Heintz v. Akbar

411 N.W.2d 736, 161 Mich. App. 533
CourtMichigan Court of Appeals
DecidedApril 30, 1987
DocketDocket 88260
StatusPublished
Cited by11 cases

This text of 411 N.W.2d 736 (Heintz v. Akbar) is published on Counsel Stack Legal Research, covering Michigan Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Heintz v. Akbar, 411 N.W.2d 736, 161 Mich. App. 533 (Mich. Ct. App. 1987).

Opinion

Beasley, J.

Defendants, J. U. Akbar, M.D., and Pigeon Clinic, P.C., appeal as of right from a jury award of $85,000 to plaintiffs, Mary Margaret Heintz and Michael Heintz. For ease of discussion, we will refer only to plaintiff Mary Margaret Heintz and to defendant Dr. Akbar.

Plaintiff alleged that Dr. Akbar, an employee of the Pigeon Clinic, committed medical malpractice in performing a midline episiotomy on her during the delivery of her first child. A midline episio-tomy is a surgical procedure in which an angular cut is made between the vaginal opening and the rectal opening to facilitate childbirth. Plaintiff claimed that defendant negligently failed to find and repair a laceration of her rectal sphincter muscle and a fistula, or opening, in the wall between her vaginal canal and rectum. Because of defendant’s negligence, plaintiff is unable, even after corrective surgery, to maintain control of her bowel movements. Defendant claimed that plaintiff was negligent in not reporting her condition to defendant sooner than she did.

After the jury rendered its verdict in favor of plaintiff, defendant filed a motion for a new trial, which was denied in a written opinion. On appeal, defendant raises two issues.

First, defendant claims that the trial court erred in allowing plaintiff’s attorney to refer in his *536 rebuttal closing argument to a laboratory test, on which there allegedly had not been any expert testimony but which had been admitted into evidence.

In his rebuttal closing argument, plaintiff’s attorney stated:

If you’ll recall Dr. Lester’s testimony when Mr. Smith in cross-examination asked him what you would expect to find with a rectal sphincter vaginal fistula, he indicated to him you would expect to find feces in the vaginal canal, and what is called e. coli [Escherichia coli], which is a bowel substance.
Let me show you something I found in the two hours and fifteen minutes, Plaintiffs’ Exhibit 9, step right up here, because this is it.
On December 22nd while she was in the hospital, they ran a vag smear on her, and the culture yielded 2 plus e. coli, 2 plus e. coli. You take that into the jury room and look. That means when they took a vaginal culture, when she was in the hospital, she had e. coli in her vagina, which is bowel substance.
And folks, the only way she can get e. coli into her vagina—.

Defendant objected on the basis that the subject matter was not part of the evidence and had not been testified to, and also requested an opportunity to respond. The trial judge overruled the objection. At the close of plaintiff’s attorney’s argument, defendant renewed his objection and again asked to respond with additional proofs or with additional argument. In denying defendant’s objection, the judge stated:

The purpose of the rebuttal argument is to respond to those issues that are raised by the Defense during the Defense closing argument and not to move into new areas. However, this—there *537 was some argument that was made in the Defense, not on that specific issue, obviously, but in the area of whether or not there was a discovery or exactly what the condition of the was after the delivery, and therefore I think that area was fairly opened up. And for that reason I’m not going to allow proofs to be reopened at this time.
I think the area is fairly opened up, and I’m going to leave it stand as it is. I’ll deny your objection, Mr. Smith.

In Reetz v Kinsman Marine Transit Co, 1 the Supreme Court described how an appellate court should review an appeal based on an attorney’s improper argument:

[T]he appellate court should first determine whether or not the claimed error was in fact error and, if so, whether it was harmless. If the claimed error was not harmless, the court must then ask if the error was properly preserved by objection and request for instruction or motion for mistrial. If the error is so preserved, then there is a right to appellate review; if not, the court must still make one further inquiry. It must decide whether a new trial should nevertheless be ordered because what occurred may have caused the result or played too large a part and may have denied a party a fair trial. If the court cannot say that the result was not affected, then a new trial may be granted. Tainted verdicts need not be allowed to stand simply because a lawyer or judge or both failed to protect the interests of the prejudiced party by timely action.

The first determination to be made is whether it was error to allow plaintiffs attorney’s remarks concerning the laboratory report. Under MCR 2.507(E), a rebuttal closing argument may not extend "beyond the issues raised in the preceding arguments.” The trial judge has broad power and *538 discretion concerning the conduct of the arguments before the jury. 2

In allowing plaintiffs attorney’s argument, the trial judge noted that in his closing argument defense counsel referred to plaintiff’s condition after delivery, and that "that area was fairly opened up.” In his September 17, 1985, opinion denying defendant’s motion for a new trial, he stated that plaintiffs expert had testified that e. coli could enter the vagina through a fistula between the rectum and vagina, if a fistula were present. The physician who performed the corrective surgery on plaintiff did refer to E. coli as one type of bacterium of the rectum that could have caused an infection. Plaintiff’s medical expert testified that a fistula can allow an infection to begin by allowing fecal material into the vagina.

Defendant contends that allowing the argument involving the laboratory report was error because expert testimony was not offered to explain it, citing Lince v Monson. 3 In Lince, the Supreme Court held that, in cases not within the common knowledge and experience of lay jurors, expert medical testimony is required in order to enable a jury to decide whether a physician’s conduct was below the applicable standard of care. In the within case, expert testimony was presented on the question of defendant’s standard of care. We do not believe that Lince means that an expert must explain every technical piece of evidence admitted at trial. In this case, some of the doctors discussed bacteria or e. coli in connection with the fistula and the breakdown of plaintiffs episiotomy, and the laboratory report that noted the presence of e. coli in plaintiffs vaginal culture had been admitted into evidence as part of plaintiffs hospi *539 tal record. In his closing argument, defendant’s attorney also referred to the exhibit and suggested that the jury read it in its entirety. In closing arguments, reasonable inferences from the testimony may be drawn by counsel. 4

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Cite This Page — Counsel Stack

Bluebook (online)
411 N.W.2d 736, 161 Mich. App. 533, Counsel Stack Legal Research, https://law.counselstack.com/opinion/heintz-v-akbar-michctapp-1987.