Bratton v. Bond, 85-1512

• Decision Date: 17 June 1987
• Docket Number: No. 85-1512,85-1512
• Parties: Maureen M. BRATTON, as Executor of the Estate of Clayton Gene Bratton and as an Individual; Clayton G. Bratton; and David M. Bratton, Appellants, v. Lowell D. BOND, Appellee.
• Court: Iowa Supreme Court

Page 39

408 N.W.2d 39

Maureen M. BRATTON, as Executor of the Estate of Clayton Gene Bratton and as an Individual; Clayton G. Bratton; and David M. Bratton, Appellants, v. Lowell D. BOND, Appellee.

No. 85-1512.

Supreme Court of Iowa.

June 17, 1987.

Robert W. Goodwin, Ames, and Mark D. Ravreby, Des Moines, for appellants.

Chester C. Woodburn, III of Hansen, McClintock & Riley, Des Moines, for appellee.

Considered by REYNOLDSON, C.J., and McGIVERIN, WOLLE, LAVORATO and NEUMAN, JJ.

McGIVERIN, Justice.

Plaintiffs Maureen Bratton, both individually and as the executor of the estate of her husband Clayton Gene Bratton (Gene), Clayton G. Bratton, and David Bratton appeal from judgment entered on an adverse jury verdict in their medical negligence action against defendant-doctor Lowell Bond. In seeking a new trial, plaintiffs contend a ruling on a jury instruction by the trial court was erroneous. They also assert that the court abused its discretion in ruling on certain evidentiary matters and in limiting the testimony of one of plaintiffs' expert witnesses. We disagree with plaintiffs' contentions and affirm the judgment.

I. Background facts and proceedings. From the evidence adduced at trial, the jury could have found the following facts. In 1976 Gene Bratton experienced pains in his chest that radiated to his arms. He sought diagnosis and treatment of his condition from Dr. Lowell Bond, a general practitioner. Dr. Bond ran an electrocardiogram (EKG) on Gene. The results of the EKG were normal and consistent with the results of another EKG conducted on Gene by Dr. Bond in 1973. Dr. Bond diagnosed the condition as a hiatal hernia or angina, a term that he asserts is synonymous with coronary vascular disease. He placed Gene on medication for the hiatal hernia and monitored the chest pains through frequent office visits with Gene. Dr. Bond also encouraged Gene to lose weight and quit smoking. Gene did not report any further pain or heart problems until 1978.

Gene visited Dr. Bond in early 1978 and again reported occasional heart pain. At that time Dr. Bond did another EKG and discovered abnormalities including extra heart beats. The doctor prescribed medication for Gene's irregular heart rate and continued the prescription drug for treatment of hiatal hernia.

Dr. Bond changed the type of heart medication prescribed for Gene's condition in response to continued occasional heart pain experienced in mid-1978.

From May 1978 to July 1982 Gene did not report any heart pain to Dr. Bond. Dr. Bond tapered Gene off the heart medication in the spring of 1981 with no apparent ill effects.

On July 12, 1982, Dr. Bond examined Gene in the doctor's office and formed an impression that Gene had congestive heart failure. Dr. Bond recommended that Gene check into a local hospital for testing. Following Gene's hospitalization that day, Dr Bond stabilized Gene's condition and recommended he visit a cardiologist for further evaluation.

In September of 1982, Dr. David Lemon admitted Gene to a Des Moines hospital for cardiological tests. Dr. Lemon diagnosed Gene's condition as "severe ischemic cardiomyopathy with inoperable coronary disease." Gene died two days after his dismissal from the hospital. The autopsy revealed that he suffered from triple vessel disease which blocked three of his coronary arteries.

Brattons, Gene's estate, wife and sons, filed this action against Dr. Bond alleging he was negligent in failing to diagnose and properly treat Gene's heart condition. Dr. Bond defended his actions by stating that he diagnosed Gene's heart condition in 1978 and treated that condition with medication. He further asserted that Gene was aware of this course of treatment and accepted it over surgical treatment of the condition. Following trial on the merits, the jury returned a verdict in favor of Dr. Bond and the trial court entered judgment in Bond's favor.

Plaintiffs appeal from this judgment challenging three adverse rulings by the trial court. First, plaintiffs argue the court abused its discretion in limiting the trial testimony of Dr. Lawrence Staples, one of plaintiffs' experts. Second, plaintiffs assert that the court erred by instructing the jury that a physician does not make any implied guarantee of results. Finally, plaintiffs contend the court abused its discretion by excluding from evidence as inadmissible hearsay a letter that Gene Bratton was writing to his brother during the two days preceding his death.

II. Limiting the testimony of an expert witness. Plaintiffs claim the trial court abused its discretion in limiting the testimony of Dr. Lawrence Staples on the ground that some of his proposed testimony was not disclosed during discovery.

During trial Dr. Staples was asked by plaintiffs' counsel, "If a patient had, say, triple vessel disease, what we have talked about, would his longevity be improved with the use of coronary bypass surgery?" Counsel for Dr. Bond interposed an objection to that question and similar questions because counsel had not been alerted to the fact that Dr. Staples would testify regarding longevity and improved quality of life had other medical procedures been used in diagnosing and treating Gene Bratton.

Iowa Rule of Civil Procedure 122(d) states that experts who are expected to testify at trial are to be identified, the subject matter of their testimony disclosed and a summary of their opinion given in response to interrogatories in connection therewith by the adverse party. It is apparent that Dr. Staples was not listed in plaintiffs' initial response to Dr. Bond's written interrogatories concerning any experts to be used by plaintiffs as witnesses at trial.

Iowa Rule of Civil Procedure 125(a)(2) recites a party's duty to supplement answers to interrogatories with regard to expert witnesses, providing the same information as initially required in the interrogatory request. A supplemental response to Dr. Bond's interrogatories identified Dr. Staples as one of plaintiffs' experts. The supplemental answer noted, "The subject matter and substance of his testimony will be as previously stated in answer to Interrogatory No. 15."

Interrogatory No. 15 was answered in the following manner:

Defendant [Dr. Bond] failed to utilize recognized diagnostic methods for diagnosis when presented with anginal pain, and chest pain radiating to the arm, palpitation, and irregular heart beats. Such tests included:

Complete gastrointestinal examinations to confirm or disprove the diagnosis of hiatal hernia;

Comparative electrocardiographic studies;

Stress electrocardiographic examinations;

Thallium studies;

Holter monitor studies;

Angiographic studies;

Cardiac enzyme tests;

Referral to cardiac experts.

Nowhere in this answer do plaintiffs disclose that Dr. Staples will testify relative to Gene's longevity or quality of life.

Plaintiffs also rely on Dr. Staples' deposition in which he stated he would be willing to respond to any question Dr. Bond posed regarding Staples' expert opinion. They claim Dr. Bond then had the opportunity to discover Dr. Staples' opinion as to Gene's longevity and quality of life if other diagnostic and treatment methods had been utilized. Dr. Bond, however, points out the following exchange between his counsel and Dr. Staples at the deposition:

A. ... intervention back here--

Q. Back here, you're referring to what? A. 1976. That could have changed the course of events. I say could have. I don't know.

Q. There's no way anybody knows that? A. No. It could have changed the course of events.

....

Q. ... There isn't any way, I take it, within a reasonable degree of medical certainty that you can testify that had something else been done differently back in 1976 that the outcome would have been any different? A. I can't testify to that, but I can testify that in my opinion the thinking process that was followed left something to be desired.

This line of questioning clearly reveals that plaintiffs did not alert Dr. Bond to the aspect of Dr. Staples' opinion that was requested at trial.

We have reviewed a trial court's allowance of testimony or imposition of sanctions for a party's failure to disclose the identity and opinion of its expert in response or in supplement to an interrogatory request in four recent cases. See Hoekstra v. Farm Bureau Mut. Ins. Co., 382 N.W.2d 100, 108-09 (Iowa 1986); Lambert v. Sisters of Mercy Health Corp., 369 N.W.2d 417, 421-23 (Iowa 1985); Hubby v. State, 331 N.W.2d 690, 697 (Iowa 1983); Sullivan v. Chicago & N.W. Transp. Co., 326 N.W.2d 320, 324 (Iowa 1982). In Hoekstra, we concluded that the trial court did not abuse its discretion by limiting the testimony of defendant's expert to the technical confines of defendant's interrogatory answer specifying the substance of the expert's opinion. 382 N.W.2d at 109.

We conclude that the trial court's limitation of Dr. Staples' testimony to the matters designated in plaintiffs' answer to defendant's Interrogatory No. 15 was not an abuse of its discretion. It was not apparent from the supplemental answer to interrogatories or Dr. Staples' deposition testimony that he had formed an expert opinion, which he would relate at trial, on the longevity and quality of life effects of a different course of medical testing and treatment of Gene Bratton's heart condition. We note that Dr. Donald Green and Dr. Lester Beachy testified as experts for plaintiffs at a later point in the trial and both presented expert opinions on the matter excluded from Dr. Staples' testimony; therefore, we also conclude on this basis that plaintiffs suffered no prejudice by the limitation of Dr. Staples' expert opinion. Cf. State v. Hicks, 245 N.W.2d 319, 321 (Iowa 1976) ("[T]he exclusion of evidence tending to show a certain fact is not reversible error where the claimed fact in question is fully established by other admitted evidence.").

III. Instructing the jury that doctor does not guarantee results. Plaintiffs also...