PROVIDENCE HOSPITAL, INC., APPELLANT/CROSS v. JOHN WILLIS, APPELLEE/CROSS-APPELLANT.

103 A.3d 533, 2014 D.C. App. LEXIS 511
CourtDistrict of Columbia Court of Appeals
DecidedNovember 20, 2014
Docket13-CV-920, 13-CV-921
StatusPublished
Cited by2 cases

This text of 103 A.3d 533 (PROVIDENCE HOSPITAL, INC., APPELLANT/CROSS v. JOHN WILLIS, APPELLEE/CROSS-APPELLANT.) is published on Counsel Stack Legal Research, covering District of Columbia Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
PROVIDENCE HOSPITAL, INC., APPELLANT/CROSS v. JOHN WILLIS, APPELLEE/CROSS-APPELLANT., 103 A.3d 533, 2014 D.C. App. LEXIS 511 (D.C. 2014).

Opinion

PER CURIAM:

A jury awarded plaintiff/cross-appellant John Willis $650,000 in damages for an injury arising from negligence by nurses employed by defendant/appellant Providence Hospital (the Hospital) when, after a surgery, they failed to place on his legs sequential compression devices (SCDs) ordered by the surgeon. The Hospital moved to set aside the verdict, arguing that Willis had not proven a causal link between the negligence and his injuries, ultimately the below-knee amputation of both of his legs at another hospital. Willis, in turn, moved for a new trial on damages asserting that the jury’s award was inadequate under the circumstances and was likely influenced by the trial court’s refusal to give an instruction on “special susceptibility.”

• The trial judge denied both motions, leading to this appeal and cross-appeal in which the parties renew their objections to the verdict. We affirm the judgment essentially for the reasons stated by Judge Kravitz in his comprehensive, painstaking opinion, which we append hereto. The following discussion, which assumes familiarity with the judge’s analysis, supplements it in two respects.

1. As the trial judge explained, the principal dispute between Willis and the Hospital at trial 1 was whether deep venous thrombosis (DVT) became “well-established” in Willis’s legs before, or instead after, a second surgery performed to ameliorate an abscess on his right buttock. If the latter was the case, then expert testimony supported the jury’s finding that negligence by nurses in not placing SCDs on Willis’s legs after the second surgery, *535 despite instructions from the surgeon to do so, contributed causally to the below-knee amputation of his legs ten days later at Prince George’s Hospital Center. The trial judge, applying the correct test of causation, 2 arrayed the pertinent evidence and concluded that the jury, “without engaging in impermissible speculation,” had reasonably found that “the plaintiffs DVT did not become well-established until after the second surgery, and that the application of SCDs beginning on [the date of that surgery,] September 10, 2008, would have prevented the formation of a well-established DVT....”

On appeal, the Hospital disputes this conclusion but does so, in our view, chiefly by overstating the plaintiffs burden of proof. It contends that the judge wrongly “shifted the burden of proof on the issue of causation” to the defense (Br. for Appellant at 16) by not recognizing that “[i]t was incumbent on Mr. Willis to prove that the DVT had not yet become ‘well-established’ by September 10th when [the surgeon] entered the order for SCDs” (id. at 6; italics added). See id. at 14 (“[N]one of the [plaintiffs] experts could establish with reasonable medical probability that the DVT had not already formed before the order for SCDs was placed” (italics added)). The Hospital thus argues that Willis had to prove a negative: It was not enough for him to show that the DVT more likely than not became well-established in the ten days after the negligence; he also had to disprove — to rule out — that it did so in the five-day interval between the two surgeries. But while the Hospital cites unassailable legal principles such as that a medical expert’s opinion must be formed “with sufficient certainty so as to make a medical judgment,” Lasley v. Georgetown Univ., 688 A.2d 1381, 1388 (D.C.1997), and that more than a temporal relationship — “contemporaneity” — between a medical procedure and an injury must have existed to prove causation, Derzavis v. Bepko, 766 A.2d 514, 522 (D.C.2000), it points to no case law or other authority requiring Willis to negate a possibility (ie., that the DVT became established too early for the ordered prophylaxis to be effective) and show by a preponderance of the evidence, as he did, that timely placement of the SCDs would have kept the DVT from becoming well-established. 3 Requiring Willis to do both, in our judgment, would amount to increasing his burden of proof to something akin to the standard in criminal cases. Cf. Chapman v. California, 386 U.S. 18, 24, 87 S.Ct. 824, 17 L.Ed.2d 705 (1967) (in criminal case, disproving prejudice “beyond a reasonable doubt” from constitutional error tantamount to dispelling any “reasonable possibility” of such prejudice).

Altogether, then, we agree with Judge Kravitz that, while “[t]his was a very close case on the issue of causation,” Dr. Hall (Willis’s chief medical expert) “never withdrew or even backed away from his opinion that the nurses’ negligence proximately caused the plaintiffs amputations, and the evidence, although hotly contested, was *536 sufficient to support his opinion.” 4 Willis, required only to meet the standard of causation stated in Travers, supra note 2, met his burden of proof.

2. Willis’s argument, as cross-appellant, that the jury’s award of $650,000 in damages was inadequate requires discussion mainly of his claim that the judge’s refusal to give the “special susceptibility” instruction was error 5 and may have caused the jury to minimize (relatively speaking) his damages. Like the trial judge, we conclude that as the case was actually tried, that instruction had no relevance to the assessment of damages the jury was called on to make.

The instruction reflects the “firmly established principle of tort law that a tort-feasor takes his victim as he finds him,” Bushong v. Park, 837 A.2d 49, 55 (D.C.2003), so that “[a] negligent actor must bear the risk that his liability will be increased by reason of the actual physical condition of the other toward whom his act is negligent.” Gubbins v. Hurson, 987 A.2d 466, 469 (D.C.2010) (quoting Restatement (Second) of Torts § 461 (1965) (italics deleted)). 6 In the present case, there was conceded evidence that Willis came to the Hospital with pre-existing medical conditions (or “risk factors”) including diabetics, obesity, hypertension, and a history of smoking. He thus argues that, without the special susceptibility instruction, the jury may have unfairly reduced or discounted his damages to the extent it saw these risk factors — all beyond the Hospital’s control — as combining with the negligence to cause the need for the amputations.

What Willis ignores, however, is that the Hospital tried the case on the theory that an independent cause, not its alleged negligence, combined with his prior conditions to necessitate the amputation.

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Bluebook (online)
103 A.3d 533, 2014 D.C. App. LEXIS 511, Counsel Stack Legal Research, https://law.counselstack.com/opinion/providence-hospital-inc-appellantcross-v-john-willis-dc-2014.