Franco v. Latina

• Decision Date: 09 January 2004
• Docket Number: No. 2002-233-Appeal.,2002-233-Appeal.
• Citation: Franco v. Latina, 840 A.2d 1110 (R.I. 2004)
• Parties: Linda J. FRANCO et al. v. Joseph A. LATINA, M.D.
• Court: Rhode Island Supreme Court

840 A.2d 1110

Linda J. FRANCO et al. v. Joseph A. LATINA, M.D.

No. 2002-233-Appeal.

Supreme Court of Rhode Island.

January 9, 2004.

Mark Decof, Providence, for Plaintiff.

Michael G. Sarli, Providence, for Defendant.

Present: WILLIAMS, C.J., FLANDERS, GOLDBERG, FLAHERTY, and SUTTELL, JJ.

OPINION

FLANDERS, Justice.

This is a medical malpractice case in which the trial justice granted a new trial to the plaintiff, surgical patient Linda J. Franco, after a jury returned a verdict for the defendant surgeon, Joseph A. Latina, M.D. (Dr. Latina). Pursuant to G.L.1956 § 9-24-7 (allowing appeals from orders granting or denying a new trial after a trial by jury), Dr. Latina appealed from the order granting plaintiff's motion for a new trial. In doing so, he asks us to vacate the new-trial order and to direct the Superior Court to enter judgment in his favor. But after reviewing the record, ascertaining that the trial justice adhered to the appropriate standard in granting a new trial, and according that decision appropriate deference, we are convinced that the order should stand.

Facts and Travel

In 1996, when he was surgically removing plaintiff's gallbladder, Dr. Latina mistakenly clipped and cut her common bile duct. As a result, plaintiff had to undergo reconstructive surgery. Doctor Latina admitted that he misidentified his patient's bile duct and, consequently, he mistakenly clipped and cut it, believing it was a cystic duct that was part of the gallbladder he was removing. But he suggested that he was not guilty of malpractice because the so-called infundibular technique he used to perform the operation was the real culprit — even though it was an accepted surgical method that was consistent with the standard of care when he operated on plaintiff in 1996.

In response to special interrogatories, the jury returned a verdict in favor of Dr. Latina on both the negligence and the lack-of-informed-consent claims in the complaint. The plaintiff then filed a motion for a new trial, which the trial justice granted, issuing a ten-page written decision. On appeal, defendant argues that the trial justice overlooked or misconceived the fact that, in this case, the surgical technique itself — rather than the manner in which he performed the operation — was to blame for the injuries that the patient suffered.

Analysis

A trial justice's duty in passing upon a new trial motion is to function as a "super juror." English v. Green, 787 A.2d 1146, 1149 (R.I.2001) (citing Long v. Atlantic PBS, Inc., 681 A.2d 249, 254 (R.I. 1996)). In carrying out this function, the trial justice should review the evidence and exercise his or her independent judgment "in passing upon the weight of the evidence and the credibility of the witnesses." Martinelli v. Hopkins, 787 A.2d 1158, 1165 (R.I.2001) (citing Dilone v. Anchor Glass Container Corp., 755 A.2d 818, 821 (R.I. 2000)). "If the trial justice determines that the evidence is evenly balanced or is such that reasonable minds, in considering that same evidence, could come to different conclusions, then the trial justice should allow the verdict to stand." Id., (quoting Graff v. Motta, 748 A.2d 249, 255 (R.I.2000)). If, however, the trial justice determines that the verdict is against the preponderance of the evidence and fails to do justice to the parties or to respond to the merits of the controversy, then he or she should grant the motion. Perkins v. City of Providence, 782 A.2d 655, 656 (R.I. 2001) (per curiam) (citing Kurczy v. St. Joseph Veterans Association, Inc., 713 A.2d 766, 770 (R.I.1998)). On appeal, when the decision of the trial justice reveals that he or she has performed this function according to the applicable standard, our review is deferential: we will not disturb a trial justice's decision either granting or denying a new-trial motion unless the trial justice overlooked or misconceived the evidence or otherwise was clearly wrong. English, 787 A.2d at 1149 (citing Kurczy, 713 A.2d at 770).

In this case, the trial justice did exactly what trial justices are supposed to do when ruling on a motion for a new trial. She conducted an extensive review of the evidence, including the testimony of the expert witnesses, the medical literature, and the testimony of Dr. Latina. She said that it was Dr. Latina's own testimony that best supported plaintiff's theory that Dr. Latina failed to meet the applicable standard of care when he mistakenly clipped and cut her common bile duct during this surgery to remove her gallbladder. The trial justice noted that Dr. Latina acknowledged the standard of care required him to properly identify the anatomical structures to be cut before he performed the surgical procedures in question. But Dr. Latina's own testimony, the trial justice concluded, demonstrated that "he was anatomically lost."

Most importantly, the trial justice rejected Dr. Latina's theory of the case: that his use of a flawed surgical technique — one that was acceptable in 1996 when he operated but was later revealed to be too dangerous — was the true cause of plaintiff's injuries. The trial justice found that even Dr. Latina acknowledged he was required to conclusively identify the anatomical structures before removing the patient's gallbladder. Regardless of which surgical method the doctor used, the trial justice found, the applicable standard of care required the surgeon to correctly identify the anatomical structures involved in the surgery before proceeding to clip and cut any of the structures in question. She noted that the doctor's admitted misidentification of the common bile duct as one of the structures to be cut indicated that he had failed to meet this standard.

The trial justice further found that "the verdict in favor of the defendant [was] not based on ample credible testimony and evidence" and that "[r]easonable minds could not have come to the conclusion reached by the jury." With respect to Dr. Latina's suggestion that the later-criticized surgical procedure he used was to blame for his misidentification of his patient's cystic duct, the trial justice rejected this theory as "disingenuous," and as having "misled the jury." Based on the testimony of the two expert witnesses who testified for plaintiff, the trial justice was convinced that even though Dr. Latina was using a surgical procedure that was within the standard of care when he performed the surgery, it was his negligent performance of this procedure — and not the technique itself — that was to blame for the doctor's misidentification of the structures in question.

Doctor Latina argues that the trial justice overlooked or misconceived evidence supporting his theory. First, he points to the cross-examination of Dr. Brock about an article that a Dr. Steven M. Strasberg wrote in 2000, four years after plaintiff's surgery. This article suggested that the procedure Dr. Latina used to remove this plaintiff's gallbladder — namely, the infundibular technique for duct identification when performing a laparoscopic cholecystectomy — was unsafe and should be abandoned by surgeons. Steven M. Strasberg, Christopher J. Eagon & Jeffrey A. Drebin, The "Hidden Cystic Duct" Syndrome and the Infundibular Technique of Laparoscopic Cholecystectomy — The Danger of the False Infundibulum, 191 J. of Am. C. Surgeons 661, 667 (2000). The article further stated that "well-trained, skilled, and experienced surgeons are involved in [causing common bile-duct] injuries."

Doctor Latina also contends that the trial justice overlooked evidence that the infundibular technique, which he used in performing this surgery, was within the standard of care in 1996. He cites Sheeley v. Memorial Hospital, 710 A.2d 161 (R.I. 1998) to support this argument. In that case, we held that "the focus in any medical malpractice case should be the procedure performed and the question of whether it was executed in conformity with the recognized standard of care." Id. The Sheeley, case, however, does not discuss the use of specific techniques in medical treatment, but...