University of Mississippi Medical Center v. Foster

107 So. 3d 149, 2013 WL 540011, 2013 Miss. LEXIS 52
CourtMississippi Supreme Court
DecidedFebruary 14, 2013
DocketNo. 2010-CT-00791-SCT
StatusPublished
Cited by4 cases

This text of 107 So. 3d 149 (University of Mississippi Medical Center v. Foster) is published on Counsel Stack Legal Research, covering Mississippi Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
University of Mississippi Medical Center v. Foster, 107 So. 3d 149, 2013 WL 540011, 2013 Miss. LEXIS 52 (Mich. 2013).

Opinion

ON WRIT OF CERTIORARI

DICKINSON, Presiding Justice,

for the Court:

¶ 1. Tamika Foster died after giving birth at the University of Mississippi Medical Center (UMMC). This wrongful-death suit followed. After a verdict for the plaintiffs, UMMC appealed, claiming that the plaintiffs produced nothing more than an unreliable autopsy report to establish medical negligence, and that the trial judge erred in refusing to allow two doctors to testify about the autopsy. But because we find sufficient evidence in the [150]*150record to support the verdict and because UMMC failed to make a proffer of the doctors’ expected testimony, we reverse the Court of Appeals’ decision and reinstate and affirm the decision of the Hinds County Circuit Court.

FACTS AND PROCEDURAL HISTORY

¶ 2. Physicians at UMMC provided prenatal care to Tamika Foster during her high-risk pregnancy. When she presented with troubling symptoms, her physicians admitted her to UMMC and diagnosed her with Class I hemolysis, elevated liver enzyme levels, and low-platelet-count syndrome (HELLP).

¶ 3. That same day, she delivered her baby — Malik—by cesarean section under emergency circumstances. After the delivery, she recovered in the intensive care unit and later was returned to the labor and delivery unit. The following day, she went into respiratory arrest and died.

¶ 4. UMMC pathologists performed an autopsy and determined that Foster’s death was caused by “myocardial ischemia with arrhythmia secondary to Thrombotic Thrombocytopenia Purpura” (TTP), meaning she died from arrhythmia caused by TTP. Although HELLP and TTP are both serious complications that cause a decrease in the number of platelets in the blood, the course of treatment for the two is not the same.

¶ 5. According to Dr. Charles Green-berg, the plaintiffs’ hematology expert, the ADAMTS13 is the only laboratory test that could distinguish between TTP and HELLP. Approximately nine hours after Foster died, the pathologists ran an ADAMTS13 test using a postmortem sample of Foster’s blood. The pathologists considered these results and Foster’s medical history to conclude that she had died from complications of TTP. Foster’s death certificate, completed before the autopsy report, did not mention TTP. Instead, it stated that the cause of death was “undetermined,” but listed HELLP under “other significant conditions.”

¶ 6. Foster’s parents, as representatives of Malik, and Foster’s wrongful-death beneficiaries, sued UMMC under the Mississippi Tort Claims Act,1 alleging Foster died from TTP, a condition UMMC failed to properly diagnose and treat. At trial, UMMC’s theory of the case was that Foster had died from HELLP and not TTP. They argued that the reason its pathologists incorrectly concluded that TTP had caused Foster’s death was because they had conducted the ADAMTS13 test using postmortem blood which — although once acceptable — recently has been shown to produce inaccurate results.

¶ 7. Hinds County Circuit Judge Tomie Green, after hearing the evidence without a jury, found that UMMC’s failure to properly diagnose and treat Foster for TTP proximately caused her death. Judge Green awarded the plaintiffs $1,230,965, which she reduced to the statutory limit of $500,000.

¶ 8. UMMC timely appealed, alleging that Judge Green unreasonably relied on the autopsy report, and that she committed reversible error by refusing to allow UMMC’s experts to testify about the autopsy report. The Court of Appeals, agreeing with UMMC on both arguments, reversed and rendered the judgment. The Fosters petitioned this Court for a writ of certiorari, which we granted.

ANALYSIS

¶ 9. UMMC raises two issues on appeal: whether Judge Green’s finding that Foster [151]*151died from TTP was supported by substantial evidence; and whether Judge Green committed reversible error by failing to allow UMMC’s expert witnesses to “comment about the content of the autopsy report.”

¶ 10. UMMC’s argument challenges the sufficiency of the evidence. We have held that “ ‘[a] circuit court judge sitting without a jury is accorded the same deference with regard to his [or her] findings as a chancellor,’ and his [or her] findings are safe on appeal where they are supported by substantial, credible, and reasonable evidence” in the record.2

¶ 11. Because we “will not disturb those findings unless they are manifestly wrong, clearly erroneous or an erroneous legal standard was applied”3 we now look to see whether Judge Green had substantial medical evidence before her to conclude that Foster died of TTP.4

The record contains substantial evidence to support Judge Green’s finding that Foster died from TTP.

■ ¶ 12. The factual dispute upon which this issue turns is whether, as the plaintiffs claim, Foster died of undiagnosed and untreated TTP; or whether, as UMMC claims, she had HELLP, and was properly diagnosed with, and treated for, HELLP. Commenting on this issue, the Court of Appeals stated that “there was no expert testimony which supported to a reasonable degree of medical certainty the notion that Foster had TTP,” and that it could find no “testimony directly linking Foster to having had TTP....”5 After reviewing the record, we reach a different conclusion.

The autopsy report

¶ 13. Three days following Foster’s death, two UMMC pathologists performed an autopsy and concluded that her cause of death was myocardial ischemia with arrhythmia secondary to TTP. The autopsy report — which included the pathologists’ opinions as to Foster’s cause of death— was admitted into evidence without objection.

¶ 14. UMMC now finds itself in the unusual position of challenging the reliability and sufficiency of the opinions of its own pathologists, who clearly are capable of making admissions on behalf of UMMC. Neither of the pathologists testified at trial, and no evidence was introduced that they had changed their minds, or that Foster’s cause of death was anything but TTP. Even if they had, UMMC cites no authority — and we know of none — for the proposition that a party’s admissions cease to be admissions simply because the party later recants or denies them.

¶ 15. A strong argument could be made that the admissions of the two UMMC pathologists, without more, sufficiently supported Judge Green’s finding that Foster died of TTP. But we need not consider that argument because there is more.

Dr. James Martin’s article

¶ 16. One of Foster’s treating physicians was Dr. James Martin, chief of maternal fetal medicine and obstetrics at UMMC. In a scholarly article, Dr. Martin described Foster as “a patient considered to have [HELLP] syndrome, but later determined to have [TTP].”6 In its brief [152]*152to this Court, UMMC says Dr. Martin made no admission in the article that Foster had died from TTP. We disagree.

Dr. Charle,s Greenberg

¶ 17. One of the plaintiffs’ expert witnesses was Dr. Charles Greenberg, a board-certified hematologist who has served on the faculties of the University of California and Duke University, and who currently serves on the faculty of the University of South Carolina. Dr. Greenberg testified that TTP caused Foster’s death:

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Bluebook (online)
107 So. 3d 149, 2013 WL 540011, 2013 Miss. LEXIS 52, Counsel Stack Legal Research, https://law.counselstack.com/opinion/university-of-mississippi-medical-center-v-foster-miss-2013.