Boyles v. Dougherty
| Decision Date | 17 January 2014 |
| Docket Number | 1120395. |
| Citation | 143 So.3d 682 |
| Parties | Tammie L. BOYLES, as mother and next friend of Colton Elijah Powell BOYLES, a minor v. Denise DOUGHERTY, R.N. |
| Court | Alabama Supreme Court |
OPINION TEXT STARTS HERE
Stephen D. Heninger of Heninger Garrison & Davis, LLC, Birmingham, for appellant.
Robert L. Williams of Hand Arendall, LLC, Birmingham, for appellee.
Tammie L. Boyles (“Boyles”), as mother and next friend of Colton Elijah Powell Boyles (“Eli”), a minor, filed a lawsuit on behalf of her son for injuries he allegedly sustained from an arterial stick while he was hospitalized at University of Alabama at Birmingham Hospital (“UAB Hospital”). 1 Boyles appeals from a summary judgment in favor of Denise Dougherty, a registered nurse at UAB Hospital. We reverse and remand.
The evidence, viewed in the light most favorable to Boyles, shows the following: On September 24, 2009, Eli was born prematurely at UAB Hospital. On September 29, 2009, Eli's treating physician ordered a blood culture, which was taken by Dougherty from Eli's right arm. Later that day, Eli's mother, who is also a nurse, noticed that Eli's fingertips on his right hand were blue or “dusky.” Dougherty applied a warm compress to Eli's right hand. The discoloration in Eli's fingertips moved upward from his right hand toward his shoulder.
On October 1, 2009, Eli was transferred to Children's Hospital of Alabama (“Children'sHospital”) for treatment of a bowel perforation. While at Children's Hospital, the fingertips of Eli's right hand auto-amputated or fell off. Boyles claims her son's injury occurred as a result of an improper arterial stick to his right arm by Dougherty.
On February 22, 2011, Boyles sued, alleging that Dougherty's nursing negligence caused the auto-amputation of Eli's fingertips. The complaint alleged that Dougherty performed an arterial stick on the right hand/arm of Boyles's infant son, Eli, instead of an arterial stick to his heel, causing “poor perfusion to his hand with resulting thrombosis of the fingertips.” In the complaint, Boyles contended that “the recommended location for blood collection on a newborn baby is the heel and the prior sticks for [her] infant son had been to his heel until [Dougherty] negligently caused or negligently allowed the arterial stick to be done at his right hand/arm.”
Dougherty filed an answer denying that she was guilty of negligence and denying that there was a causal relationship between her actions and the injury alleged in the complaint. Boyles identified Lauren Cooper, R.N., as an expert witness in this case.
On October 17, 2012, Dougherty filed a motion for a summary judgment premised on Boyles's failure to offer expert testimony as to causation in the case. 2 Boyles filed a response to Dougherty's summary-judgment motion arguing that Cooper was qualified to testify as an expert witness and that the Children's Hospital records showed that the cause of the auto-amputation of Eli's fingertips was “poor perfusion and thrombotic fingertips while at UAB [Hospital].” In opposing Dougherty's summary-judgment motion, Boyles submitted: excerpts from her deposition; excerpts from Dougherty's deposition; excerpts from Cooper's deposition; UAB Hospital's progress note dated September 30, 2009; certified copies of the medical records of Children's Hospital; various photographs; and UAB Hospital's Interdisciplinary Standard Regarding Arterial Punctures for Specimen Collection.
On November 21, 2012, the trial court entered a summary judgment in favor of Dougherty. The trial court concluded that a summary judgment in favor of Dougherty was proper because “[Boyles] lacks an expert capable of testifying as to causation [and] there has been no evidence presented to the [trial court] that [Eli]'s injuries were probably a result of a breach of the standard of care by Dougherty.” Boyles appealed.
Boyles challenges the summary judgment in favor of Dougherty. In determining whether the trial court erred in entering the summary judgment, we consider the following:
Substantial evidence is defined in the medical-malpractice context as ‘that character of admissible evidence which would convince an unprejudiced thinking mind of the truth of the fact to which the evidence is directed.’ § 6–5–542(5)[, Ala.Code 1975]. Rule 56, Ala. R. Civ. P., governing motions for summary judgment, must be read in conjunction with that definition of substantial evidence. Golden v. Stein, 670 So.2d 904, 907 (Ala.1995).
“This Court's review of a summary judgment in a medical-malpractice case, as in other cases, is guided by the proposition that ‘this Court must review the record in a light most favorable to the nonmovant and must resolve all reasonable doubts against the movant.’ Hobson v. American Cast Iron Pipe Co., 690 So.2d 341, 344 (Ala.1997), quoted in Hauseman v. University of Alabama Health Servs. Found., 793 So.2d 730, 734 (Ala.2000).
“If the movant in a medical-malpractice case makes a prima facie showing that there is no genuine issue of material fact, then, as in other civil cases, the burden shifts to the nonmovant to present substantial evidence creating such an issue. Ex parte Elba Gen. Hosp. & Nursing Home, Inc., 828 So.2d 308, 311 (Ala.2001).
“ ‘To maintain a medical-malpractice action, the plaintiff ordinarily must present expert testimony from a “similarly situated health-care provider” as to (1) “the appropriate standard of care,” (2) a “deviation from that standard [of care],” and (3) “a proximate causal connection between the [defendant's] act or omission constituting the breach and the injury sustained by the plaintiff.” ’
“Lyons v. Walker Reg'l Med. Ctr., 791 So.2d 937, 942 (Ala.2000) (bracketed language original).
“ ‘[A] medical malpractice plaintiff must produce substantial evidence that “the alleged negligence ‘probably caused the [complained of] injury,’ ” in order to survive a summary judgment motion, if the defendant has made a prima facie showing that no genuine issue of material fact exists as to the issue of causation.'
“ ‘ '
“Rivard v. University of Alabama Health Servs. Found., P.C., 835 So.2d 987, 988 (Ala.2002).”
Cain v. Howorth, 877 So.2d 566, 575–76 (Ala.2003). See Breland v. Rich, 69 So.3d 803, 814–15 (Ala.2011). Additionally, regarding causation, this Court has stated:
“
“Dixon v. Board of Water & Sewer Comm'rs of Mobile, 865 So.2d 1161, 1166 (Ala.2003).”Miller v. Bailey, 60 So.3d 857, 867 (Ala.2010).
On appeal, Boyles argues that the summary judgment was improper because, she says, she presented substantial evidence that Dougherty's negligence probably caused Eli's injury. Boyles contends that the record supports her contention that Dougherty breached the appropriate standard of care in her arterial stick to Eli's arm, and, she says, the certified medical records from Children's Hospital and the testimony by Cooper establish that the injury occurred as a result of the improper arterial stick by Dougherty.
Boyles alleged in her complaint that Eli sustained auto-amputation of his fingertips through negligence on the part of Dougherty. Dougherty filed a motion for a summary judgment, arguing that the only issue before the court was whether Boyles would be able to present testimony that any breach of the standard of care by Dougherty proximately caused Eli's injury.
The record supports a “logical sequence of cause and effect” based on the time line and the absence of any other explanation in the record. See Miller v. Bailey, 60 So.3d at 867. Further, this logical sequence is corroborated under the facts of this case by certified medical records that were before the trial court and by the testimony of Boyles's expert, Cooper. Boyles presented certified medical records and testimony that would support a reasonable inference that the negligent conduct of Dougherty probably caused the auto-amputation of Eli's fingertips. See Miller. The evidence submitted by Boyles in opposition to Dougherty's summary-judgment motion shows that Dougherty breached the appropriate standard of care in her arterial stick to Eli's hand and in applying a warm compress to that hand, which worsened a problem with perfusion of blood circulation. The certified medical records establish that the...
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