Ward v. Epting

351 S.E.2d 867, 290 S.C. 547, 1986 S.C. App. LEXIS 465
CourtCourt of Appeals of South Carolina
DecidedDecember 1, 1986
Docket0823
StatusPublished
Cited by39 cases

This text of 351 S.E.2d 867 (Ward v. Epting) is published on Counsel Stack Legal Research, covering Court of Appeals of South Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ward v. Epting, 351 S.E.2d 867, 290 S.C. 547, 1986 S.C. App. LEXIS 465 (S.C. Ct. App. 1986).

Opinion

Cureton, Judge:

Michael E. Ward commenced this wrongful death action as Administrator of the Estate of Evelyn Ward against Dr. *550 Anne C. Epting. The jury returned a verdict against Dr. Epting for $400,000.00 actual damages. Dr. Epting appeals. We affirm.

Evelyn Ward, a twenty-two year old mother of a ten week old son, entered Baker Hospital on October 5,1983 to have a saggital split osteotomy for a congenital jaw defect. Dr. Epting, Chief of Anesthesia at Baker, was Mrs. Ward’s anesthesiologist. Dr. Epting obtained a medical history from Mrs. Ward on the evening prior to the surgery. Dr. Epting testified that, except for a history of asthma as a child, and a hiatal hernia, Mrs. Ward presented no potential difficulty under anesthesia. Dr. James Ingrassia, an oral surgeon, operated on Mrs. Ward for approximately three hours on the morning of October 6. Mrs. Ward experienced no difficulties during the surgery. Dr. Epting used an endotracheal tube during the surgery to assist Mrs. Ward’s respiration. An endotracheal tube is inserted through the nostril down into the trachea, or windpipe. A nasal tube was necessary to enable Dr. Ingrassia to work unobstructed on Mrs. Ward’s jaw.

Upon completion of surgery around eleven o’clock, Dr. Epting awoke Mrs. Ward and removed the tube. She testified Mrs. Ward was breathing on her own and was alert enough to respond to directions. Mrs. Ward was taken to the recovery room at 11:05. At 11:06 she began experiencing respiratory problems and turned blue, which is evidence of cyanosis. Cyanosis is a blue or purplish discoloration of the skin due to deficient oxygenation of the blood. Dr. Epting testified Mrs. Ward was having a laryngospasm, which she described as having “closed off the entrance to the windpipe.” Mrs. Ward did not respond when Dr. Epting attempted to give her oxygen with a face mask and ambu bag. Dr. Epting estimated she pumped approximately a gallon of air into Mrs. Ward’s stomach through the esophagus, since the oxygen could not pass through an apparent obstruction in her trachea.

Dr. Epting then entubated Mrs. Ward with a endotracheal tube. She testified Mrs. Ward responded to this attempt and very shortly began to breathe on her own; however, she soon became cyanotic again. Dr. Epting repositioned the tube and ordered drugs to dilate the bronchi of the lungs. These *551 attempts helped briefly, according to Dr. Epting. Mrs. Ward, however, continued to have difficulty. At approximately 11:30 Dr. Epting used a bronchoscope to check the position of the endotracheal tube and to check for obstruction of the tube. 1 Dr. Epting and a respiratory therapist both testified they saw the rings and the carina of the trachea. The carina is the point of bifurcation of the trachea into the left and right lungs.

Mrs. Ward’s condition continued to deteriorate. A “mayday” was declared in the recovery room. CPR was administered to her at approximately 11:40. At 11:40 Dr. Epting cut the wires holding Mrs. Ward’s jaw shut and viewed the tube’s position using a laryngoscope. 2 A blood gas study 3 taken at that time showed profound inadequacy of oxygen. At that point Mrs. Ward’s pupils were fixed and dilated, incicating severe brain damage. At approximately noon, a portable x-ray was taken. Resuscitation attempts continued until 12:45, at which point Mrs. Ward was declared dead.

The x-ray and autopsy revealed the endotracheal tube inserted into Mrs. Ward at the beginning of her respiratory problem was actually in her esophagus, not in the trachea. The cause of death was “Hypoxia or lack of oxygen due to edema of the upper airway and inadequate artificial ventilation.” The pathologist testified Dr. Epting was “rather surprised” to learn the tube was in the esophagus. Apparently the x-ray had not been studied until after Mrs. Ward’s death. Dr. Epting maintains the tube dislodged from the trachea between 11:45, when she checked its position using a laryngoscope, and noon, when the x-ray was taken. Dr. Epting suggests the tube was dislodged during resuscitation attempts or when Mrs. Ward was lifted up for the x-ray. She testified there was no clinical indication that the tube had been in the esophagus until the x-ray was taken. In Dr. Epting’s opinion, Mrs. Ward died as a result of a severe *552 asthmatic attack manifesting itself in bronchospasm, which is constriction of the airway below the point where artificial ventilation can be supplied.

Mr. Ward alleges Dr. Epting negligently failed to establish an adequate airway, failed to ascertain the airway had not been adequately established, and failed to use proper methods of resuscitation. Mr. Ward prayed for actual damages and costs under the South Carolina Wrongful Death Act. The case was tried from March 18-26,1985, with a verdict of $400,000.00 actual damages. The numerous issues on appeal will be discussed separately.

I.

Dr. Epting first argues the lower court erred in allowing cross-examination of Dr. Epting by referring to opinions of a doctor who was not called as a witness and whose deposition was not introduced into evidence.

Dr. Ray Ivester, a local anesthesiologist, was consulted by Dr. Epting’s insurer and, after the suit was filed, by her attorney. Dr. Ivester reviewed the medical records and spoke briefly with Dr. Epting. Dr. Epting listed Dr. Ivester on Answers to Interrogatories as a potential expert witness. When Mr. Ward served notice of taking Dr. Ivester’s deposition, Dr. Epting moved for a protective order, arguing Dr. Ivester was consulted in anticipation of litigation, would probably not be called as a witness at trial, and the information he had received was privileged work product. The court denied the motion and allowed the deposition to proceed. At trial, Dr. Epting announced Dr. Ivester would not be called as a witness.

On cross-examination of Dr. Epting, Mr. Ward’s counsel elicited the fact that Dr. Epting had read Dr. Ivester’s deposition to prepare for trial of the case, and she regarded him as a respected physician. Counsel then proceeded to ask Dr. Epting: “Do you agree with Dr. Ivester....” Dr. Epting’s counsel objected at this point. The court held the objection was premature and instructed Mr. Ward’s counsel to finish asking the question. Dr. Epting’s counsel then attempted to explain to the court that he objected to the use of Dr. Ivester’s deposition to actually publish his opinions to the jury through the pretense of cross-examining Dr. Epting. *553 The court refused to stop this manner of questioning, stating “His question was completely proper.” The judge did, however, sustain Dr. Epting’s objections to two subsequent questions based on Dr. Ivester’s deposition where the objections were stated after the questions were asked.

Dr. Epting argues the judge erred in allowing Mr. Ward to question her by the use of deposition testimony of an expert who had not testified in court, and from a deposition that was not in evidence. Dr.

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Cite This Page — Counsel Stack

Bluebook (online)
351 S.E.2d 867, 290 S.C. 547, 1986 S.C. App. LEXIS 465, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ward-v-epting-scctapp-1986.