RENDERED: MARCH 22, 2024; 10:00 A.M. NOT TO BE PUBLISHED
Commonwealth of Kentucky Court of Appeals NO. 2022-CA-0771-MR
CARRIE HALL, AS ADMINISTRATOR OF THE ESTATE OF HASSEL DARRELL HALL AND ALICE HALL APPELLANTS
APPEAL FROM FLOYD CIRCUIT COURT v. HONORABLE THOMAS M. SMITH, JUDGE ACTION NO. 17-CI-00215
HIGHLANDS HOSPITAL CORPORATION APPELLEE
AND
NO. 2022-CA-0773-MR
HIGHLANDS HOSPITAL CORPORATION CROSS-APPELLANT
CROSS-APPEAL FROM FLOYD CIRCUIT COURT v. HONORABLE THOMAS M. SMITH, JUDGE ACTION NO. 17-CI-00215
CARRIE HALL, AS ADMINISTRATOR OF THE ESTATE OF HASSEL DARRELL HALL AND ALICE HALL CROSS-APPELLEES
OPINION AFFIRMING IN PART AND REVERSING IN PART
** ** ** ** **
BEFORE: EASTON, JONES, AND LAMBERT, JUDGES.
JONES, JUDGE: The estate of Hassel Darrell Hall (“The Estate”) and Alice Hall,
his widow, appeal from an order of the Floyd Circuit Court which granted
summary judgment in favor of Highlands Hospital Corporation (“Highlands”),
resulting in dismissal of the estate’s claim for pain and suffering and Alice’s claim
for loss of consortium. Highlands filed a cross-appeal, arguing the trial court erred
in denying its motion for summary judgment related to the need for an expert
witness as to Hall’s medical expenses prior to his death or, alternatively, by not
granting its motion for directed verdict on the same issue at trial. We affirm the
trial court’s order granting summary judgment in favor of Highlands relating to the
claims for pain and suffering and loss of consortium. We reverse the final
judgment of the trial court because expert testimony was required with regard to
medical expenses; therefore, summary judgment should have been granted on
behalf of Highlands.
-2- I. BACKGROUND
In the days leading up to March 27, 2016, Hassel Hall was
experiencing shortness of breath, difficulty breathing, and low oxygen saturation
levels. On the evening of March 26, 2016, Hassel’s oxygen saturation levels
dropped into the mid-to-low sixties, but he refused to go to the hospital.1 Hassel
was prescribed oxygen therapy at all times due to emphysema, COPD,2 and coal
worker’s pneumoconiosis (black lung disease). He was also in consultation with a
pulmonologist specialist at the University of Kentucky for a possible lung
transplant.
On the morning of March 27, 2016, Hassel finally agreed to go to the
emergency room at Highlands. His wife, Alice, drove him; their daughter, Carrie,
met them there. Carrie arrived first and went into the emergency department to
retrieve a wheelchair. Upon arrival, Hassel was alert and able to get himself out of
the car and into the wheelchair unassisted, while holding his portable oxygen tank.
Carrie then pushed Hassel into the emergency department.
1 The Halls’ daughter, Carrie Hall, testified that Hassel’s oxygen saturation levels were never above 92%. Although the medical records indicate Hassel’s wife, Alice, told medical personnel at Highlands that Hassel’s oxygen saturation levels had dropped into the “mid-fifties” on March 26, 2016, in her testimony, Alice stated his levels only dropped as low as the mid-sixties. “Normal oxygen saturation levels in a healthy individual are 96-99%.” Bryan v. CorrectCare- Integrated Health, Inc., 420 S.W.3d 520, 522 n.1 (Ky. App. 2013). 2 Chronic Obstructive Pulmonary Disease.
-3- Testimony from hospital staff indicate Hassel was “blue,” “dusky,”
and “cyanotic” upon entering the emergency department. Upon arriving at the
triage window, Hassel became unresponsive. Carrie described it as “a seizure” and
testified he was biting his tongue and his head fell forward. Nancy Fraley, a triage
nurse at Highlands who witnessed the events, testified she knew Hassel was in
respiratory distress.
At that point, hospital staff and Carrie began to transport Hassel
through triage for examination and treatment. Hassel was still in the wheelchair
obtained from hospital staff upon arrival, being pushed by Carrie. The wheelchair
did not have footrests and Hassel’s feet were dragging the floor. By all accounts,
Hassel was a large man and weighed approximately 250 pounds. Nurse Fraley and
a registration clerk, Jessica Scarberry, attempted to assist in the transport of Hassel
by lifting his feet off the floor. Upon doing so, the wheelchair tipped backward
and both Hassel and the wheelchair landed on Carrie, although Hassel remained in
the chair. Highlands’ staff were able to get Hassel upright in the wheelchair once
again, but upon lifting his legs, the wheelchair tipped backward for a second time,
and Hassel’s head struck the floor. Carrie described Hassel’s coloring as “black”
at that point. Hospital staff were able to get Hassel onto a gurney where they
started CPR. He was subsequently intubated. A CT scan of Hassel’s head was
-4- performed, among other testing and treatment. He also tested positive for
influenza.
Eventually, doctors at Highlands decided to transport Hassel to
Pikeville Medical Center (“PMC”) for treatment. He was taken by ambulance to a
helipad, and from there he was airlifted to PMC. After arriving at PMC, another
CT scan of Hassel’s head was performed along with various other tests and
treatment. Hassel never regained consciousness and was removed from the
ventilator on March 29, 2016. He died approximately two minutes later. His death
certificate lists the immediate cause of death as severe anoxic brain injury due to
acute hypoxic respiratory failure due to coal worker’s pneumoconiosis and COPD.
On March 23, 2017, the Estate filed the underlying complaint against
Highlands. The Estate maintained, and continues to maintain, that this is a general
negligence action based in premises liability. The Estate made claims for pain and
suffering, medical expenses, punitive damages, and Alice made a claim for loss of
consortium. Discovery ensued and, on March 10, 2021, the Estate filed its
preliminary witness list, which included the names of Hassel’s treating physicians
at Highlands and PMC. Although the Estate included a section entitled “Rule
26.02 disclosures,” the contents of this section failed to comply with CR3 26.02 or
3 Kentucky Rule of Civil Procedure.
-5- the Agreed Scheduling Order of the parties. As a result, no expert witnesses were
disclosed by the Estate.
The next day, Highlands filed a motion for summary judgment, citing
a lack of expert testimony by the Estate to prove injury, pain and suffering, and
medical expenses. At the hearing before the trial court, the Estate argued that there
was no “science” involved because this was not a medical malpractice case. The
Estate also admitted that it could not relate Hassel’s death to the wheelchair
tipping, but it could show that the wheelchair tipped twice, and Hassel hit his head
on the ground. Although the Estate argued expert medical testimony was not
necessary, it pointed to Hassel’s CT scan from Highlands to show what it
characterized as brain swelling due to the fall. The trial court entered an order
ruling that expert testimony was needed for any causal connection between the
wheelchair tipping and Hassel’s medical condition or death.
As a result, the trial court dismissed the Estate’s wrongful death
claim, including medical expenses not caused by the wheelchair tipping event.
Alice’s loss of consortium claim was dismissed for the same reasons. The trial
court also found that expert testimony was needed to show pain and suffering
attributable to the wheelchair tipping, and therefore also dismissed that claim. The
trial court denied Highlands’ motion for summary judgment related to any medical
-6- expenses which the Estate could prove were specifically caused by the wheelchair
tipping.
Discovery continued and, on June 23, 2021, Highlands filed a second
motion for summary judgment on all remaining medical expenses, arguing a lay
juror could not differentiate between medical expenses caused by Hassel’s
respiratory arrest and underlying conditions versus those caused by the wheelchair
tipping. It also asserted the Estate had not produced any testimony that pointed to
which expenses were specifically caused by the wheelchair tipping. Further,
Highlands argued the Estate could not establish that the wheelchair event, and not
Hassel’s other medical conditions, more likely than not caused the medical
expenses. The trial court denied the motion.
In August 2021, Highlands moved the trial court to clarify which
medical expenses would be admissible at trial. The trial court held a hearing and
accepted an itemization of hospital expenses that the Estate’s counsel separated
from the rest of Hassel’s medical expenses for the three days he received treatment
and testing at Highlands and PMC. Although the Estate argued it should be
allowed to seek all $127,000 in medical expenses, the trial court allowed only
those expenses that the Estate’s counsel had determined were directly related to the
wheelchair tipping, which were approximately $46,000. The Estate presented no
lay or expert testimony at the hearing, or in any deposition prior to the hearing,
-7- about which medical expenses could be tied specifically to the wheelchair tipping
event. It does not appear from the record before us that the trial court entered an
order regarding permissible medical expenses.
A three-day trial was held in April. Redacted medical bills totaling
$46,049.47 were admitted into evidence without any accompanying testimony
from lay or expert witnesses. The jury found for the Estate and awarded $40,000
in medical expenses. All parties appealed. Further facts will be developed as
necessary.
II. STANDARD OF REVIEW
We begin by noting that Highlands appeals from a denial of a motion
for summary judgment or, in the alternative, from denial of its motion for directed
verdict at trial.
The general rule under CR 56.03 is that a denial of a motion for summary judgment is, first, not appealable because of its interlocutory nature and, second, is not reviewable on appeal from a final judgment where the question is whether there exists a genuine issue of material fact. Bell v. Harmon, Ky., 284 S.W.2d 812 (1955).
However, there is an exception to the general rule found in Gumm v. Combs, Ky., 302 S.W.2d 616 (1957), and subsequently approved in Loy v. Whitney, Ky., 339 S.W.2d 164 (1960), and Beatty v. Root, Ky., 415 S.W.2d 384 (1967). The exception applies where: (1) the facts are not in dispute, (2) the only basis of the ruling is a matter of law, (3) there is a denial of the motion, and (4) there is an entry of a final judgment with an appeal
-8- therefrom. Then, and only then, is the motion for summary judgment properly reviewable on appeal, under Gumm.
Transportation Cabinet, Bureau of Highways, Commonwealth of Ky. v. Leneave,
751 S.W.2d 36, 37 (Ky. App. 1988).
In the case at bar, there are no factual disputes. The trial court ruled as
a matter of law that expert testimony was not needed with regard to medical
expenses related to the wheelchair tipping, and a final judgment was entered
following the trial. Accordingly, the denial of Highlands’ motion for summary
judgment is properly before us. Also before us is the appeal of the trial court’s
order granting summary judgment in favor of Highlands due to lack of expert
testimony related to pain and suffering and loss of consortium.
Ordinarily, we review appeals from summary judgment rulings de
novo; however, we review preceding issues such as the adequacy of discovery or
the necessity of expert testimony under the abuse of discretion standard, although
they may be addressed by the trial court in a summary judgment order. Whether
expert testimony is required is wholly within the trial court’s discretion. Green v.
Owensboro Medical Health System, Inc., 231 S.W.3d 781, 783 (Ky. App. 2007).
We will reverse only upon finding the trial court abused its discretion. Id. “In
Kentucky, the test for abuse of discretion is whether the trial court’s decision was
-9- arbitrary, unreasonable, unfair, or unsupported by sound legal principles.” Jackson
v. Ghayoumi, 419 S.W.3d 40, 43 (Ky. App. 2012) (citation omitted).
III. ANALYSIS
Highlands has maintained that this is a medical malpractice case
because the Estate has claimed negligence and the failure to provide the minimum
standard of care. See, e.g., Chamis v. Ashland Hospital Corporation, 532 S.W.3d
652 (Ky. App. 2017). Highlands also argues that expert testimony was necessary
to prove each element of the Estate’s claims regardless of what type of case it is.
In contrast, the Estate has maintained that this is not a medical malpractice case,
but rather, that its claims lie in general negligence and expert testimony is therefore
not needed.
KRE4 702 provides:
If scientific, technical, or other specialized knowledge will assist the trier of fact to understand the evidence or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training, or education, may testify thereto in the form of an opinion or otherwise, if:
(1) The testimony is based upon sufficient facts or data;
(2) The testimony is the product of reliable principles and methods; and
4 Kentucky Rule of Evidence.
-10- (3) The witness has applied the principles and methods reliably to the facts of the case.
To determine if expert testimony was necessary, we begin by looking
at each element of a negligence claim. “To demonstrate that the defendant was
negligent a plaintiff must show that (1) the defendant owed the plaintiff a duty of
care; (2) the defendant breached that duty of care; (3) a causal connection between
the defendants[’] conduct and the plaintiff’s damages; and (4) damages.” Gonzalez
v. Johnson, 581 S.W.3d 529, 532 (Ky. 2019) (footnote omitted).
“In medical malpractice cases the plaintiff must prove that the
treatment given was below the degree of care and skill expected of a reasonably
competent practitioner and that the negligence proximately caused injury or death.
The bare possibility of causation will not suffice.” Reams v. Stutler, 642 S.W.2d
586, 588 (Ky. 1982) (citations omitted). This is ordinarily accomplished through
expert testimony that “must be that an alleged negligent act probably caused the
injury, and that a nexus between the alleged act and the injury is not merely
possible.” Jackson v. Ghayoumi, 419 S.W.3d 40, 45 (Ky. App. 2012) (citing
Jarboe v. Harting, 397 S.W.2d 775 (Ky. 1965)). Highlands’ alleged negligent
conduct would be a legal cause of harm to Hassel if: (a) Highlands’ conduct is a
substantial factor in bringing about the harm; and (b) there is no rule of law
relieving Highlands from liability because of the manner in which its negligence
-11- has resulted in the harm. See Deutsch v. Shein, 597 S.W.2d 141, 144 (Ky. 1980),
abrogated on other grounds by Osborne v. Keeney, 399 S.W.3d 1 (Ky. 2012).
The Estate’s theory of the case throughout the proceedings, including
trial and now before this Court, is that Highlands breached the standard of care by
not providing a wheelchair with footrests to transport Hassel. The Estate maintains
that, because the wheelchair did not have footrests, Hassel’s feet dragged the floor.
This, in turn, required Highlands’ staff to lift his legs, which caused the wheelchair
to tip backwards and Hassel to hit his head on the floor. The Estate argues Hassel
had pain and suffering, related medical expenses, and Alice Hall experienced a loss
of consortium, as consequences.
As previously stated, the Estate did not identify any expert witnesses.
Although it did identify two of Hassel’s treating physicians at Highlands and PMC
as lay witnesses, only one of those physicians, Dr. Paul Weinberger, emergency
room physician at PMC, testified at the trial. However, he was not asked to testify
to the standard of care. In contrast, Highlands offered testimony from nursing
expert Patricia Howard that the nurses at Highlands did what any reasonable and
prudent nurse would do in providing care to Hassel, including providing a
wheelchair without footrests. Ms. Howard explained that, due to the “dead
weight” of an unresponsive patient, footrests on a wheelchair can actually act as a
hinderance.
-12- This is not a case in which hospital staff are alleged to have operated
the wheelchair negligently by pushing it into a wall. Rather, the Estate’s argument
concerns the type of wheelchair supplied by the hospital. We agree with
Highlands that whether it met the standard of care in the type of wheelchair
provided to Hassel is beyond the knowledge of a layperson and required expert
testimony. The average juror may be familiar with wheelchairs in a general sense,
but this “does not mean that a jury would necessarily understand the specifics of
[wheelchair usage] or the standard of care upon medical personnel [who provide
them to patients for use].” Baptist Healthcare Systems, Inc. v. Miller, 177 S.W.3d
676, 680 (Ky. 2005). A layperson could not possibly know what type of
wheelchair would have been appropriate to transport a patient who was alert and
ambulating on his own when the wheelchair was provided, but who suffered
respiratory arrest and became unresponsive just moments later. Stated differently,
a layperson would not know the medical reasons for transporting a patient with
certain health issues in a wheelchair with footrests versus without. A lay juror
would not know if there if there was some sort of defect in the wheelchair because
it lacked footrests or if there was an overall design defect. Accordingly, we agree
with Highlands that expert testimony was needed regarding the standard of care.
We next turn to the element of causation. The trial court found that
expert testimony was required to show the wheelchair tipping caused: (1) a
-13- worsening of Hassel’s medical condition; and (2) pain and suffering. We agree
with the trial court in this respect and summary judgment in favor of Highlands
was appropriate. However, the trial court also determined expert testimony was
not necessary to prove medical expenses attributable to the wheelchair tipping. We
disagree with the trial court in this regard.
The Estate essentially argues it is possible for a lay juror to isolate the
wheelchair tipping and discern pain and suffering and medical expenses caused
solely by those events, and not from any other medical reason, without expert
testimony. “There may, of course, be situations in which causation is so apparent
that laymen with a general knowledge would have no difficulty in recognizing it.”
Jarboe, 397 S.W.2d at 778. “But excepting those situations we have adhered to
the rule that the causal connection between an accident and an injury must be
shown by medical testimony and the testimony must be that the causation is
probable and not merely possible.” Id. The Estate believes the case at bar falls
into the category of cases where causation is readily apparent and requires no
expert testimony. We disagree.
Further, although the Estate does not use the term in its brief to this
Court, it is arguing that the doctrine of res ipsa loquitor (“the thing speaks for
itself”) applies with respect to negligence. However, the Estate must establish
-14- causation before any inference of negligence can be made. The Kentucky Supreme
Court has recently addressed this issue. To wit,
Res ipsa loquitur applies in medical malpractice cases when “any layman is competent to pass judgment and conclude from common experience that such things do not happen if there has been proper skill and care” or “when ‘medical experts may provide a sufficient foundation for res ipsa loquitur on more complex matters.’” [Perkins v. Hausladen, 828 S.W.2d, 652, 655 (Ky. 1992)] (quoting Paintsville Hosp. Co. v. Rose, 683 S.W.2d 255, 256-57 (Ky. 1985)). The former is “illustrated by cases where the surgeon leaves a foreign object in the body or removes or injures an inappropriate part of the anatomy.” Id. at 654. The latter occurs when expert testimony establishes the “type of injury was not an ordinary risk of the surgery, that the method by which it occurred was within the exclusive control of the defendant, and that the injury was not due to any voluntary action or contribution on the part of the plaintiff.” Id. at 655. In other words, “when the circumstances and the probabilities as to the causative factors of an accident lie within the ken of experts, expert evidence is necessary to establish a foundation that gives rise to an inference of negligence.” 65A C.J.S. Negligence § 820 (emphasis added).
Crucial to remember is res ipsa loquitur “allows an inference of negligence in certain cases, not causation; established causation is a prerequisite to the application of the doctrine.” Id. at § 821 (emphasis added). “A lack of knowledge as to the cause of the accident does not call for the application of the doctrine.” Cox v. Wilson, 267 S.W.2d 83, 84 (Ky. 1954). That “[t]he plaintiff’s injury must have resulted from the accident[,]” is a basic element of res ipsa loquitur in Kentucky. Id. See also Quillen v. Skaggs, 233 Ky. 171, 25 S.W.2d 33, 34-35 (1930). Res ipsa loquitur “must be linked with the injury suffered. There may be an inference of negligence when,
-15- according to common knowledge and experience, the accident would not have happened except for the wrongful act of the defendant.” Jos. N. Rice Co. v. Grayson, 341 S.W.2d 238, 239 (Ky. 1960). The doctrine is therefore inapplicable where more than one cause can be inferred from the evidence. Schroerlucke v. McDaniel Funeral Home, Inc., 291 S.W.2d 6, 8 (Ky. 1956). “[T]he doctrine [can] be applied only when the nature of the accident itself not only clearly supports the inference of negligence on the part of the defendant but excludes all other inferences that it might be due to one or more causes of which the defendant is not responsible.” Id. at 9.
Saint Elizabeth Medical Center, Inc. v. Arnsperger, No. 2022-SC-0302-DG, ---
S.W.3d ---, 2024 WL 316434, at *4 (Ky. Jan. 18, 2024) (internal footnote
omitted).5
We now address the question of whether expert testimony was needed
to establish that the wheelchair tipping event alone caused pain and suffering to
Hassel. To receive an award for pain and suffering, there must be substantial
evidence to establish that pain and suffering actually occurred. Worldwide
Equipment, Inc. v. Mullins, 11 S.W.3d 50, 61 (Ky. App. 1999) (emphasis added).
Importantly, the Estate never established that Hassel sustained an injury from the
wheelchair tipping event. External physical examinations of his head at PMC
revealed no injury, including bumps or bruising. Although the CT scan performed
5 On February 8, 2024, the Kentucky Supreme Court issued a finality letter indicating that the case is now final and that it has been designated as published.
-16- at Highlands showed “some posterior swelling,” the record also indicates his
treating physician “could not rule out stroke” in addition to the possibility it was
caused by the wheelchair tipping. Testimony from expert witness Owen Samuels,
M.D., produced by Highlands, indicated there was no sign of trauma to the brain
either externally or from the two CT scans. Rather, he attributed the brain swelling
to lack of oxygen due to respiratory arrest. Defense expert John E. Parker, M.D.,
also provided an affidavit stating that Hassel’s brain swelling was unrelated to
trauma from the wheelchair tipping. The Estate notably acknowledged at the
hearing on the motion for summary judgment that it was seeking damages for pain
and suffering only for the time between the first and second wheelchair tipping,
which it admitted was a very small period of time, “seconds to a minute or two.”
This is because the Estate contends Hassel was conscious and capable of
experiencing pain until he hit his head on the floor during the second tipping
event.6
By all accounts, Hassel went into respiratory arrest and became
unresponsive prior to the wheelchair tipping. He had severe, chronic, and complex
underlying health issues and presented to Highlands extremely ill, including with
undiagnosed influenza. The Estate argues because Carrie testified Hassel looked
6 “[D]amages for pain and suffering are not allowed to an unconscious person.” Vitale v. Henchey, 24 S.W.3d 651, 659 (Ky. 2000).
-17- her in the eye for a brief moment when he was on the floor after the first
wheelchair tipping, that necessarily means he was at least partially conscious.
“Damages for pain and suffering may be awarded, however, if the injured person
was partly conscious, had intervals of consciousness, or was conscious for a short
time before death.” Vitale, 24 S.W.3d at 659 (internal quotation marks and
footnote omitted). However, a layperson would not be qualified to say if, given
Hassel’s medical conditions, he was conscious or partially conscious between
wheelchair tipping events, regardless of whether his eyes were open.7
Whether an individual experiencing Hassel’s medical conditions was
conscious and able to experience pain is a question based on scientific, technical,
or specialized knowledge. Accordingly, whether the wheelchair tipping event
alone caused pain and suffering for Hassel required expert testimony. We
therefore affirm the trial court’s order dismissing the Estate’s claim for pain and
suffering as well as Alice Hall’s corresponding claim for loss of consortium.8
7 Although all witness testimony indicated Hassel became “unresponsive” prior to the wheelchair tipping, whether “unresponsive” is medically the same as “unconscious” and unable to experience pain is also outside the knowledge of a lay juror.
8 “Loss of consortium damages can be obtained whenever a spouse is wrongfully incapacitated by a third party to the extent that the marital relationship has been damaged due to that harm.” Martin v. Ohio Cnty. Hosp. Corp., 295 S.W.3d 104, 109 (Ky. 2009). Here, due to his underlying medical conditions – both past and present on the morning of March 27, 2016 – neither the Estate nor Alice Hall can prove without expert testimony that Highlands wrongfully incapacitated Hassel. See also Kentucky Revised Statute (KRS) 411.145.
-18- We now turn to whether expert testimony was needed to prove
medical causation related to the medical expenses the Estate attributed to the
wheelchair tipping. Prior to trial, the Estate presented medical bills totaling
approximately $127,000. Upon motion from Highlands to clarify which expenses
would be admissible at trial, the trial court conducted a hearing and concluded the
admissible medical expenses to be approximately $46,000, based solely on
determinations made by the Estate’s counsel without reference to any lay or expert
witness testimony. The bills making up the $46,000 that were submitted to the
jury were for the following: (1) the CT scan at Highlands; (2) radiology services at
Highlands; (3) ambulance services to the helipad; (4) airlift services to PMC; and
(4) the CT scan at PMC. Of the approximately $46,000 in medical bills, the bill
for airlift services comprised roughly $38,000 of that total.
The question before us is not whether those amounts were reasonable,
but whether the wheelchair tipping was a substantial factor in the resulting medical
expenses presented to the jury. Gonzalez, 581 S.W.3d at 534. Dr. Paul
Weinberger, Hassel’s treating physician at PMC, testified he did not analyze the
medical records for which tests and treatment were necessary for the head trauma
versus respiratory arrest. He also testified that he could not say whether Hassel
would have required transfer to PMC for respiratory failure regardless of any
possible head trauma, or if he needed to be transferred to PMC due to both
-19- respiratory failure and possible head trauma. However, Highlands presented
expert testimony that all medical tests and treatment received by Hassel would
have been necessary regardless of the wheelchair tipping due to the lack of oxygen
to his brain during respiratory arrest. Further, the medical records present in the
record before us vary as far as indicating whether Hassel’s primary medical issue
at the time was respiratory arrest or head trauma with most, including the record
for air transport services, indicating respiratory arrest was the primary medical
issue.
To recover damages for medical expenses, the Estate must show with
reasonable certainty that said expenses “are the direct, natural, and proximate
consequences of the defendant’s wrongful act.” Western Union Telegraph Co. v.
Guard, 139 S.W.2d 722, 727 (Ky. 1940). Although it was never shown that Hassel
sustained an injury from the wheelchair tipping, Highlands and PMC may have
needed to investigate the possibility of an injury from the events. However, in a
lengthy list of medical bills, it was an abuse of discretion for the trial court to allow
the Estate’s counsel to cherry-pick expenses he believed derived solely from the
wheelchair tipping without the benefit of expert testimony.
The absence of proof on any one of the required elements of a
negligence claim (i.e., duty, breach, causation, and damages) is fatal to the claim.
M & T Chemicals, Inc. v. Westrick, 525 S.W.2d 740, 741 (Ky. 1974). A medical
-20- malpractice case may only proceed to trial without expert testimony when “duty,
breach, causation, and injury are readily apparent within the common knowledge
of a jury[.]” Arnsperger, 2024 WL 316434, at *4. Here, due to Hassel’s severe
underlying health issues and the complications that arose when he arrived at
Highlands, none of the elements are readily apparent to a lay juror without expert
testimony to isolate and differentiate the wheelchair tipping event. In other words,
Hassel’s past and present medical conditions meant that more than one cause could
be inferred from the evidence. Id.
IV. CONCLUSION
For the foregoing reasons, we affirm the Floyd Circuit Court’s order
granting summary judgment to Highlands with regard to the Estate’s claims for
pain and suffering and loss of consortium. We reverse the trial court’s final order
awarding medical expenses totaling $40,000 to the Estate for medical expenses due
to lack of expert testimony.
ALL CONCUR.
-21- BRIEF FOR APPELLANTS/CROSS- BRIEF FOR APPELLEE/CROSS- APPELLEES CARRIE HALL AS APPELLANT HIGHLANDS ADMINISTRATOR OF THE HOSPITAL CORPORATION: ESTATE OF HASSEL DARRELL HALL AND ALICE HALL: Clay M. Stevens Kristen H. Fowler Jarrod Bentley Rachel A. Stratton Prestonsburg, Kentucky Louisville, Kentucky
-22-