Health Law Daily Wrap Up, FOOD SAFETY—Mo. App.: New trial affirmed for minor sickened by preterm baby formula, (Aug 17, 2026)

By Molly Platnick

The lower court complied with Missouri’s weight-of-the-evidence rules.

The Missouri Court of Appeals affirmed a trial court’s order granting a new trial in a case brought on behalf of a minor against manufacturers of a preterm infant formula and the hospital where he received the formula. The defendants moved to appeal the lower court’s order, arguing the minor had not raised “submissible” claims and the trial court exceeded its discretion in violation of Missouri Rule 78. The appellate court found the minor established causation for his claims based on the applicable standard of review. The appellants could not prevail on the learned intermediary doctrine or the defense that attacking an “entire category of products” is impermissible for a design defect claim. The court ruled the trial court cited the correct standard in ordering a new trial and satisfied Rule 78’s weight-of-the-evidence analysis (K.W. v. Saint Louis Children’s Hospital, No. ED113441 (Mo. App. Aug. 11, 2026)).

Factual background & procedural history. The minor plaintiff was born prematurely in St. Louis in August 2017. Because his mother struggled to produce breast milk, staff at the Saint Louis Children’s Hospital (SLCH) fed him the defendant manufacturers’ “specialized preterm infant formulas.” In September 2017, the minor was diagnosed with the gastrointestinal condition necrotizing enterocolitis (NEC). He underwent surgery and spent months in the neonatal intensive care unit.

The minor’s mother filed this suit in July 2022 as her son’s Next Friend against SLCH and the formula manufacturers. She alleged the preterm infant formulas caused her son’s injuries and were “defective and unreasonably dangerous because they significantly increase the risk of NEC.” In her amended petition she sought punitive damages based on products liability and negligence, including medical negligence against SLCH.

A jury found for the hospital and manufacturer defendants after a four-week trial. The minor moved for a new trial, which the lower court granted. The defendants filed the instant appeal disputing that order.

Standard of review—Missouri Rule 78.02. Missouri trial courts may grant a new trial where the verdict was “against the weight of the evidence.” The lower courts have “nearly unfettered discretion,” and appellate courts will uphold their decision so long as the plaintiff has made a “submissible case.” Case law directs appellate courts to view evidence for a motion for a new trial “in the light most favorable to the trial court’s order.”

Order affirmed. The trial court did not abuse its discretion in finding the verdict was against the weight of the evidence and granting a new trial.

The appellants argued the lower court erred because (1) the order was based on purported error and did not include a weight-of-the-evidence analysis; (2) the court applied the incorrect standard in ordering a new trial; and (3) the minor did not make a “submissible case” on all of his claims. The appellate court addressed these arguments in reverse order, combining the latter two.

Minor made submissible case on all claims. The appellants alleged the minor did not make a submissible case because (1) he failed to establish causation; (2) the learned intermediary doctrine precluded his failure to warn claim; (3) attacking an “entire category of products” is impermissible for a design defect claim; and (4) the trial court cited the incorrect standard in ordering a new trial.

Causation. The appellants pointed to expert testimony to suggest the minor did not prove the required element of causation for any of his claims. They also asked the appellate court to give deference to the jury’s verdict. The court rejected both theories. It accused the appellants of “cherry-picking…[what] is favorable to their defense” from the voluminous evidence presented at trial. Reviewing evidence in the light most favorable to the defendants would go against the established standard of review. As described above, appellate courts are bound to view evidence in the light most favorable to the trial court’s decision. Here, there was ample evidence supporting the trial court’s decision, as it had the opportunity to assess the credibility of both sides’ experts to determine the causation element.

Failure to warn. Before trial, the lower court awarded the minor partial summary judgment on the appellants’ learned intermediary defense. That court decided the defense did not apply to the preterm infant formulas because they were not a prescription medicine or medical device. The appeals court did not address the merits of this argument because it refused to review an order for summary judgment on an appeal from a motion for a new trial.

The appellant manufacturers contended that even if the preterm formula had a warning, it would not have mattered because the minor’s mother never saw the bottle. The court acknowledged that common law failure to warn leaves plaintiffs with a “Catch-22” by which they must show they would have acted differently had they had a warning. Missouri, however, has “avoided this dilemma” with a presumption that “had an adequate warning been given, it would have been heeded.” In this case, the court was satisfied that had the minor’s mother seen a warning on the formula, she would presumably have heeded it.

Design defect. The appellants alleged the minor called its formula defective because it was made from cow’s milk. Under their interpretation, this was an attack on an entire category of products, which is not permissible for a design defect claim. However, the court found this theory was based on a single statement the minor’s counsel made during closing argument. Put in context, it was not a statement that all infant formula is unreasonably dangerous in design. Even if the minor’s counsel had attacked an entire category, Missouri case law holds that “statements made during opening and closing argument are not evidence.”

Trial court applied correct standard. The appellants charged the trial court with incorrectly viewing the evidence in the light most favorable to the minor when granting the motion for a new trial. In its order, the lower court wrote, “When conducting its review, this Court views the evidence in the light most favorable to the plaintiff, and the plaintiff is given the benefit of all reasonable inferences.” The appellate court agreed this was the wrong standard of review but deemed it immaterial because “immediately thereafter” the trial court stated it considered “all of the evidence presented.” The appellate court was not persuaded this incorrect citation “constitute[d] a reversible error.”

Lower court granted motion for new trial on discretionary grounds. The issue on appeal was whether the trial court exceeded its discretionary authority under Missouri statute. As described above, Rule 78.02 empowers trial courts to grant new trials if the verdict was against the weight of the evidence. That rule is tempered by Rules 78.03 and 84.05, which mandate every order for a new trial must specify the grounds on which the new trial is granted. The appellate court clarified the trial court’s discretion is limited to whether or not to grant a new trial; it cannot rule on any issues of law in its order.

The appellants relied on Dick v. Children’s Mercy Hospital and McDowell v. Kawasaki Motors Corporation to show the trial court’s order was not based on a weight-of-the evidence analysis. The appellate court found the instant case was distinguishable because in McDowell and Dick, the “trial courts merely referred to paragraphs in the moving party’s post-trial motion.” Here, by contrast, the trial court did not address any issue of law presented in the minor’s motion and “clearly stated grounds for granting a new trial.”

The appellants argued that even if the trial court acted within its discretionary authority, it did not conduct a complete weight-of-the-evidence analysis. The appellate court, however, took it as “well settled” that a trial court’s order for a new trial “is not required to set forth its reasons for the conclusion reached.” The bar is so low that “even in a situation where the trial court gives obscure, incorrect or erroneous reasons for its order granting a new trial on the ground that the verdict was against the weight of the evidence, the decision is conclusively presumed to have been made on that ground.”

The case is No. ED113441.

Judge: Wright, M.

Attorneys: John G. Simon (The Simon Law Firm) for K.W. William Ray Price Jr. (Armstrong Teasdale LLP) for Saint Louis Children’s Hospital, Abbott Laboratories, Abbott Laboratories, Inc., Mead Johnson & Co., LLC, and Mead Johnson Nutrition Co.

Companies: Saint Louis Children’s Hospital; Abbott Laboratories; Abbott Laboratories, Inc.; Mead Johnson & Co., LLC; Mead Johnson Nutrition Co.

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