L.C. Bell, Personal Representative of the Estate of Lonnie C. Bell, Deceased v. United States

854 F.2d 881, 1988 U.S. App. LEXIS 11208, 1988 WL 83957
CourtCourt of Appeals for the Sixth Circuit
DecidedAugust 16, 1988
Docket86-2169
StatusPublished
Cited by13 cases

This text of 854 F.2d 881 (L.C. Bell, Personal Representative of the Estate of Lonnie C. Bell, Deceased v. United States) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
L.C. Bell, Personal Representative of the Estate of Lonnie C. Bell, Deceased v. United States, 854 F.2d 881, 1988 U.S. App. LEXIS 11208, 1988 WL 83957 (6th Cir. 1988).

Opinions

BOGGS, Circuit Judge.

The personal representative of Lonnie Bell’s estate sued the United States under the Federal Tort Claims Act, 28 U.S.C. §§ 1346(b), 2671-2680. The plaintiff claimed that Bell’s death was caused by the failure of physicians at the Veterans Administration Medical Center, where Bell was hospitalized, to diagnose timely Bell’s abdominal aortic aneurysm. After a bench trial, the district court found the plaintiff had established that the Veterans Administration doctors breached their duty of care toward Bell. However, the court also found that the plaintiff failed to prove that Bell had a better than 50% chance of surviving an operation to correct the aneurysm on and after the date that the duty of care was breached. Thus, the court concluded that even if Bell’s condition had been diagnosed when a careful doctor would have diagnosed it, the evidence indicated that Bell’s life would not “have been spared dr prolonged....” Accordingly, the court entered judgment for the defendant.

We reverse. Our review of the record has left us with the “ ‘definite and firm conviction’ ” 1 that the key finding of fact relied upon by the district court in entering judgment for the defendant is clearly erroneous. The district court found that “significant leaking” of the aneurysm had occurred by December 24, 1983, the date by which the court also determined that the duty of care was breached. Given such leaking, the district court concluded that the probability Bell would have survived an operation to correct the aneurysm was less than 50%.

We accept the district court’s finding that the' duty of care was breached by December 24, 1983, as that finding is sup[883]*883ported by the record. However, while there is evidence that some leaking had occurred by December 24, and that leakage is a significant event in the development of an aneurysm, we find no evidence which supports the conclusion that the leakage of Bell’s aneurysm had risen to such a level that there was not a “reasonable probability” that Bell would have survived an operation to correct the condition in the days immediately after the duty of care was breached.

Moreover, we do not interpret Michigan law as requiring a plaintiff to prove that the deceased had a better than 50% chance of survival when the duty of care was breached in order to establish that the negligent failure to diagnose a medical condition was the proximate cause of death or injury. All Michigan requires is proof that the deceased had a “reasonable probability” of recovery if the medical condition had been discovered and treated within the appropriate time. Although the evidence concerning Bell’s chance for recovery after December 24, 1983, was confusing, the evidence clearly placed his prognosis near 50%. Accordingly, the district court erred when it entered judgment for the defendant on the ground that Bell did not have a better than 50% chance of surviving an operation to correct the aneurysm once the duty of care was breached.

I

Bell was admitted to the Saginaw Veterans Administration Medical Center on November 21, 1983, for surgical treatment of a prostate gland condition. Except for a period of approximately twenty-four hours, Bell remained hospitalized at the Center until his death on January 16, 1984.

Dr. John A. Feemster, a board-certified doctor in general and thoracic cardiovascular surgery, testified extensively at the trial on behalf of the plaintiff. He stated that he is familiar with the diagnosis and surgical treatment of abdominal aortic aneurysms. Dr. Feemster’s testimony focused on when the standard of care was breached and whether the breach of that standard was the proximate cause of Bell’s death.

According to Dr. Feemster, “[a]neu-rysms are sacs formed by weakness in the wall of a retaining blood vessel. This weakness can occur by several different ways but it results in a ballooning out of the blood vessel....” The pressure an aneurysm causes in a blood vessel can make the blood vessel rupture which in turn can cause a person to bleed to death.

According to Dr. Feemster, abdominal aortic aneurysms are especially common in black males between the ages of 50 and 70. Bell was a 55-year-old black male. Dr. Feemster testified that in light of these facts, and the facts that Bell had a history of peripheral vascular disease and persistently complained of symptoms indicating an abdominal aneurysm while hospitalized at the Center, his doctors should have diagnosed his aneurysm “within a period of a week or two weeks.... [from the time of] the first development of symptoms.”

Dr. Feemster testified, based on Bell’s medical records, that Bell first complained of low abdominal and low back pain on December 9, 1983. Dr. Feemster identified these complaints as the first signs that Bell had an aneurysm. From December 9 through mid-December, 1983, Bell continued to complain of low back pain and also of “pain radiating out to his flanks.” According to Dr. Feemster, pain in the back and lower abdomen are “pretty classic” symptoms of an aneurysm. He explained that an aneurysm

can cause pain just from [the] pressure [it creates] alone. Pain can also, of course, be caused by the [blood] leakage or what is called dissection, and dissection is the process by which the blood does not leak directly out of the blood vessel into the abdominal cavity, but leaks between the walls of the blood vessel.

Dr. Feemster stated that according to the medical records, on December 23, 1983, Bell complained that the pain in his back was starting to radiate down into his sacrum. The following questions and answers [884]*884from the trial transcript explain the significance of this event:

Q. What significance, if any, does radiating pain into the sacrum have?
A. Well, radiating pain ... would lead you to believe that the patient is starting to leak....
******
Well, when we say leak, we're talking about leakage versus open rupture.
Let’s say you have a cup of water and you can have a pinpoint hole in that cup of water and the water leaks, drips through that small hole.
As that hole enlarges, then the water gushes out.
And that would be considered a rupture.
******
THE COURT: Like a slow flat tire; is that it?
A. That’s a good analogy.
******
.... When the hole gets big enough, it’s a blowout, and then it collapses right away.
Where with the slow leak, the tire can go for days, and then you notice it as you start to lose air.
THE COURT: As this leaks out, that means the blood that’s down below there is actually coming into the abdominal cavity?
A. Usually what happens in a slow leak — now this is why the patient lives ... [is] that it gives you warning and gives you enough time to get something done.

Dr. Feemster testified that the records indicate Bell’s pain was worsening between December 28, 1983, and January 2, 1984.

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Bluebook (online)
854 F.2d 881, 1988 U.S. App. LEXIS 11208, 1988 WL 83957, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lc-bell-personal-representative-of-the-estate-of-lonnie-c-bell-ca6-1988.