2nd Circuit Reverses in Part Caddo Parish Med Mal Case Over Causation Issue

With the vast criticisms that surround medical malpractice cases, it is no wonder why many keep a close eye on these types of cases. While it is very rare for an appellate court to do so, once in a blue moon an appellate decision will overturn a jury verdict of a medical malpractice judgment. Patten v. Gayle is one of those cases in which the plaintiff appeals the court’s verdict that malpractice occurred, but resulted in no injury and thus awarded no damages.

The plaintiff, Ms. Charlotte Patten, was the patient of her OB-GYN, Dr. Christopher Gayle, the defendant. Dr. Gayle had scheduled Ms. Patten for a laparoscopic evaluation after Ms. Patten complained of severe pain that was believed to be related to an abdominal hysterectomy she received from Dr. Gayle in 1997. In performing the procedure, Dr. Gayle placed multiple operative trocars (a medical instrument used to gain access into the abdominal cavity) throughout the abdominal area in order to insert a laparoscope, which enabled Dr. Gayle to see within Ms. Patten’s abdominal cavity. While performing the procedure, Dr. Gayle moved the trocars to gain better visibility of Ms. Patten’s abdominal cavity, and inadvertently punctured Ms. Patten’s abdomen. Initially, Dr. Gayle did not believe that the abdomen cavity had been compromised, but after further investigation later in the procedure, Dr. Gayle discovered that the trocars had penetrated through Ms. Patten’s small bowel. The result of the injury required Dr. Gayle to have the hospital’s general surgeon perform an emergency surgery on Ms. Patten to correct the error. In addition, feculent material was found to have leaked into Ms. Patten’s abdominal cavity a few days after the surgery had been completed, resulting in an abdominal infection known as peritonitis and pneumonia. After her recovery, Ms. Patten filed a medical malpractice suit against, among other individuals, Dr. Gayle. The jury determined that Dr. Gayle had in fact deviated from the required standard of care and had committed malpractice, but found that his actions did not result in the injuries sustained to Ms. Patten and awarded no damages. Ms. Patten appealed stating that the jury manifestly erred in finding a lack of causation between Ms. Patten’s injuries and Dr. Gayle’s malpractice.

In medical malpractice cases, the appellate courts apply the manifest error standard of review when ruling on issues of causation. The manifest error standard, as stated in Johnson v. Morehouse General Hospital, mandates that an appellate court may not overturn a trial court’s ruling, unless it is determined that the court’s factual determination is clearly wrong or manifestly erroneous. The court in Johnson states that it is not enough that the appellate court disagree with the trial court’s decision, it must find that there is no reasonable factual basis for the trial court’s conclusion. The court in Lovelace v. Giddens requires the appellate courts to pay close attention to medical malpractice cases when it comes to conclusions of causation, as great deference must be given when medical experts make differing conclusions as to medical causation.

While the appellate court affirmed the trial court’s conclusions about the causation of Mr. Gayle’s performance, the court did reverse the finding that the injuries to Ms. Patten’s bowel and the time and expense of its repair were not related to Dr. Gayle’s negligence. The appellate court determined that additional costs were directly incurred because of Dr. Gayle’s puncturing of Ms. Patten’s bowel. The appellate court explained that Ms. Patten’s placement under anesthetic gases for a longer period of time to repair the punctured bowel, for instance, was a direct result of the negligently punctured bowel. Such additional costs would not have occurred had Dr. Gayle properly performed the procedure, concluding that the trial court’s decision that no causation existed between some of the injury and Dr. Gayle’s negligence was manifestly erroneous. Because of the conflicting testimony from medical experts, the lack of damages awarded for the post-surgery illnesses sustained by Ms. Patten was not reversed. Based on the direct medical expenses to the repair of Ms. Patten’s bowel and some pain and suffering related to her injury, the appellate court awarded just over $14,000 in damages.

The small amount of damages awarded to Ms. Patten as a result of her appeal highlights the very difficult and technical nature of medical malpractice cases. Full of medical jargon and expert testimony, it is a rarity that one would see a reversal in judgment for such a case as Ms. Patten’s. However, medical accidents do happen, and it is always important to consult a lawyer if you believe to be the victim of any medical procedure believed to have gone wrong.