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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. 1598
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR BECK.
6521S.01I KRISTINA MARTIN, Secretary
AN ACT
To repeal sections 516.105, 538.205, and 538.210, RSMo, and to enact in lieu thereof three new
sections relating to liability for the use of artificial intelligence by health care providers.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Sections 516.105, 538.205, and 538.210, RSMo, 1
are repealed and three new sections enacted in lieu thereof, to 2
be known as sections 516.105, 538.205, and 538.210, to read as 3
follows:4
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
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which the patient in the exercise of ordinary care should 17
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 act of neglect complained of 36
is the negligent use, selection, or implementation or 37
unduly, detrimentally, or erroneously relying on artificial 38
intelligence, as such term is defined in section 538.205, in 39
the diagnosis, treatment, and care of a patient, the action 40
shall be brought within two years from the date of the 41
discovery of such alleged negligence or reliance, or from 42
the date on which the patient in the exercise of ordinary 43
care should have discovered such alleged negligence or 44
reliance, whichever date first occurs; and 45
(4) In cases in which the person bringing the action 46
is a minor less than eighteen years of age, such minor shall 47
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have until his or her twentieth birthday to bring such 48
action. 49
In no event shall any action for damages for malpractice, 50
error, or mistake be commenced after the expiration of ten 51
years from the date of the act of neglect complained of or 52
for two years from a minor's eighteenth birthday, whichever 53
is later. 54
2. Any service on a defendant by a plaintiff after the 55
statute of limitations set forth in subsection 1 of this 56
section has expired or after the expiration of any extension 57
of the time provided to commence an action pursuant to law 58
shall be made within one hundred eighty days of the filing 59
of the petition. If such service is not made on a defendant 60
within one hundred eighty days of the filing of the 61
petition, the court shall dismiss the action against the 62
defendant. The dismissal shall be without prejudice unless 63
the plaintiff has previously taken or suffered a nonsuit, in 64
which case the dismissal shall be with prejudice. 65
538.205. As used in sections 538.205 to [538.230] 1
538.235, the following terms shall mean: 2
(1) "Artificial intelligence", a computer system, 3
computer software or algorithms, or physical hardware that 4
provide or generate human-like perception, cognition, 5
planning, learning, decision-making, communication, or 6
physical action in the rendering or assisting of rendering 7
of health care services; 8
(2) "Catastrophic personal injury", a physical injury 9
resulting in: 10
(a) Quadriplegia defined as the permanent loss of 11
functional use of all four limbs; 12
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(b) Paraplegia defined as the permanent loss of 13
functional use of two limbs; 14
(c) Loss of two or more limbs; 15
(d) An injury to the brain that results in permanent 16
cognitive impairment resulting in the permanent inability to 17
make independent decisions or engage in one or more of the 18
following activities of daily living: eating, dressing, 19
bathing, toileting, transferring, and walking; 20
(e) An injury that causes irreversible failure of one 21
or more major organ systems; or 22
(f) Vision loss such that the patient's central visual 23
acuity is no more than twenty/two-hundred in the better eye 24
with the best correction or whose field of vision in the 25
better eye is restricted to a degree that its widest 26
diameter subtends an angle no greater than twenty degrees; 27
[(2)] (3) "Economic damages", damages arising from 28
pecuniary harm including, without limitation, medical 29
damages, and those damages arising from lost wages and lost 30
earning capacity; 31
[(3)] (4) "Employee", any individual who is directly 32
compensated by a health care provider for health care 33
services rendered by such individual and other nonphysician 34
individuals who are supplied to a health care provider by an 35
entity that provides staffing; 36
[(4)] (5) "Equitable share", the share of a person or 37
entity in an obligation that is the same percentage of the 38
total obligation as the person's or entity's allocated share 39
of the total fault, as found by the trier of fact; 40
[(5)] (6) "Future damages", damages that the trier of 41
fact finds will accrue after the damages findings are made; 42
[(6)] (7) "Health care provider", any physician, 43
hospital, health maintenance organization, ambulatory 44
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surgical center, long-term care facility including those 45
licensed under chapter 198, dentist, registered or licensed 46
practical nurse, optometrist, podiatrist, pharmacist, 47
chiropractor, professional physical therapist, psychologist, 48
physician-in-training, and any other person or entity that 49
provides health care services under the authority of a 50
license or certificate; 51
[(7)] (8) "Health care services", any services that a 52
health care provider renders to a patient in the ordinary 53
course of the health care provider's profession or, if the 54
health care provider is an institution, in the ordinary 55
course of furthering the purposes for which the institution 56
is organized. Professional services shall include, but are 57
not limited to, transfer to a patient of goods or services 58
incidental or pursuant to the practice of the health care 59
provider's profession or in furtherance of the purposes for 60
which an institutional health care provider is organized; 61
[(8)] (9) "Medical damages", damages arising from 62
reasonable expenses for necessary drugs, therapy, and 63
medical, surgical, nursing, x-ray, dental, custodial and 64
other health and rehabilitative services; 65
[(9)] (10) "Noneconomic damages", damages arising from 66
nonpecuniary harm including, without limitation, pain, 67
suffering, mental anguish, inconvenience, physical 68
impairment, disfigurement, loss of capacity to enjoy life, 69
and loss of consortium but shall not include punitive 70
damages; 71
[(10)] (11) "Past damages", damages that have accrued 72
when the damages findings are made; 73
[(11)] (12) "Punitive damages", damages intended to 74
punish or deter malicious misconduct or conduct that 75
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intentionally caused damage to the plaintiff, including 76
exemplary damages and damages for aggravating circumstances; 77
[(12)] (13) "Self-insurance", a formal or informal 78
plan of self-insurance or no insurance of any kind. 79
538.210. 1. A statutory cause of action for damages 1
against a health care provider for personal injury or death 2
arising out of the rendering of or failure to render health 3
care services is hereby created, replacing any such common 4
law cause of action. The elements of such cause of action 5
are that the health care provider failed to use that degree 6
of skill and learning ordinarily used under the same or 7
similar circumstances by members of the defendant's 8
profession and that such failure directly caused or 9
contributed to cause the plaintiff's injury or death. A 10
health care provider failing to use that degree of skill and 11
learning ordinarily used under the same or similar 12
circumstances by members of the defendant's profession and 13
where the failure directly causes or contributed to cause 14
the plaintiff's injury or death includes, but is not limited 15
to, a health care provider negligently using, selecting, or 16
implementing or unduly, detrimentally, or erroneously 17
relying on artificial intelligence in the diagnosis, 18
treatment, and care of a patient and such negligence or 19
reliance directly causes or contributes to the plaintiff's 20
injury. 21
2. (1) In any action against a health care provider 22
for damages for personal injury arising out of the rendering 23
of or the failure to render health care services, no 24
plaintiff shall recover more than four hundred thousand 25
dollars for noneconomic damages irrespective of the number 26
of defendants. 27
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(2) Notwithstanding the provisions of subdivision (1) 28
of this subsection, in any action against a health care 29
provider for damages for a catastrophic personal injury 30
arising out of the rendering or failure to render heath care 31
services, no plaintiff shall recover more than seven hundred 32
thousand dollars for noneconomic damages irrespective of the 33
number of defendants. 34
(3) In any action against a health care provider for 35
damages for death arising out of the rendering of or the 36
failure to render health care services, no plaintiff shall 37
recover more than seven hundred thousand dollars for 38
noneconomic damages irrespective of the number of defendants. 39
3. This section shall also apply to any individual or 40
entity, or their employees or agents: 41
(1) That provide, refer, coordinate, consult upon, or 42
arrange for the delivery of health care services to the 43
plaintiff; and 44
(2) Who is a defendant in a lawsuit brought against a 45
health care provider under this chapter, or who is a 46
defendant in any lawsuit that arises out of the rendering of 47
or the failure to render health care services. 48
4. No health care provider whose liability is limited 49
by the provisions of this chapter shall be liable to any 50
plaintiff based on the actions or omissions of any other 51
entity or individual who is not an employee of such health 52
care provider, unless the individual is an employee of a 53
subsidiary in which the health care provider has a 54
controlling interest and the subsidiary does not carry a 55
professional liability insurance policy or self-insurance 56
covering said individual of at least one million dollars per 57
occurrence and a professional liability insurance policy or 58
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self-insurance covering said subsidiary of at least one 59
million dollars per occurrence. 60
5. The limitations on liability as provided for in 61
this section shall apply to all claims for contribution. 62
6. In any action against a health care provider for 63
damages for personal injury or death arising out of the 64
rendering of or the failure to render health care services, 65
where the trier of fact is a jury, such jury shall not be 66
instructed by the court with respect to the limitation on an 67
award of noneconomic damages, nor shall counsel for any 68
party or any person providing testimony during such 69
proceeding in any way inform the jury or potential jurors of 70
such limitation. 71
7. For purposes of sections 538.205 to 538.230, any 72
spouse claiming damages for loss of consortium of their 73
spouse shall be considered to be the same plaintiff as their 74
spouse. 75
8. Any provision of law or court rule to the contrary 76
notwithstanding, an award of punitive damages against a 77
health care provider governed by the provisions of sections 78
538.205 to [538.230] 538.235 shall be made only upon a 79
finding by the jury that the evidence clearly and 80
convincingly demonstrated that the health care provider 81
intentionally caused damage to the plaintiff or demonstrated 82
malicious misconduct that caused damage to the plaintiff. 83
Evidence of negligence including, but not limited to, 84
indifference to or conscious disregard for the safety of 85
others shall not constitute intentional conduct or malicious 86
misconduct. 87
9. For purposes of sections 538.205 to [538.230] 88
538.235, all individuals and entities asserting a claim for 89
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a wrongful death under section 537.080 shall be considered 90
to be one plaintiff. 91
10. The limitations on awards for noneconomic damages 92
provided for in this section shall be increased by one and 93
seven-tenths percent on an annual basis effective January 94
first of each year. The current value of the limitation 95
shall be calculated by the director of the department of 96
commerce and insurance, who shall furnish that value to the 97
secretary of state, who shall publish such value in the 98
Missouri Register on the first business day following 99
January first, but the value shall otherwise be exempt from 100
the provisions of section 536.021. 101
11. In any claim for damages under this chapter, and 102
upon post-trial motion following a jury verdict with 103
noneconomic damages exceeding four hundred thousand dollars, 104
the trial court shall determine whether the limitation in 105
subsection 2 of this section shall apply based on the 106
severity of the most severe injuries. 107
12. If a court of competent jurisdiction enters a 108
final judgment on the merits that is not subject to appeal 109
and that declares any provision or part of either section 110
1.010 or this section to be unconstitutional or 111
unenforceable, then section 1.010 and this section, as 112
amended by this act and in their entirety, are invalid and 113
shall have no legal effect as of the date of such judgment, 114
and this act, including its repealing clause, shall likewise 115
be invalid and of no legal effect. In such event, the 116
versions of sections 1.010 and this section that were in 117
effect prior to the enactment of this act shall remain in 118
force. 119
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