Christus Spohn Health System Corporation v. Fuente, No. 13-04-00485-CV (Tex. App. 8/16/2007)
| Decision Date | 16 August 2007 |
| Docket Number | No. 13-04-00485-CV.,13-04-00485-CV. |
| Parties | CHRISTUS SPOHN HEALTH SYSTEM CORPORATION, INDIVIDUALLY AND D/B/A SPOHN HOSPITAL SOUTH AND SPOHN HOSPITAL SOUTH, INDIVIDUALLY, Appellants, v. LISA MARIE DE LA FUENTE AND REYES DE LA FUENTE, INDIVIDUALLY AND AS NATURAL GUARDIANS AND NEXT FRIENDS OF GIOVANI SETH DE LA FUENTE, A MINOR, Appellees. |
| Court | Texas Court of Appeals |
On Appeal from the 347th District Court of Nueces County, Texas.
Before Chief Justice VALDEZ and Justices HINOJOSA1 and GARZA
Christus Spohn Health System Corporation, Individually and d/b/a Spohn Hospital South, and Spohn Hospital South, Individually (collectively "Spohn"), appeal a judgment resulting from an adverse jury verdict in a medical malpractice case. Plaintiffs below and appellees and cross-appellants herein, Lisa Marie De La Fuente and Reyes De La Fuente, individually and as natural guardians of Giovani Seth De La Fuente, a minor, bring a cross appeal regarding the trial court's application of a settlement credit. We modify the trial court's judgment to vacate the award of mental anguish damages and, as modified, affirm the judgment.
Lisa De La Fuente delivered her first child by cesarean section and delivered her second child vaginally. Lisa anticipated delivering Giovani, her third child, vaginally. Lisa was admitted to Spohn and treated by Dr. Juan Caceres during her labor with Giovani. Lisa's labor was augmented with the drug Pitocin. During labor, Giovani began suffering variable decelerations in his heartbeat, and Lisa complained of pain and began vomiting. After Giovani began experiencing bradycardia, a low heart rate, Dr. Caceres called for an emergency cesarean section. In the operating room, the nurses could no longer hear Giovani's heartbeat. Upon performing the cesarean, Dr. Caceres discovered that Lisa had suffered a ruptured uterus and placental abruption. Giovani was stillborn but was resuscitated. Giovani suffered profound brain damage from the loss of oxygen caused by the uterine rupture and placental abruption. At the time of trial, Giovani had cerebral palsy, could not swallow, suck, or gag, and was being fed through a stomach tube.
The appellees brought suit against Spohn and Dr. Caceres. Before trial, appellees entered a high-low settlement with Dr. Caceres. At trial, appellees contended that Spohn was negligent in, inter alia (1) over-administering Pitocin to Lisa, resulting in hyperstimulation of the uterus, resulting in the uterine rupture, (2) caring for Lisa during her labor, and (3) delaying the cesarean section. The jury found that Spohn was negligent and Dr. Caceres was not.
Spohn raises eight issues on appeal: (1) the trial court erred in entering judgment on the verdict when there is legally and factually insufficient evidence to support the jury's finding that Spohn was negligent or that said negligence proximately caused the injuries in question, (2) the trial court abused its discretion in denying Spohn's motion to exclude testimony that Pitocin causes uterine rupture, (3) the trial court erred in entering judgment on the jury's award of $2,000,000 in mental anguish damages to the De La Fuentes in light of law barring parents from recovering mental anguish damages for the negligent infliction of non-fatal injuries to their children, (4) the trial court erred in entering judgment on the jury's award of $5,000,000 in future medical expenses to the De La Fuentes where there is legally and factually insufficient evidence to support such damages, (5) the trial court abused its discretion in denying Spohn's motion to exclude Dr. Alex Willingham's testimony regarding Giovani's projected life expectancy, (6) the trial court erred in entering judgment on the jury's award of $675,000 in past medical expenses to the De La Fuentes when there is legally and factually insufficient evidence to support such damages, (7) the trial court erred in submitting a broad-form question on liability in the jury charge where the question improperly allowed the jury to find Spohn liable based on theories of negligence for which there are legally insufficient evidence, and (8) the trial court improperly applied Spohn's settlement credit to the jury's award of damages in light of the Texas Supreme Court's decision in Battaglia v. Alexander requiring settlement credits to be applied to an award of past damages first.
In its first issue, Spohn contends that the trial court erred in entering judgment on the verdict because there is legally and factually insufficient evidence to support the jury's finding that Spohn was negligent or that such negligence proximately caused the injuries in question.
In reviewing a legal sufficiency challenge, we determine whether the evidence as a whole rises to a level that would enable reasonable and fair-minded people to differ in their conclusions. City of Keller v. Wilson 168 S.W.3d 802, 822 (Tex. 2005). Anything more than a scintilla of evidence is legally sufficient to support the finding. Leitch v. Hornsby 935 S.W.2d 114, 118 (Tex. 1996). More than a scintilla of evidence exists if the evidence furnishes some reasonable basis for differing conclusions by reasonable minds about the existence of a vital fact. Rocor Int'l, Inc. v. Nat'l Union Fire Ins. Co. 77 S.W.3d 253, 262 (Tex. 2002).
We view the evidence in the light favorable to the verdict, crediting favorable evidence if reasonable jurors could, and disregarding contrary evidence unless reasonable jurors could not. City of Keller 168 S.W.3d at 827. Evidence is legally insufficient when the record discloses: (1) a complete absence of evidence of a vital fact; (2) the court is barred by rules of law from giving weight to the only evidence offered to prove a vital fact; (3) the evidence offered to prove a vital fact is no more than a mere scintilla; or (4) the evidence establishes conclusively the opposite of a vital fact. Id. at 810.
In reviewing a factual sufficiency challenge, we consider and weigh all of the evidence in support of and contrary to the finding, and will set aside a finding only if it is so contrary to the overwhelming weight of the evidence as to be clearly wrong and manifestly unjust. Cain v. Bain 709 S.W.2d 175, 176 (Tex. 1986). In making this review, we do not substitute our judgment for that of the jury, even if a different answer could be reached on the evidence. See City of Keller 168 S.W.3d at 821. It is well established that jurors are the sole judges of the credibility of the witnesses and the weight to be given to their testimony. Id. at 819. Therefore, a jury confronted with conflicting evidence may choose to believe one witness and disbelieve others; it may resolve inconsistencies in the testimony of any witness; or it may accept lay testimony over that of experts. Id.
Plaintiffs in medical negligence cases are required to prove by a preponderance of the evidence that the allegedly negligent act or omission was a proximate cause of the harm alleged. See Kramer v. Lewisville Mem'l Hosp., 858 S.W.2d 397, 400 (Tex. 1993). To establish proximate cause, the plaintiff must prove (1) foreseeability and (2) cause-in-fact. Leitch 935 S.W.2d at 118-19. The ultimate standard of proof on the causation issue "is whether, by a preponderance of the evidence, the negligent act or omission is shown to be a substantial factor in bringing about the harm and without which the harm would not have occurred." Park Place Hosp. v. Estate of Milo 909 S.W.2d 508, 511 (Tex. 1995); see also Arguelles v. U.T. Family Med. Ctr., 941 S.W.2d 255, 258 (Tex. App.-Corpus Christi 1996, no writ). The precise words of "reasonable medical probability" are not essential, but evidence of causation must still rise above mere conjecture or possibility. See Duff v. Yelin 751 S.W.2d 175, 176 (Tex. 1988);Brownsville Pediatric Ass'n v. Reyes, 68 S.W.3d 184, 189 (Tex. App.-Corpus Christi 2002, no pet.). The trier of fact may decide the issue of proximate cause in medical malpractice cases based upon: (1) general experience and common sense from which reasonable persons can determine causation; (2) scientific principles provided by expert testimony allowing the fact finder to establish a traceable chain of causation from the condition back to the event; or (3) a probable causal relationship as articulated by expert testimony.Columbia Med. Ctr. of Las Colinas v. Bush 122 S.W.3d 835, 852-853 (Tex. App.-Fort Worth 2003, pet. denied); Marvelli v. Alston 100 S.W.3d 460, 470 (Tex. App.-Fort Worth 2003, pet. denied).
Spohn asserts that appellees failed to present legally or factually sufficient evidence that it (1) negligently administered Pitocin and such negligence caused Lisa's uterus to rupture, or (2) negligently delayed Giovani's delivery and the delay caused his injuries. We first examine the evidence regarding the alleged delay in Giovani's delivery.
According to Spohn, Nurse Monica Jarzmik timely called Dr. Caceres to the labor room at 5:08 p.m., Dr. Caceres had the sole authority to call an emergency cesarean section, and there was no delay in executing the call for an emergency cesarean. In contrast, the jury had ample evidence from which it could have found several periods of delay attributable to Spohn. First, there was some evidence from which the jury could have concluded that Spohn delayed in failing to identify signs of uterine rupture and failing to institute the chain of command to institute a cesarean section in a timely manner. Second, the jury might have concluded that once Dr. Caceres called for an emergency caesarean section, Spohn delayed both in removing Lisa from the hospital room to the emergency operating room and in failing to have the emergency operating room prepared for the surgery.
The parties presented...
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