Cole v. Raut
| Decision Date | 09 June 2008 |
| Docket Number | No. 26503.,26503. |
| Citation | 378 S.C. 398,663 S.E.2d 30 |
| Parties | Marty K. COLE and Tracy S. Cole, as co-administrators of the Estate of Kyle Austin Cole, and Tracy S. and Marty K. Cole, individually, Respondents, v. Pratibha P. RAUT, M.D., and Dr. Raut & Associates, P.A., Petitioners. |
| Court | South Carolina Supreme Court |
Robert H. Hood, Robert H. Hood, Jr., and Deborah Harrison Sheffield, of counsel, all of Hood Law Firm, of Charleston, for Petitioners.
Charles L. Henshaw, Jr., of Furr, Henshaw & Ohanesian, of Columbia, for Respondents.
In this medical negligence case, the court of appeals reversed the trial court's general verdict in favor of Petitioner doctor, holding that the trial court erred in instructing the jury on the defense of assumption of the risk. This Court granted certiorari to review the decision of the court of appeals. We reverse the decision of the court of appeals and reinstate the general jury verdict for Petitioner.
Before delivering her son in February 1997, Respondent Marty Cole ("Cole") discussed the various delivery options with her obstetrician, Petitioner Dr. Pratibha Raut ("Dr. Raut"). Cole had previously delivered a baby by caesarian section (or C-section), but Dr. Raut recommended that Cole undergo a "vaginal birth after caesarian section," known as a VBAC. At the time, VBAC was the recommended method of delivery despite the risk that the uterine scar from Cole's previous C-section could rupture and cause the baby to suffer harm from oxygen deprivation.
Dr. Raut discussed the risks of a VBAC delivery with Cole and her husband during a prenatal visit two days before giving birth, and the next day, Cole informed Dr. Raut that she wanted to attempt a VBAC. Because she was two weeks past her due date, Dr. Raut scheduled Cole to have labor induced the following day at Chester Memorial Hospital. When Cole reported to the hospital the following day, the nurse obtained Cole's written informed consent before beginning the labor and delivery process. The consent form documented Cole's consent to a VBAC delivery, induction of labor through medication, and augmentation of labor with medication, and also indicated Cole's authorization to delivery by C-section if necessary. Specifically, the form provided:
I recognize that during the course of the operation, unforeseen conditions may necessitate additional or different procedures or services that [sic] those set forth above and I further authorize and request that the above named surgeon ... perform such procedures as are, in his professional judgment, necessary and desirable.
Dr. Raut induced labor at 8:00 a.m. intending to deliver Cole's baby by VBAC, yet retaining a surgical crew on-call in case an emergency C-section became necessary.1 Labor progressed slowly and at 1:30 the following morning, the fetal heart monitor began indicating changes in the baby's heart rate. These changes did not appear abnormal to the nursing staff. However, by 2:00 a.m., further changes in the baby's heart rate prompted nurses to administer oxygen to Cole and to summon Dr. Raut, who was already present at the hospital, to the delivery room. When she viewed the baby's heart rate monitor, Dr. Raut became concerned and attempted to notify the on-call surgical crew, which had already been summoned to the hospital to attend to another emergency, that it needed to remain there. Because the on-call crew was still operating on the emergency patient, Dr. Raut's initial call to the operating room went unanswered, and it was not until 2:10 a.m. that the operating room received formal standby notice.
At 2:15 a.m., Cole began to complain of abdominal pains, indicating that her uterine wall had ruptured, and at 2:20 a.m., Dr. Raut formally ordered an emergency C-section for Cole. The C-section began at 2:42 a.m. and son Kyle was born at 2:45 a.m. Kyle suffered from brain damage and related problems, including cerebral palsy, developmental delays, and a seizure disorder. As a result of these conditions, Kyle died in August 2003.
The Coles brought a medical negligence action in their individual capacities and on behalf of Kyle against Dr. Raut and her medical practice. The Coles alleged that Dr. Raut's delay in ordering the emergency C-section and failure to deliver Kyle in a timely manner by C-section resulted in fetal oxygen deprivation causing Kyle's various medical conditions and his ultimate death. At trial, expert witnesses for the Coles testified that Dr. Raut was negligent in failing to order a C-section at 2:00 a.m. when the heart rate monitor first indicated troublesome variables in Kyle's heart rate. The Coles' expert obstetrician further testified that in accordance with American College of Obstetrics and Gynecology standards, the surgical team should have been able to deliver Kyle in this manner by 2:30 a.m. at the latest, and that in his opinion, delivery by no later than 2:33 a.m. would have resulted in a neurologically healthy baby. This testimony differed slightly from that of the Coles' expert witness on neonatalogy who opined that permanent brain damage had almost certainly occurred by 2:30 a.m. Conversely, expert witnesses for the defense testified that Dr. Raut did not deviate from the standard of care with respect to ordering Kyle's delivery by C-section because there was nothing to indicate an emergency until 2:20 a.m., at which time Dr. Raut promptly ordered the C-section. The defense also emphasized that the hospital had only one operating crew available at this hour, and that this crew was performing an emergency procedure on another patient when Dr. Raut first expressed concern.
At the close of evidence, the trial court granted Dr. Raut's earlier motion to amend her pleadings to include assumption of the risk as an affirmative defense, but denied the doctor's request for a special verdict form. The trial court instructed the jury on the law of negligence followed by a charge on the doctrine of assumption of the risk, and the jury returned a general verdict in favor of Dr. Raut. The Coles moved for a new trial on the grounds that the court erroneously charged the jury on the doctrine of assumption of the risk because Cole had not assumed the risk of a delayed C-section. The trial court denied the Coles' motion and the Coles appealed.
The court of appeals initially affirmed the trial court's judgment in favor of Dr. Raut based on the application of the two-issue rule. After the Coles' petitioned for rehearing, the court of appeals reversed the case and remanded, finding that that the trial court's erroneous charge on assumption of the risk prejudiced the Coles and that the two-issue rule did not apply to uphold the jury verdict. Cole v. Raut, 365 S.C. 434, 617 S.E.2d 740 (Ct.App.2005). This Court granted certiorari, and Dr. Raut raises the following issue for review:
Did the court of appeals err in finding that the trial court's jury instructions on the defense of assumption of the risk constituted reversible error?
An appellate court will not reverse the trial court's decision regarding jury instructions unless the trial court committed an abuse of discretion. Clark v. Cantrell, 339 S.C. 369, 389, 529 S.E.2d 528, 539 (2000). An abuse of discretion occurs when the trial court's ruling is based on an error of law or is not supported by the evidence. Id.
Dr. Raut argues that the court of appeals erred in finding that the trial court's jury instructions on the defense of assumption of the risk constituted reversible error, and we agree.
As a primary matter, we find that the court of appeals correctly held that the trial court erred in charging the jury on assumption of the risk. A jury charge consisting of irrelevant and inapplicable principles may confuse the jury and constitutes reversible error where the jurys confusion affects the outcome of the trial. State v. Washington, 338 S.C. 392, 400, 526 S.E.2d 709, 713 (2000). In order for the doctrine of assumption of the risk to apply in a particular case, the injured party must have freely and voluntarily exposed himself to a known danger which he understood and appreciated.2 Faile v. Bycura, 289 S.C. 398, 399, 346 S.E.2d 528, 529 (1986).
In this case the assumption of the risk charge was improper because even if Cole assumed the risk with respect to the VBAC procedure by signing the consent form, Cole did not simultaneously assume the risk of any danger specifically associated with a delayed C-section delivery, which is the basis for the Coles' medical negligence claim. The court of appeals found, and we agree, that the record does not indicate that Cole recognized any danger posed by a delay between the doctor's observation of the warning signs indicating the need for a C-section delivery and actual commencement of a C-section delivery. Furthermore, Cole was not aware of the possible circumstances under which such a delay might occur. Accordingly, Cole could not understand and appreciate the nature and extent of the danger of a delay. Therefore, the court of appeals correctly found that the trial court erred in charging assumption of the risk.
An erroneous jury instruction, however, is not grounds for reversal unless the appellant can show prejudice from the erroneous instruction. Ellison v. Simmons, 238 S.C. 364, 372, 120 S.E.2d 209, 213 (1961). From this premise, the majority writing for the court of appeals found that the jury charge on assumption of the risk constituted reversible error because the charge "had the potential to confuse the jury concerning the underlying factual basis of the Coles' claims and availed Raut with a defense that was not supported by the evidence." Cole, 365 S.C. at 443, 617 S.E.2d at 744. We disagree with this conclusion.
An examination of the jury charges is instructive in this matter. After giving the charge on...
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