St. Pierre v. Elgert

765 A.2d 1054, 145 N.H. 620, 2000 N.H. LEXIS 122
CourtSupreme Court of New Hampshire
DecidedDecember 28, 2000
DocketNo. 98-426
StatusPublished
Cited by6 cases

This text of 765 A.2d 1054 (St. Pierre v. Elgert) is published on Counsel Stack Legal Research, covering Supreme Court of New Hampshire primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
St. Pierre v. Elgert, 765 A.2d 1054, 145 N.H. 620, 2000 N.H. LEXIS 122 (N.H. 2000).

Opinion

DALIANIS, J.

The plaintiff, Donna St. Pierre, appeals the Superior Court’s (Fitzgerald, J.) grant of the motion of the defendant, Stephen Elgert, M.D., for directed verdict in her medical negligence case. We reverse and remand.

The following facts are undisputed. On December 10, 1993, the defendant, the plaintiff’s physician, delivered the plaintiff’s second child. Following the delivery, the plaintiff began to hemorrhage. After examining the plaintiff’s uterus, the defendant determined that the placenta had partially separated from the uterus and that the hemorrhaging came from the placental insertion site on the [621]*621uterine wall. With the assistance of Pitocin and uterine massage, the plaintiff delivered the placenta. The defendant examined it and determined that there were no “major breaks or tears or anything that looked like it was a missing piece.” The placenta was sent to pathology for examination.

On December 14, two days after she was discharged from the hospital, the plaintiff visited the hospital’s emergency room. An emergency room doctor placed her on antibiotics to treat a suspected kidney infection. When the plaintiff failed to improve, an ultrasound was done, which indicated that there were possible retained products of conception (i.e., pieces of the placenta). The defendant discussed various options with the plaintiff, including either waiting for the retained materials to pass or doing a dilation and curettage (D&C). The plaintiff had a D&C. A few days later, because the plaintiff continued to bleed and have pain, another doctor performed a second D&C. The second D&C perforated the plaintiff’s uterus. Follow-up testing revealed an infection requiring the removal of one of the plaintiff’s fallopian tubes.

The plaintiff sued the defendant, alleging that because of his negligence, products of conception remained in her uterus, leading to infection and the removal of a fallopian tube. At the close of the plaintiff’s case, the defendant moved for a directed verdict. The trial court granted the defendant’s motion and denied the plaintiff’s motion for reconsideration.

On appeal, the plaintiff argues that the trial court’s directed verdict ruling was in error. We agree.

A motion for directed verdict “should be granted only when the sole reasonable inference that may be drawn from the evidence, which must be viewed in the light most favorable to the nonmoving party, is so overwhelmingly in favor of the moving party that no contrary verdict could stand.” Bronson v. The Hitchcock Clinic, 140 N.H. 798, 800, 677 A.2d 665, 667-68 (1996) (quotation omitted). “The trial court cannot weigh the evidence or judge the credibility of the witnesses, and, if the evidence is conflicting or several reasonable inferences may be drawn, the motion for a directed verdict should be denied.” Arthur v. Holy Rosary Credit Union, 139 N.H. 463, 465, 656 A.2d 830, 832 (1995) (quotation and brackets omitted). “In addition, the trial judge’s discretion to remove questions of fact from the jury is very limited.” Young v. Clogston, 127 N.H. 340, 342, 499 A.2d 1007, 1009 (1985).

“This court will uphold a trial court’s decision to grant a motion for a directed verdict unless the trial judge abused his or her discretion in determining that no rational juror could find for the [622]*622party against whom the motion is filed.” Holy Rosary Credit Union, 139 N.H. at 465, 656 A.2d at 832.

The plaintiff’s burden of proof in a medical negligence action is defined by statute, RSA 507-E:2, I (1997), which

requires the plaintiff to prove by competent expert testimony the standard of care required of the defendant at the time the medical care was rendered, that the defendant failed to act in accordance with such standard, and that as a proximate result, [the plaintiff] suffered injuries which she would not otherwise have sustained.

Bissett v. Renna, 142 N.H. 788, 792, 710 A.2d 404, 406 (1998). Accordingly, we must determine whether, viewing the evidence in the light most favorable to the plaintiff, she met her burden of producing sufficient expert medical testimony from which a reasonable juror could conclude that the defendant breached the relevant standard of care and that his breach proximately caused her injuries. See Bronson, 140 N.H. at 801, 677 A.2d at 668.

We first examine the plaintiff’s evidence of the relevant standard of care and of the defendant’s breach of that standard. The plaintiff presented one expert to meet her burden who, on direct examination, testified:

Q. Now, after the placenta’s been delivered, what is the standard — general standard of reasonable medical practice pertaining to the examination of the placenta? And I want you to tell me whether or not that standard was different in 1993 from what it is today.
A. Sure. I don’t — first of all, the standard has been not different for as long as I can remember. The placenta, delivery of the placenta, is an old thing that’s gone on ever since people have been born, and we’ve known for a long time that the placenta can cause some trouble if it isn’t delivered intact. So once the placenta has been delivered or born, if you will, the obstetrician or the physician doing the delivery has the obligation to make sure that it’s all there.
So to complete a delivery the doctor who does that . . . has to be certain that the entire placenta has been totally expelled from the mother.
[623]*623Q. Do you have an opinion, Doctor, based upon your background and experience, your review of the record and what you just expressed concerning whether [the defendant’s] examination of the placenta was a deviation from the standard reasonable medical practice for a family physician under these circumstances and at this time?
A. Well, I can’t — I can’t speak to exactly what his examination consisted of because 1 don’t know that. I didn’t read his deposition. But it’s clear that there was a piece left.
I think that speaks for itself to know that there were retained products. And so clearly, whatever examination he did was inadequate because he missed a piece. That’s as much as I can say about that.

On cross-examination, the expert testified:

Q. Now, you’re not saying every time that there — you have confirmed the presence of retained products by ultrasound that that means you must have negligently failed to observe in the first instance that there was missing placental tissue when you inspected the placenta, are you?
A. No. f think just missing it, you know, it depends on how it was inspected, how it was examined. Negligence has not to do with not finding it. It’s got to do with how you did it.
Q. Well, so one could do a perfectly reasonable and careful exam and still fail to detect missing placental tissue in the absence of negligence?
A. It’s possible. It’s possible. Not probable I must say.

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Cite This Page — Counsel Stack

Bluebook (online)
765 A.2d 1054, 145 N.H. 620, 2000 N.H. LEXIS 122, Counsel Stack Legal Research, https://law.counselstack.com/opinion/st-pierre-v-elgert-nh-2000.