PREFERRED WOMEN'S HEALTHCARE LLC v. JASON A. SAIN

CourtCourt of Appeals of Georgia
DecidedMay 31, 2023
DocketA23A0413
StatusPublished

This text of PREFERRED WOMEN'S HEALTHCARE LLC v. JASON A. SAIN (PREFERRED WOMEN'S HEALTHCARE LLC v. JASON A. SAIN) 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
PREFERRED WOMEN'S HEALTHCARE LLC v. JASON A. SAIN, (Ga. Ct. App. 2023).

Opinion

THIRD DIVISION DOYLE, P. J., GOBEIL, J., and SENIOR APPELLATE JUDGE PHIPPS

NOTICE: Motions for reconsideration must be physically received in our clerk’s office within ten days of the date of decision to be deemed timely filed. https://www.gaappeals.us/rules

May 31, 2023

In the Court of Appeals of Georgia A23A0413. PREFERRED WOMEN’S HEALTHCARE LLC et al. v. SAIN et al.

PHIPPS, Senior Appellate Judge.

Jason Sain, individually, as the administrator of the estate of his deceased wife

Debbie Sain, and as next friend of the couple’s minor child, brought this medical

malpractice and wrongful death action against several defendants, including

appellants Preferred Women’s Healthcare, LLC (“PWH”); Lisa Dickerson, as

executor of the estate of Byron Dickerson, M.D.; and Mary Long, M.D. These

defendants appeal from the denial of their motion for a new trial following a jury

verdict largely in Jason’s favor. They contend that the trial court erred when it:

(i) denied their motion to exclude the testimony of one of Jason’s expert witnesses;

and (ii) entered a judgment against them premised on an inconsistent verdict. For the reasons that follow, we disagree with both contentions and affirm the trial court’s

judgment.

On appeal following a jury trial, we view the evidence in the light most

favorable to the jury’s verdict. Moore v. Jackson, 343 Ga. App. 532, 532 (807 SE2d

495) (2017). So viewed, the record shows that Debbie Sain became pregnant in early

2012, when she was 36 years old. Ultrasounds performed by two different PWH

sonographers on April 3, 10, and 20, 2012, revealed a mass in Debbie’s right adnexa.1

On April 3, the mass measured between 5.7 and 6.27 centimeters, and it appeared to

be unchanged on April 10 and 20. The sonographers documented their findings in

Debbie’s medical records to draw the mass to the attention of her PWH doctors.

Two expert witnesses testified at trial that the mass’s appearance in April 2012

was consistent with a dermoid,2 which typically will not resolve on its own, and one

of Debbie’s sonographers similarly thought that the mass was a dermoid. However,

following the first ultrasound, the PWH obstetrician-gynecologist who met with

1 The adnexa is the space inside a woman’s abdomen and pelvis, between the inside of her abdominal wall and uterus, and includes all structures that attach to the uterus, such as the ovaries and fallopian tubes. 2 A dermoid is a generally benign tumor of the ovary that may contain various elements, including skin, hair, and teeth.

2 Debbie — Audrey Arona, M.D. — shared no concerns about the results.3 In fact,

Debbie was not told about the mass during any of her PWH visits, and her medical

records contain no indication that her doctors took any action related to the mass

during her pregnancy. Moreover, while Debbie’s obstetrical chart included a

“problem list,” the mass was not included on it.4 Similarly, in Debbie’s antepartum

record, her adnexa was noted to be normal, and the mass was not documented in the

space provided for ultrasound notes.

Sometime in April or May 2012, Dr. Dickerson, one of Debbie’s PWH

physicians, referred her to Charles Read, M.D., a maternal-fetal medicine specialist,

for several reasons unrelated to her adnexal mass. When Debbie visited Dr. Read,

PWH personnel did not inform him of the mass identified in the April 2012

ultrasounds.

3 Dr. Arona was not named as a defendant in Jason’s initial complaint. In 2019, we reversed the trial court’s order granting Jason’s motion to amend the complaint to add Dr. Arona as a party on the ground that his claims against her were barred by the statute of repose. Preferred Women’s Healthcare v. Sain, 348 Ga. App. 481, 482, 490-491 (823 SE2d 569) (2019). 4 A “problem list” is a tool for medical practitioners to share a patient’s most pressing medical issues with other practitioners the patient may see.

3 An ultrasound performed in May 2012 in Dr. Read’s office also indicated the

presence of a right adnexal mass. But nothing in Debbie’s medical records indicates

that she or Jason was informed of the mass before she gave birth in November 2012.

The couple likewise was not told of any problems requiring follow-up after their

son’s delivery, which was performed by Dr. Long via cesarean section. Moreover,

during Debbie’s delivery, Dr. Long did not identify the adnexal mass, and she did not

know that a mass was seen in ultrasounds during Debbie’s pregnancy.

On January 3, 2013, Debbie visited an emergency room, complaining of

abdominal pain and a fever. When a CT scan showed a mass in her abdomen, she

underwent emergency surgery performed by Dr. Dickerson. During the surgery, the

mass — which measured 11 centimeters and had ruptured — was removed. Because

the mass already had excreted 500 milliliters of dermoid contents into Debbie’s

pelvis, it likely measured between 12 and 15 centimeters before it ruptured.

The mass was found to contain squamous cell carcinoma arising from a mature

teratoma.5 Debbie’s ensuing cancer treatment included several surgeries,

5 A squamous cell carcinoma is an epithelial cancer that forms within a benign dermoid or teratoma. Two of Jason’s expert witnesses testified that the terms “teratoma” and “dermoid” are interchangeable. Another expert testified that a dermoid is a subset of teratomas.

4 chemotherapy, radiation, and long stays in the hospital. The treatments ultimately

were unsuccessful, and she died in December 2013.

In 2014, Jason brought this action for medical malpractice, wrongful death, and

related claims against several defendants, including the appellants.6 Before trial, the

defendants moved to exclude the testimony of Christopher DeSimone, M.D. — an

expert witness on the issue of causation — on the ground that his opinion as to the

five-year survival rate for Debbie’s cancer was neither scientifically reliable nor

relevant to the issues in this case. In particular, the defendants challenged

Dr. DeSimone’s opinion that Debbie more likely than not would have lived for at

least five years if her cancer had been diagnosed when it was still classified as stage

1, before the mass ruptured in January 2013. The defendants further contended that,

without Dr. DeSimone’s causation testimony, they were entitled to summary

The trial court initially granted in part the defendants’ motion and barred

Dr. DeSimone from providing “any opinion testimony based upon the extrapolation

of data from the study of epithelial ovarian cancer.” In that same order, the court

denied the defendants’ motion for summary judgment. The court subsequently

6 Because Dr. Dickerson died before trial, his estate was named as a defendant.

5 granted Jason’s motion for reconsideration of its order partially excluding

Dr. DeSimone’s expert testimony, vacated the prior order, and denied the defendants’

motion to exclude the testimony.

During the ensuing jury trial, both Dr. DeSimone and a second expert witness,

James Quirk, M.D., testified that various medical professionals’ failures to timely

intervene when Debbie’s right adnexal mass was discovered likely caused or

substantially hastened her death. A third expert, John McBroom, M.D., testified that,

as of Debbie’s November 2012 delivery date, her cancer likely was confined to the

inside of her adnexal mass and therefore classified as stage 1A. Dr. McBroom further

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PREFERRED WOMEN'S HEALTHCARE LLC v. JASON A. SAIN, Counsel Stack Legal Research, https://law.counselstack.com/opinion/preferred-womens-healthcare-llc-v-jason-a-sain-gactapp-2023.