Cook v. Sunrise Hospital & Medical Center

• Decision Date: 30 October 2008
• Docket Number: No. 48414.,No. 47220.,47220.,48414.
• Parties: Linda F. COOK and Frank Cook, Individually and as Husband and Wife, Appellants, v. SUNRISE HOSPITAL AND MEDICAL CENTER, LLC, Respondent. Linda F. Cook and Frank Cook, Individually and as Husband and Wife, Appellants, v. Sunrise Hospital and Medical Center, LLC, Respondent.
• Court: Nevada Supreme Court

194 P.3d 1214

Linda F. COOK and Frank Cook, Individually and as Husband and Wife, Appellants, v. SUNRISE HOSPITAL AND MEDICAL CENTER, LLC, Respondent.

Linda F. Cook and Frank Cook, Individually and as Husband and Wife, Appellants, v. Sunrise Hospital and Medical Center, LLC, Respondent.

No. 47220.

No. 48414.

Supreme Court of Nevada.

October 30, 2008.

Sterling Law, LLC, and Beau Sterling, Las Vegas; Cobeaga Law Firm and J. Mitchell Cobeaga, Las Vegas, for Appellants.

Hall Prangle & Schoonveld, LLC, and Michael T. Koptik and Lisa D. Parker, Las Vegas, for Respondent.

Before The Court En Banc.

OPINION

By the Court, GIBBONS, C.J.:

These appeals center on a "mere happening" jury instruction—an instruction asserting that the mere happening of an accident is, by itself, an insufficient basis for liability—given by the district court in a medical malpractice action. Initially, we must determine whether appellants preserved for our review their objection to respondent's proposed jury instruction. We conclude that appellants' objection to the jury instruction was sufficient to preserve the claimed error for our review because the objection placed the district court on notice that the instruction's language required further review.

Next, we address whether the "mere happening" instruction given by the district court misstated the law, and if the instruction was in fact erroneous, whether appellants have proven that the inaccurate instruction was prejudicial rather than harmless error. The jury instruction given by the district court in this matter set forth that "the mere fact that an unfortunate or bad condition resulted to the patient involved in this case does not prove, or even imply, that by virtue of that fact, the defendant is negligent." This instruction misstated Nevada law because the instruction failed to inform the jury that it could consider all of the circumstances leading to the plaintiff's injury as possible evidence of the defendant's negligence, and thus, the instruction may have confused or misled the jury to its verdict. Given this conclusion, we also must consider whether appellants have proven that the inaccurate instruction was prejudicial rather than harmless error. After reviewing the evidence, we conclude that prejudice was shown because, but for the mistake in instructing the jury, it is probable that a different result may have been reached as the case was close and appellants introduced evidence that could support a finding of negligence against respondent.

Because the given jury instruction misstated the law, which could have confused or misled the jury, and appellants have met their burden of showing prejudice, we reverse the district court's judgment and remand this matter to the district court for a new trial. We also vacate the district court's order awarding costs and fees to respondent since we have reversed the judgment upon which this award was based.

FACTS AND PROCEDURAL HISTORY

In January 2000, appellant Linda Cook underwent back surgery at Sunrise Hospital. Dr. Mark B. Kabins, who was assisted by Dr. John A. Ameriks, a neurovascular surgeon, performed the surgery. During the surgery a blood clot formed in Mrs. Cook's left leg, and complications related to the blood clot arose, ultimately leading to the amputation of Mrs. Cook's lower left leg. She and her husband, Frank Cook, filed a medical malpractice action against respondent Sunrise Hospital and Dr. Ameriks, asserting that their negligence in identifying and treating the complications that arose during and after surgery caused the loss of Mrs. Cook's leg.¹ Specifically, the Cooks alleged that (1) Sunrise's failure to provide specific requested equipment prevented Dr. Ameriks from properly treating Mrs. Cook's limb and increased the time her vessels were without oxygen; (2) hospital equipment, a "Quantum" operating table, interfered with the ability to obtain adequate diagnostic imaging of Mrs. Cook's lower leg; (3) because Sunrise failed to provide adequate equipment, Sunrise's medical care fell below the standard of care; and (4) Sunrise fell below the standard of care when, despite the assurance by its hospital staff, an angiography suite was not made available, increasing the harm to Mrs. Cook's limb.

The case ultimately proceeded to a jury trial. After Sunrise rested its case, the district court held a hearing to settle the jury instructions. At the hearing, Sunrise proffered an instruction that stated, in relevant part, "The mere fact that an unfortunate or bad condition resulted to the patient involved in this case does not prove, or even imply, that by virtue of that fact, the defendant was negligent." The Cooks objected to the instruction, arguing that because they presented evidence of Sunrise's negligence, this case's facts did not warrant the so-called mere happening instruction—an instruction based on this court's statement in Gunlock v. New Frontier Hotel² that the mere fact that an accident occurred is "not of itself sufficient to predicate liability." Moreover, the Cooks asserted that, even if this case was appropriate for a Gunlock-based jury instruction, Sunrise's proposed jury instruction misstated the law set forth in Gunlock.

In response to the Cooks' objections, Sunrise's counsel asserted that the instruction was proper because, as the Cooks' opening argument stated, the issue to be decided by the jury was "who is responsible." According to Sunrise, the purpose of its proposed instruction was to remind the jury that the mere happening of a bad result does not mean that anyone is responsible. Moreover, Sunrise reminded the district court that something more than an accident and consequent injury was required to demonstrate negligence, particularly when the Cooks' expert had repeatedly testified that one risk associated with this type of surgery was the loss of limbs resulting from a risk of damage to arteries and veins. Sunrise further argued that if the court refused to give its proposed instruction, it would support the Cooks' argument that simply because something bad happened, someone must be held accountable, but, Sunrise asserted, the Cooks were required to prove that negligence occurred.

Following these arguments, the district court concluded that the jury instruction was a correct statement of the law. Again, the Cooks' counsel objected stating that the proposed instruction was not an accurate Gunlock instruction.

The jury returned a quotient verdict, six to two, in favor of Sunrise, upon which the district court entered judgment and later awarded costs. These consolidated appeals followed.

DISCUSSION

The Cooks' objection to the proposed instruction

As an initial matter, Sunrise contends that, on appeal, the Cooks have waived their challenge to the jury instruction because a proper objection to the jury instruction was not raised in the district court. The Cooks assert that their objection sufficiently preserved the issue for our review because their counsel's statement that the proffered language was not "an appropriate [Gunlock] instruction" put the district court on notice that Sunrise's language should have been reviewed further.

With regard to the proper manner of objecting to a proposed jury instruction so that the challenge is preserved for appellate review, NRCP 51(c) provides that a party objecting to an instruction, or the failure to give an instruction, must "distinctly" state the matter objected to and the grounds for the objection. Objections are sufficient when they serve NRCP 51(c)'s purpose to give the trial court the opportunity to correct the potential error by focusing the court's attention on the alleged error.³ This does not require that counsel give a discourse on the applicable law.⁴ Indeed, we have held that providing the district court with a citation to relevant legal authority in support of the objection satisfies the requirements of NRCP 51(c).⁵ A general objection, however, is not sufficient to preserve the issue on appeal, unless there is plain error.⁶

In this case, at the hearing to settle the jury instruction, the Cooks objected to Sunrise's proposed instruction because it was not a proper "mere happening" instruction under this court's 1962 opinion, Gunlock v. New Frontier Hotel,⁷ The Cooks' counsel stated twice that the proffered language was not a proper Gunlock instruction. Moreover, the Cooks' objection, together with Sunrise's argument, informed the district court what the main issue for the jury's determination was— who was responsible for the loss of Mrs. Cook's limb. Thus, the district court was on notice that the language of Sunrise's proposed jury instruction should have been reviewed further, and the court was provided with a citation to pertinent authority. The need for further review should have been particularly evident, because Gunlock is a Nevada Supreme Court case and, as Sunrise acknowledged to the district court, its given instruction was based on a South Dakota Supreme Court case.⁸

Sunrise's argument that the Cooks' objection was not adequately preserved because they were required to specifically state to the district court the exact language that should have been added is unpersuasive, since under NRCP 51(c), the Cooks' objection needed only to focus the district court's attention on the alleged error, which it did. Accordingly, the Cooks' objection to giving the "mere happening" instruction was properly preserved for appeal.

Jury instruction was misstatement of Nevada law

Having concluded that the Cooks properly preserved the jury instruction issue for our review, we next consider whether the proffered instruction was a misstatement of the law. We review de novo the claimed error that a proffered instruction is an incorrect statement of the law.⁹

Here, the Cooks' theory of liability against Sunrise rested on Sunrise's alleged negligence in failing to provide adequate equipment, as requested by Mrs. Cook's treating...