Preston Ex Rel. Preston v. Simmons

747 N.E.2d 1059, 321 Ill. App. 3d 789, 254 Ill. Dec. 647, 2001 Ill. App. LEXIS 195
CourtAppellate Court of Illinois
DecidedMarch 30, 2001
Docket1-98-4451
StatusPublished
Cited by13 cases

This text of 747 N.E.2d 1059 (Preston Ex Rel. Preston v. Simmons) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Preston Ex Rel. Preston v. Simmons, 747 N.E.2d 1059, 321 Ill. App. 3d 789, 254 Ill. Dec. 647, 2001 Ill. App. LEXIS 195 (Ill. Ct. App. 2001).

Opinion

JUSTICE TULLY

delivered the opinion of the court:

This case concerns an action for medical malpractice brought by a minor plaintiff, Paige Preston, against defendants Dr. Gayle Simmons, Dr. Mary Horan, and St. Joseph Hospital, for injuries plaintiff suffered at the time of her birth. The jury returned a verdict in plaintiffs favor and awarded damages in the amount of $1,010,000. Defendants thereafter filed a posttrial motion, seeking a new trial or judgment notwithstanding the verdict, which the trial court denied. Defendants now appeal from that order, arguing a new trial is or judgment notwithstanding the verdict is warranted because: (1) the trial court improperly coerced the jury into rendering a verdict when the jury was deadlocked; (2) the trial court allowed the use of prejudicial demonstrative evidence; (3) plaintiffs counsel violated motions in limine barring certain evidence; (4) plaintiffs counsel improperly cross-examined defendants’ medical expert; (5) the trial court improperly circumscribed defendants’ cross-examination of plaintiffs witness; (6) plaintiffs counsel engaged in improper closing argument; (7) the trial court issued instructions on damages not supported by any evidence; (8) the jury awarded excessive damages; and (9) the verdict was against the manifest weight of the evidence. This court has jurisdiction pursuant to Supreme Court Rules 301 and 303 (155 111. 2d Rs. 301, 303). For the reasons set forth below, we reverse and remand for a new trial.

Background

On May 15, 1991, Patricia Preston gave birth to plaintiff at St. Joseph Hospital. In the course of delivery, plaintiffs shoulder became impacted under Mrs. Preston’s pelvic bone, a condition known as shoulder dystocia. Shoulder dystocia is a potentially emergent condition because the infant may be deprived of oxygen until the shoulder is released and the infant is delivered. Defendants, Dr. Gayle Simmons (Dr. Simmons), a board-certified obstetrician and gynecologist, and Dr. Mary Horan (Dr. Horan), a first-year obstetrics and gynecology resident, were in attendance during Mrs. Preston’s labor and utilized several techniques to try to release plaintiffs shoulder. After several attempts, plaintiff was released and delivered, but she suffered an injury to the nerves in her left arm and shoulder, known as a brachial plexus nerve injury, permanently depriving her of some use of her left arm. Plaintiff thereafter brought a medical malpractice action alleging Dr. Simmons failed to properly supervise Dr. Horan, and Dr. Simmons and Dr. Horan failed to use the proper techniques when delivering plaintiff, thereby causing her injury. A jury trial commenced on March 24, 1998.

Dr. Simmons testified at trial that she had seven years’ experience in labor, delivery and performing shoulder dystocia maneuvers, had trained residents to perform these maneuvers during her tenure as St. Joseph’s assistant medical director, and had trained Dr. Horan in shoulder dystocia maneuvers and performed 50 deliveries with Dr. Ho-ran prior to plaintiffs delivery. Dr. Simmons stated that when Mrs. Preston arrived at St. Joseph Hospital, she and Dr. Horan examined her to determine her stage of labor. At 11:30 a.m., Mrs. Preston was completely dilated and Dr. Simmons and Dr. Horan began the delivery of plaintiff. Mrs. Preston lay supine on a delivery bed, Dr. Simmons and Dr. Horan stood between her legs, guiding plaintiffs head down the birth canal, and Elmer Preston, plaintiffs father and Mrs. Preston’s husband, stood on the right side of Mrs. Preston. At 11:37 a.m., plaintiffs head was delivered and Dr. Simmons suctioned plaintiffs mouth and nostrils to remove fetal stool and amniotic fluid. Dr. Horan felt for the umbilical cord and informed Dr. Simmons that it was wound tightly around plaintiffs neck. Dr. Simmons cut the cord and placed her hands over Dr. Horan’s hands to correctly position them for delivery. Dr. Horan attempted to deliver plaintiff, applying gentle downward traction, but discovered plaintiffs shoulder was impacted. When Dr. Horan alerted Dr. Simmons to this fact, Dr. Simmons pushed Mrs. Preston’s left leg back, applied suprapubic pressure, and told Dr. Horan to attempt delivery again. Dr. Simmons represented that in shoulder dystocia cases, suprapubic pressure is an appropriate procedure to dislodge an impacted shoulder, while progressively more invasive procedures are used if the shoulder cannot be freed. Dr. Ho-ran tried gentle downward traction again, but plaintiffs shoulder remained impacted. When informed of this, Dr. Simmons called over two nurses to help perform a McRoberts maneuver. A McRoberts maneuver involves hyper-flexing both of the mother’s legs, while applying suprapubic pressure to the mother and gentle downward traction to the infant. The maneuver facilitates delivery by flattening the mother’s backbone and rotating the pelvic bone, creating a larger opening for the infant to be delivered through. Two nurses held both of Mrs. Preston’s legs back, while Dr. Simmons applied suprapubic pressure, and Dr. Horan applied gentle downward traction to plaintiff. Plaintiff was delivered easily at 11:40 a.m., but in the process of delivery, the nerves in her left shoulder and arm were stretched, resulting in a brachial plexus nerve injury. In Dr. Simmons’ opinion, plaintiffs injury was caused by the impaction of her shoulder under Mrs. Preston’s pelvic bone, and Dr. Horan acted within the normal scope of expertise as a first-year resident in aiding in plaintiffs delivery.

Dr. Horan testified that she was a board-certified obstetrician and gynecologist, but at the time of plaintiffs delivery, she was in the tenth month of her first year of a four-year residency in obstetrics and gynecology. In her first year of residency, Dr. Horan performed roughly 270 deliveries, supervised by an attending physician, was trained in shoulder dystocia maneuvers, and was present during four to five shoulder dystocia deliveries, prior to plaintiffs delivery. Dr. Horan agreed that too much traction could cause a brachial plexus injury by stretching the nerves in an infant’s neck and shoulders. Dr. Horan could not quantify in pounds the amount of force she used in delivering plaintiff because the proper amount of traction could only be measured by feel. Dr. Horan stated that the amount of traction used on an infant during delivery does not vary according to whether a delivery is normal or whether a shoulder dystocia delivery is indicated, because gentle downward traction is the only appropriate force. Dr. Horan testified that she used gentle downward traction at all times when attempting to deliver plaintiff.

Elmer Preston testified on behalf of plaintiff at trial. Prior to examination of Mr. Preston, the court granted plaintiffs motion in limine, over defendants’ objection, to bar cross-examination of Mr. Preston concerning his estrangement from Mrs. Preston and the fact that he lived with another woman outside Illinois, so long as the direct testimony did not invite inquiry into these issues.

Mr. Preston testified that when plaintiffs delivery began, he stood on the right side of Mrs. Preston, while Dr. Horan and Dr. Simmons stood between Mrs. Preston’s legs. When plaintiffs head was delivered, Dr. Horan stated that the umbilical cord was around plaintiffs neck, at which point the doctors cut the umbilical cord and suctioned plaintiff. After the cord was cut, Dr. Horan began pulling on plaintiff s head, while Dr. Simmons pushed Mrs. Preston’s leg back, but did not apply pressure to Mrs. .Preston’s abdominal or pubic area. Dr.

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Bluebook (online)
747 N.E.2d 1059, 321 Ill. App. 3d 789, 254 Ill. Dec. 647, 2001 Ill. App. LEXIS 195, Counsel Stack Legal Research, https://law.counselstack.com/opinion/preston-ex-rel-preston-v-simmons-illappct-2001.