Rye v. Women's Care Ctr. of Memphis

Decision Date10 March 2014
Docket NumberNo. W2013-00804-COA-R9-CV,W2013-00804-COA-R9-CV
CourtTennessee Court of Appeals
PartiesMICHELLE RYE, and her Husband, RONALD RYE v. WOMEN'S CARE CENTER OF MEMPHIS, MPLLC d/b/a RUCH CLINIC, a Tennessee for-profit Limited Liability Company, and DIANE LONG, M.D.

Interlocutory Appeal from the Circuit Court for Shelby County

No. CT-000920-09

Gina C. Higgins, Judge

This interlocutory appeal concerns the trial court's grant of partial summary judgment to the Defendant/Appellee medical providers on various issues. The Plaintiff/Appellant couple filed a complaint for damages stemming from the medical providers' failure to administer a RhoGAM injection during wife's pregnancy. The couple alleged causes of action for compensatory damages associated with medical malpractice, negligent infliction of emotional distress, and disruption of family planning. The trial court granted summary judgment to the medical providers on the wife's claim for future medical expenses, husband's claim for negligent infliction of emotional distress, and the couple's claim for disruption of family planning. The trial court declined to grant summary judgment on wife's physical injury claim, her negligent infliction of emotional distress claim, and the claim that wife could present evidence of the disruption of her family planning as evidence in her negligent infliction of emotional distress claim. We reverse the trial court's grant of summary judgment on wife's claim for future medical expenses associated with future pregnancy and husband's claim for negligent infliction of emotional distress, which he may support with evidence concerning the disruption of the couple's family planning. The trial court's ruling is affirmed in all other respects. Affirmed in part, reversed in part, and remanded.

Tenn. R. App. P. 9 Interlocutory Appeal; Judgment of the Circuit Court Affirmed in

Part; Reversed in Part; and Remanded

J. STEVEN STAFFORD, J., delivered the opinion of the Court, in which DAVID R. FARMER, J., and D. MICHAEL SWINEY, J., joined.

Gary K. Smith and C. Philip M. Campbell, Memphis, Tennessee, for the appellant, Michelle Rye and Ronald Rye.

William H. Haltom, Jr., and Margaret F. Cooper, Memphis, Tennessee, for the appellees, Women's Care Center of Memphis, MPLLC d/b/a Ruch Clinic and Diane Long, M.D.



The Plaintiffs/Appellants Michelle Rye and her husband Ronald Rye (together, "the Ryes") filed a complaint on February 24, 2009 alleging medical malpractice against the Defendants/Appellees Women's Care Center of Memphis, MPLLC, d/b/a Ruch Clinic ("the Clinic"), and Diane Long, M.D., (together with the Clinic, "Appellees"), stemming from Dr. Long's failure to give Mrs. Rye a RhoGAM injection during the 28th week of her third pregnancy.1 According to the complaint, Mrs. Rye, who has Rh negative blood, did not receive an injection of RhoGAM during her third pregnancy, and, as a result, she became Rh-sensitized—meaning she has antibodies in her body to Rh positive blood.2 The Ryes asserted that this failure was a deviation from the recognized standard of care and that it caused damages to the Ryes, including physical injuries to Mrs. Rye, disruption of family planning, infliction of emotional distress on both Mrs. and Mr. Rye, and future medical expenses likely to be incurred by Mrs. Rye for any future pregnancies or blood transfusions. According to the Ryes' complaint, they intended to have additional children, but because of the increased risks to future pregnancies due to Mrs. Rye's Rh-sensitization, they have altered their family plans by attempting to avoid future conception.

The Appellees answered the complaint on April 7, 2009, admitting that the failure to provide the RhoGAM injection was a deviation from the standard of care, but denying that the Ryes had suffered any damages as a result. Discovery ensued, including the depositions of the parties. The Ryes both testified that after the birth of their third child, Dr. Long referred the couple to Dr. Michael Schneider, a doctor who specializes in high risk pregnancies. According to both the Ryes, Dr. Schneider told them that any future pregnancy would be "high risk" due to Mrs. Rye's Rh-sensitivity. Further, Dr. Schneider informed the Ryes that the risks would increase for every successive pregnancy due to an increased immune system response from Mrs. Rye. Due to the possible complications of any future pregnancy, the Ryes testified that they have chosen to attempt to limit their family through the use of natural family planning methods. The Ryes testified, however, that because of theirreligion, they are unable to pursue other forms of contraception. Specifically, Mrs. Rye testified that she and her husband sought a special dispensation from their church to allow Mrs. Rye to undergo voluntarily sterilization, as this would remove some of the anxiety about a possible future pregnancy. However, Mrs. Rye testified that the church would not give a dispensation for a voluntary sterilization unless the mother's life was at risk. Mrs. Rye testified to the fear and anxiety caused by this situation, especially given the risks she learned any future child may face. Mrs. Rye testified that Dr. Schneider "kind of actually discouraged us from having more children." For this reason, Mrs. Rye testified that she and her husband have altered their behavior in order to be less "risky" with regard to the possibility of having another child. Despite her anxiety, neither Mrs. Rye nor her husband ever received any psychological or psychiatric counseling.

Dr. Long testified in her deposition concerning the circumstances surrounding the failure to give Mrs. Rye a RhoGAM injection at the appropriate time during her pregnancy. According to Dr. Long, who served as Mrs. Rye's obstetrician during her third pregnancy, Mrs. Rye failed to receive the RhoGAM injection because her blood type was not properly flagged on her chart when she was admitted as a Clinic patient or when she submitted to lab tests at the Clinic. Dr. Long also testified that due to issues with Mrs. Rye's prior pregnancies, she was scheduled for different tests than those that were usually administered; accordingly, Mrs. Rye did not have blood glucose testing around her 28th week of pregnancy, when the RhoGAM is supposed to be administered.

Dr. Long also explained the concerns associated with failing to give a RhoGAM injection at an appropriate time during a pregnancy. The concerns, according to Dr. Long, are not to the mother or the current baby, but to any subsequent baby that the mother may conceive. According to Dr. Long, when a pregnant woman is Rh negative, has become Rh-sensitized,3 as is the case with Mrs. Rye, and carries a child who is Rh positive, the antibodies in the mother's blood can "cross through the placenta and attack the baby's red blood cells and cause those baby's red blood cells to lice, or damage them so that the baby's blood count could drop [causing the baby to become anemic.]" Dr. Long further testified that although the actual risk of death to a fetus4 was low due to aggressive treatment andmonitoring, there was still a "low risk" of death to a child conceived under this scenario. According to Dr. Long, however, these risks increase with subsequent pregnancies. Dr. Long further admitted that the decision to have or not have a child was a "huge deal" and that the Ryes' decision to attempt to prevent future pregnancies was reasonable given the potential risks.

On July 13, 2010, the Appellees moved to dismiss the Ryes' complaint, or in the alternative, for a grant of summary judgment, contending that the Ryes had suffered no compensable damages or injuries. The Appellees filed the affidavit of their expert witness Dr. Thomas Stovall who opined that the risks to an Rh-sensitized woman are "extremely remote" and that it could not be said with any reasonable degree of medical certainty that an Rh-sensitized woman would ever sustain any injuries or damages. Dr. Stovall also opined that it could not be said with any degree of medical certainty that if an Rh-sensitized woman were to conceive another child, there would be any injury to such child.

In response, the Ryes submitted the affidavit of expert witness Dr. Joseph Bruner who concluded that Mrs. Rye has sustained an injury because, biologically, she is not the same person she was before she became Rh-sensitized. According to Dr. Bruner, Ms. Rye now suffers from "diseased blood" that makes future pregnancies less safe to her future unborn children. Specifically, Dr. Bruner opined that: (1) it is more likely than not that Mrs. Rye will become pregnant again because the Ryes have declined to use contraceptives due to their religious beliefs; (2) if Mrs. Rye becomes pregnant, there is an approximately 70% chance that the fetus will have Rh positive blood; and (3) if Mrs. Rye becomes pregnant and the child has Rh positive blood, it is more likely than not that the fetus will have moderate to severe disease and require invasive procedures. These complications can include: (1) enlarged spleen and liver, causing damage or rupture; (2) excessive bleeding due to low blood cell count; (3) erythroblastosis fetalis;5 (3) hyperbilirubinemia, causing jaundice, or a yellow tone of the skin and eyes; (4) kernicterus, a condition that can lead to deafness, speech problems, cerebral palsy, or mental retardation; (5) high levels of insulin and low bloodsugar; (6) and hydrops fetalis, a condition where fluid accumulates in the baby's body, inhibiting breathing, interfering with lung growth, and possibly causing death; (7) and anemia, which may lead to heart problems. Dr. Bruner further opined that with "good modern medical treatment, most babies can be saved." According to Dr. Bruner, the procedures used to determine whether the child is at risk of complications also create risks to both the fetus and to the mother. He further testified that Mrs. Rye's irreversible...

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