Schultz v. Guoth

• Decision Date: 04 March 2011
• Docket Number: No. 2010–CC–0343.,2010–CC–0343.
• Citation: 57 So.3d 1002
• Parties: Sharon SCHULTZ et al.,v.Janos GUOTH, M.D., and Khaled F. Rabie, M.D.
• Court: Louisiana Supreme Court

57 So.3d 1002

Sharon SCHULTZ et al.,
v.
Janos GUOTH, M.D., and Khaled F. Rabie, M.D.

No. 2010–CC–0343.

Supreme Court of Louisiana.

Jan. 19, 2011.Rehearing Denied March 4, 2011.

[57 So.3d 1003]

Sooter & Associates, LLC, Elizabeth Brown Hilburn, Victor Herbert Sooter, Alexandria, for Applicant.Dalrymple & Ledet, Joseph Texada Dalrymple, Alexandria; Judice & Adley, APLC, Marc W. Judice, for Respondent.GUIDRY, Justice.^*

[2010-0343 (La. 1] We granted the defendant physician's writ application in this medical malpractice action to determine whether he is entitled to summary judgment on the ground that the plaintiff is unable to produce any expert witness evidence in support of her claims the physician breached the applicable standard of care and this breach caused her injuries. The trial court denied the defendant's motion for summary judgment, stating that expert medical evidence was not necessary under Pfiffner v. Correa, 94–0924 (La.10/17/94), 643 So.2d 1228, for the plaintiff to prove her medical malpractice claim, despite the fact that the defendant's motion was supported by the unanimous opinion of the medical review panel and an affidavit of one of its members. The court of appeal denied the defendant's writ application. On our de novo review of the defendant's motion for summary judgment, the accompanying exhibits, and the applicable law, we conclude there were no genuine issues of material fact and the defendant was entitled to summary judgment as a matter of law. Accordingly, for the reasons set forth below, we reverse the lower courts' rulings and render summary judgment in favor of the defendant.

[2010-0343 (La. 2] FACTS

In April 2002, Leanne Brow, then age fourteen and eleven months, consulted Dr. Janos Guoth, an obstetrician-gynecologist, complaining of cramps and having missed her period. Ms. Brow was diagnosed with oligomenorrhea (infrequent menstruation) and instructed to return for a pregnancy test in one week. Ms. Brow returned to Dr. Guoth on October 29, 2002, and was then determined to be 28.4 weeks pregnant. On November 3, 2002, Ms. Brow presented at Oakdale Community Hospital (hereinafter, “Oakdale”) complaining of severe abdominal cramping. The emergency room physicians found her to have been in labor for two hours and noted that she was bleeding, but her vital signs were normal. Dr. Guoth and Dr. Chaftari, an emergency room physician, both examined her. Fetal heart beats were recorded at 143 beats per minute.

Because Ms. Brow was deemed to be six months pregnant and Oakdale lacked sufficient monitoring and surgical equipment, Dr. Guoth issued a transfer order, directing that Ms. Brow be transferred to Rapides Women's and Children's Hospital (hereinafter, “RWCH”) for a higher level of neonatal care. Dr. Guoth's order indicated the plaintiff was suffering from a placental tear. The transfer form, signed at 5:30 a.m., indicated there was no material deterioration of the patient's condition likely to result from the transfer. Dr. Khaled F. Rabie, an obstetrician-gynecologist on call at RWCH, accepted the transfer. During the transfer, the fetal heart rate was recorded at 170.

Ms. Brow arrived at RWCH at 6:29 a.m. Upon her arrival, fetal heart tones could not be detected, and the fetus was found to be in a breech position. Dr. Rabie was notified of her arrival, and he issued orders by telephone at 6:35 a.m. Prior to Dr.

[57 So.3d 1004]

Rabie's arrival at the hospital, fetal heart rates ranging between 160–180 were [2010-0343 (La. 3] recorded. Dr. Rabie arrived at 6:55 a.m. and performed an ultrasound, but was unable to detect any fetal heart tones. At 7:13 a.m., a fetal scalp electrode (hereinafter, “FSE”) was applied, and a fetal heart rate fluctuating from 60–144 was found. Dr. Rabie ordered a C-section at 7:14 a.m. The C-section was commenced at 7:25 a.m. At 7:33 a.m., Dr. Rabie delivered a stillborn fetus.

Subsequently, Ms. Brow, hereinafter the plaintiff, filed a medical malpractice complaint against Dr. Rabie, hereinafter the defendant.¹ The matter proceeded to a medical review panel, which rendered a unanimous opinion finding the evidence did not support the conclusion that the defendant failed to meet the applicable standard of care as charged in the complaint. In its opinion, the medical review panel stated:

Dr. Rabie accepted the transfer of the patient who was determined at the time of the transfer to be stable. He responded to take care of the patient in a timely fashion, within 26 minutes of her arrival to Rapides General [sic]. It is not the standard of care to be waiting at the hospital for the transfer of a patient who is deemed to be stable at the time of the transfer. It is unfortunate that when Dr. Rabie first examined the patient, the baby was probably already dead, as determined by the absence of fetal cardiac activity on ultrasound exam. Once the order for C-section was given, the baby was delivered in an appropriate amount of time. It would have been inappropriate for Dr. Rabie to order a C-section sooner with the facts he was given earlier. It is most probable that this baby went into distress and died during the transfer. Any earlier intervention on Dr. Rabie's part would not have affected the outcome.

Following the rendition of the medical review panel's opinion, the plaintiff filed the instant medical malpractice suit against the defendant. In her suit, the plaintiff sought damages for the death of her unborn child. In response, the defendant filed a motion for summary judgment. Relying on the opinion of the medical review panel, as well as an affidavit from Dr. Charles Padgett, one of the panel members, the defendant argued his actions did not fall below the applicable standard of care.

[2010-0343 (La. 4] The plaintiff opposed the motion for summary judgment. Although she was unable to produce any expert evidence supporting her claim, she relied on this court's opinion in Pfiffner v. Correa, 94–0924 (La.10/17/94), 643 So.2d 1228, for the proposition that the medical and factual issues were such that a lay jury could perceive negligence in the defendant's actions. Specifically, she argued the facts contradicted the medical review panel's finding the fetus was dead on arrival, as the medical records indicated the fetus had a heartbeat at 7:13 a.m.

After a hearing, the trial court denied the defendant's motion for summary judgment. In written reasons for judgment, the trial court stated it “believe [d] that the factual issues are such that a lay person can perceive negligence in the physician's conduct. There are genuine issues of material fact (i.e., whether Dr. Rabie timely arrived at the hospital to respond to the

[57 So.3d 1005]

emergency, whether Dr. Rabie waited too long before performing the Cesarean section, and whether his delay caused the death of plaintiff's unborn child).” The trial court went on to find that “the Medical Review Panel opinion and the individual affidavits from the members of the panel alone are not sufficient to succeed at summary judgment.” The trial court reasoned “the plaintiff need not present her own expert to defeat the defendant's motion” because “the medical and factual issues are such that a jury can reasonably infer whether negligence occurred.”

The court of appeal initially denied the defendant's application for supervisory writs, with one judge dissenting. The dissenting judge stated: “Given the complex medical issues involved in this case, without expert testimony the Plaintiff will be unable to sustain her burden of proving at trial that [the defendant's] conduct constituted a breach in the applicable standard of care, and that this breach resulted in damages sustained.” Upon the defendant's application to this court, we summarily [2010-0343 (La. 5] granted the writ and remanded the case to the court of appeal for briefing, argument, and opinion. Schultz v. Rabie, 09–1384 (La.10/2/09), 18 So.3d 119.

On remand, a 2–1 majority of the court of appeal again denied the writ application, but gave reasons for its ruling. The majority stated in part:

The hearing on the motion for summary judgment was not recorded, and we are unable to determine what evidence, if any, was submitted by Ms. Brow. However, it is possible that Ms. Brow will rely on the testimony of the defendant doctors themselves as to the standard of care, and on Dr. Rabie's testimony regarding his alleged breach of that standard of care. In addition, as noted in Pfiffner, 643 So.2d 1228, the facts of this case could demonstrate that Dr. Rabie's failure to respond timely to the patient's emergency is an example of obvious negligence that requires no expert testimony to show his fault.

After reviewing the evidence in this case and hearing arguments of counsel, the trial court determined that the jury could infer negligence from the facts of the case. The Louisiana Supreme Court noted in Pfiffner that a physician's delay in responding to an emergency is an example of obvious negligence that would require no expert testimony. In addition, it is possible that Dr. Rabie's testimony in his deposition could provide Ms. Brow with proof of a breach of the standard of care. Based on the information provided to this court, we deny Dr. Rabie's writ application, finding that there are genuine issues of material fact that warrant trial on the merits. We find that pursuant to the Pfiffner case, expert testimony is not required in order for Ms. Brow to prove her malpractice claim.

We granted the defendant's writ application to review the correctness of the denial of the motion for summary judgment. Shultz v. Rabie, 10–0343 (La.6/04/10), 38 So.3d 290.

LAW

A motion for summary judgment is a procedural device used when there is no genuine issue of material fact for all or part of the relief prayed for by a litigant. Samaha v. Rau, 07–1726, pp. 3–4 (La.2/26/08), 977 So.2d 880, 882–83; Duncan v. U.S.A.A. Ins. Co., 06–363, p. 3 (La.11/29/06), 950 So.2d 544, 546, see La.Code Civ. Proc...