Perry v. MAGIC VALLEY REGIONAL MED. CENTER

Decision Date28 February 2000
Docket NumberNo. 24709.,24709.
Citation134 Idaho 46,995 P.2d 816
PartiesPauline Collins PERRY, Plaintiff-Respondent, v. MAGIC VALLEY REGIONAL MEDICAL CENTER, a political subdivision of Twin Falls County, Defendant-Appellant.
CourtIdaho Supreme Court

Tolman Law Office, Twin Falls, for appellant. Jennifer K. Brizee argued.

May, Sudweeks, Kershaw & Browning, Twin Falls; Spence, Moriarity & Schuster, Provo, Utah, for respondent. Lynn C. Harris argued.

KIDWELL, Justice.

Magic Valley Regional Medical Center (Hospital) appealed from the judgment in a medical malpractice case. The jury awarded plaintiff Pauline Collins Perry $1,550,000 in economic damages and $150,000 in non-economic damages for injuries to the sciatic nerve sustained from an injection that Hospital personnel administered in the gluteal area. We affirm and remand in part.

I. FACTS AND PROCEDURAL HISTORY

Pauline Collins (now Pauline Collins Perry) (Perry) walked into the Hospital's emergency room on June 4, 1994 for treatment of an infected cut on her small toe. Because Perry had received no previous immunizations against tetanus, the emergency room physician ordered treatment with two tetanus shots, "DT" and "Hyper-Tet."

Hyper-Tet is administered to patients who have incomplete immunizations and are at risk of contracting tetanus. When it is administered in conjunction with a DT injection, Hyper-Tet is administered as an intramuscular injection in the gluteal region. The manufacturer and standard medical texts caution against injecting in the central gluteal region because of the risk of injuring the sciatic nerve.1 The approved injection region is on the upper, outer quadrant of the hip.

Nurse Teresa Phillips administered the injections. In Hospital records, Phillips charted the Hyper-Tet injection as administered appropriately in the hip area. Perry claimed, however, that Phillips actually administered the injections in the middle of the right buttock. Pamela Babb, Perry's sister who had accompanied her to the emergency room, also testified that Phillips administered the injection in the buttock. Perry testified that she felt immediate, debilitating pain after the injection. She hopped out of the emergency room, assisted by Babb. Unable to obtain crutches from the hospital, Perry bought crutches within a few hours after the injection and used them for several days.

Perry visited the Hospital emergency room two weeks later for pain in her right leg. The physician prescribed codeine, amitriptyline, and large doses of ibuprofen. When the pain persisted and worsened in the following week, Perry visited a neurologist. She described a persistent pain in the right buttock and back of the leg and difficulty in walking, driving, and sitting. Perry acknowledged a history of chronic intermittent lower back pain but told the neurologist that she had no recent injury or exacerbation of that pain. The neurologist diagnosed right sciatica as a result of the Hyper-Tet injection. The neurologist prescribed stretches and more powerful painkillers and recommended an MRI and an epidural injection if Perry's pain symptoms persisted.

In the months and years that followed, Perry continued to experience extreme pain. She visited a long succession of doctors and hospitals attempting to obtain relief. By the beginning of 1998, she had visited doctors fifty-six times, had six operations, and had incurred $119,000 in medical expenses. She took Percocet, a powerful painkiller. An electrical device was implanted in her abdomen to control pain.

In 1995, Perry and her then-husband Steven Collins filed a complaint against the Hospital and the emergency room physician. They presented three claims: negligence, lack of informed consent, and loss of consortium. The physician moved for summary judgment, which was granted in September 1996.

Perry and Collins separated within months of filing the complaint. Divorce and child custody proceedings were not amicable. Clinical social worker Susan DeHaan performed a court-ordered child custody evaluation of each parent's fitness in the fall of 1995. Afterwards, Collins reached a settlement with the Hospital whereby he dropped his loss of consortium claim against the Hospital for $15,000. His deposition, in which he made many statements unfavorable to Perry's claim, was taken the following day. In his deposition, he mentioned DeHaan's unfavorable view of Perry. Thereafter, the Hospital listed DeHaan as a fact and expert witness. The trial court dismissed Collins as a party on September 15, 1997. The Hospital filed a motion in limine to exclude evidence of the amount and terms of the settlement agreement. The trial court ruled that the settlement could not be mentioned during voir dire or Perry's case in chief, but deferred until trial a decision about using the settlement during cross-examination. At trial, the court granted the Hospital's motion in part.

After a prolonged period of discovery, Perry filed her first pre-trial motions on August 28, 1997. Perry moved to compel the Hospital to supplement discovery and to exclude witnesses for failure to supplement discovery. Accusing the Hospital of attempting to transform the proceedings from a medical malpractice case to character assassination, Perry charged that the Hospital was dragging its feet on discovery and hiding witnesses and evidence.

At a deposition, DeHaan expressed an opinion that Perry suffered from a character disorder affecting her truthfulness about pain. Perry moved for a protective order excluding DeHaan as a fact and expert witness, which the trial court denied. Perry also moved to exclude DeHaan from testifying as to character disorders. At a hearing to determine the basis for and admissibility of this evidence, the trial court held that DeHaan could not testify as to any disorder because her methodology was deficient.

The Hospital moved to have a psychiatrist, Richard Worst, perform a psychological examination of Perry, which the trial court allowed. Perry moved to exclude Worst's testimony. The trial court excluded Worst's testimony as more prejudicial than probative.

A jury trial took place between January 27 and February 7, 1998. The rancorous tone of the pretrial proceedings continued into the trial with Perry continuing to insist that the Hospital was deflecting the focus of proceedings from the elements of medical malpractice to attacking Perry's personal life. The Hospital objected to the reading of deposition testimony from Hospital nurses about the local standard of care, as well as to the testimony of Ann Petersen, Perry's nursing expert. The Hospital unsuccessfully attempted to introduce a videotape of Perry jet-skiing as impeachment evidence and to introduce testimony that Perry had given away some of her pain medication. The trial court disallowed the Hospital's attempt to use Perry's 1995 applications for unemployment insurance to impeach her testimony that she was unable to work. The Hospital also objected to many of the jury instructions as well as the special verdict form.

The jury deliberated one day before reaching its conclusion. It returned a special verdict finding that the actions of the Hospital and its agents were the proximate cause of Perry's injuries. The jury awarded Perry $1,550,000 in economic damages and $150,000 in non-economic damages. Judgment was entered on February 11, 1998.

After trial, Perry filed a memorandum of costs, claiming over $12,000 in costs as a matter of right and over $27,000 in discretionary costs. Perry also claimed prejudgment interest on $119,000. After a hearing on the Hospital's objection to the claimed costs, the trial court denied Perry's motion for prejudgment interest and awarded her $31,102.36 in costs.

The Hospital filed a motion for judgment notwithstanding the verdict and, in the alternative, motions for a new trial and remittitur of damages. After a hearing, the trial court denied each of the motions. The Hospital filed a timely notice of appeal.

II. STANDARD OF REVIEW

This Court reviews challenges to a trial court's evidentiary rulings under the abuse of discretion standard. Kozlowski v. Rush, 121 Idaho 825, 827, 828 P.2d 854, 856 (1992). These include trial court decisions admitting or excluding expert witness testimony, Morris By and Through Morris v. Thomson, 130 Idaho 138, 144, 937 P.2d 1212, 1218 (1997); and excluding evidence on the basis that it is more prejudicial than probative, Burgess v. Salmon River Canal Co., 127 Idaho 565, 573, 903 P.2d 730, 738 (1995). Error is disregarded unless the ruling is a manifest abuse of the trial court's discretion and affects a substantial right of the party. Burgess, 127 Idaho at 574,903 P.2d at 739; see also Hake v. DeLane, 117 Idaho 1058, 1065, 793 P.2d 1230, 1237 (1990). To determine whether a trial court has abused its discretion, this Court considers whether it correctly perceived the issue as discretionary, whether it acted within the boundaries of its discretion and consistently with applicable legal standards, and whether it reached its decision by an exercise of reason. See Lamar Corp. v. City of Twin Falls, 133 Idaho 36, 40, 981 P.2d 1146, 1150 (1999).

This Court reviews jury instructions to determine "whether the instructions, when considered as a whole, fairly and adequately present the issues of the case and state the applicable law." Empire Lumber Co. v. Thermal-Dynamic Towers, Inc., 132 Idaho 295, 304, 971 P.2d 1119, 1128 (1998). Reversible error occurs if an instruction misleads the jury or prejudices a party. Lawton v. City of Pocatello, 126 Idaho 454, 462, 886 P.2d 330, 338 (1994). Whether the jury instructions fairly and adequately present the issues and state the applicable law is a question of law over which this Court exercises free review. State v. Bush, 131 Idaho 22, 32, 951 P.2d 1249, 1259 (1997). However, whether a reasonable view of the evidence supports an instruction to the jury is within a...

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