Missouri hospitals continue to pursue a billion-dollar lawsuit against Big Tobacco -- a potentially precedent-setting case that could open the doors for similar lawsuits nationwide, the St. Louis Dispatch reported Sept. 15.

The hospitals seek to recoup losses assessed at $1 billion for the care provided to uninsured or indigent smokers since 1993. The more than 40 tobacco companies listed as defendants contend that the hospitals were not directly damaged by cigarettes and should not be reimbursed for patients' health problems.

Judge Michael P. David has been asked to decide the case based on current filings. If he decides not to do so, jury selection will begin in January 2010.

Kenneth Brostron, a St. Louis lawyer representing the plaintiffs, says the cigarette companies understood the potential impact on the hospitals. "They knew when they made the cigarette that someone was going to get sick and die," Brostron said, "and they knew that someone would have to take care of them."

The case has bogged down in the discovery process, but the delays may help the hospitals since landmark cases over the past 10 years have altered the landscape of tobacco law. "The St. Louis hospitals are in a much stronger position than they were a decade ago," said Edward L. Sweda, senior attorney for the Tobacco Product Liability Project at Northeastern University in Boston, adding that a finding for the hospitals will force attorneys "to distinguish the case from all the others that failed."