Stalkup v. Vancouver Clinic, Inc., PS

145 Wash. App. 572
CourtCourt of Appeals of Washington
DecidedJuly 1, 2008
DocketNo. 35682-1-II
StatusPublished
Cited by18 cases

This text of 145 Wash. App. 572 (Stalkup v. Vancouver Clinic, Inc., PS) is published on Counsel Stack Legal Research, covering Court of Appeals of Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Stalkup v. Vancouver Clinic, Inc., PS, 145 Wash. App. 572 (Wash. Ct. App. 2008).

Opinion

Quinn-Brintnall, J.

¶1 The jury in a medical malpractice case returned a special verdict finding that, although Dr. James Hampton was negligent, his negligence did not cause John Stalkup’s death. John’s1 widow, Susan Stalkup, moved for a judgment as a matter of law on the issue of proximate cause under CR 50(a)(1) and a new trial on the sole issue of damages under CR 59(a)(7). The trial court denied Susan’s motion but held that the jury’s verdict was inconsistent and ordered a new trial on all issues.

¶2 Hampton and the Vancouver Clinic, Inc., PS, appeal from the new trial order claiming that, when applying the appropriate legal standard, the multiple theories presented at trial support the jury’s verdict and it is not internally [576]*576inconsistent. We agree with Hampton, vacate the new trial order, and remand with directions that the trial court reinstate the jury’s verdict.

FACTS

Factual Background

¶3 In 2004, Hampton, a family practice physician, treated John on two separate occasions at the Vancouver Clinic. On March 8, John saw Hampton for the first time for a skin rash and to refill a prescription for Pravachol, a cholesterol-lowering medication his former physician had previously prescribed. Without ordering any blood tests to assess John’s liver function or present cholesterol levels, Hampton authorized a refill of the Pravachol prescription. He also prescribed Lamisil for John’s rash.

¶4 John made a second appointment to see Hampton on June 10. At the second appointment, John complained that he had been experiencing chest pains and shortness of breath when he exerted himself. He indicated these symptoms had been going on for approximately one week. John described the pain as sharp and dull with some pressure on his chest but denied experiencing any radiating pain. Hampton examined John for approximately 30 minutes. He checked John’s vital signs, listened to his heart and lungs, felt his carotid arteries and pulse, and checked his abdomen. Hampton also palpated John’s chest wall and confirmed that doing so reproduced John’s pain.

¶5 Hampton told John that he likely suffered from costochrondritis, an inflammation of the chest wall. But in order to rule out an acute heart attack, Hampton performed an electrocardiogram (EKG), with normal test results. Hampton told John to take ibuprofen, reduce his activity for two to three weeks, and return if his symptoms continued beyond two or three weeks. He also told John to return immediately or go to the emergency room if his symptoms worsened or changed.

¶6 Nine days later, on June 19, John told his neighbors, Bobbie and Chris Blessing, who are both emergency medi[577]*577cal technicians, that he had pain radiating down his left arm and that his left hand was numb. He also told them that the ibuprofen was not relieving all of his pain. The Blessings expressed concern, telling John that his symptoms fit the “classic picture” of a heart attack. 1 Report of Proceedings (RP) at 181.

¶7 Later that same evening, while John was outside speaking with a friend, he collapsed in the driveway. His wife called 911. Paramedics, including the Blessings, arrived and tried to resuscitate him. Their efforts were unsuccessful, however, and paramedics pronounced John dead at the scene.

Procedural History

¶8 Susan, individually and as the personal representative of John’s estate, sued Hampton and the Vancouver Clinic, alleging that her husband’s death was due to medical negligence.2 On August 21, 2006, trial commenced in Clark County Superior Court.

A. Motion in Limine

¶9 Before trial, Hampton’s trial counsel moved, under ER 401 and 403, to preclude Susan from alleging that, on March 8, Hampton was negligent when he failed to order blood tests to determine John’s cholesterol levels and liver function before refilling the Pravachol prescription because there was no expert testimony establishing a causal link between the claimed negligence and John’s death.

¶10 Susan’s trial counsel conceded that it was “not [Susan’s] claim that [John] died of . . . liver failure or problems with his liver” and that Susan did not have any evidence that Hampton’s failure to run the blood tests on March 8 contributed to John’s death. 1 RP at 12. Rather, Susan’s trial counsel argued that evidence of Hampton’s alleged negligence on March 8 should be allowed to show “a [578]*578course of conduct of how [Hampton] handled this particular patient” and that Hampton was not “paying attention to the issue of [John’s] potential for coronary artery disease” and “was treating [John] in a rather loose fashion.” 1 RP at 11-12. The trial court instructed Susan’s trial counsel to limit his discussion of Hampton’s failure to conduct blood tests on March 8 to the factual background of the case and not to ascribe negligence to Hampton’s conduct. See ER 404(b).

B. Trial Testimony

¶11 But at trial, Susan called Hampton as an adverse witness and questioned him about refilling John’s Pravachol prescription on March 8 without taking a blood test to measure John’s cholesterol levels. During this testimony, Hampton also acknowledged that John had certain risk factors for coronary artery disease because he was male, over the age of 45, had high cholesterol, and was overweight.

¶12 Dr. Cynthia Smyth, an internist, testified to the causes of chest pain, including costochrondritis, risk factors for coronary artery disease, and how the disease leads to cardiac arrest. Smyth explained the role of high density lipoprotein (HDL)3 cholesterol and low density lipoprotein (LDL)4 cholesterol and testified that, because of the relationship between the two types of cholesterol, it was important to take blood tests to determine the different levels.

¶13 Dr. Smyth testified that Hampton violated the standard of care for a general family practitioner on June 10 because he failed to adequately rule out coronary artery disease. Specifically, Smyth testified that Hampton must have suspected that John had coronary artery disease as [579]*579demonstrated by the fact that he ordered an EKG. In addition, Smyth testified that Hampton should have conducted blood tests on John when he complained of chest pains5 to make sure his cholesterol levels were under control and because there are specific blood tests that can detect if chest pains are due to ischemia, a type of blood vessel constriction.6

¶14 Dr. Smyth also testified that the standard of care required that Hampton promptly give a patient presenting with John’s symptoms a stress test or refer him to a cardiologist. Smyth further testified that John was not suffering from costochrondritis as Hampton had diagnosed on June 10, but rather was experiencing angina pain due to coronary artery disease. Smyth opined that Hampton should not have told John that he had costochrondritis based on the normal EKG and that, under proper care, a cardiologist would have diagnosed the coronary artery disease and treated it with a stent.7 Two of Susan’s other experts, Dr. Samuel Cullison and Dr. Jeffrey Westcott, opined that John would not have died if the coronary artery disease had been timely diagnosed.

¶15 Susan’s medical experts, Drs.

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Bluebook (online)
145 Wash. App. 572, Counsel Stack Legal Research, https://law.counselstack.com/opinion/stalkup-v-vancouver-clinic-inc-ps-washctapp-2008.