STITH v. BELLA VITA HEALTH

CourtCourt of Appeals of Arizona
DecidedJuly 6, 2026
Docket1 CA-CV 24-0484
StatusPublished
AuthorJames B. Morse, Jr.

This text of STITH v. BELLA VITA HEALTH (STITH v. BELLA VITA HEALTH) is published on Counsel Stack Legal Research, covering Court of Appeals of Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
STITH v. BELLA VITA HEALTH, (Ark. Ct. App. 2026).

Opinion

IN THE ARIZONA COURT OF APPEALS DIVISION ONE

PEGGY STITH, Plaintiff/Appellee,

v.

BELLA VITA HEALTH & REHABILITATION CENTER, et al., Defendants/Appellants.

No. 1 CA-CV 24-0484 FILED 07-06-2026

Appeal from the Superior Court in Maricopa County No. CV2016-050619 The Honorable Melissa Iyer Julian, Judge

REVERSED

COUNSEL

Law Office of Ilya E. Lerma, Esq., LLC, Phoenix By Ilya E. Lerma Co-Counsel for Plaintiff/Appellee

Complex Appellate Litigation Group LLP, San Francisco, CA By Brian A. Sutherland, Michael von Loewenfeldt Co-Counsel for Plaintiff/Appellee Ensign Services, Inc., Higley By Michael J. Ryan, Michael S. Redhair Co-Counsel for Defendants/Appellants

Jones, Skelton & Hochuli P.L.C., Phoenix By Eileen Dennis Gilbride Co-Counsel for Defendants/Appellants

OPINION

Judge James B. Morse Jr. delivered the opinion of the Court, in which Presiding Judge Jennifer M. Perkins joined. Judge D. Steven Williams dissented.

M O R S E, Judge:

¶1 Defendant Bella Vita Health & Rehabilitation Center ("Bella Vita") asserts the superior court erred by (1) denying its Arizona Rule of Civil Procedure ("Rule") 50(a) motion for judgment as a matter of law ("JMOL") at the close of plaintiff Peggy Stith's case-in-chief and (2) allowing Stith to provide prima facie causation evidence for the first time in her rebuttal case. Stith argues that denial of a Rule 50(a) JMOL is not reviewable on appeal and that any review of the denied JMOL must include evidence she presented on rebuttal. For the reasons set forth below, denial of a Rule 50(a) JMOL motion is reviewable on appeal and our review is limited to the evidence presented before the close of Stith's case-in-chief.

FACTS AND PROCEDURAL BACKGROUND

¶2 Bella Vita provided rehabilitation for Stith following neck surgery. As Bella Vita's nursing staff transferred Stith to a bed, her head hit a wall. Nursing staff checked Stith and found no swelling, bruising, or outward signs of injury. Nursing staff, however, did not contact Stith's physician or perform checks to detect potential brain trauma, instead administering pain medicine and allowing Stith to sleep. The next morning, Bella Vita staff found Stith unresponsive and took her to the hospital, where she was diagnosed with a subdural hematoma (commonly known as a brain bleed) and underwent surgery. Stith survived but suffered significant and permanent brain damage as a result.

2 STITH v. BELLA VITA HEALTH, et al. Opinion of the Court

¶3 Stith later sued Bella Vita, alleging that the failure to contact a physician and perform neurological checks worsened her condition. Specifically, she argued that her subdural hematoma would have been detected earlier, increasing her chances of a more favorable outcome, had Bella Vita's staff performed regular neurological checks after her head hit the wall.

¶4 At trial, Stith presented testimony from standard-of-care expert Eleanor Tache, an experienced nurse. She testified that when a patient suffers a head strike, nurses should perform an initial assessment of the patient before notifying a physician and conducting neurological checks. Rena Castro, Bella Vita's director of nursing, confirmed that neurological checks are performed at regular, timed intervals after a head strike to detect changes in a patient's cognitive function. Tache further testified that Bella Vita's failure to perform these neurological checks after Stith's head hit the wall breached the standard of care. Two of Stith's other expert witnesses—Dr. Woodcock and Dr. Chaudry—opined that Stith's subdural hematoma was an acute event and not the result of a chronic, pre- existing condition. But, in her case-in-chief, Stith did not present expert- witness testimony that the failure to conduct neurological checks caused Stith's subdural hematoma or that her outcome would have been different with proper checks.

¶5 After Stith rested her case-in-chief, Bella Vita moved for JMOL under Rule 50(a). Bella Vita argued that Stith had not presented expert testimony on causation to establish that conducting neurological checks would have led to a better outcome. Bella Vita also argued that Arizona law prohibits juries from inferring causation in medical cases. In response, Stith argued that the expert-witness testimony she had provided allowed the jury to infer that notifying a physician and performing neurological checks would have resulted in a different outcome. The superior court denied the JMOL motion, finding that Stith's expert-witness testimony provided sufficient evidence of causation.

¶6 After Bella Vita presented its case and rested, Stith recalled Dr. Woodcock in rebuttal. He testified neurological checks were "designed specifically" to discover subdural hematoma symptoms and "prevent this type of outcome." Dr. Woodcock testified that, had Bella Vita's staff conducted these checks, Stith's symptoms would have been detected earlier, leading to a better "neurologic outcome," and potentially "prevent[ing] the degree of severe brain damage." The jury ruled in Stith's favor and awarded her ten million dollars in damages. Bella Vita renewed its JMOL motion under Rule 50(b), which the superior court denied.

3 STITH v. BELLA VITA HEALTH, et al. Opinion of the Court

¶7 Bella Vita timely appealed and we have jurisdiction under A.R.S. § 12-2101(A)(1).

DISCUSSION

I. Reviewability of a Rule 50(a) Motion and Scope of Review.

¶8 Relying on Unitherm Food Systems, Inc. v. Swift-Eckrich, Inc., 546 U.S. 394 (2006), Stith argues the denial of a Rule 50(a) motion is unreviewable on appeal. We disagree.

¶9 In Unitherm, the United States Supreme Court addressed whether a Federal Rule of Civil Procedure ("Federal Rule") 50(a) motion preserves a sufficiency of the evidence challenge on appeal when the motion is not renewed under Federal Rule 50(b) after the jury's verdict. See Unitherm, 546 U.S. at 396. The Supreme Court held that, because "respondent failed to renew its preverdict motion as specified in [Federal] Rule 50(b), there was no basis for review of respondent's sufficiency of the evidence challenge in the Court of Appeals." Id. at 407. That statement, however, implies that it is appropriate to review a pre-verdict Federal Rule 50(a) motion when a party renews its sufficiency of the evidence challenge under Federal Rule 50(b). And, contrary to Stith's argument, post-Unitherm federal appellate courts continue to evaluate Federal Rule 50(a) denials as long as parties preserve the issue in a post-verdict Federal Rule 50(b) motion. See, e.g., Elm Ridge Expl. Co., LLC v. Engle, 721 F.3d 1199, 1215–21 (10th Cir. 2013) (analyzing the denial of a Federal Rule 50(a) motion); Alejandro-Ortiz v. PREPA, 756 F.3d 23, 26–30 (1st Cir. 2014) (same); Kevin M. Ehringer Enterprises, Inc. v. McData Servs. Corp., 646 F.3d 321, 324–28 (5th Cir. 2011) (same); MGE UPS Sys., Inc. v. GE Consumer and Indus., Inc., 622 F.3d 361, 365–370 (5th Cir. 2010) (same).

¶10 While Arizona cases have not directly opined on whether the denial of a Rule 50(a) motion is appealable, in Glazer v. State, 237 Ariz.

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STITH v. BELLA VITA HEALTH, Counsel Stack Legal Research, https://law.counselstack.com/opinion/stith-v-bella-vita-health-arizctapp-2026.