Tell It to the Jury: Louisiana Court of Appeal Reverses District Court in Medical Malpractice Case

historical-medical-devices-3-1566087-1024x678Upon entering a facility for medical treatment, we all hope that we will be treated properly. However, what happens when a medical or health care professional deviates from the profession’s standards? What happens if there is a mistake in the diagnosis or treatment? Such victims certainly have an opportunity to seek redress however sometimes a jury verdict can prove disappointing.  This case out of Jefferson Parish demonstrates what happens when a trial court jury does not get the proper instructions necessary for deciding a complex medical malpractice claim in Louisiana.

Doris Greathouse was admitted to East Jefferson General Hospital on June 2, 2008 for elective heart surgery. Shortly after Dr. Cougle and CRNA Wilkinson intubated Mrs. Greathouse, she suffered cardiac arrest and her brain was deprived of oxygen. Mrs. Greathouse was transferred to the Intensive Care Unit with fatal brain damage until her family removed her life support. Mrs. Greathouse’s children then filed a wrongful death and survival action against Dr. Cougle and Ms. Wilkinson alleging that they committed medical malpractice resulting in their mother’s injuries and death.   

Pursuant to La. R.S. 40:1299.47(B)(1)(a)(i), health care providers in Louisiana cannot be sued for medical malpractice under the the Medical Malpractice Act (“MMA”) unless the plaintiff submits a complaint to a Medical Review Panel (“Panel”), composed of three healthcare providers and an attorney. The Panel’s sole duty is to express its expert opinion as to whether the evidence supports the conclusion that the defendants complied with the standards of care. See La. R.S. 40:1299.47(G). The Panel may not render an opinion on any disputed issue of material fact that does not require its medical expertise. See La. R.S. 40:1299.47(H).

In accordance with the MMA, a Panel was formed to evaluate the merits of the case. The Panel found that the Defendants did not breach the standard of care. The case proceeded to a jury trial before the Judicial District Court for the Parish of Jefferson.  The jury found that the Defendants did not breach the standard of care. The Plaintiffs then appealed the case to the Louisiana Fifth Circuit Court of Appeal.  

First, the Plaintiffs argued that the District Court erred in admitting the Panel’s unredacted opinion and that the amount of time Mrs.Greathouse was deprived of oxygen should have been redacted.  Second, the Plaintiffs argued that the Panel’s opinion regarding Mrs.Greathouse’s informed consent should also have been redacted because the parties stipulated that informed consent would not be at issue. Finally, the Plaintiffs also argued that the District Court erred in its jury instructions by excluding an explanation of Louisiana law on the loss of chance of survival in a medical malpractice action.

A trial court must instruct jurors on the applicable law.  When a trial court erroneously instructs the jury and the error probably contributed to the verdict, an appellate court must reverse the verdict where the jury was misled to the extent that it was unable to dispense justice. See Adams v. Rhodia, Inc., 983 So.2d 798 (La. 2008).  Pursuant to La. R.S. 9:2794(A), to prevail on a medical malpractice claim, a plaintiff must prove three elements: (1) the standard of care applicable to the healthcare provider defendant, (2) a breach of that standard of care, and (3) that the breach of the standard of care caused the plaintiff to suffer injuries. Loss of chance of survival is a legal doctrine that applies to the third element of a medical malpractice claim when the alleged malpractice results in a patient’s death. Under Louisiana law, a plaintiff needs to prove that the malpractice resulted in the patient’s losing a chance of survival. See Hastings v. Baton Rouge Gen. Hosp., 498 So.2d 713 (La. 1986).

The Court of Appeal agreed that the Panel’s opinion contained a finding of a disputed material fact that should have been excluded from the jury’s consideration. The Court of Appeal concluded that this error prejudiced the Plaintiffs’ case, which required reversal. The inclusion of the Panel’s opinion on the amount of time Mrs. Greathouse was without oxygen could appear as an expert opinion to the jury. The Panel’s opinion, however, was the Panel’s impermissible conclusion of material facts, which should not have been before the jury.

The Court of Appeal also concluded that the District Court’s error on informed consent and its failure to instruct the jury on the loss of chance of survival required reversal. The District Court erred in admitting the Panel’s opinion because informed consent was irrelevant and should have been excluded. Its inclusion could have easily persuaded the jury that Mrs. Greathouse’s consent to surgery meant she consented to death.  The Plaintiffs also argued that the District Court erred in its jury instructions by excluding an explanation of Louisiana law on the loss of chance of survival in a medical malpractice action. Loss of chance of survival applied in this case because the Plaintiffs claimed that Mrs. Greathouse died as a result of the Defendants’ malpractice. The Court of Appeal found that the District Court’s failure to instruct the jury on the loss of chance of survival probably contributed to the jury’s verdict. The Court of Appeal concluded that this prejudicial error, together with the District Court’s error on informed consent, contributed to the verdict to the extent that the jury was unable to dispense justice, which required reversal.

In the end, the Court of Appeal found that the District Court’s admission of the Panel’s unredacted opinion constituted a prejudicial error of law. It reversed the judgment and remanded the case to the District Court for a new trial. This case demonstrates that a good lawyer is crucial for the many complexities involved in a medical malpractice case. The Plaintiffs’ persistence in pursuing the appeal led to another opportunity at victory.  

Additional Sources: TERRA MATRANGA, JOHN P. GREATHOUSE, JR., GINA G. GREATHOUSE AND JAMES E. GREATHOUSE VERSUS PARISH ANESTHESIA OF JEFFERSON LLC, MONICA WILKINSON, CRNA, CHRISTOPHER COUGLE, M.D., AND LOUISIANA MEDICAL MUTUAL INSURANCE COMPANY

Written by Berniard Law Firm Blog Writer: Fareena Azhar

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