Styles v. Ceranski

• Decision Date: 09 January 1996
• Docket Number: CA-CV,No. 1,1
• Citation: 916 P.2d 1164,185 Ariz. 448
• Parties: Maria B. STYLES and Charles E. Styles, wife and husband, Plaintiffs-Appellees, v. Walter A. CERANSKI, M.D. and Cathy Ceranski, husband and wife, and Walter A. Ceranski, M.D., LTD., an Arizona corporation, Defendants-Appellants. 93-0450.
• Court: Arizona Court of Appeals

Page 1164

916 P.2d 1164

185 Ariz. 448

Maria B. STYLES and Charles E. Styles, wife and husband, Plaintiffs-Appellees, v. Walter A. CERANSKI, M.D. and Cathy Ceranski, husband and wife, and Walter A. Ceranski, M.D., LTD., an Arizona corporation, Defendants-Appellants.

No. 1 CA-CV 93-0450.

Court of Appeals of Arizona Division 1, Department A.

Jan. 9, 1996.

Reconsideration Denied March 14, 1996.

Petition for Review Withdrawn May 30, 1996.

Harris & Palumbo, P.C. by John D. Harris and Gene M. Cullan, Phoenix, and Steptoe & Johnson by Bruce E. Meyerson and Mark A. Fuller, Phoenix, for Plaintiffs-Appellees.

Weyl, Guyer, MacBan & Olson, P.A. by Barry A. MacBan and Jolane D. Veeder, Phoenix, and Mitten, Goodwin & Raup by Donald F. Froeb, Phoenix, for Defendants-Appellants.

OPINION

NOYES, Presiding Judge.

Walter A. Ceranski, M.D., Cathy Ceranski, and Walter A. Ceranski, M.D., Ltd. appeal from a judgment entered on a jury's verdict holding Dr. Ceranski solely at fault for an unnecessary pancreatectomy performed by Dr. Attila S. Szokol on Appellee Maria B. Styles. Because there is no evidentiary support for a verdict that Dr. Ceranski was at fault but Dr. Szokol was not, we reverse the judgment. Because the liability and damages issues were intertwined, and were both impacted by the trial court's error in allowing three of Styles' damages witnesses to become standard of care witnesses as well, we remand for new trial on all liability and damages issues. Because none of the errors at trial affected the statute of limitations defense, we affirm the jury's finding that Styles' claims were not time-barred.

I

The events that led to this lawsuit began on August 17, 1983, when Styles went to the hospital with acute abdominal pain. Dr. Ceranski, a board-certified family physician, was called in because he had been Styles' treating physician since September 1982. The next day, Ceranski asked three gastroenterologists to help diagnose her condition. One found Styles' complaints consistent with those she had been making since 1977 and noted, "Rule out pancreatitis." Another noted, "I suspect she is ventral pancreas (pancreas divisum), which can be associated with chronic pancreatitis."

Dr. Szokol, a board-certified general surgeon, was also called in to see Styles, his former patient. In 1977 and 1979, Szokol had removed Styles' appendix and gallbladder in response to her complaints of abdominal pain. In the 1983 consultation, Szokol diagnosed chronic pancreatitis and recommended surgery. Szokol told Ceranski that a pancreatectomy was probably the procedure of choice, but he would not know what to resect until he was in surgery. Ceranski approved an exploratory laparotomy, with pancreatectomy at the discretion of Szokol.

Styles signed a form consenting to "exploratory laparotomy with pancreatectomy, possible hemorrhoidectomy." Szokol contended that he explained to Styles the test results, the diagnosis, the surgery, and the related complications. Styles contended that the doctors did not explain anything; they just said they could cure her pain.

On August 26 Szokol operated on Styles, assisted by a board-certified surgeon as first assistant and Ceranski as second assistant. When Szokol saw the pancreas and concluded that it was abnormal, he removed ninety percent of the pancreas and all of the spleen. At trial, Styles proved that the pancreas was normal, that it should not have been removed, and that its removal caused her to become diabetic.

After discharge from the hospital on September 5, 1983, Styles saw Ceranski for follow-up care until August 1987, when she began going to the Mayo Clinic and there learned that her diabetes had been caused by the pancreatectomy. In January 1989, Styles and her husband brought this medical malpractice action against Szokol and Ceranski and their corporations and spouses (and others who were dismissed), claiming that the defendant doctors inaccurately diagnosed chronic pancreatitis and performed an unnecessary pancreatectomy that made her an insulin-dependent diabetic.

The claims against Szokol went to binding arbitration on the issue of damages, Szokol having admitted fault for purposes of that proceeding. The arbitration panel awarded Styles and her husband $825,000 in damages against Szokol, who then settled with Styles. Later, when the case proceeded to jury trial, Ceranski argued that Szokol was a non-party at fault, and Styles argued that the jury should assign all fault to Ceranski and award Styles no less than four million dollars in damages. The jury did just that; the verdict assigned all fault to Ceranski and awarded Styles four million dollars in damages. The jury also found that Styles' complaint was not time-barred. The court entered judgment and denied Appellants' motion for new trial. We have jurisdiction of the appeal pursuant to Arizona Revised Statutes Annotated ("A.R.S.") sections 12-2101(B) and (F)(1) (1994).

II

A motion for new trial on grounds that the verdict is against the weight of the evidence is within the sound discretion of the trial court. The trial court's denial of the motion will be reversed only if it reflects a manifest abuse of discretion given the record and circumstances of the case. Blakely Oil, Inc. v. Wells Truckways, Ltd., 83 Ariz. 274, 278, 320 P.2d 464, 466 (1958). In reviewing a jury verdict, we view the evidence in a light most favorable to sustaining the verdict, and if any substantial evidence could lead reasonable persons to find the ultimate facts sufficient to support the verdict, we will affirm the judgment. Curlee v. Morris, 72 Ariz. 125, 127, 231 P.2d 752, 753 (1951). However, "it is not only our right, but our duty, to set aside a verdict" if there is no evidence in the record to justify it. Spain v. Griffith, 42 Ariz. 304, 305, 25 P.2d 551, 551 (1933).

We find absolutely no evidence to justify a conclusion that Ceranski was at fault but Szokol was not. Styles' main injury was caused by the unnecessary removal of her pancreas, and it was undisputed that Szokol was the one who decided to remove her pancreas. If Ceranski was at fault for this surgery, so was Szokol.

At trial, Ceranski attempted to show that he had met the standard of care by calling in physicians with more expertise (three gastroenterologists and surgeon Szokol) when he himself could not determine the cause of Styles' abdominal complaints. Styles countered by arguing that Ceranski, as the family physician, was responsible for her overall care and the supervision of consulting physicians, and bore the ultimate responsibility for any misdiagnosis or treatment she received. The jury's verdict reflects total acceptance of this theory, but this theory is no justification for disregarding the undisputed role--and fault--of Szokol in this unnecessary surgery.

Styles argues that Ceranski never faulted Szokol. This is true, but Ceranski did not exonerate Szokol; he merely said that he, Ceranski, a family physician, did not feel qualified to criticize a surgeon's operating-room decisions. All of the experts who did feel qualified to criticize Szokol did so in clear terms. Styles' standard of care expert, Dr. Moossa, testified that Ceranski had a majority of the fault pre-operatively and post-operatively, but that Szokol was in charge during surgery and was the one at fault for removing a normal pancreas. Dr. Moossa identified nine specific ways in which Szokol fell below the standard of care in treating Styles. Ceranski's standard of care expert, Dr. Price, testified that the surgeon is responsible for the surgery and for the surgical care of the patient. Szokol himself admitted that he was in charge of getting Styles ready for surgery, he was in charge of Styles during surgery, he was the one who "made the decision" to remove her pancreas, and he made this decision without consulting Ceranski.

In denying the motion for new trial, the trial court found that the jury's failure to assign any fault to Szokol could be explained by the fact that Szokol did not admit fault and Ceranski did not fault Szokol. As discussed above, Ceranski did not exonerate Szokol; he just did not feel qualified to criticize him. And the reason that Szokol did not admit fault (in this trial) was that he believed he had done nothing wrong by removing Styles' pancreas. Styles' experts ridiculed this opinion, and the damages verdict makes plain that the jury rejected this opinion.

During oral argument on the motion for new trial, the trial court said to counsel, "there's only one person in the courtroom who didn't think Szokol was at fault.... And that's Dr. Ceranski." To which Ceranski's counsel accurately responded, "And his testimony was, 'I'm not qualified to render that opinion.' " But in its minute entry denying the motion for new trial, the court found that "a jury could rationally decide that Dr. Szokol was not at fault." On this record, however, a jury could not rationally decide that only the surgeon's second assistant was at fault for the surgeon's decision to remove a normal pancreas.

In the minute entry denying the motion for new trial, the court found that the evidence of negligence and causation was "overwhelming." If that is true for Ceranski, it must also be true for Szokol. Styles' liability theory concerning Ceranski, in the main, was that Szokol's diagnosis of chronic pancreatitis and his recommendation for surgery were such patently unfounded decisions that even a family physician such as Ceranski should have known it. For example, Dr. Moossa testified that Szokol's diagnosis of chronic pancreatitis "was totally wrong, and the evidence thus far is that Ceranski should have challenged that opinion or should have asked for some explanation." According to Dr. Moossa, "[i]f Ceranski had done his job, Szokol would never have gotten to her." In Dr. Moossa's opinion, anyone who agreed with Szokol's recommendation for surgery was in "cuckoo land." If that is where Ceranski was,...