Mcglothlin v. Christus St. Patrick Hosp..

• Decision Date: 01 July 2011
• Docket Number: No. 2010–C–2775.,2010–C–2775.
• Citation: 65 So.3d 1218
• Parties: Margie McGLOTHLIN, et al.v.CHRISTUS ST. PATRICK HOSPITAL.
• Court: Louisiana Supreme Court

65 So.3d 1218

Margie McGLOTHLIN, et al.
v.
CHRISTUS ST. PATRICK HOSPITAL.

No. 2010–C–2775.

Supreme Court of Louisiana.

July 1, 2011.

[65 So.3d 1221]

Stockwell, Sievert, Viccellio, Clements & Shaddock, Benjamin Joseph Guilbeau, Lake Charles, LA, for Applicant.Kenneth Michael Wright, LLC, Kenneth Michael Wright, Lake Charles, LA, for Respondent.

[65 So.3d 1222]

KNOLL, Justice.

[2010-2775 (La. 1] This medical malpractice action presents the issue of whether La.Rev.Stat. § 40:1299.47(H) mandates the admission of a medical review panel opinion when the panel exceeds its statutory authority and renders an opinion based on its determination of plaintiffs' credibility, not on the medical standard.

After submitting their medical malpractice complaint to a medical review panel and the rendition of the panel's opinion, plaintiffs, Margie and John McGlothlin, filed the instant suit against defendant, Christus St. Patrick Hospital. Over both parties' objections, the District Court admitted the panel's opinion, subject to its redaction of all credibility language, and subsequently rendered judgment in conformity with the jury's verdict in favor of the hospital. The Court of Appeal reversed, finding the lower court erred in admitting an edited version of the opinion. Under de novo review, the appellate court concluded plaintiffs proved the hospital's malpractice caused the injury, awarding plaintiffs both general and special damages. We granted this writ to address the correctness vel non of the appellate court's reversal. McGlothlin v. Christus St. Patrick Hospital, 10–2775 (La.3/4/11), 58 So.3d 462. For the following reasons, we find while the medical [2010-2775 (La. 2] review panel opinion was inadmissible, its admission was nevertheless harmless error and, therefore, the appellate court erred in its de novo review. Finding no manifest error in the jury's verdict, we reverse the judgment of the Court of Appeal and reinstate the District Court's judgment.

FACTS

On May 17, 1999, Margie McGlothlin was admitted to Christus St. Patrick Hospital for bilateral total knee replacement surgery.¹ Dr. Lynn Edward Foret, an orthopedic surgeon, successfully performed the surgery, ² and Margie's initial recovery was uneventful.

Three days later, Dr. Foret issued orders transferring Margie from the post surgery unit to the rehabilitation unit. During the course of her stay in “rehab” from May 20, 1999 through May 28, 1999, Margie had consistent progression in her rehabilitation; her records reflected she went from ambulating twenty-five feet with a standard walker up to three hundred feet. However, on Friday, May 28, 1999, Margie was progressing in her therapy session before the onset of pain to her left knee. At that point, her session was suspended, and she was taken back to her room where the nurses awaited further orders. An order was received to perform an x-ray, and it was determined from the films Margie had suffered a patella dislocation. As a result of that dislocation, Margie underwent significant medical [2010-2775 (La. 3] treatment to address both the dislocation and the substantial infectious complications

[65 So.3d 1223]

arising therefrom—nine surgical procedures in total, including the removal of the prosthesis in her left knee. The specific cause of the patella's dislocation is the underlying issue in this litigation.

Pursuant to La.Rev.Stat. § 40:1299.47, the McGlothlins first submitted their claims for damages to a medical review panel, alleging that two incidents—the first occurring on May 20, 1999, and the second occurring on May 29, 1999—involving the transfer or attempted transfer of Margie from her wheelchair to (1) her hospital bed and (2) a commode caused damage to her left knee arthroplasty. On June 13, 2005, the panel, composed of orthopedic surgeons David DeLapp, Lee Leonard, and Gregory Gidman, rendered a unanimous opinion in favor of Christus St. Patrick Hospital, rejecting plaintiffs' claims for their “inconsistencies”:

The Medical Review Panel, comprised of the undersigned, convened in the above captioned matter, and after due proceedings and review of the evidence presented, renders the following unanimous decision:

The evidence does not support the conclusion that the defendant, Christus St. Patrick Hospital, failed to comply with the appropriate standard of care as charged in the complaint.

Written reasons for opinion:

The post-surgery patella dislocation and infection are known complications of this procedure, and could have occurred without any negligence on the part of the hospital. The patient and her family allege that two incidents occurred involving hospital staff that caused a twisting injury and an acute flexation injury, damaging the total knee arthroplasty, resulting in a dislocated patella. However, the LPN alleged to be involved in the initial incident on May 20, 1999, upon admit to the rehab unit, emphatically denies that any incident occurred; the alleged incident was not documented in the hospital records at the time of the occurrence; no contemporaneous Incident Report was filed; the patient did not report the incident during the hospital assessment report done at the time of the rehab admit; the patient did not report the incident to the P.A. the following morning; and the patient attended physical therapy for several days thereafter with progress being noted. On May 28, 1999, an x-ray was [2010-2775 (La. 4] ordered which showed lateral displacement of the left kneecap, possibly due to rotation or true lateral displacement, but the patient and her family allege the second incident occurred in the bathroom on May 29, 1999, a day later. Once again, the CNA alleged to be involved in the second incident emphatically denies that any incident occurred, the alleged incident was not documented in the hospital records at the time of occurrence, and no contemporaneous Incident Report was filed. The follow-up x-rays of May 31, 1999, and June 1, 1999, do indicate that lateral displacement was occurring, but we feel that the versions of both of the incidents, by the patient and her family, appear to have numerous inconsistencies. (Bold emphasis in original; underlining indicative of redaction).

Thereafter, the McGlothlins filed the instant suit against Christus St. Patrick Hospital, alleging two separate acts of medical malpractice by two attending certified nursing assistants (CNA) caused the patella dislocation Margie suffered:

III.

While hospitalized, on May 20, 1999 she was transferred to rehabilitation. At the time of the transfer an employee

[65 So.3d 1224]

of Christus St. Patrick Hospital tried to put the Plaintiff on the bed without any help. The Plaintiff was half dropped and hurt her knee which had just been operated on. Plaintiff alleges that the factual basis for this proceeding involve unusual occurrences during the time of medical supervision by the Defendant, at a time when the Plaintiff was under the total care, custody and control of the Defendant, and its employees and warrant the imposition of the doctrine of Resipsa loquitur [sic].

IV.

Following the incident, the Plaintiff was administered pain medication because of the injury that day. Dr. Foret's [P.A.] David Guillory examined the knee when he was contacted. Dr. Foret examined the knee at the time and felt it would be alright even though they had to administer pain medication. She continued to be in pain from the knee.

V.

On May 29, 1999, the Plaintiff while still under the total care, custody, and control of the Defendant, was being helped to the restroom in rehabilitation. A plastic commode seat was attached to the commode to raise the position where the Plaintiff would be sitting so as not to have to bend her knees very much. The commode seat was not properly fastened and because of this it gave way when the Plaintiff tried to mount it and she was seriously injured. The x-rays taken later that day showed that the Plaintiff had displaced the patella in the knee. The displacement caused the Plaintiff to undergo another surgery in which an infection occurred causing further complications.

[2010-2775 (La. 5] The three-day jury trial on the merits began on June 16, 2009. During trial it was not disputed Margie sustained a patella dislocation while under the care, custody, and control of the hospital; she was under the hospital's care, custody, and control at the time both instances allegedly occurred; the CNA's involved in the alleged transfers were employees of Christus St. Patrick Hospital; and the standard of care applicable to the movement of a morbidly obese bilateral total knee replacement patient from a wheelchair to a bed or commode required the coordination of more than one trained individual and/or the assistance of a gait belt and/or walker. The primary disputes were whether the two alleged events actually occurred and whether the medical review panel opinion was admissible.

By way of defense, the hospital and its employees emphatically denied either event occurred as alleged by the McGlothlins and meticulously outlined the inconsistencies in plaintiffs' versions of the events. The hospital also presented the expert testimony of orthopedic surgeon, Dr. Leonard, who opined dislocation of a prosthetic patella is a known complication of bilateral knee replacement surgery and could result from physical therapy. Through his testimony, the hospital also introduced the medical review panel opinion. However, prior to its introduction and in response to plaintiffs' motion in limine, the District Court redacted the first sentence in its entirety and the last clause of the final sentence. Subject to both parties' objections, Dr. Leonard read the panel's redacted opinion to the jury.

After deliberation, the jury returned a verdict in favor of Christus St. Patrick Hospital, finding plaintiffs did not prove by a preponderance of the evidence defendant “deviated from the appropriate standard of care owed to the...