unique procedural requirements that can trip up even strong cases. Here’s what else you need to know:
1. Statute of Limitations
In Missouri, patients generally have two years from the date the alleged malpractice occurred to file a lawsuit per the Statute of Limitations. This is shorter than in many other states (the national average is 2.15 years), making prompt legal action critical.
There are a few exceptions to this timeline:
- If the injury was not immediately discoverable, the clock may start from the date of discovery.
- For minors, they have until they reach the age of 20 to file a medical malpractice lawsuit.
- In wrongful death cases stemming from medical negligence, the lawsuit must be filed within 3 years from the date of death.
2. Damage Caps
Missouri places a cap on non-economic damages in medical malpractice cases, such as pain and suffering or loss of enjoyment of life. The caps do not apply to economic damages, such as medical bills or lost income. As of 2025, the Missouri Department of Insurance indicates:
- The cap for non-catastrophic injuries is $473,444.
- For catastrophic injuries, like brain damage or paralysis, the cap increases to $828,529.
Section 538.210.8 provides an annual increase to these caps at a constant rate of 1.7 percent to account for inflation.
The rationale behind these damage caps was to protect healthcare providers and insurance companies from big payouts. Lobbyists argued the caps would help keep medical costs down for consumers, but those opposed argued it would make it harder for patients to recover the total compensation they deserve.
One thing both sides agree on, however, is that this damage cap created a stronger incentive for patients and their attorneys to pursue only the most clear-cut and potentially lucrative medical malpractice cases.
3. Affidavit of Merit Requirement
Missouri plaintiffs are required to file an affidavit of merit within 90 days of initiating a medical malpractice lawsuit. This affidavit is a formal statement confirming that a legally qualified healthcare provider has reviewed the case and believes the defendant failed to meet the appropriate standard of care, and that this failure directly caused or contributed to the patient’s injuries.
According to § 538.225 RSMo:
- The affidavit must name and include the qualifications and address of the medical expert.
- The expert must be licensed in Missouri or a contiguous state, be in the same profession, and be actively practicing or retired within the last five years in the same or similar specialty as the defendant.
- A separate affidavit must be filed for each defendant named in the case.
- The court may grant a one-time extension of up to 90 days if good cause is shown.
If the affidavit is not filed on time, the court must dismiss the claim against the requesting defendant. However, the dismissal is without prejudice, meaning it can be refiled after the issue is corrected.
Additionally, any defendant can request the court to privately review the expert’s opinion within 180 days of the petition being filed. If the court finds the opinion legally insufficient, a hearing must be held within 30 days. Essentially, the affidavit requirement serves as a gatekeeping tool to ensure that only credible medical malpractice claims move forward in Missouri’s courts.
Missouri vs Illinois: A Comparative Look at Pre-litigation Medical Malpractice Requirements
Missouri and Illinois share a similar purpose when it comes to pre-litigation requirements in medical malpractice cases: to prevent frivolous lawsuits by requiring early expert involvement. However, the timing and structure of these requirements differ.
Illinois Medical Malpractice Requirements
Similar to Missouri, Illinois has a two-year statute of limitations for medical malpractice cases. The timing begins when the plaintiff discovers, or should have reasonably discovered, the injury caused by medical negligence. However, there are some exceptions:
- If the injury is not immediately discoverable, the patient has two years from the date the injury is discovered. However, in no event can the patient bring a claim more than four years from the date the malpractice occurred.
- If the injured party was a minor at the time of the alleged malpractice (under the age of 18), the claim may be filed within eight years, but not after the person’s 22nd birthday.
- If the injured patient has a disability, the statute of limitations clock is paused until the disability ends. The patient then has two years to file the claim.
In addition to meeting the statute of limitations, plaintiffs must also comply with expert review requirements. According to 735 ILCS section 5/2-622, the plaintiff must file an Affidavit of Merit along with the initial complaint. This affidavit must state that the plaintiff has consulted a healthcare professional who:
- Is knowledgeable about the medical issues involved in the case,
- Is currently practicing or teaching in the same area of medicine (or has done so within the past six years), and
- Has experience and competence in the lawsuit’s subject matter
A written report from the healthcare professional stating there is a “reasonable and meritorious cause” for filing the lawsuit must be attached to the affidavit.
If the complaint is being filed near the end of the statute of limitations period, Illinois law allows a short extension: the affidavit and report may be filed within 90 days of filing the lawsuit.
Failure to file a compliant affidavit as required, either at the time of filing or within the allowable extension, will result in a medical malpractice lawsuit being dismissed.
Why Missouri’s Laws Matter for Your Case
The combination of strict timelines, damage caps, and affidavit requirements makes Missouri a challenging environment for medical malpractice claims. However, these barriers don’t mean you’re out of options.
To give your case the best possible chance:
- Act quickly to meet the two-year statute of limitations.
- Consult with an experienced medical malpractice attorney who can connect with the right expert witnesses.
Take the First Step with Simon Law
Medical malpractice cases are complicated, but you don’t have to face them alone. With over 20 years of experience and more than $1 billion in verdicts and settlements, the medical malpractice lawyers at Simon Law know how to hold negligent providers accountable.
We’ll guide you through every step, from expert affidavits to courtroom advocacy, and fight for the full compensation you deserve.
Contact Simon Law today for a free consultation and find out if you have a viable malpractice claim.
