Talley v. Varma

689 A.2d 547, 1997 D.C. App. LEXIS 13, 1997 WL 50547
CourtDistrict of Columbia Court of Appeals
DecidedJanuary 30, 1997
Docket95-CV-796, 95-CV-1271, 96-CV-1008 and 96-CV-1009
StatusPublished
Cited by31 cases

This text of 689 A.2d 547 (Talley v. Varma) 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
Talley v. Varma, 689 A.2d 547, 1997 D.C. App. LEXIS 13, 1997 WL 50547 (D.C. 1997).

Opinion

KING, Associate Judge:

Althea E. Talley and her husband Gregory B. Talley (collectively “Talley”) brought a medical malpractice negligence action in the Superior Court of the District of Columbia against Vijay M. Varma, M.D., and Varma’s employer, the George Washington University Medical Center (collectively “Varma”). Talley appeals the grant of Varma’s motion for directed verdict on one liability theory, the adverse verdict on a second theory of liability, and the imposition of costs against her. Varma cross-appeals contending that the trial court erred in not granting the motion for directed verdict on the second theory of liability, and erred in the calculation of costs. We affirm the judgments in each appeal.

Mrs. Talley suffered almost total, permanent loss of taste following radiation treatment by Dr. Varma to ablate (remove) any remaining thyroid tissue left in Mrs. Talley after surgery to remove her cancerous thyroid gland. The case was presented to the jury on two separate theories: (1) that Dr. Varma breached the standard of care by administering too much radioactive iodine (“I-1B1”) to Mrs. Talley, which caused the injuries sustained by her (“causation” issue); and (2) that Dr. Varma did not inform Mrs. Talley of the risks and benefits associated with 1-131 and failed to advise her of alternative treatment methods (“informed consent” issue).

At the close of Talley’s evidence, Varma moved for a directed verdict contending both that Talley had failed to prove the causal nexus between the alleged violation of the standard of care and the injuries sustained, and that Talley failed to establish an issue of informed consent to be resolved by the jury, arguing that because there were no known previous cases of permanent loss of taste, Dr. Varma had no duty to inform Mrs. Talley of such risk. The trial court denied Varma’s motion on the informed consent claim, but granted the motion on the causation issue. With respect to the latter; the court stated:

As to causation, I find the defendant’s argument compelling and not the least bit rebutted by anything argued by the plaintiff, that the issue in this ease is not whether the radioactive iodine treatment caused the loss of taste.
The issue is whether, by violating what Dr. Hoffer considers to be the standard of care in giving 150 millicuries as opposed to 125 or less, whether that additional 25 or more millicuries is the cause of the •permanent loss of taste.
Taking Dr. Hoffer’s testimony in the light most favorable to the plaintiffs, I do not see that he said that. He indicated, in general, that the increase in dosage slightly increased risk in general, that doesn’t make it more probable than not.
And it was made quite clear from cross-examination that he had no basis to believe that an additional 25 millicuries is what is responsible for the loss of taste and that it *550 would not have occurred had he been within the standard of care and given 125 or less.
So, on that first prong of negligence, I don’t think we have a case to go to the jury-

(emphasis added). The trial then resumed on the remaining issue of informed consent. At the close of all evidence, Varma again moved for a directed verdict, which the court denied. The jury later returned a verdict in favor of Varma on that issue. Varma thereafter moved for an allowance of costs in the amount of $38,528.11. Judge Abrecht, however, ordered that plaintiffs pay defendants $3,658.29 in costs.

In No. 95-CV-796, Talley contends that the trial court erred in granting Varma’s motion for a directed verdict as to the issue of causation, and that the adverse verdict on the informed consent issue must be reversed because of trial court errors; 1 in No. 95-CV-1271, Talley contends that the trial court improperly awarded costs to the defendants. On cross-appeal, in No. 96-CV-1009, Varma argues that the trial court erred by denying Varma’s motions for a directed verdict on the issue of informed consent; 2 in No. 96-CV-1008, Varma argues that the trial court failed to properly award costs to him.

We hold, in this medical malpractice action involving the administration of radioactive iodine prescribed by the defendant, that the plaintiff faded as a matter of law to prove that an assertedly excessive amount itself was the cause of her injury. We also hold that expert witness fees may not be taxed as costs in excess of the statutory amount, and that under the facts of this case, the trial judge did not err in taxing certain other costs to the plaintiff.

I. Underlying Facts

In October 1990, after biopsies of her thyroid gland showed follicular neoplasia (probable cancer), Mrs. Althea Talley underwent surgery for removal of her thyroid gland. *551 Because the surgeon could not safely remove all of the thyroid tissue, some tissue remained after the surgery. This is a common occurrence and is not an issue in this case. Pathology reports confirmed that Mrs. Talley’s thyroid gland was cancerous. She was referred to Dr. Vijay Varma of George Washington University Medical Center (“GWUMC”) for consultation regarding radioactive iodine treatment (“1-131”) to destroy any remaining thyroid tissue.

Mrs. Talley contacted Dr. Varma’s office and arranged for necessary blood tests and for a diagnostic scan. The scan used a ten millieurie (“mCi”) dose of 1-131. Mrs. Talley did not report any alteration in taste following this initial dose of 1-131. On November 12, 1990, Mrs. Talley met with Dr. Varma and several resident physicians concerning her scan results. Dr. Varma recommended that Mrs. Talley should receive a dose of 150 mCi of 1-131 to ablate any remaining thyroid tissue and cancer cells. At trial, Dr. Varma testified that he informed Mrs. Talley of the risks, benefits and alternatives to 1-131 treatment at the November 12 consultation. Mrs. Talley testified, however, that Dr. Var-ma never informed her of any risks, benefits or alternative treatments. Mrs. Talley agreed to the recommended treatment and signed a consent form the same day.

On November 14, Mrs. Talley was admitted to GWUMC for the 1-131 treatment, and received a 150 mCi dose. After the treatment she experienced a metallic taste in her mouth but did not inform anyone about it, although she did complain of a swollen neck the next day. Mrs. Talley was discharged on November 16. On November 26, Mrs. Talley discovered large brown spots on her tongue and immediately contacted Dr. Varma. At this time, she also told him that she had a metallic taste in her mouth and that the taste had been there since the 1-131 treatment. Dr. Varma saw Mrs. Talley on November 27 and referred her to a taste and smell specialist at Georgetown University. The specialist performed a biopsy of Mrs. Talley’s tongue and determined that she had lost ninety-six to ninety-eight percent of her taste buds. The loss is apparently permanent.

At trial, Talley’s expert, Dr. Hoffer, testified that in his opinion the standard of care for Mrs. Talley would require a maximum I-131 dose of 100 mCi, that a dose of 150 mCi would not be within that standard of care, and that giving a dose of 150 mCi to Mrs.

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Bluebook (online)
689 A.2d 547, 1997 D.C. App. LEXIS 13, 1997 WL 50547, Counsel Stack Legal Research, https://law.counselstack.com/opinion/talley-v-varma-dc-1997.