Solomon v. Hall
| Decision Date | 18 November 1988 |
| Citation | 767 S.W.2d 158 |
| Parties | Delma Ruth SOLOMON and William M. Solomon, Plaintiffs-Appellants, v. R. Glenn HALL, W. Dickson Moss, III, Individually and d/b/a Cookeville Pathology Laboratory, Defendants-Appellees. |
| Court | Tennessee Court of Appeals |
John A. Day, Eugene N. Bulso, Jr., Boult, Cummings, Conners & Berry, Nashville, Thomas L. Reed, Jr., Reed & Watson, Murfreesboro, for plaintiffs-appellants.
Jon E. Jones, Moore, Jones, Rader & Clift, P.C., Cookeville, for defendants-appellees.
The trial court granted defendants' motion for summary judgment in this malpractice suit, and plaintiffs have appealed.
The pertinent facts are as follows:
Because she experienced a painful discharge from her right breast, Plaintiff Delma Ruth Solomon visited her family physician. Her family physician referred her to Dr. Jules Trudel of Smithville, Tennessee. Dr. Trudel did a biopsy on plaintiff's breast by performing a partial mastectomy. He removed approximately one-fourth of the tissue from plaintiff's right breast.
Dr. Trudel sent the breast tissue to defendants R. Glenn Hall and W. Dickson Moss, III, both medical doctors who are partners d/b/a Cookeville Pathology Laboratory in Cookeville, Tennessee.
Defendants examined the tissue and reported to Dr. Trudel that the tissue exhibited "in situ and invasive carcinoma."
As a result of the diagnosis by defendants, Dr. Trudel called plaintiff back to his office and told her that she had cancer of the breast. Arrangements were made for plaintiff to be admitted to the hospital in Smithville to have her "breast removed."
Instead of going to the hospital in Smithville, she went to see Dr. Rob Roy, an oncologist in Nashville. 1
Dr. Roy examined plaintiff and then referred her to Dr. Robert Sadler, a surgeon in Nashville. The pertinent portions of Dr. Sadler's affidavit are as follows:
On October 15, 1984, I admitted Mrs. Delma Solomon to the West Side Hospital. She came to me on a referral from Dr. Rob Roy. She said she had been operated on nine (9) days previously by a physician in Smithville, Tennessee, and that a biopsy report showed invasive carcinoma. She did not have a written pathology report.
Upon physical examination, which I performed on October 15, 1984, I found that Mrs. Solomon's right breast had a recent wound in the inferior half along the areolos cutaneous junction. Approximately twenty-five percent (25%) of the breast was missing as a result of this earlier partial mastectomy. There was no acute infection present, but there was moderte inflammation. There was a hard, deep mass in the center of the breast. The nipple was somewhat disfigured from the previous surgery.
In my medical opinion, the right breast needed additional biopsy regardless of the results of any prior biopsy. I, therefore, did not obtain the biopsy report from Cookeville, nor the slides from Cookeville Pathology Laboratory for review by the pathologist at West Side Hospital prior to surgery. It was my intention to obtain biopsies of my own and rely on the evaluation of the pathologists at Nashville. I explained this to Mrs. Solomon prior to surgery and she understood and agreed.
Initially, I made a supra-areolar incision, and I removed almost the entire central segment of the breast. In the center of the tissue, there appeared to be gross evidence of carcinoma. In my professional opinion, it was necessary to remove almost the entire central segment of the breast for biopsy, and I made this decision without relying on the pathology from Cookeville in any way. The tissue, which I removed, contained a hard mass, which grossly appeared to be carcinoma.
The removal of this tissue for biopsy destroyed the blood supply to the nipple. This biopsy, together with the previous removal of approximately one quarter of the breast, which had occurred nine (9) days prior to admission, essentially destroyed the breast and dictated the removal of the remainder of the breast tissue. After my initial biopsy, the breast could not have been reconstructed.
The tissue, which I initially removed from Mrs. Solomon's breast, was examined by frozen section by pathologist Mary Schatz, M.D. Dr. Schatz reported to me that she did not find carcinoma. Following this, it was my information that Dr. Schatz, or someone in her office, made contact with someone in the pathologists' office in Cookeville, and the pathologists' office in Cookeville reported over the phone that Mrs. Solomon had an invasive carcinoma. I then excised the areolar nipple and all of the remaining tissue in the central portion of the breast and sent this to the pathologist for examination by frozen section, and this tissue was also reported to be free of carcinoma.
After the first biopsy, which I performed, the nipple and remaining portion of the breast was not salvageable. I proceeded with a modified radical mastectomy.
I did not rely on the pathology report from the Cookeville Pathology Laboratory at the time I admitted Mrs. Solomon to surgery. In my opinion, and on the basis of physical examination, Mrs. Solomon required an additional biopsy, and I intended to rely solely on the pathology done at the West Side Hospital. My initial biopsy, together with the prior removal of approximately twenty-five percent (25%) of the breast in Smithville, had destroyed the blood supply to the nipple and disfigured the breast beyond reconstruction. The breast was destroyed prior to the phone call, which Dr. Schatz's office reportedly made to the pathologists' office in Cookeville, and I would have proceeded with the modified radical mastectomy regardless of the telephone report.
Plaintiff presents the following two-part issue:
Whether the trial court erred in finding that Defendants' negligence did not proximately cause injury to the Plaintiff as a matter of law and in granting the Defendants' motion for summary judgment.
A. Whether Dr. Sadler's inconsistent statements regarding his reliance on the pathological findings of Defendants in removing Plaintiff's breast cancer created a genuine issue of material fact.
B. Whether Dr. Sadler's reliance on the pathological findings of the Defendants in performing his...
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