JEFFERSON CITY, Mo. -- Breaking a 30-hour debate, the Missouri Senate gave initial approval Friday evening to legislation that would impose new limits on medical malpractice cases and other personal injury lawsuits.

Republican supporters of the legislation praised it as a way to slow the skyrocketing malpractice premiums of physicians, who had rallied by the hundreds at the Capitol earlier this year.

They also touted it as a way to boost Missouri's business climate, which has been hit by one of the highest job-loss rates in the nation during the recent recession.

Following a 19-9 party line vote, Senate President Pro Tem Peter Kinder declared: "We have a great victory for jobs and investment and economic opportunity in our state" and "we have a balanced bill that does not repeal the current rights of ordinary Missourians to have access to the courts."

But shortly before the vote, Democratic Gov. Bob Holden vowed to veto the legislation if it is sent to his desk without changes. The bill still requires a final Senate vote before moving to the House, which previously passed its own version of the legislation that imposes even more restrictions on lawsuits.

Holden and Democratic legislators agreed that something must be done to help doctors and the medical community, but they wanted provisions placing new controls on the medical malpractice insurance industry. They also objected to the bill's provision imposing limits on all types of personal injury cases.

Senate Minority Leader Ken Jacob said the proposed lawsuit limits would only hurt the victims of medical mistakes and other accidents by making it more difficult for them to sue and win money for their injuries.

"What they did today is throw out a thousand years of Anglo-American jurisprudence and sent us back to the dark ages in terms of how our civil justice system would work," said Jacob, D-Columbia. "The corporate powers are in control of the state legislature."

Jacob, who had played a leading role in the filibuster that spanned 30 hours over three days, said Democrats decided to relent after receiving an assurance from Holden that he would veto the bill unless it was narrowed to affect primarily the medical community.

In midafternoon, Holden issued a brief statement backing up the veto threat.

"It is important to give doctors relief from high medical malpractice rates so they can continue to provide medical services to citizens in need," Holden said. "The bill in its current form has provisions that do nothing to advance that goal and I would veto it."

Sen. John Griesheimer, R-Washington, said that to separate medical malpractice issues from other personal injury cases also would have killed the bill.

"If we're going to deal with tort reform, we're going to deal with tort reform on everything," said Griesheimer, his voice rising during Senate debate. "We are here to settle this issue."

The bill would restore a $350,000 cap on non-economic damages for such things as pain and suffering in medical malpractice insurance cases, with an annual adjustment for inflation to start anew next year.

A 1986 law setting the same inflation-adjusted cap had allowed the limit to grow to $557,000. But lawmakers of both parties say a recent state court decision effectively negated the cap by allowing awards for multiple "occurrences" that contribute to a person's injury.

The legislation effectively would reverse that court ruling.

The bill's limits on jury awards would not apply to other forms of personal injury lawsuits. And senators removed provisions that would have limited punitive damages.

But the bill still would affect all types of personal injury lawsuits by limiting where they could be filed and protecting wealthy corporations only slightly at fault from being forced to pay a poorer codefendant's share of a verdict.

Those two issues -- described as venue and joint and several liability in the legal world -- proved the biggest sticking points in the protracted Senate debate.

Lobbyists for attorneys groups fought the new restrictions on lawsuits, which were backed by business lobbyists.

While some senators worked with lobbyists outside the Senate chamber to try to reach a compromise, other senators stalled debate by telling stories about their childhoods, spring break vacations or -- in one instance -- the way filibusters work in the U.S. Senate.