Pernia v. Trail

519 So. 2d 231, 1988 WL 2700
CourtLouisiana Court of Appeal
DecidedJanuary 11, 1988
Docket87-CA-581
StatusPublished
Cited by10 cases

This text of 519 So. 2d 231 (Pernia v. Trail) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pernia v. Trail, 519 So. 2d 231, 1988 WL 2700 (La. Ct. App. 1988).

Opinion

519 So.2d 231 (1988)

Rita Carabeo Pernia, Wife of and Jose PERNIA
v.
Mervin TRAIL, M.D.

No. 87-CA-581.

Court of Appeal of Louisiana, Fifth Circuit.

January 11, 1988.
Writ Denied March 11, 1988.

Martin E. Regan, Jr., Regan & Associates, New Orleans, for plaintiffs-appellants.

Charles A. Boggs, Thomas W. Lewis, Boggs, Loehn & Rodrigue, New Orleans, for defendant-appellee.

Before KLIEBERT, BOWES and GAUDIN, JJ.

KLIEBERT, Judge.

Plaintiffs Rita and Jose Pernia brought this medical malpractice action for recovery of damages allegedly sustained as a result of defendant Dr. Mervin Trail's negligent performance while surgically removing a cyst from Mrs. Pernia's throat. After a judge trial Dr. Trail's exception of prescription was overruled and judgment rendered dismissing the Pernias' suit on the merits for failure to prove Dr. Trail was guilty of negligence or malpractice. The Pernias appealed. We affirm the judgment of the trial court.

FACTS

Mrs. Rita Pernia is a fifty-four year old college professor. On April 21, 1978 she was referred to Dr. Marvin Trail, a specialist in diseases of the ear and larynx (otolaryngologist) for treatment of a lump in her throat. Dr. Trail's diagnosis was a thyroglossal duct cyst, and he continued Mrs. Pernia on antibiotics as prescribed by the referring physician. When the antibiotics failed to effect improvement, Dr. Trail recommended removal of the cyst by surgery. Mrs. Pernia signed the appropriate consent form and surgery was performed on May 9, 1978.

*232 After incision the cystic mass was visualized as extending from the cricothyroid membrane to the infrahyoid area. A second mass was identified as either a projection of the thyroid gland or a pyramidal lobe. After removing the second mass Dr. Trail utilized blunt and sharp dissection to retract the thyroglossal duct cyst on its upper end. The lower end of the tract turned 180° superiorly behind the thyroid cartilage. The inferior half of the thyroid cartilage was ensized and the tract visualized as penetrating the underlying membrane for two to three millimeters. The entire tract, including the cyst, was excised in one piece. The edges of the thyroid cartilage were reapproximated with a No. 30 wire. Before concluding the operation Dr. Trail performed a laryngoscopic examination which revealed the presence of a possible mucosal laceration, three to four millimeters in length, near the anterior commissure.

Post-surgical progress was uneventful; the sutures were removed and the vocal cords moved well. However, when examined on July 12, 1978 Mrs. Pernia complained of hoarseness. Dr. Trail found no objective basis for the complaint as the vocal cords appeared normal and moved satisfactorily. Dr. Herbert Marks, an associate of Dr. Trail, noted a slight edema (swelling) of the vocal cords but otherwise movement was good. Mrs. Pernia was given a prescription for "Valium" and told to consult a speech therapist for problems with articulation and phonics. It was Mrs. Pernia's last visit with Dr. Trail.

Mrs. Pernia sought treatment from Dr. Lawrence Travis, an otolaryngologist, on September 27, 1979 for congestion in her ears associated with post-nasal drainage and chronic sore throat. She informed Dr. Travis of hoarseness and vocal cord dysfunction since the operation of May 9, 1978. Examination revealed a slightly atrophic right vocal cord. Dr. Travis intervened surgically on October 16, 1979, using a laser to divide scar tissue which was believed to be pulling down slightly on the right vocal cord. No improvement was noted. A second diagnostic laryngoscopy revealed a small web of scar tissue involving the right vocal cord and the anterior commissure, and the left vocal cord was atrophic and scarred. A sterile glycerine solution injected into the left vocal cord to increase its bulk effected no demonstrative improvement. Final examination on April 23, 1980 revealed the posterior commissure rotated to the left. Dr. Travis referred Mrs. Pernia to a speech therapist.

From April through June of 1980 Mrs. Pernia was treated by Dr. Oscar Valdes, a psychiatrist, for depression with anxiety secondary to the loss of her normal vocal capabilities. She filed the instant suit on September 25, 1980, claiming the hoarseness and vocal cord dysfunction impacted on her ability to teach and to support herself and her family. After suit was filed she was examined by Dr. Francis LeJuene, an otolaryngologist, who diagnosed a "bowing" or gap in the approximation of the vocal cords. The central issues at trial were whether the thyroglossal duct cyst operation was negligently performed and whether, as a proximate result of negligence, Mrs. Pernia suffered injuries that would not otherwise have been incurred.

PRESCRIPTION

Counsel for Dr. Trail reurges the exception of prescription in appellate brief. Since he does not wish to have the judgment modified, revised or reversed, no answer to the appeal or separate appeal was necessary and the prescription issue could be addressed by this court. La.C.C.P. Article 2133; Varnado v. Ins. Corp. of America, 484 So.2d 813 (1st Cir.1986) writ denied 489 So.2d 248; Clark v. McDonald's System, Inc., 383 So.2d 61 (2nd Cir.1980) writ denied 386 So.2d 95. However, in the interest of judicial economy we choose to decide the case on the merits without addressing the prescription issue.

LIABILITY OF DR. TRAIL

The burden of proof in cases such as the present is set forth in LSA-R.S. 9:2794 as follows:

A. In a malpractice action based on the negligence of a physician licensed *233 under R.S. 37:1261 et seq., a dentist licensed under R.S. 37:751 et seq., or a chiropractic physician licensed under R.S. 37:2801 et seq., the plaintiff shall have the burden of proving:
(1) The degree of knowledge or skill possessed or the degree of care ordinarily exercised by physicians, dentists, or chiropractic physicians licensed to practice in the state of Louisiana and actively practicing in a similar community or locale and under similar circumstances; and where the defendant practices in a particular specialty and where the alleged acts of medical negligence raise issues peculiar to the particular medical specialty involved, then the plaintiff has the burden of proving the degree of care ordinarily practiced by physicians, dentists, or chiropractic physicians within the involved medical specialty.
(2) That the defendant either lacked this degree of knowledge or skill or failed to use reasonable care and diligence, along with his best judgment in the application of that skill, and
(3) That as a proximate result of this lack of knowledge or skill or the failure to exercise this degree of care the plaintiff suffered injuries that would not otherwise have been incurred.

Counsel for Mrs. Pernia acknowledged at the outset that Dr. Trail had the necessary knowledge and skill to perform the surgery in question. Counsel sought, through the testimony of two expert witnesses, Dr. Herbert Dietrich and Dr. Cyril Costello, to establish nine separate instances in which Dr. Trail allegedly failed to use reasonable care and diligence, along with his best judgment in the application of his skill:

(1) Methylene Blue should have been injected into the cyst so it could be better identified;

(2) A horizontal incision should have been used to dissect the cricothyroid membrane instead of a vertical incision;

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Cite This Page — Counsel Stack

Bluebook (online)
519 So. 2d 231, 1988 WL 2700, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pernia-v-trail-lactapp-1988.