Brandon HMA, Inc. v. Bradshaw

• Decision Date: 11 October 2001
• Docket Number: No. 2000-CA-00735-SCT.,2000-CA-00735-SCT.
• Citation: 809 So.2d 611
• Parties: BRANDON HMA, INC. d/b/a Rankin Medical Center v. Dawn BRADSHAW.
• Court: Mississippi Supreme Court

809 So.2d 611

BRANDON HMA, INC. d/b/a Rankin Medical Center v. Dawn BRADSHAW.

No. 2000-CA-00735-SCT.

Supreme Court of Mississippi.

October 11, 2001.

Rehearing Denied January 10, 2002.

Whitman B. Johnson, III, Jackson, Charles Gregory Copeland, Ridgeland, Shelly G. Burns, Jackson, Janet G. Arnold, Ridgeland, for Appellant.

Bobby L. Dallas, Brad Sessums, Jennifer P. Burkes, Jane Brennan Morgan, Jackson, for Appellee.

EN BANC.

DIAZ, Justice, for the Court:

¶ 1. On August 27, 1998, Dawn Bradshaw (Bradshaw) filed suit in the Circuit Court of Rankin County against Brandon HMA, Inc. (Brandon), d/b/a Rankin Medical Center (RMC). Bradshaw's complaint, as later amended, alleged that, while a patient at RMC for treatment of bacterial pneumonia, she received treatment from the nursing staff that was negligent and fell below the applicable standard of care. The subpar treatment led to her permanent disability from brain damage. Specifically, Bradshaw alleged that the nursing personnel failed to properly monitor her, to report vital information to her physician, and in allowing her condition to deteriorate to a critical and acute stage before providing urgently needed care and implementing life support.

¶ 2. On January 24, 2000, a trial began on the matter, presided over by the Honorable John Kitchens. After five days of testimony and evidence, the jury found in favor of Bradshaw and awarded $9,000,000.00 in damages. On January 31, 2000, Judge Kitchens entered a final judgment on the jury verdict. The usual litany of post-trial motions by Brandon followed, and a hearing on those motions was held on March 14, 2000. At the hearing's conclusion, the trial judge ruled in favor of Bradshaw, denying the motions, and entered the corresponding order. After an extension, Brandon filed a timely appeal asserting that the trial court erred (1) in denying its motion for judgment notwithstanding the verdict; (2) in denying its motion for a new trial because the jury's verdict was against the overwhelming weight of the evidence; (3) in admitting evidence of the total amount of Bradshaw's past medical bills, as opposed to the amount of medical costs paid by Medicaid; (4) in denying Brandon's motion for a new trial based on certain evidentiary errors; and (5) in denying its motion for a remittitur or new trial as to damages.

FACTS

¶ 3. On February 17, 1997, Bradshaw was admitted to RMC under the care of Dr. Edgar Bobo for treatment of bacterial pneumonia. She was prescribed oxygen and various medications. On February 21, 1997, Dr. Jeffrey H. Glover, a general surgeon, inserted a chest tube on Bradshaw's left side to drain the accumulated fluid. Due to the natural pain and discomfort associated with a chest tube, Tylenol Extra Strength and Lorcet Plus (every six hours as needed) were prescribed for the pain. In addition, Dr. Bobo prescribed Ativan to relieve Bradshaw's anxiety.

¶ 4. During the afternoon and evening following the insertion of the chest tube, two nurses periodically checked on Bradshaw, took her vital signs, and noted that she exhibited "no distress." Around 11:00 p.m., Alex Lewis (Lewis), a licensed practical nurse (LPN), was assigned by Pam Nail (Nail), the floor's charge nurse, to provide primary care to Bradshaw. At the time of the incident and with full knowledge of his superiors, Lewis was working two full-time nursing jobs, 11:00 p.m. to 7:00 a.m. at RMC and 7:00 a.m. to 3:00 p.m. at the Mississippi State Hospital at Whitfield. Before checking on Bradshaw, Lewis reviewed the notes and a tape detailing Bradshaw's condition left by the previous nurse. Then, at approximately midnight, Lewis made his first visit to Bradshaw's room, took her vital signs (normal except a slightly elevated pulse), and noted that she was experiencing some pain on her left side. At the same time, Nail hung an IV bag in the room; she later testified that when in a patient's room, she will visually assess the patient's condition and IV setup.

¶ 5. Some time before 1:00 a.m., a respiratory therapist checked on Bradshaw and did not notice any problems, but he did note that she was restless. Shortly after, at 1:00 a.m., Lewis made his second visit to Bradshaw's room. She continued to complain of pain in her chest, but Lewis did not take her vital signs and gave her an Extra Strength Tylenol instead. However, he did make a note that "patient complains of pain left side, appeared to be in distress." The parties argue over how much weight should be given this statement, but it matters little for our analysis.

¶ 6. At 2:00 a.m., Lewis's next visit, Bradshaw again complained that she could not sleep and that the pain had increased. Despite her complaints, Lewis again failed to take her vital signs. Instead, he consulted Nail and administered an injection of Ativan to relieve Bradshaw's anxiety and restlessness. Ativan is a sedative and carries with it the associated risks of other sedatives. When administering any sedative, healthcare professionals know to be mindful of possible adverse effects.

¶ 7. Forty minutes later, Bradshaw again complained of increased pain. Lewis noticed that she was sitting up in bed and her respiration had become short and rapid. Feeling that the earlier Lorcet Plus was wearing off, Lewis gave her another dose. Lorcet Plus is a narcotic pain reliever and carries with it certain risks that require precautions be taken. However, Lewis again failed to check Bradshaw's vital signs.

¶ 8. Nail hung another IV bag in Bradshaw's room at 3:00 a.m. and did not note any problems.

¶ 9. When Lewis returned to Bradshaw's room at 3:30 a.m., her condition had significantly worsened. She was nauseous, disoriented, covered in sweat, and did not follow verbal commands. Lewis checked her vital signs and found her temperature had fallen to 95.8 degrees. Realizing the seriousness of Bradshaw's condition, Lewis left the room to find Nail for assistance. At this point, testimony among RMC's employees varies. Lewis and Deborah Washington, a nurses' aide, testified that Lewis found Nail and Washington conversing in the hallway. According to the two testimonies, Nail and Lewis discussed Bradshaw's condition and returned to the room at 3:40. On the other hand, Nail testified that she was in another patient's room hanging an IV when Lewis found her. Furthermore, she testified that Lewis wanted her to check on Bradshaw but that he said it was not an emergency. The parties and their experts argued over the time lapse for reasons relating to the brain damage. As a fact issue, we need not decide which side to believe; that was the jury's job.

¶ 10. In either case, when Lewis and Nail returned to the room, they found Bradshaw cyanotic (turned blue) and that she had stopped breathing and had no pulse. Nail called a "code" and started CPR. She testified that she yelled for a code cart, but Lewis said he ran down the hall yelling for one. The code team arrived from the emergency room and revived Bradshaw by administering Epinephrine.

¶ 11. Bradshaw was transferred to ICU where she remained comatose for two weeks. She received further medical attention at RMC until she was transferred to Mississippi Methodist Rehabilitation Center (MMRC) for treatment. While in treatment, MRIs of Bradshaw's brain were ordered and showed evidence of brain damage due to lack of oxygen. The parties each introduced into evidence the testimony of experts as to the cause of Bradshaw's brain damage (basically, cardiac arrest then respiratory arrest, versus respiratory failure then cardiac arrest). Again, this was a question of fact for the jury.

¶ 12. Bradshaw's present condition as a result of the cardiopulmonary arrest and hypoxic brain damage (lack of blood flow and oxygen) is permanent and quite severe. She has significant difficulty in moving due to rigidity in her muscles and is prone to bouts of spasms. Dr. Stuart Yablon, director of the brain injury program at MMRC, prescribed injections of botluinum toxin (a harsh drug) to relax her muscles. In addition, a pump, filled with Baclofen for the spasms, was surgically implanted into Bradshaw's abdomen with a tube connected to her spinal cord. The pump must be refilled every three months and replaced entirely every five to seven years. She cannot walk without assistance and often falls due to a lack of stability. She is also unable to perform many daily activities without the aid of her mother or someone else, including dressing, brushing her teeth, driving a car, and going to the bathroom (she is unable to have voluntary bowel movements). Since only her motor functions have been damaged, the psychological effect has also been quite severe. In essence, Bradshaw will be dependent upon others for the remainder of her life.

DISCUSSION

I. WHETHER THE TRIAL COURT ERRED IN DENYING BRANDON'S MOTION FOR JUDGMENT NOTWITHSTANDING THE VERDICT.

¶ 13. A motion for jnov is the equivalent of challenging the sufficiency of the evidence to support the jury's verdict. Patton-Tully Transp. Co. v. Douglas, 761 So.2d 835, 843 (Miss.2000). A jury verdict can only be set aside when it is based on legally insufficient evidence or it is against the substantial weight of the evidence. C & C Trucking Co. v. Smith, 612 So.2d 1092, 1098-99 (Miss.1992). Furthermore, we review "the evidence as a whole, taken in the light most favorable to the verdict" and will reverse only if "no reasonable, hypothetical juror could have found as the jury found." Bell v. City of Bay St. Louis, 467 So.2d 657, 660 (Miss.1985).

¶ 14. Brandon argues that its motion for jnov should have been granted because Bradshaw's expert witnesses, Dr. Carl Hauser (a specialist in critical care and expert on the standard for nursing care) and Valorie Dearmon (a RN and expert on nursing's standard of care), were merely speculating as to the cause of Bradshaw's injuries. In essence, Brandon's theory is that based on the MRI, its expert, Dr. Elias Chalhub (a neurologist),...