Rixey v. West Paces Ferry Hospital, Inc.

916 F.2d 608
CourtCourt of Appeals for the Eleventh Circuit
DecidedNovember 1, 1990
DocketNo. 89-8171
StatusPublished
Cited by7 cases

This text of 916 F.2d 608 (Rixey v. West Paces Ferry Hospital, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rixey v. West Paces Ferry Hospital, Inc., 916 F.2d 608 (11th Cir. 1990).

Opinion

HATCHETT, Circuit Judge:

In this diversity of citizenship case, a jury found a doctor and hospital liable for medical malpractice and awarded substantial damages. We are asked to determine whether the district court properly granted motions for judgment notwithstanding the verdicts, a new trial, and a conditional new trial. Concluding that the district court erroneously granted these motions, we reverse.

FACTS

On April 18, 1986, Thomas C. Rixey, age 24, began experiencing shortness of breath and a tight chest. The following day Rixey went to the Humana Med-First Center, Smyrna, Georgia, for treatment, in the morning and in the afternoon. Because Rixey’s condition grew progressively worse, he went to the emergency room at West Paces Ferry Hospital, Atlanta, Georgia (West Paces).

The events at the hospital are hotly disputed. Rixey arrived at West Paces Ferry Hospital emergency room at 8:55 p.m., and [610]*610shortly thereafter suffered a respiratory arrest. Emergency room personnel inserted an endotracheal tube in his throat. At 9:25 p.m., Dr. Andrew Zadoff, a board-certified pulmonologist, took over Rixey’s care. Dr. Zadoff obtained a chest X-ray which showed air in the subcutaneous neck tissues and some mediastinal air. Dr. Zadoff placed Rixey on a mechanical ventilator and prescribed morphine as a sedative.

Around 11:45 p.m., Dr. Zadoff left West Paces without informing either the emergency room physician, Dr. Robert Sasine, or Rixey’s attending nurses and respiratory therapist about the air noted in the X-ray, and the possibility that Rixey would develop a tension pneumothorax while being mechanically ventilated. About 11:55 p.m., the respiratory therapist, Barbara Segers, went to the hospital cafeteria for dinner. At approximately 12:26 a.m., Rixey began turning blue. Nurse Jody Frazier removed Rixey from the mechanical ventilator and began ventilating him manually with a ventilator bag. Frazier simultaneously paged Segers who arrived within a few minutes and began manually compressing Rixey’s chest. The heart monitor reflected cardiac arrythmia, then a flat line, and at 12:29 a.m. Frazier activated the code 99 emergency button, signaling that Rixey had arrested.

Segers soon discovered that Rixey’s scrotum was ballooned-out with air. She found the scrotal air immediately before the code was called, and notified Dr. Sasine, the emergency room physician, who responded to the code 99, of this discovery when he arrived. According to Dr. Sasine, Segers did not inform him of her discovery when he arrived. Rather, Dr. Sasine testified that air was found in Rixey’s left chest, left abdomen, and scrotum “well into” the code.

In any event, Dr. Sasine made two unsuccessful attempts to defibrillate Rixey’s heart. After a hospital employee called Dr. Zadoff via his beeper, Dr. Zadoff directed that bilateral chest tubes be immediately placed in Rixey’s chest to relieve pressure on the lungs and heart. At trial, Dr. Za-doff testified that, at that time, he presumed that Rixey had a pneumothorax (i.e. accumulated air between the visceral and parietal pleura of the lung) or a tension pneumothorax (i.e. accumulation of air in the pleural cavity which occurs when an opening in the tissues inside the lung acts as a one-way valve, allowing air to enter the pleural cavity but not to leave it). Dr. Sasine implanted the left chest tube at approximately 12:46 a.m., and Dr. Zadoff implanted the right tube at approximately 12:50 a.m., when he returned to West Paces.

At about 1 a.m., Rixey’s heart began to contract in an irregular manner. Subsequent neurological checks revealed that Rixey had no brain function. He died. The precipitating cause of Rixey’s death was a tension pneumothorax which resulted in the collapse of his lungs and cardiac arrest.

PROCEDURAL HISTORY

John F. Rixey, Thomas Rixey’s father, brought this lawsuit individually and as administrator of the Estate of Thomas Cor-neth Rixey, deceased. In this opinion, John F. Rixey will be referred to as “the administrator.”

In November,. 1986, the administrator filed a two-count complaint seeking damages for the wrongful death of his son. The administrator alleged professional medical negligence against West Paces and Dr. Zadoff on the following theories: (1) that Dr. Zadoff negligently failed to insert chest tubes in Rixey’s chest before leaving the hospital at 11:45 p.m. (failure to insert tubes allegation); (2) that Dr. Zadoff negligently failed to alert Dr. Sasine or intensive care unit (ICU) personnel that it might be necessary to implant chest tubes very quickly at the first sign of a tension pneu-mothorax (failure to alert allegation); (3) that Dr. Zadoff negligently prescribed excessive doses of morphine (excessive morphine allegation); (4) that the ICU personnel negligently failed to monitor Rixey’s condition (failure to properly monitor allegation); (5) that respiratory therapist Seg-ers failed to report Rixey’s distended scrotum to Dr. Sasine immediately upon his arrival after the code (failure to notify alie-[611]*611gation); and (6) that Dr. Sasine negligently failed to insert chest tubes in a timely manner.

After the administrator presented his case to the jury, the district court granted Dr. Zadoff’s motion for a partial directed verdict on the excessive administration of morphine allegation and West Paces’s motion for a directed verdict on the administrator’s allegation that Dr. Sasine acted negligently during the code. The jury returned a verdict against West Paces and Dr. Zadoff for $520,000.

West Paces and Dr. Zadoff then moved for judgment notwithstanding the verdicts (JNOY), and new trials. The district court (1) granted Dr. Zadoff’s motion for a JNOV on the failure to alert allegation, (2) denied his motion for a JNOV on the failure to insert tubes claim, and (3) granted West Paces’s motion for JNOV as to both the failure to properly monitor allegation, and the failure to notify Dr. Sasine allegation. Additionally, the district court granted Dr. Zadoff’s motion for a new trial on the failure to insert tubes allegation, and granted Dr. Zadoff and West Paces a conditional new trial as to those allegations on which it entered a JNOV.

CONTENTIONS

The administrator contends that the district court erred when it granted Dr. Za-doff’s and West Paces’s motions for JNOV. According to the administrator, the district court improperly weighed the evidence, improperly determined the credibility of witnesses, and ignored substantial evidence in the record reflecting Dr. Zadoff’s and West Paces’s negligence. The administrator also contends that the district court abused its discretion when it granted the various motions for new trials because the jury’s verdicts were not contrary to the great weight of the evidence.

In response, Dr. Zadoff and West Paces contend that the district court properly granted the motions for JNOV. Dr. Zadoff and West Paces argue that Rixey failed to introduce substantial evidence that either West Paces’s or Dr. Zadoff’s actions or inactions proximately caused Rixey’s death. Further, Dr. Zadoff and West Paces maintain that the district court properly granted the motions for new trials because the jury’s verdict is contrary to the overwhelming weight of the evidence.

ISSUES

We address the following issues: Whether the district court erred in granting West Paces’s and Dr. Zadoff’s motions for JNOV and for new trials.

DISCUSSION

I. Standard of Review

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Bluebook (online)
916 F.2d 608, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rixey-v-west-paces-ferry-hospital-inc-ca11-1990.