Kwee Wong v. Mary L. Chappell

773 S.E.2d 496, 333 Ga. App. 422
CourtCourt of Appeals of Georgia
DecidedJuly 23, 2015
DocketA15A0345
StatusPublished
Cited by2 cases

This text of 773 S.E.2d 496 (Kwee Wong v. Mary L. Chappell) 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
Kwee Wong v. Mary L. Chappell, 773 S.E.2d 496, 333 Ga. App. 422 (Ga. Ct. App. 2015).

Opinion

McFadden, Judge.

Ruth Oleana Wong died after undergoing a cryoablation of the endometrium, a procedure to destroy a thin layer of the lining of her uterus through freezing. After her death, her husband, Kwee Wong, filed this medical malpractice action. He appeals the defense verdict in favor of doctors Mary L. Chappell, Kimberly A. Huffman, and Terry V. Kelley, and their practice, OB-GYN Associates, P.A.

Wong argues that the trial court erred by refusing to charge the jury on simple negligence. Because at least some of Wong’s allegations call into question only the execution of administrative, clerical tasks and not the exercise of professional skill and judgment, we agree and therefore reverse and remand. Since we are remanding, we address Wong’s arguments that are likely to recur on retrial. Wong argues that the trial court erred by refusing to instruct the jury on the unauthorized practice of medicine and negligence per se. We agree because Wong presented some evidence that an unlicensed medical assistant engaged in acts that required a medical license. However, we reject Wong’s argument that the trial court erred by refusing to instruct the jury that the printed material from the manufacturer of the cryoablation device —■ the “package insert” and user’s manual — established the standard of care for the use of the device. Although the printed material is relevant, expert testimony is required to establish the standard of care. We reject Wong’s argument that the trial court erred by admitting a resource guide published after Mrs. Wong’s procedure because he has not shown that the trial court abused her discretion. We do not address Wong’s argument that the trial court erred in directing a verdict on his punitive damages claim because the resolution of that claim on retrial will depend on the evidence introduced. Nor do we address his argument that the trial court erred in allowing defense counsel to strike a juror for cause after the *423 parties had begun exercising their peremptory challenges because any such error is unlikely to recur on retrial.

1. Facts.

Mary Chappell, an obstetrician-gynecologist, performed a cryoablation on Ruth Oleana Wong on October 4, 2010. Chappell performed the procedure in her office.

A few days after the procedure, Mrs. Wong began experiencing increased pain, which radiated along her flank to her back. On October 13, Mrs. Wong called Chappell’s office. She spoke to Lauren Gephart, an unlicensed medical assistant. She told Gephart that she was experiencing pain radiating from her flank and back, bleeding, and changes in her bowel movement. Gephart thought that Mrs. Wong might have a urinary tract infection, so Gephart asked her whether she had any of the typical symptoms. Gephart did not talk to any doctor, nurse practitioner, or physician’s assistant about the back and flank pain or the bleeding because she did not think Mrs. Wong’s complaints were sufficiently serious, although she may have made a comment to Chappell in passing about Mrs. Wong’s question about her bowel movement. Gephart told Mrs. Wong that her symptoms could be normal and advised her to take 800 milligrams of Ibuprofen; Gephart had been instructed by the doctors that she should advise patients to take 800 milligrams of Ibuprofen every eight hours as needed for any sort of abdominal or back pain. Gephart was not authorized to make medical diagnoses or to give medical advice, she testified, but one of the doctors in the practice, defendant Kelley, testified that the medical assistants were authorized to give medical advice that had been “supervised, taught, trained,” by the physicians in the office. Huffman, another doctor-defendant, testified that Gephart should have asked Mrs. Wong the intensity, duration, and severity of her pain, and should have notified Chappell if the pain was severe. Huffman testified that medical assistants “are allowed to give clinically relevant information as instructed by their supervising physician.”

On October 17, Mrs. Wong went to the emergency room and was admitted to the intensive care unit. In the early morning of October 18, Huffman, who was the on-call doctor for OB-GYN Associates, saw Mrs. Wong. Later that day, Mrs. Wong underwent exploratory laparoscopic surgery. Although another physician performed the laparoscopy, defendants Chappell and Kelley were in the operating room; Chappell had asked Kelley to be available to assist should Mrs. Wong need a hysterectomy. Mrs. Wong’s uterus was “very boggy,” with a “dark, mottled” appearance. Chappell and Kelley believed that the cryoablation could have caused Mrs. Wong’s uterus to look that way. Chappell decided not to remove Mrs. Wong’s uterus, and Kelley *424 concurred in the decision because he thought that Mrs. Wong would not survive a hysterectomy.

Eleven days after she was admitted to the hospital, Mrs. Wong died. More than two months after the cryoablation procedure — and after Mrs. Wong had died — Mrs. Wong’s written antibiotic prescription was found at the OB-GYN Associates office. Chappell had written on the slip, “Found December 8, 2010, at front desk.”

Wong filed this action individually and as executor of Mrs. Wong’s estate. He alleged that Chappell perforated the wall of Mrs. Wong’s uterus during the cryoablation, eventually leading to sepsis and necrosis; that when Mrs. Wong called OB-GYN Associates about the resulting pain, Gephart failed to handle the call appropriately; that when she consulted at the hospital, Huffman failed to give Mrs. Wong care; and that Chappell and Kelley observed Mrs. Wong’s necrotic, ischemic uterus during the exploratory laparoscopic surgery, but failed to perform a hysterectomy. Wong sought damages for Chappell’s, Huffman’s, and Kelley’s professional negligence and for OB-GYN Associates’ vicarious liability for Gephart’s and the front desk staff’s negligence.

After a 16-day trial, the jury returned a defense verdict. Wong filed this appeal.

2. Refusal to charge the jury on ordinary negligence and instead charging that professional negligence applied to all claims.

Wong argues that the trial court erred by denying his request to charge the jury on ordinary negligence and instead instructing the jury that the medical malpractice standard of care applied to all of Wong’s claims. We agree.

Among his other allegations, Wong alleged that the defendants were vicariously liable for the following acts of negligence:

The front desk staff’s failure to ensure that Mrs. Wong took her antibiotic prescription with her after the procedure, failure to notice that the prescription was left at the front desk for more than two months, and failure to notify Mrs. Wong or Chappell that Mrs. Wong did not get the antibiotic;
The staff’s failure to implement proper procedures for handling prescription slips and failure to maintain the front desk in an organized manner so that the slip would not be lost;
Medical assistant Lauren Gephart’s failure to properly note Mrs. Wong’s complaint of flank pain, failure to determine the severity, intensity and duration of her pain and *425 continued bleeding, and failure to relay to a physician Mrs. Wong’s complaints; and

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773 S.E.2d 496, 333 Ga. App. 422, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kwee-wong-v-mary-l-chappell-gactapp-2015.