Holloway v. Robertson
| Citation | 500 So.2d 1056 |
| Parties | Charles Warner HOLLOWAY, Administrator of the Estate of Clara Whitman McCain, deceased v. Dr. Adam D. ROBERTSON and Jefferson Clinic, P.C. 84-1209. |
| Decision Date | 31 October 1986 |
| Court | Alabama Supreme Court |
J. Earl Langner of Langner & Langner, Birmingham, for appellant.
W. Stancil Starnes and W. Hill Sewell of Starnes & Atchison, Birmingham, for appellees.
Plaintiff Charles Warner Holloway appeals from a judgment entered in a medical malpractice suit in favor of defendants. We affirm.
On October 26, 1981, Holloway filed suit against Dr. Adam D. Robertson and Dr. Robertson's employer, Jefferson Clinic, P.C., alleging the wrongful death of Holloway's intestate (his mother) Clara Whitman McCain (sometimes hereinafter "the deceased"). Holloway alleges that McCain's death was a result of negligence which occurred on April 15, 1981, in the Cooper Green Hospital emergency room operated by Jefferson Clinic under a contract with the hospital.
On April 15, 1981, at approximately 3:00 p.m., McCain suddenly became quite ill. A neighbor called the Warrior Rescue Squad. The emergency technicians who responded to the call recorded McCain's blood pressure at 60/40, which is abnormally low. An emergency technicians' report was prepared, and blood pressure and vital signs were recorded. McCain was taken by ambulance to the Cooper Green Hospital emergency room and arrived there at 4:20 p.m. The emergency technicians' report was delivered to the nurse in attendance at the emergency room.
McCain was initially examined by Susan Hubbard, a nurse employed by Cooper Green Hospital, and then by Dr. Robertson. Dr. Robertson performed a physical examination and ordered chest X-rays on McCain. Dr. Robertson testified that he never saw the emergency technicians' report that contained the rescue squad's recording of McCain's blood pressure at 60/40. He stated that nearly half of these reports never make it to the patient's chart by the time the doctor examines the patient. The blood pressure readings taken at the hospital were considerably higher than that recorded by the rescue squad. Based on the nurse's notes and the results of the physical examination and the chest X-rays, Robertson determined that McCain was suffering from right-sided pleuritic chest pain. This was consistent with her prior history of pleurisy. Pleurisy is an inflammation of the membrane enveloping the lungs and lining the walls of the thoracic cavity. He prescribed Indocin, an anti-inflammatory medication, to relieve the pleuritic chest pain.
Holloway and his wife had been waiting in the emergency waiting room while McCain was being attended to by the medical personnel. At approximately 6:00 p.m., a nurse informed the Holloways that McCain was ready to be released. Mrs. Holloway went into the treatment room to help McCain get dressed. Mrs. Holloway informed a nurse that McCain was throwing up and was not ready to be discharged. Dr. Robertson then reportedly gave McCain a shot for nausea and told the Holloways to call him if they needed him, whereupon McCain was discharged from the emergency room. The Holloways were given written instructions to return if McCain's condition worsened or other problems occurred.
The following morning, Thursday, April 16, 1981, McCain's condition did not improve. She remained very weak, she could not sit up, and she continued to vomit. Holloway telephoned Dr. Robertson several times that day, and at 4:30 p.m., Dr. Robertson returned his call. Holloway informed Dr. Robertson of McCain's condition, and Dr. Robertson replied that these symptoms were expected with side pleurisy and told Holloway to get a laxative for McCain. These instructions were carried out.
That evening, McCain, upon being asked if she wanted to return to the hospital, reportedly stated that she wanted to wait until the morning. At 4:30 a.m. that next morning, April 17, 1981, she was found unconscious. She was taken to Carraway Methodist Hospital. There, Dr. Teiszen, the treating physician, diagnosed her condition as upper gastrointestinal bleeding, perforated ulcer, duodenal ulcer, shock, hypotension, gram negative sepsis, bleeding disorder, kidney failure, and severe hypoglycemia. Surgery was performed on McCain on Friday evening, and a perforated duodenal ulcer was found. Following the operation, her condition progressively declined. She died on Sunday, April 19, 1981.
The trial of this case commenced on March 18, 1985, before a jury. Dr. Tieszen testified that the cause of deceased's death was diagnosed as perforated duodenal ulcer, and that in his opinion, deceased had the perforated ulcer at the time the rescue squad transported her to the emergency room at Cooper Green Hospital. Holloway presented Dr. Tieszen with a hypothetical question that included the facts and circumstances describing deceased's illness and the medical treatment rendered to her at the Cooper Green Hospital emergency room. It was his opinion that based on those facts and circumstances, Dr. Robertson did not meet the required standard of care. It was his opinion that Dr. Robertson negligently diagnosed deceased's condition and that deceased should have been admitted to the hospital for further observation. He further opined that Dr. Robertson's negligence contributed to deceased's death. Dr. Talley, Holloway's expert medical witness, also testified that in his opinion the required standard of care had not been met, and that Dr. Robertson's negligence contributed to the deceased's death.
Dr. Robertson's expert medical witness, Dr. Slaughter, testified that there are six symptoms or characteristics commonly associated with a perforated duodenal ulcer: (1) mid-epigastric pain (where the perforation is recent); (2) severe pain; (3) a rigid, board-like abdomen; (4) rebound tenderness; (5) free air under the diaphragm; and (6) a history of ulcers. Dr. Robertson testified that deceased did not present any one of these six symptoms. Dr. Slaughter testified that he has seen patients for duodenal ulcers for over 25 years, and "I would say every patient that I have seen with a perforated duodenal ulcer has presented with more than one of these findings." Dr. Slaughter personally reviewed the chest X-rays of deceased and testified that no free air was visible. Holloway's own medical expert witness, Dr. Talley, testified at his deposition that there was very little about deceased's condition while she was in the emergency room at Cooper Green Hospital which was consistent with peptic ulcer disease.
Dr. Slaughter was also given a hypothetical question incorporating the facts and circumstances of the present case. He was then asked if he had an opinion on whether Dr. Robertson exercised the required standard of care. Dr. Slaughter opined that Dr. Robertson had met the required standard of care.
On March 22, 1985, the jury returned a verdict in favor of Dr. Robertson and Jefferson Clinic. Holloway's motion for new trial was denied, and this appeal followed. The issues are framed as follows by the appellant: (1) whether the trial court committed reversible error by disallowing the opinion of Holloway's expert medical witness on the cause of deceased's death; (2) whether Holloway was entitled to a new trial because of alleged prejudice resulting from the change in Dr. Robertson's testimony at trial from the testimony given at his prior deposition; (3) whether Holloway was entitled to a new trial based on the allegedly erroneous ruling of the trial court that Holloway could not lead or impeach his rebuttal witness; (4) whether the verdict was against the great weight of the evidence so that a new trial should have been granted.
Holloway contends that the trial court committed reversible error by rejecting the opinion of Holloway's expert medical witness, Dr. Talley, on the cause of deceased's death. After a careful review of the record, we find no error as alleged.
Holloway, through the use of a hypothetical question, attempted to elicit Dr. Talley's opinion that Dr. Robertson's failure to diagnose deceased's ulcer contributed to or caused deceased's death. After Holloway's attorney read the hypothetical question to the expert, the following transpired:
On the following day of the trial, Holloway continued his direct examination of Dr. Talley. Holloway again presented the same hypothetical question incorporating the facts and circumstances of the...
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