Langley v. Michael

• Decision Date: 03 April 1986
• Docket Number: No. 14151,14151
• Citation: Langley v. Michael, 710 S.W.2d 373 (Mo. App. 1986)
• Parties: Claude L. LANGLEY, D.V.M., et ux., Plaintiffs-Respondents, v. Harvey R. MICHAEL, M.D., and Smith-Glynn-Callaway Clinic, Inc., Defendants-Appellants.
• Court: Missouri Court of Appeals

Page 373

710 S.W.2d 373

Claude L. LANGLEY, D.V.M., et ux., Plaintiffs-Respondents, v. Harvey R. MICHAEL, M.D., and Smith-Glynn-Callaway Clinic Inc., Defendants-Appellants.

No. 14151.

Missouri Court of Appeals,

Southern District,

Division One.

April 3, 1986.

Motion for Rehearing or to Transfer to

Supreme Court Denied April 24, 1986.

Application to Transfer Denied

June 17, 1986.

B.H. Clampett, Max E. Lilley and Patrick K. Roberts, Daniel, Clampett, Rittershouse, Lilley, Dalton, Powell & Cunningham, Springfield, for defendants-appellants.

John R. Courtney, Courtney & Peebles, P.C., Springfield, for plaintiffs-respondents.

PER CURIAM.

Defendants, Dr. Harvey Michael and his employer, Smith-Glynn-Callaway Clinic, Inc. (Smith-Glynn), appeal from a judgment affirming a jury verdict in the sum of $300,000 in favor of plaintiff, Dr. Claude Langley. Michael is an M.D., specializing in orthopedic surgery. Langley is a general veterinarian. Langley sued Michael and Smith-Glynn, alleging medical malpractice in Michael's treatment of his injured thumb.

The cause was submitted on a verdict directing instruction that told the jury their verdict must be for Langley if they believed that on May 24, 1983, Langley had infection in his right thumb which Michael negligently failed to culture, debride, and adequately cleanse and irrigate, and that, as a result of such negligence, Langley sustained damage.

In their first assignment of error, defendants assert that Langley's verdict directing instruction was erroneous for lack of evidentiary support.

In considering this assertion, we view the evidence and all reasonable inferences derived therefrom in the light most favorable to the party who offered it, disregarding all evidence and inferences to the contrary. Hartenbach v. Johnson, 628 S.W.2d 684, 688 (Mo.App.1982).

Viewed in that light, there was substantial evidence introduced that on Friday, May 20, 1983, Langley, while attempting to deliver a breeched calf, slipped and fell in a barnyard. His right thumb was injured in the fall. When Langley attempted to clean the mud and manure from his hands, he noticed his right thumbnail was blue and depressed at least 1/4 of an inch under the skin at the base of the nail. Langley went to the office of his personal physician, Dr. Alfred Staeger, an osteopath, who examined the thumb. Langley's thumb was swollen, dirt was under the nail, and the nail was depressed into the nail bed. Dried blood was visible at the base of the nail and "there was a little discharge there and quite a tear or laceration of that area" (about 3/8 inch behind the cuticle). An x-ray revealed a fracture of the distal phalanx of Langley's thumb. By reason of the nature of the wound and fracture, Staeger referred Langley to Smith-Glynn for treatment.

At Smith-Glynn, Langley's thumb was again x-rayed, and a nurse brushed the thumb with a gauze pad saturated with a betadine solution. Langley told Michael that he had fallen in a barn lot and injured his thumb. Michael did not take any significant history from Langley concerning the accident, or discover the nail depression and discharge from the base of the nail. Michael diagnosed the injury as a closed fracture of the distal phalanx of the thumb, immersed the thumb in the betadine solution, deadened the thumb with a local anesthetic, reduced the fracture by manipulation, and applied a splint. Michael told Langley to elevate the thumb and use ice packs on it, and gave him an appointment for a follow-up examination the following Friday.

Langley's pain did not subside but, in fact, increased. On Sunday, May 22, he unsuccessfully attempted to contact Michael. Dr. Ben C. Harmon, another orthopedic surgeon employed by Smith-Glynn, returned Langley's call, advised Langley that pain and swelling were to be expected, and told him to loosen the splint. The pain and swelling persisted. Langley again contacted Smith-Glynn and was given an appointment to see Michael on Tuesday, May 24.

On May 24, when Michael examined the thumb, he noticed that there was a bluish discoloration of Langley's swollen thumb, that the nail was loosened from the nail bed and that there was a serous discharge coming from the base of the nail. Michael knew that Langley's injury was now "an open situation," and knew, or should have known, that the drainage and loosened nail were suggestive of infection. Michael did not culture the discharge to determine if it was caused by a bacterial infection, or deeply cleanse or irrigate the area of suspected infection, or debride or surgically remove any devitalized tissue from the wound site. Michael told Langley his thumb "looked all right," and applied a new splint. Claude's pain became more severe, and the swelling increased. When attempts to contact Dr. Michael were unsuccessful, Mrs. Langley took Claude to the emergency room at St. John's Regional Health Center on Thursday, May 26. When the splint was removed, Langley's thumb was "all black and rotten --- stinking."

The distal portion of Langley's thumb was then amputated by Dr. Marion Wolf. Later, Dr. Darrell Domann, a reconstructive surgeon, operated on Langley's thumb to provide a full thickness skin flap over the end of the stump. The loss suffered by Langley severely handicapped him in performing the duties of his profession as a veterinarian.

Dr. Dale E. Darnell, a board certified orthopedic surgeon, testified that, in his opinion, Michael's failure, on Tuesday, May 24, to deeply cleanse, irrigate, and debride the injured area of Langley's thumb, and to culture fluids taken from it, constituted a departure from that degree of skill and learning ordinarily used under the same or similar circumstances by members of the medical profession, and that such lack of care directly contributed to cause the loss of Langley's thumb. These facts and expert opinions, and reasonable inferences derived therefrom, were sufficient to support a jury verdict for Langley on the basis of the verdict directing instruction. The point has no merit.

Defendants next contend that the trial court erred in overruling their objections and requests for mistrial because of alleged...