Horton v. Eaton

452 S.E.2d 541, 215 Ga. App. 803, 94 Fulton County D. Rep. 4202, 1994 Ga. App. LEXIS 1385
CourtCourt of Appeals of Georgia
DecidedDecember 5, 1994
DocketA94A0978
StatusPublished
Cited by13 cases

This text of 452 S.E.2d 541 (Horton v. Eaton) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Horton v. Eaton, 452 S.E.2d 541, 215 Ga. App. 803, 94 Fulton County D. Rep. 4202, 1994 Ga. App. LEXIS 1385 (Ga. Ct. App. 1994).

Opinions

McMurray, Presiding Judge.

Loyd E. and Betty C. Horton brought a medical malpractice action against Dr. S. Boyd Eaton, Jr., a radiologist, essentially alleging that Eaton’s negligent failure to diagnose a neck fracture in Loyd Horton’s X-ray films resulted in inappropriate and injurious treatment by other physicians. The Hortons appeal from the judgment entered on a jury verdict in Eaton’s favor.

The original injury resulted from a 20-foot fall that occurred when Loyd Horton (“Horton”) lost his balance while attempting to cut down a tree in his yard. Horton landed on his shoulders and the back of his head, causing tingling in his hands. Horton was first examined by the family’s osteopathic physician (hereinafter “osteopath”). Horton reported he could feel grinding in his head when he turned it. Since the osteopath did not have a technician available at that time, he sent Horton to the emergency room at West Paces Ferry Hospital to obtain X-rays. There Horton was examined by a medical doctor who ordered X-rays of Horton’s spine and left knee. The examining physician told Horton that he had torn muscles and ligaments, and also that he had arthritis in his neck. Horton was given a prescription for a muscle relaxer and for pain, and was instructed to return to the osteopath for follow-up.

Sometime after Horton was discharged, Dr. Eaton received the X-ray films of Horton’s cervical spine along with a radiology request form. He issued a report stating that he did not see any fractures. Dr. Eaton had no contact with Horton nor with any other physician before issuing his report.

Two days later Horton returned to the osteopath’s office for a follow-up visit as instructed. At that time Horton still experienced a [804]*804grinding sensation as his head moved, but other symptoms had not yet manifested themselves. Within a week to ten days, however, the right side of Horton’s face became numb, and there was a lump in his throat that made it very difficult to swallow. At the same time he began experiencing a “constant” ache on the right side of his head. He also began having trouble achieving a full erection.

Horton returned to the osteopath soon after the onset of these symptoms. Having been told of Horton’s symptoms, the osteopath “manipulated” Horton’s neck by turning his head up and down and side to side, causing Horton to roll his body to prevent more extensive manipulation. No further X-rays were taken at that time. During a subsequent visit, however, the osteopath did have follow-up X-rays done using his own technician. Concluding that Horton had a vertebra out of place, the osteopath referred him to Dr. Tarek Nessouli, an orthopedic surgeon. Upon viewing these latest X-rays, Dr. Nessouli instructed Horton not to move, informing him that his neck was broken. Specifically, the fracture was located in the area where the first cervical vertebra, which holds the skull, fuses to the body of the second cervical vertebra, forming an area referred to as the “odontoid process.” Horton eventually underwent neurosurgery. Horton complained at trial of continuing numbness, headaches, a “lump” in his throat, total impotence, depression, and a general weakness in his right side.

The Hortons initially brought suit against Dr. Eaton, later adding the osteopath and the doctor who originally examined Horton at the hospital.1 The added parties eventually settled with the Hortons and were dropped from the case, leaving Dr. Eaton as the sole defendant. Dr. Eaton testified at trial that the original X-ray films presented, and his interpretation reflected, a “false negative,” and that X-rays taken after manipulations by the osteopath showed an obvious fracture. Dr. Eaton further testified that in his opinion the odontoid fracture would have held its position and there would have been fewer medical problems but for the neck manipulations applied by the osteopath. Dr. Eaton maintained that his original interpretation of Mr. Horton’s X-rays was within the applicable standard of care under the circumstances. His own expert corroborated this conclusion, but affirmed on cross-examination that Dr. Eaton would have been held to a higher standard of care (i.e., required to perform additional testing) had the X-ray requisition form directed to Dr. Eaton from the emergency room (but lost from the hospital’s medical records) advised that' the patient was experiencing neck pain. Held:

[805]*8051. The Hortons contend that Dr. Eaton was erroneously allowed to testify as to the appropriate standard of care for an osteopathic physician, a matter on which Dr. Eaton openly conceded he was not qualified to testify. This enumeration is without merit.

Even assuming that the matter was properly preserved for appellate review, we do not interpret Dr. Eaton’s testimony in the manner urged by the Hortons. Dr. Eaton testified that “everybody knows we ought not to mess around the neck where there’s been an injury,” and that it would not be sufficient for someone in the osteopath’s position to rely on a radiologist’s original findings alone before manipulating Horton’s neck given that “there’s a false negative rate [for fractures] from 20 to 40 %” with respect to initial X-ray films. Dr. Eaton was certainly authorized to testify in absolute terms regarding the extent to which his own findings should (and should not) be relied upon by other health care professionals in charting a course of treatment. We note that while Dr. Eaton did not hesitate to suggest that all medical doctors should be aware of the shortcomings inherent in a radiologist’s initial findings, he expressly refrained from testifying that osteopathic physicians should likewise be aware of such limitations. Taken as a whole and viewed in its proper context, we find nothing improper in the challenged testimony.

2. In their second enumeration, the Hortons challenge the propriety of allowing Dr. Eaton to testify as to the likely contents of an emergency room requisition for an examination and diagnosis of Mr. Horton’s X-rays. The record indicates that such requisition orders may include a general description of the type of X-rays needed, the nature of injury giving rise to the need for X-ray evaluation, the incident which purportedly caused a patient’s injuries and symptoms displayed or reported by the patient upon presentation in the emergency room. In this vein, Dr. Eaton’s own expert affirmed on cross-examination that if the requisition form had contained information regarding pain in the patient’s neck, the requisite standard of care would have required more studies than Dr. Eaton performed. It thus becomes apparent that the remarks on Mr. Horton’s emergency room X-ray requisition order are key to framing the standard of care upon which to measure Dr. Eaton’s diagnosis of Mr. Horton’s X-rays.

The emergency room requisition form was not available to the Hortons because it mysteriously disappeared from the medical records of Dr. Eaton’s place of employment. While this omission left a gap in the Hortons’ case against Dr. Eaton, it was not fatal to their cause. OCGA § 24-4-22; J. B. Hunt Transport v. Bentley, 207 Ga. App. 250, 256 (3) (427 SE2d 499). On the other hand, Dr. Eaton’s failure to produce the emergency room requisition form and testimony that he does not recall the remarks on the requisition order (regarding circumstances of the need for X-ray examination and eval[806]*806uation) left Dr.

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Horton v. Eaton
452 S.E.2d 541 (Court of Appeals of Georgia, 1994)

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Bluebook (online)
452 S.E.2d 541, 215 Ga. App. 803, 94 Fulton County D. Rep. 4202, 1994 Ga. App. LEXIS 1385, Counsel Stack Legal Research, https://law.counselstack.com/opinion/horton-v-eaton-gactapp-1994.