Delta Reg'l Med. Ctr. v. Taylor

• Decision Date: 02 May 2013
• Docket Number: No. 2011–CA–00413–COA.,2011–CA–00413–COA.
• Citation: 112 So.3d 11
• Parties: DELTA REGIONAL MEDICAL CENTER, Appellant v. James TAYLOR and Eva Taylor, Appellees.
• Court: Mississippi Court of Appeals

112 So.3d 11

DELTA REGIONAL MEDICAL CENTER, Appellant

v.James TAYLOR and Eva Taylor, Appellees.

No. 2011–CA–00413–COA.

Court of Appeals of Mississippi.

Sept. 11, 2012.

Rehearing Denied Feb. 5, 2013.

Certiorari Denied May 2, 2013.

L. Carl Hagwood, Jackson, Mary Frances Stallings–England, Greenville, attorneys for appellant.

Edward A. Williamson, Christopher Morgan Posey, Philadelphia, attorneys for appellees.

Before IRVING, P.J., BARNES and CARLTON, JJ.

CARLTON, J., for the Court:

¶ 1. James and Eva Taylor filed this Mississippi Torts Claim Act (MTCA) medical-malpractice suit pursuant to Mississippi Code Annotated section 11–46–13(1) (Rev.2002) against Delta Regional Medical Center (DRMC), alleging negligence by DRMC's physicians and staff after James suffered a stroke.

¶ 2. Specifically, the Taylors claimed that DRMC physicians and staff negligently breached the applicable standard of medical care in rendering treatment to James upon his presentation to DRMC's emergency room (ER) for stroke symptoms. The Taylors claim this negligent medical care proximately caused James to subsequently suffer damages and permanent debilitating conditions resulting from a massive stroke suffered after his discharge from DRMC. The Taylors asserted in their complaint that if James had been properly diagnosed and treated, then he would not have suffered his current debilitation and partial paralysis in his right hand, right arm, right leg, and right foot.

¶ 3. The judgment and opinion and order of the circuit judge after a bench trial ¹ shows that the circuit judge found that DRMC ER physician Dr. Hilton O'Neal “breached the applicable standard of care incumbent upon him by failing to admit [James] to the hospital, to provide him with supportive care treatment[,] and to monitor him for a progressive worsening of his symptoms, and in failing to do so, Dr. O'Neal was negligent.” The circuit judge additionally held that James suffered the following injuries and damages as a proximate result of Dr. O'Neal's negligence: permanent impairment and partial loss of use of full body function; permanent loss of wage-earning capacity; past, present, and future medical expenses and costs of rehabilitation; past, present, and future pain and suffering, mental and emotional distress, and loss of enjoyment of life; and past, present, and future out-of-pocket expenses related to his medical care and hiring of outside individuals to perform activities and household chores that he could no longer perform himself due to his injuries. With respect to the Taylors' claim for loss of consortium, the circuit judge found that Eva had been deprived of services, society, companionship, and marital rights and had experienced pain, suffering, anxiety, and emotional upset as the proximate result of Dr. O'Neal's negligent care in providing medical treatment. The circuit judge awarded the Taylors $390,000 in monetary damages. In its final judgment, the circuit court adopted and incorporated the findings set forth in the court's previously issued opinion and order.

¶ 4. On appeal, DRMC asserts the following assignments of error:

(1) the [circuit] court erred as a matter of law and abused its discretion because it did not make specific findings of fact and conclusions of law that can be reviewed[; and]

(2) the [circuit] court erred as a matter of law when it entered its final judgment on February 14, 2011[,] and its opinion and order on March 17, 2011, as the judgment and order taken together do not state findings of fact that establish a standard of care, the legal standard that was breached, and causation between the breach and damages. There is no medical or scientific basis to support the final judgment and order and opinion entered by the [circuit] court.

¶ 5. We find no abuse of discretion by the circuit court, since the record reflects substantial evidence supporting its judgment.

FACTS

¶ 6. James worked as a forklift operator and material handler. His work week began on Monday and ended on Saturday. On Saturday, August 19, 2006, James worked until the end of his 3:30 p.m. shift and, feeling ill, went home to bed. He felt weak and dizzy on Sunday morning when awakened, so Eva called her son to drive James to the ER.

¶ 7. According to medical records from DRMC and Bolivar Medical Center (BMC) and testimony in the record, James ² arrived at DRMC's ER at 11:15 a.m. on the morning of Sunday, August 20, 2006, complaining of dizziness, lightheadedness, and right-sided weakness. The ER physician, Dr. O'Neal, took James's medical history, as well as performed a physical examination, EKG, and a CT scan without contrast. After performing the tests, Dr. O'Neal rendered a differential diagnoses of James's condition, stating the following three alternative diagnoses potentially causing James's symptoms: “vertigo, TIA versus early CVA.” Dr. O'Neal prescribed Antivert and Plavix. The ER of DRMC discharged James at 1:45 p.m. on August 20, 2006, less than two hours after he arrived at the hospital. He was discharged with instructions to follow up with his primary physician in two to three days. Eva drove James to a local pharmacy to fill his prescriptions. James then took his medicine and returned home to Shaw, Mississippi.

¶ 8. The record shows that once James arrived home from the hospital, he suffered a progression of his symptoms over the course of several hours. James's symptoms increased to include slurred speech and inability to walk independently. Eva then drove him to BMC, a different hospital in the region. James lacked the ability to walk on his own into BMC. The physicians at BMC conducted a full carotid work-up and diagnosed CVA,³ or stroke, and BMC admitted James at approximately 6:30 p.m. for supportive care, treatment, and therapy. BMC provided James supportive medical care, such as oxygen and aspirin. The physicians at BMC diagnosed James as suffering from a stroke that caused damages including permanent impairment and partial loss of use of full body function. At BMC, James received medical treatment, supportive care, as well as speech, physical, and occupational therapy. BMC released James on August 24, 2006, but James continued to receive rehabilitative therapy on an outpatient basis and continued to suffer permanent debilitating conditions. The parties stipulated that James has been unable to return to work.

¶ 9. The Taylors subsequently filed suit against DRMC. The Taylors filed an amended complaint ⁴ on October 8, 2009, alleging two theories of negligence.⁵ First, they alleged James should have been given tPA, or another form of thrombolytic agent, on presentation to the DRMC emergency department. Second, they alleged the failure to admit James to DRMC and provide supportive care, which breached of the standard of care, proximately caused James's injuries. Pursuant to Mississippi Code Annotated section 11–46–13(1), a bench trial was held on June 7–9, 2010.

¶ 10. At trial, the Taylors presented the following two medical experts ⁶ in support of their theory: Dr. David Wiggins, an expert in the field of emergency medicine, and Dr. Frances Mary Dyro, an expert in the field of neurology.⁷ The complaint reflects the Taylors asserted two theories of medical negligence. The first basis asserted negligence in the failure to administer thrombolytic agent (tPA). The second basis asserted negligence in the failure of DRMC to admit James for treatment and in the failure to provide supportive stroke care. At trial, the record shows both of the Taylors' expert witnesses testified regarding both bases of asserted negligence. More specifically, both expert witnesses testified at trial that Dr. O'Neal ⁸ breached the standard of care because he failed to administer tPA to James to reverse the effects of a stroke in progress. The Taylors' experts testified that James should have been admitted to DRMC for treatment and for supportive care when diagnosed with the differential diagnoses, which included possible early CVA, to prevent his condition from worsening and to treat the trauma of the stroke.

¶ 11. Dr. Wiggins's testimony particularly addressed the failure of Dr. O'Neal and DRMC to provide supportive care or further monitoring and treatment. Dr. Wiggins's testimony also addressed Dr. O'Neal's differential diagnoses of “vertigo, TIA versus early CVA.” Dr. Wiggins opined that Dr. O'Neal negligently failed to complete his diagnoses of the source of James's impairments before discharging James. In support of his opinion regarding negligence, Dr. Wiggins cited to James's medical records from DRMC's ER on the date at issue, wherein the clinical impression by Dr. O'Neal provides a differential diagnoses, and the discharge instructions recommend “follow up with [primary care physician] on Monday if no improvement.”

¶ 12. Dr. Wiggins testified at trial as follows regarding Dr. O'Neal's differential medical diagnoses and the standard of care requiring supportive stroke care:

A: Well, it's my professional opinion that the standard of care is to admit patients for ischemic strokes to provide them supportive care and to monitorfor the progression of symptoms, and in failing to do that, [Dr. O'Neal] was negligent.

Q: Specifically, what in the medical record would signal to you that Dr. O'Neal should have admitted [James]?

A: Well, his diagnoses itself is the main thing. He considered TIA vs. early CVA. Both TIA and CVAs are admitted. The standard of care is to admit these patients for supportive care and further monitoring, progression of the stroke further, and perhaps reverse any subsequent deficits that may arise.

Q: What type of supportive care?

A: Generally, when we admit people through the emergency department, we'll start them on oxygen, which is very important. We'll make sure they receive an aspirin, which is also very important, although it doesn't seem like much.

Plavix is often used as well. We often start heparin, unless there is some...