Neal v. Sparks Reg'l Med. Ctr.

• Court: Arkansas Supreme Court
• Writing for the Court: COURTNEY HUDSON GOODSON
• Citation: Neal v. Sparks Reg'l Med. Ctr., 2012 Ark. 328, 422 S.W.3d 116 (Ark. 2012)
• Decision Date: 11 October 2012
• Docket Number: No. 11–1196.,11–1196.
• Parties: Laura NEAL, Individually and as Administratrix of the Estate of Arvilla Langston, Deceased, David Langston, and Lelia Branch, Appellants v. SPARKS REGIONAL MEDICAL CENTER, Appellee.

2012 Ark. 328

422 S.W.3d 116

Laura NEAL, Individually and as Administratrix of the Estate of Arvilla Langston, Deceased, David Langston, and Lelia Branch, Appellants

v.SPARKS REGIONAL MEDICAL CENTER, Appellee.

No. 11–1196.

Supreme Court of Arkansas.

Sept. 13, 2012.

Rehearing Denied Oct. 11, 2012.

McCutchen and Sexton, Attorneys at Law, Fort Smith, by: Sam Sexton, III, for appellants.

Conner & Winters, LLP, Fayetteville, by: G. Alan Wooten and Vicki Bronson, for appellee.

COURTNEY HUDSON GOODSON, Justice.

Appellants Laura Neal, individually and as administratrix of the estate of Arvilla Langston (Langston), David Langston, and Lelia Branch appeal two orders of the Sebastian County Circuit Court granting summary judgment in favor of appellee Sparks Regional Medical Center (SRMC), denying their motion for reconsideration, and striking their amended complaint. For reversal, appellants argue that the circuit court erred in granting summary judgment, in failing to rule on a loss-of-chance theory of recovery, and in striking their amended complaint. This court has jurisdiction pursuant to Arkansas Supreme Court Rule 1–2(a)(7), as we previously decided Neal v. Sparks Regional Medical Center, 375 Ark. 46, 289 S.W.3d 8 (2008). We affirm.

On July 20, 2003, Arvilla Langston, an eighty-one-year-old woman, presented to SRMC's emergency room with complaints of chest pain, left-arm numbness, back discomfort, and nausea. Langston described her pain as a ten on a level from one to ten. Medical records revealed that her July 20, 2003 emergency-room visit was her fourth visit in a two-week period. Dr. Jose Alemparte, a cardiologist, admitted Langston to SRMC.

On July 21, 2003, Dr. Alemparte performed a diagnostic catheterization, which revealed a ninety-five-percent blockage of the left anterior descending artery. Dr. Jorge Hernandez, an interventional cardiologist, then performed an angioplasty that included the insertion of a stent. He also ordered Plavix, an anti-platelet drug, in conjunction with Heparin, an anti-coagulant medication, but Langston did not receive Plavix until the following day. After the angioplasty, Langston complained of significant chest pain. Dr. Hernandez performed a second arteriogram, finding that the stent was in place and that the blood vessel was open. Langston developed hypotension and continued experiencing severe chest pain. An electrocardiogram showed a small pericardial effusion and an impression of mild atrial collapse. The two doctors discussed these findings, and Dr. Hernandez performed a pericardiocentesis, which resulted in the collection of twenty to thirty milliliters of fluid. Langston was transferred to the intensive-care unit where she remained relatively stable.

On July 22, 2003, at 6:04 a.m., an electrocardiogram revealed that Langston had suffered a heart attack. At 9:00 a.m., Dr. Alemparte learned of Langston's condition and ordered another electrocardiogram, which revealed the same findings as the previous electrocardiogram. Dr. Hernandez performed another catheterization and found a blockage in the artery where he had placed the stent the previous day. Dr. Hernandez performed a procedure on the occluded stent and placed two additional stents in that area. At this time, Langston's blood work indicated that her hemoglobin level had steadily and rapidly declined, and she received multiple blood transfusions. Subsequently, she developed hypotension, acidosis, and liver failure. She also developed renal insufficiency, which the consulting nephrologist thought was due to her hypotension and possibly the use of the contrast dye required by the heart-catheter and angioplasty procedures. Langston's condition remained guarded at this point, and she was placed on a do-not-resuscitate status per the family's request.

On July 23, 2003, Langston's condition continued to decline, and that afternoon, she coded. Dr. Hernandez responded to the code and found her in an agonal rhythm. The doctor discussed Langston's condition with her family, and no further life-saving attempts were made per the family's request. According to the deposition testimony of appellant Laura Neal, Neal's brother informed her that a nurse and a student nurse had not locked the hospital bed, which caused Langston and the mattress to fall off the bed. The two nurses caught the mattress and Langston and placed them back on the bed. When Neal was asked if she spoke to the nurses or anyone at SRMC about this incident, she replied, “No.” Langston died shortly thereafter.

On July 19, 2005, appellants filed a medical-malpractice action against SRMC and Sparks Medical Foundation alleging that Langston died as the result of SRMC's alleged failure to properly care for, diagnose, and treat Langston. Specifically, appellants alleged that Langston's death was caused by the negligence of SRMC nurses in failing to administer Plavix at the time of, or after, her first angioplasty procedure on July 21, 2003, and in failing to notify Dr. Alemparte of the results of the July 22, 2003 electrocardiogram. SRMC filed an amended answer, and the circuit court dismissed the case on the grounds of charitable immunity. This court reversed, holding that the circuit court erred in failing to strike the amended answer. Neal, supra.

On remand, SRMC moved for summary judgment on the wrongful-death claim, arguing that any alleged negligence did not proximately cause the death of Arvilla Langston because appellants could not show that Langston would have survived in the absence of SRMC's negligence. In support of its motion for summary judgment, SRMC offered the following exhibits: appellants' complaint; Dr. Alemparte's deposition; Dr. Hernandez's deposition; Langston's medical records; Dr. Timothy C. Waack's affidavit; appellants' responses to interrogatories and requests for the production of documents; and Nurse Carolyn Ford's affidavit. Appellants filed a response supported by portions of the deposition testimony of Dr. Alemparte and Dr. Hernandez, as well as the deposition of appellant Laura Neal. After considering the motions and pleadings, the circuit court entered an order granting summary judgment and dismissing appellants' claims. In its order, the circuit court made the following rulings:

Neither Dr. Hernandez nor Dr. Alemparte stated that any actions or failure to act on the part of employees of [SRMC] proximately caused Mrs. Langston's death. Dr. Waack specifically testified in his affidavit that earlier intervention in the catheterization would not have changed the course of Mrs. Langston's care, that the fact that the patient did not receive Plavix following the initial catheterization and stint [sic] procedure or the failure to document why the medication was not given was not a proximate cause of the death of Mrs. Langston and, finally, that the failure to notify Dr. Alemparte of the change in Mrs. Langston's EKG on July 22, 2003 was not a proximate cause of decedent's death. The only other testimony [appellants] have to offer is the testimony of two nurses. The testimony of the additional expert named Elizabeth Stolzfus is unknown as there is no affidavit or no suggestion as to the subject matter of her specific testimony. The other nurse, Carolyn Ford, does offer the opinion that Mrs. Langston expired as a result of improper care received at [SRMC].

[Appellants] have failed to sustain the burden of proof to meet facts with fact or refute any of the material facts in this case.... Although a nurse may be an expert witness as to the standard of care for other nurses, it is not proper for a nurse to offer testimony on the issue of proximate causation as this is outside of the area of their expertise.

On September 12, 2011, appellants timely filed their notice of appeal from the judgment.

After the entry of the court's order, appellants filed an amended complaint attempting to raise a pre-death claim not pled in the initial complaint. Appellants filed a motion for reconsideration and new trial, requesting the circuit court to reconsider its ruling granting summary judgment in favor of SRMC and dismissing appellants' complaint. The circuit court denied appellants' motion for reconsideration and new trial and granted SRMC's motion to strike appellants' amended complaint. In its order, the circuit court ruled that appellants failed to set forth specific grounds for reconsideration; that appellants were not permitted to pursue a claim for Langston's conscious pain and suffering not previously pled; that no evidence supported such a claim; and that appellants filed the amended complaint after the circuit court had already granted summary judgment and dismissed the complaint. Appellants timely filed a notice of appeal and amended notice of appeal. From both of the circuit court's orders, appellants bring their appeal.

For the first point on appeal, appellants argue that the circuit court erred in granting summary judgment and in ruling that no genuine issue of material fact existed on the issue of causation between SRMC's alleged negligence and Langston's death. In support of this argument, appellants point to alleged discrepancies between the doctors' deposition testimony. More specifically, appellants assert that they presented a genuine issue of material fact on SRMC's alleged failure to administer Plavix and failure to notify a doctor until three hours after Langston's heart attack on the morning of July 22, 2003. SRMC responds that the circuit court properly granted summary judgment because appellants failed to meet their burden of proof on the element of causation.

We consider summary judgment as one of the tools in a circuit court's efficiency arsenal. Foreman Sch. Dist. No. 25 v. Steele, 347 Ark. 193, 61 S.W.3d 801 (2001). Summary judgment is to be granted by a trial court if the pleadings, depositions, answers to interrogatories and admissions on file, together with affidavits, if any, show that there is no genuine...