Title: Hink v. Helfrich
Citation: N/A
Docket Number: SC96371
State: Missouri
Issuer: Missouri Supreme Court
Date: May 1, 2018

SUPREME COURT OF MISSOURI
en banc 
MARILYN HINK, 
)
)
Appellant, 
)
)
v. 
) 
No. SC96371 
) 
LORING HELFRICH, M.D., 
)
)
Respondent, 
)
)
and 
)
)
LY PHAN, M.D., MISSOURI 
) 
DELTA PHYSICIANS SERVICES, 
) 
and MISSOURI DELTA MEDICAL 
) 
CENTER, 
) 
) 
Defendants. 
) 
APPEAL FROM THE CIRCUIT COURT OF SCOTT COUNTY 
The Honorable David A. Dolan, Judge 
Appellant Marilyn Hink appeals the Scott County circuit court’s judgment 
dismissing her medical malpractice case without prejudice for failure to file an “affidavit 
of merit” under section 538.225.1  She argues section 538.225’s affidavit requirement 
violates Missouri’s open courts provision as well as her right to trial by jury and the 
1 All statutory citations are to RSMo 2016, unless otherwise noted. 
Opinion issued May 1, 2018
 
2 
principle of separation of powers under the Missouri Constitution. See Mo. Const. 
art. I, § 14; id. art. I, § 22(a); id. art. II, § 1.  This Court reaffirms its decision in 
Mahoney v. Doerhoff Surgical Services, Inc., 807 S.W.2d 503 (Mo. banc 1991), 
upholding the constitutional validity of section 538.225’s requirement of an affidavit 
stating the plaintiff or plaintiff’s attorney has the opinion of a legally qualified medical 
provider on the issues of breach of the standard of care and causation of damages.   
 
This Court declines to adopt Ms. Hink’s argument that revisions to the statute 
since Mahoney require a single expert be relied on to support all theories of causation, 
standard of care, and damages even when multiple experts will be used at trial.  This 
Court need not reach the question posed by Ms. Hink of whether the statute restricts the 
definition of “legally qualified health care provider” in a way that disqualifies experts 
who would otherwise be able to make a submissible case at trial from supplying the 
opinion supporting an affidavit.  Not only is such a serious constitutional problem 
unlikely to arise in light of this Court’s broad interpretation of what constitutes 
“substantially the same specialty” in Spradling v. SSM Health Care St. Louis, 313 S.W.3d 
683 (Mo. banc 2010), but in any event, the issue is not presented here.  Ms. Hink’s case 
was dismissed because she failed to file any affidavit, not because she offered multiple 
affidavits or because the judge believed the medical opinions were not offered by persons 
in substantially the same specialty as experts who would have offered sufficient evidence 
as to breach of the standard of care, causation, and damages to make a submissible case at 
trial.  Accordingly, this Court affirms.  
 
 
3 
I. 
FACTUAL AND PROCEDURAL BACKGROUND 
 
On May 7, 2013, Dr. Loring Helfrich performed a scheduled surgery to remove 
Marilyn Hink’s gall bladder.  Ms. Hink’s right hepatic duct was allegedly injured during 
the procedure, causing bile to leak into the surgical field.  Over the next several months, 
Ms. Hink required additional medical attention and a second surgery to repair the injured 
duct.  On May 5, 2015, just less than two years after her surgery, Ms. Hink filed a 
petition in the Scott County circuit court alleging (1) Dr. Helfrich was negligent in 
injuring her hepatic duct during the May 7 surgery and (2) the affidavit requirement of 
House Bill 393, contained in section 538.225, unconstitutionally barred her access to the 
courts to pursue her malpractice claim.2   
 
In a medical malpractice action, section 538.225 requires the plaintiff or plaintiff’s 
attorney to file an affidavit, often called an “affidavit of merit,” stating “that he or she has 
obtained the written opinion of a legally qualified health care provider” that the defendant 
breached the applicable standard of care and this failure directly caused or contributed to 
cause plaintiff’s damages.  The affidavit must be filed within 90 days of filing a petition 
unless the circuit court grants an extension.  Id.   
Ms. Hink’s first petition was dismissed without prejudice on September 24, 2015.  
Section 537.100 permits the refiling of a petition within one year of dismissal even when 
the statute of limitations may have run.  Lang v. Goldsworthy, 470 S.W.3d 748, 752 n.6 
                                              
2 Section 516.105 provides: “All actions against physicians … for damages for 
malpractice, negligence, error or mistake related to health care shall be brought within 
two years from the date of occurrence of the act of neglect complained of.”  Although 
 
4 
(Mo. banc 2015).  On September 21, 2016, Ms. Hink refiled her petition.  She sought, 
and was granted, a 90-day extension to file her affidavit, as permitted by section 538.225. 
This made the affidavit due no later than March 20, 2017.  When Ms. Hink failed to file 
an affidavit by that date, Dr. Helfrich filed a motion to dismiss for failure to timely file an 
affidavit of merit.  Ms. Hink conceded she failed to file the required affidavit but asked 
the court to overrule the motion to dismiss on the ground that section 538.225, as revised 
in 2005, violates a plaintiff’s right to jury trial, Missouri’s open courts provision, and 
separation of powers.  The circuit court again dismissed the petition without prejudice.   
Although a dismissal without prejudice generally is not appealable because it is 
not an adjudication on the merits, when an action cannot be refiled or when the litigant 
chooses to stand on the “right under the state and federal constitutions to maintain the 
action unencumbered by [the section 538.225 affidavit] requirement,” then the dismissal 
may be appealed because “the dismissal without prejudice sanction for failure to file the 
health care provider affidavit is a dismissal of the action, and not merely the petition.”  
Mahoney, 807 S.W.2d at 506.  Ms. Hink properly filed her appeal in this Court because 
she attacks the validity of a Missouri statute.  Mo. Const. art. V, § 3.  
II. 
STANDARD OF REVIEW 
 
“Challenges to the constitutional validity of a state statute are subject to de novo 
review.”  State v. Shanklin, 534 S.W.3d 240, 241 (Mo. banc 2017), quoting, Hill v. Boyer, 
480 S.W.3d 311, 313 (Mo. banc 2016).  “Statutes are presumed constitutional and will be 
                                                                                                                                                  
Ms. Hink made additional allegations of unconstitutionality of other statutory sections, 
she did not pursue those claims below and does not raise their dismissal on appeal.    
 
5 
found unconstitutional only if they clearly contravene a constitutional provision.”  Hill v. 
Boyer, 480 S.W.3d 311, 313-14 (Mo. banc 2016).  The party bringing the constitutional 
challenge “has the burden of proving the act clearly and undoubtedly violates the 
constitutional limitations.”  State v. Vaughn, 366 S.W.3d 513, 517 (Mo. banc 2012).  
“This Court also reviews de novo questions … about a party’s standing to raise such 
constitutional questions.”  Brehm v. Bacon Twp., 426 S.W.3d 1, 4 (Mo. banc 2014). 
III. 
STATUTORY FRAMEWORK OF SECTION 538.225 
 
Section 538.225.1 requires that the plaintiff or plaintiff’s counsel 
shall file an affidavit with the court stating that he or she has obtained the 
written opinion of a legally qualified health care provider which states that 
the defendant health care provider failed to use such care as a reasonably 
prudent and careful health care provider would have under similar 
circumstances and that such failure to use such reasonable care directly 
caused or directly contributed to cause the damages claimed in the petition. 
 
(Emphasis added).  When first enacted, the statute further provided, if no such affidavit is 
filed within 90 days, “the court may, upon motion of any party, dismiss the action against 
such moving party without prejudice.”  § 538.225.5, RSMo 1985 (emphasis added).  The 
statute was amended in 2005 to provide the court “shall” dismiss the action if an affidavit 
is not filed.  The 2005 amendment also added, for the first time, language defining a 
“legally qualified health care provider” as one licensed “in the same profession as the 
defendant and either actively practicing or within five years of retirement from actively 
practicing substantially the same specialty as the defendant.”  § 538.225.2, RSMo 2005.   
Ms. Hink’s sole point relied on states as follows: “The trial court erred in 
sustaining Dr. Helfrich’s Motion to Dismiss for Failure to File Healthcare Affidavit 
 
6 
pursuant to RSMo. § 538.225 because RSMo. §538.225 is unconstitutional in that there 
are circumstances where it is impossible for the plaintiff to comply with the requirements 
of RSMo. § 538.225.”  As the separate opinion notes, Ms. Hink’s point is an abstract 
statement of law and is too general and vague, as is her argument regarding the alleged 
violation of the right to jury trial and separation of powers.  But this Court prefers to 
dispose of cases on the merits if it can discern the argument being made.  See Pub. Water 
Supply Dist. No. 2 of Jackson Cty. v. Alex Bascom Co., 370 S.W.2d 281, 291 (Mo. 1963); 
see also Lueker v. Mo. W. State Univ., 241 S.W.3d 865, 867 (Mo. App. 2008) (“An 
appellate court prefers to dispose of a case on the merits rather than to dismiss an appeal 
for deficiencies in the brief.”).  This Court can discern from the argument section of Ms. 
Hink’s brief and oral argument, from the amicus brief, and from her citation to this 
Court’s discussion of similar issues in Mahoney, 807 S.W.2d at 503, that her key 
argument is section 538.225 violates the open courts provision of Missouri’s constitution 
because the post-2005 definition of “legally qualified healthcare provider” arbitrarily and 
unreasonably restricts a plaintiff’s access to the courts in that it leads to dismissal of a 
case for failure to file an affidavit even if the plaintiff otherwise would have made a 
submissible case.3   
 
                                              
3 The separate opinion suggests this Court should await better briefing to decide an 
unresolved constitutional issue, but this Court is declining to reach the only novel 
constitutional issue raised, as it concerns a hypothetical situation not relevant to the 
dismissal of Ms. Hink’s suit.  The remainder of the opinion explains that the other issues 
raised already were decided in Mahoney and are without merit.  These holdings are well 
within this Court’s prerogative to address. 
 
7 
IV.  
THIS COURT REAFFIRMS THE CONSTITUTIONAL VALIDITY OF 
REQUIRING AN AFFIDAVIT FROM A QUALIFIED HEALTH CARE 
PROVIDER  
 
 Mahoney is directly on point and controlling here. In Mahoney, the plaintiffs’ 
malpractice claim was dismissed after they failed to submit an affidavit of merit within 
the time limits set by section 538.225.  807 S.W.2d. at 505.  The plaintiffs argued “the 
‘screening’ process of § 538.225 that requires ‘a health care provider’s written report’ not 
only violates the guarantee that courts be open ‘without denial or delay[]’ but also 
imposes an unreasonable precondition to free access to the courts” and so to the right to 
trial by jury.  Id. at 509. 
This Court disagreed, holding the right of access to the courts “means simply the 
right to pursue in the courts the causes of action the substantive law recognizes.”  
Id. at 510.  In medical malpractice actions, the substantive law requires a plaintiff to 
“prove by a qualified witness that the defendant deviated from an accepted standard of 
care.  Without such testimony, the case can neither be submitted to the jury nor be 
allowed to proceed by the court.”  Id.  And, Mahoney held, the affidavit requirement is 
consistent with this substantive law because the purpose of requiring an “affidavit of 
merit” under section 538.225 is to prevent frivolous medical malpractice lawsuits when a 
plaintiff cannot put forth adequate expert testimony to support their claims.  Id.  For this 
reason, this Court held section 538.225’s affidavit requirement “denies no fundamental 
right, but at most merely [re]design[s] the framework of the substantive law to 
accomplish a rational legislative end,” id. at 510, of “protect[ing] the public and litigants 
from the cost of ungrounded medical malpractice claims,” id. at 507 (citation and 
 
8 
quotations omitted).  
For similar reasons, this Court rejected the argument that section 538.225’s 
affidavit requirement violates the right to trial by jury, stating “it is not the ‘screening’ 
procedure of § 538.225 that impedes the progression of [a plaintiff’s] petition to the jury 
… but their failure to meet a requirement of substantive law.”  Id. at 508.  Mahoney noted 
Rule 55.03 “requires of the party or attorney the duty of reasonable inquiry that the 
petition or other paper filed ‘is well grounded in fact and is warranted by existing law.’”  
Id.  In the same way, Mahoney held, the affidavit requirement simply ensures “that a 
party who sues for the malpractice of a health care provider has by a reasonable inquiry 
come to a reasonable belief that the petition is warranted by the proof and the law.”  Id.  
Mahoney also compared the affidavit requirement to traditionally recognized procedures 
such as a directed verdict or summary judgment, and rejected the jury trial challenge 
because the affidavit requirement simply “parallels the practice already prescribed for all 
civil actions, and is hardly more onerous to the right to trial by jury.”  Id.   
This Court also rejected the Mahoney plaintiffs’ argument the affidavit 
requirement “invades the judicial function by having a health care provider rather than a 
judicial officer determine the validity of [a plaintiff’s] cause of action.”  Id. at 510.  
Rather, this Court held dismissing a claim for lack of compliance with section 538.225 
“is a determination that under the substantive law of medical malpractice the petition 
cannot succeed, and so is frivolous.  It is a judge that decides that the case may not 
proceed, not a health care provider.”  Id. 
Ms. Hink does not dispute Mahoney so held nor does she suggest it should be 
 
9 
overruled.  Rather, in oral argument, and implicit in the argument section of her brief, is 
her suggestion Mahoney can be distinguished because, at the time it was decided, section 
538.225 simply said a judge “may” dismiss a case for the failure to file an affidavit of 
merit, whereas now, as a result of a 2005 amendment, section 538.225 provides the judge 
“shall” dismiss the case if plaintiff fails to file an affidavit of merit.  Mahoney did not 
base its ruling on the statute’s use of the word “may,” however, and this Court does not 
agree the change from “may” to “shall” affects the open courts and jury trial rights.  
While previously a judge did not have to dismiss the suit when an affidavit was not 
provided, the trial judge in Mahoney did dismiss the suit precisely for that failure.  The 
analysis in Mahoney, therefore, focused on whether dismissal for failure to file an 
affidavit constitutes denial of the right to jury trial or violates the open courts provision or 
separation of powers principles, just as is alleged here.  Accordingly, Mahoney’s analysis 
is directly applicable without regard to the change from “may” to “shall.” 
Ms. Hink argues another change in the statute adopted in 2005 raises an issue not 
addressed in Mahoney and dispositive here.  In addition to changing “may” to “shall,” the 
2005 amendment to section 538.225 for the first time defined “legally qualified 
healthcare providers” to include only those who practice in “substantially the same 
specialty” as the defendant.  
Ms. Hink argues this new limitation on who can provide the requisite opinion 
supporting an affidavit of merit imposes a stricter burden on the plaintiff than is required 
to prove a prima facie case of negligence at trial.  At trial, a medical malpractice plaintiff 
bringing a claim of negligence can make a prima facie case through expert testimony 
 
10 
from any qualified expert, regardless of whether the expert practices in substantially the 
same specialty as the defendant.  See Klotz v. St. Anthony’s Med. Ctr., 311 S.W.3d 752, 
761 (Mo. banc 2010) (rejecting the notion that proving standard of care “requires that 
expert testimony at trial be limited to persons in the defendant’s specialty”).  This means 
a plaintiff might be out of court because he or she is unable to provide an affidavit of 
merit from a physician in substantially the same specialty even though the plaintiff could 
make a submissible case if the affidavit requirement did not exist.  But this argument fails 
to recognize this Court has held a “health care provider may have a different board 
certification but may practice ‘substantially the same specialty’ because of an expertise in 
the medical procedure at issue.  Many medical procedures are not peculiar to one board 
certification.”  Spradling, 313 S.W.3d at 689.  In most cases, therefore, this Court’s 
interpretation of “substantially” the same specialty, which includes persons qualified by 
expertise rather than board certification, means the same experts would qualify under 
either standard. 
Ms. Hink posits there nonetheless may be some instances in which an expert could 
not arguably be considered even “substantially” in the same specialty yet would be 
considered a qualified trial expert.  She suggests this may be the case, for instance, in the 
case of the family doctor, who may not be considered a specialist of any sort, or in the 
case of a failure by such a doctor to diagnose cancer, in which case an oncologist might 
need to be called, and the latter would be in a different specialty.   
As just noted, under Spradling, when the expert has gained the requisite expertise 
through experience, then it would not matter that he or she practiced in different fields.  
 
11 
Ms. Hink suggests there may nonetheless be exceptions, particularly in cases that are so 
complex the plaintiff may need to rely on unique or multiple experts in different fields at 
trial, including fields not related to that of the defendant’s practice, to show damages or 
to support a complex theory of causation.  Some of those experts would likely be in 
different specialties from the defendant.  Even worse, Ms. Hink argues, compliance with 
the statute may prohibit her from relying on multiple experts at all, for she reads its use of 
the phrase “legally qualified health care provider” to mean a plaintiff must rely on a 
single health care provider to support standard of care, causation, and damages of all 
types and all theories.  This, she says, is an arbitrary additional requirement and, in a 
complex case, may require dismissal of an otherwise meritorious case.  
These indeed are issues different than those rejected in Mahoney.  There, the Court 
found the affidavit requirement constitutional because it simply required plaintiffs to 
show what the substantive law already requires – there exists “a qualified witness [who 
will attest] that the defendant deviated from an accepted standard of care.”  807 S.W.3d at 
510.  This did not violate the right to jury trial or open courts or the separation of powers 
because, “Without such testimony, the case can neither be submitted to the jury nor be 
allowed to proceed by the court.”  Id.  Mahoney did not suggest the legislature could add 
a requirement that would preclude an otherwise meritorious, submissible case from going 
to trial because of the inability to find an expert to testify to a matter not required to be 
shown to submit a cause of action.  
Here, however, Ms. Hink has failed to show section 538.225 imposes such 
requirements.  Nothing in section 538.225 provides the affidavit may rely on only a 
 
12 
single expert opinion on all issues.  Section 538.225 simply provides a plaintiff “shall file 
an affidavit with the court stating that he or she has obtained the written opinion of a 
legally qualified health care provider” as to the defendant’s breach of the standard of care 
and causation.  While the statute uses the term “a legally qualified health care provider,” 
Missouri law expressly provides the singular includes the plural unless otherwise stated.4  
Any requirement in this case that the entire breach of standard of care and causation be 
proven by a single expert appears to have been self-imposed.  
Further, nothing in section 538.225 provides every single element of damage 
claimed must be supported in the opinion that forms the basis of the affidavit, as 
Ms. Hink suggests she was unable to accomplish.  Neither does Mahoney support such a 
reading of the statute.  To the contrary, Mahoney says the purpose of the affidavit 
requirement is to allow the early dismissal of frivolous claims.  807 S.W.3d at 507.  That 
purpose necessarily is served if the plaintiff files an affidavit stating he or she has the 
opinion of a qualified health care provider that the defendant failed to meet the standard 
of care, caused the injury, and damages resulted.  Whether every theory or every claimed 
item of damage later is found to be submissible need not be determined in deciding 
whether the action itself is frivolous, and that is what the affidavit requirement addresses.  
Finally, and most importantly, even were Ms. Hink’s unduly labored reading of 
                                              
4 Section 1.030 provides: “When any subject matter, party or person is described or 
referred to by words importing the singular number or the masculine gender, several 
matters and persons, and females as well as males, and bodies corporate as well as 
individuals, are included.”  Thus, section 538.225’s use of the singular – “a legally 
qualified health care provider” – cannot be read as a requirement only one expert must be 
used.   
 
13 
the statute a correct one, the record simply does not show her case was dismissed because 
her affidavit showed she could not obtain an opinion from a physician in the right 
specialty, or because the affidavit showed she obtained only a single expert opinion 
addressing some but not all her claims of liability or damages.  Rather, the record reveals 
she failed to file any affidavit at all.  While Ms. Hink says this was because she feared her 
affidavit would be rejected if filed, this Court can act only based on the record before it, 
not based on hypothetical facts not supported by the record.  Harris v. Consol. Sch. Dist. 
No. 8 C, Dunklin Cty., 328 S.W.2d 646, 654 (Mo. banc 1959) (“An advisory decree upon 
hypothetical facts is improper.”).  Further, “Generally, only those adversely affected by a 
statute have standing to challenge the constitutionality of the statute.”  Brehm, 426 
S.W.3d at 5.5  Ms. Hink is not affected by the alleged deficits in the statute she argues 
exist, and this Court, therefore, declines to further discuss the merits of her hypothetical 
constitutional arguments.   
V. 
CONCLUSION  
For these reasons, the circuit court’s judgment is affirmed. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
_________________________________  
 
 
 
 
 
 
 
     LAURA DENVIR STITH, JUDGE 
Draper, Russell, Powell and Breckenridge, JJ.,  
concur; Fischer, C.J., files separate opinion:  
Wilson, J., concurs in opinion of Fischer, C.J. 
                                              
5 In Missouri, “standing is a prerequisite to the court’s authority to address substantive 
issues and so must be addressed before all other issues.” Schweich v. Nixon, 408 S.W.3d 
769, 774 n.5 (Mo. banc 2013).  A party’s “[l]ack of standing cannot be waived.”  Farmer 
v. Kinder, 89 S.W.3d 447, 451 (Mo. banc 2002). 
 
 
SUPREME COURT OF MISSOURI 
en banc 
 
MARILYN HINK, 
) 
 
) 
 
Appellant, 
) 
 
 
) 
v. 
 
) 
 
No. SC96371 
 
 
) 
LORING HELFRICH, M.D., 
) 
 
 
) 
 
Respondent, 
) 
 
 
) 
and 
 
) 
 
 
) 
LY PHAN, M.D., MISSOURI 
) 
DELTA PHYSICIANS SERVICES, 
) 
and MISSOURI DELTA MEDICAL 
) 
CENTER, 
) 
 
 
) 
 
 
Defendants. 
) 
 
SEPARATE OPINION 
 
Ms. Hink failed to raise her constitutional claims at the earliest opportunity and her 
sole point relied on violates Rule 84.04 and preserves nothing for appellate review.  
Because Ms. Hink failed to preserve her constitutional claims, the appeal should be 
dismissed.   
The Rule 84.04 briefing rules are mandatory.  Storey v. State, 175 S.W.3d 116, 126 
(Mo. banc 2005).  Rule 84.04(d)(1) requires an appellant's brief to contain a "Point Relied 
2 
 
On" identifying a claim of reversible error, concisely stating the legal reasons for the claim, 
and summarily explaining why the stated legal reasons support the claim of reversible 
error.  The principal opinion acknowledges Ms. Hink's point relied on violates Rule 84.04 
because it is an abstract statement of law that fails to explain a claim of reversible error.  
The principal opinion further acknowledges Ms. Hink's brief fails to set forth any 
discernible argument that the § 538.225 affidavit requirement violates the right to trial by 
jury and separation of powers.  Because Ms. Hink's improper briefing preserves nothing 
for appellate review, her allegations of error "shall not be considered in any civil appeal."  
Rule 84.13(a).  Despite the clear mandate of Rule 84.13(a), the principal opinion reviews 
Ms. Hink's unpreserved constitutional claims in several pages of unnecessary dicta based 
on admittedly deficient briefing.   
Furthermore, for decades, and for prudential reasons, this Court has held fast to the 
principle that "[a] court will avoid the decision of a constitutional question if the case can 
be fully determined without reaching it."  State ex rel. Union Elec. Co. v. Pub. Serv. 
Comm'n, 687 S.W.2d 162, 165 (Mo. banc 1985).  This Court has recently and repeatedly 
reaffirmed this important principle of not reaching constitutional issues unless necessarily 
required.  Brainchild Holdings, LLC v. Cameron, 534 S.W.3d 243, 246 (Mo. banc 2017); 
Lang v. Goldsworthy, 470 S.W.3d 748, 751 (Mo. banc 2015); State ex rel. SLAH, L.L.C. v. 
City of Woodson Terrace, 378 S.W.3d 357, 361 (Mo. banc 2012).  This long-standing 
principle of judicial restraint is inherent in the constitutional separation of powers and 
grounded in institutional prudence.  It recognizes the power to determine the validity of a 
legislative enactment "is one which the judge, conscious of the fallibility of the human 
3 
 
judgment, will shrink from exercising in any case where he can conscientiously and with 
due regard to duty and official oath decline the responsibility."  Ashwander v. Tenn Valley 
Auth., 297 U.S. 288, 345 (1936) (Brandeis, J., concurring) (internal quotation omitted).  
The principal opinion stands these settled principles on their head and decides fundamental 
constitutional issues after concluding the issues are not preserved for this Court's review.  
Doing so requires this Court to improperly assume an advocacy role and needlessly risks 
foreclosing potentially legitimate constitutional arguments.  I cannot concur in this 
approach and reserve the option of deciding these fundamental constitutional issues when 
they are properly preserved, adequately briefed, and presented to this Court.1  
The principal opinion offers no persuasive reason to ignore this Court's rules and 
long-standing principles of judicial precedence and restraint.  The principal opinion cites 
Public Water Supply District No. 2 of Jackson County v. Alex Bascom Co., 370 S.W.2d 
281, 291 (Mo. 1963), to excuse Ms. Hink's failure to properly brief and preserve her 
constitutional claims.  Bascom involved the valuation of property taken by eminent 
domain, not the constitutional validity of a state statute.  Bascom does not support the 
principal opinion's determination to gratuitously decide fundamental issues of state 
constitutional law based on deficient briefing.   
                                                          
 
1 Aside from the fact the constitutional issues in this case are not preserved, this Court's role in 
interpreting and applying Missouri law is best served by deciding cases when counsel complies 
with the allegedly unconstitutional statutory requirement and fully develops the constitutional 
arguments.  That did not occur in this case.  
 
4 
 
The principal opinion asserts plain error review is warranted, but plain error review 
rarely is granted in civil cases.  Mayes v. St. Luke's Hosp. of Kansas City, 430 S.W.3d 260, 
269 (Mo. banc 2014).  In civil cases, Rule 84.13(c) provides for discretionary review of 
unpreserved "[p]lain errors affecting substantial rights…when the court finds that manifest 
injustice or miscarriage of justice has resulted therefrom."  The principal opinion's 
conclusion that § 538.225 is constitutional precludes a finding of manifest injustice 
permitting plain error review pursuant to Rule 84.13(c).    
The principal opinion's error is compounded by the fact Ms. Hink waived her right 
to trial by jury and separation of powers claims by failing to properly assert them in the 
circuit court.  To preserve a constitutional claim, a party must  
(1) raise the constitutional question at the first available opportunity; 
(2) designate specifically the constitutional provision claimed to have 
been violated, such as by explicit reference to the article and section or 
by quotation of the provision itself; (3) state the facts showing the 
violation; and (4) preserve the constitutional question throughout for 
appellate review. 
 
Mayes, 430 S.W.3d at 266.    
Ms. Hink filed suggestions in opposition to the defendants' motion to dismiss stating 
the facts supporting her claim that the § 538.225 affidavit requirement violates the open 
courts provision in article I, section 14 of the Missouri Constitution by imposing an 
allegedly unreasonable burden on access to the courts.  Instead of stating facts showing 
§ 538.225 violates the right to trial by jury and the separation of powers, Ms. Hink 
summarily referred to "the same reasons discussed above" in her open courts argument.   
Ms. Hink's reference to the facts regarding her open courts claim necessarily failed to state 
5 
 
the facts showing a violation of the distinct constitutional provisions guaranteeing the right 
to trial by jury and establishing separation of powers.  Ms. Hink not only failed to 
adequately brief her claims that § 538.225 violates the right of trial by jury and separation 
of powers, but she also waived these claims by failing properly assert them in the circuit 
court in the first place.2   
The correct resolution of this appeal requires nothing more than adherence to this 
Court's mandatory briefing rules, Rule 84.13, and the long-standing line of cases holding 
this Court avoids constitutional questions if the case can be otherwise resolved.  Ms. Hink's 
failure to preserve her constitutional claims is dispositive.  In my view, the appeal should 
be dismissed.  
 
________________________ 
 
 
 
 
 
 
 
Zel M. Fischer, Chief Justice 
 
 
 
  
 
                                                          
 
2 The principal opinion implicitly concedes this point by noting Ms. Hink's substitute brief is 
"inadequate to preserve this issue for review" because it simply argues § 538.225 violates the right 
to trial by jury and separation of powers "for the same reasons RSMo. § 538.225 violates the open 
courts clause of the Missouri Constitution."  Because Ms. Hink's brief is inadequate to preserve 
her jury trial and separation of powers claims, Ms. Hink's substantively identical suggestions in 
opposition were also inadequate to properly raise these important constitutional issues in the circuit 
court.