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EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted
and is intended to be omitted in the law.
SECOND REGULAR SESSION
SENATE BILL NO. 1190
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR CARTER.
5445S.01I KRISTINA MARTIN, Secretary
AN ACT
To repeal section 516.105, RSMo, and to enact in lieu thereof two new sections relating to actions
against health care providers.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Section 516.105, RSMo, is repealed and two new 1
sections enacted in lieu thereof, to be known as sections 2
516.105 and 538.212, to read as follows:3
516.105. 1. All actions against physicians, 1
hospitals, dentists, registered or licensed practical 2
nurses, optometrists, podiatrists, pharmacists, 3
chiropractors, professional physical therapists, mental 4
health professionals licensed under chapter 337, and any 5
other entity providing health care services and all 6
employees of any of the foregoing acting in the course and 7
scope of their employment, for damages for malpractice, 8
negligence, error or mistake related to health care shall be 9
brought within two years from the date of occurrence of the 10
act of neglect complained of, except that: 11
(1) In cases in which the act of neglect complained of 12
is introducing and negligently permitting any foreign object 13
to remain within the body of a living person, the action 14
shall be brought within two years from the date of the 15
discovery of such alleged negligence, or from the date on 16
which the patient in the exercise of ordinary care should 17
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have discovered such alleged negligence, whichever date 18
first occurs; [and] 19
(2) In cases in which the act of neglect complained of 20
is the negligent failure to inform the patient of the 21
results of medical tests, the action for failure to inform 22
shall be brought within two years from the date of the 23
discovery of such alleged negligent failure to inform, or 24
from the date on which the patient in the exercise of 25
ordinary care should have discovered such alleged negligent 26
failure to inform, whichever date first occurs; except that, 27
no such action shall be brought for any negligent failure to 28
inform about the results of medical tests performed more 29
than two years before August 28, 1999. For purposes of this 30
subdivision, the act of neglect based on the negligent 31
failure to inform the patient of the results of medical 32
tests shall not include the act of informing the patient of 33
the results of negligently performed medical tests or the 34
act of informing the patient of erroneous test results; [and] 35
(3) In cases in which the person bringing the action 36
is a minor less than eighteen years of age, such minor shall 37
have until his or her twentieth birthday to bring such 38
action; and 39
(4) In cases in which the act of neglect complained of 40
is related to the provision of a gender transition surgery 41
or other gender transition services or in the course of 42
prescribing or administering cross-sex hormones or puberty- 43
blocking drugs, the action shall be brought within fifteen 44
years from the date of discovery of the injury and of the 45
causal relationship between the injury and the provision of 46
a gender transition surgery or other gender transition 47
services or in the course of prescribing or administering 48
cross-sex hormones or puberty-blocking drugs. As used in 49
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this subdivision, the terms "gender transition", "gender 50
transition services", "cross-sex hormones", and "puberty 51
blocking drugs" shall have the same meaning as such terms in 52
section 191.1720. 53
Except for those actions provided in subdivision (4) of this 54
subsection, in no event shall any action for damages for 55
malpractice, error, or mistake be commenced after the 56
expiration of ten years from the date of the act of neglect 57
complained of or for two years from a minor's eighteenth 58
birthday, whichever is later. 59
2. Any service on a defendant by a plaintiff after the 60
statute of limitations set forth in subsection 1 of this 61
section has expired or after the expiration of any extension 62
of the time provided to commence an action pursuant to law 63
shall be made within one hundred eighty days of the filing 64
of the petition. If such service is not made on a defendant 65
within one hundred eighty days of the filing of the 66
petition, the court shall dismiss the action against the 67
defendant. The dismissal shall be without prejudice unless 68
the plaintiff has previously taken or suffered a nonsuit, in 69
which case the dismissal shall be with prejudice. 70
538.212. 1. Notwithstanding any other provision of 1
this chapter to the contrary, there shall be a statutory 2
cause of action for damages against a health care provider 3
for personal injury or death arising out of the rendering or 4
failure to render health care services while in the course 5
of performing a gender transition surgery or other gender 6
transition services or in the course of prescribing or 7
administering cross-sex hormones or puberty-blocking drugs. 8
This section shall replace any such common law cause of 9
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action and actions covered by section 538.210 that are filed 10
after August 28, 2026. 11
2. The limitation on damages provided in section 12
538.210 shall not apply to actions brought pursuant to 13
subsection 1 of this section. In any action against a 14
health care provider for damages pursuant to subsection 1 of 15
this section, a prevailing plaintiff may recover economic 16
and noneconomic damages and punitive damages, without 17
limitation to the amount, but shall not recover less than 18
five hundred thousand dollars in the aggregate. The 19
judgment against a defendant in an action brought pursuant 20
to this section shall be in an amount of three times the 21
amount of any economic and noneconomic damages or punitive 22
damages assessed. Any award of damages in an action brought 23
pursuant to this subsection to a prevailing plaintiff shall 24
include attorney's fees and court costs. 25
3. Any purported waiver of liability by an injured 26
party for the provision of services or for the failure to 27
perform services related to a gender transition surgery or 28
other gender transition services or in the prescription or 29
administration of cross-sex hormones or puberty-blocking 30
drugs by a health care provider shall be void and 31
unenforceable. 32
4. For purposes of this section, the following terms 33
mean: 34
(1) "Biological sex", the biological indication of 35
male or female in the context of reproductive potential or 36
capacity, such as sex chromosomes, naturally occurring sex 37
hormones, gonads, and nonambiguous internal and external 38
genitalia present at birth, without regard to an 39
individual's psychological, chosen, or subjective experience 40
of gender; 41
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(2) "Cross-sex hormones", testosterone, estrogen, or 42
other androgens given to an individual in amounts that are 43
greater or more potent than would normally occur naturally 44
in a healthy individual of the same age and sex; 45
(3) "Gender", the psychological, behavioral, social, 46
and cultural aspects of being male or female; 47
(4) "Gender transition", the process in which an 48
individual transitions from identifying with and living as a 49
gender that corresponds to his or her biological sex to 50
identifying with and living as a gender different from his 51
or her biological sex, and may involve social, legal, or 52
physical changes; 53
(5) "Gender transition surgery", a surgical procedure 54
performed for the purpose of assisting an individual with a 55
gender transition, including, but not limited to: 56
(a) Surgical procedures that sterilize, including, but 57
not limited to, castration, vasectomy, hysterectomy, 58
oophorectomy, orchiectomy, or penectomy; 59
(b) Surgical procedures that artificially construct 60
tissue with the appearance of genitalia that differs from 61
the individual's biological sex, including, but not limited 62
to, metoidioplasty, phalloplasty, or vaginoplasty; or 63
(c) Augmentation mammoplasty or subcutaneous 64
mastectomy; 65
(6) "Puberty-blocking drugs", gonadotropin-releasing 66
hormone analogues or other synthetic drugs used to stop 67
luteinizing hormone secretion and follicle stimulating 68
hormone secretion, synthetic antiandrogen drugs to block the 69
androgen receptor, or any other drug used to delay or 70
suppress pubertal development in children for the purpose of 71
assisting an individual with a gender transition. 72
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