The EState Willson v. Addison

• Decision Date: 29 July 2011
• Docket Number: No. DA 10–0519.,DA 10–0519.
• Citation: 361 Mont. 269,2011 MT 179,258 P.3d 410
• Parties: The ESTATE OF Madeleine WILLSON and Robert Willson, Plaintiffs and Appellants,v.Dr. Brice T. ADDISON, Benefits Healthcare System and Peace Hospice of Montana, Defendants, Appellees, and Cross–Appellant.
• Court: Montana Supreme Court

361 Mont. 269

258 P.3d 410

2011 MT 179

The ESTATE OF Madeleine WILLSON and Robert Willson, Plaintiffs and Appellants,

v.Dr. Brice T. ADDISON, Benefits Healthcare System and Peace Hospice of Montana, Defendants, Appellees, and Cross–Appellant.

No. DA 10–0519.

Supreme Court of Montana.

Submitted on Briefs June 22, 2011.Decided July 29, 2011.

For Appellants: Geoffrey C. Angel, Angel Law Firm, Bozeman, Montana.For Appellees: Kevin A. Twidwell, Larry E. Riley, Garlington, Lohn & Robinson, PLLP, Missoula, Montana (Dr. Addison) Julie A. Lichte, Kiely Keane, Crowley Fleck, PLLP, Bozeman, Montana (Benefis and Peace Hospice).Justice MICHAEL E. WHEAT delivered the Opinion of the Court.

[361 Mont. 270] ¶ 1 Plaintiffs, the Estate of Madeleine Willson and Robert Willson, individually, (collectively “Robert”) appeal an order of the Eighth Judicial District Court, Cascade County, granting Defendants' Benefis Hospitals, Inc. (“Benefis”), Peace Hospice of Montana (“Peace Hospice”), ¹ and Dr. T. Brice Addison (“Dr. Addison”) ² motion for summary judgment and denying Robert's motion for summary judgment. Benefis cross-appeals. We affirm.

¶ 2 Dr. Addison was Madeleine Willson's (“Madeleine”) physician for approximately 20 years. In 2000, Madeleine was diagnosed with breast cancer. She had a double mastectomy but declined chemotherapy or radiation treatment. In July 2005, Madeleine's condition had deteriorated significantly. She contacted Dr. Addison's office on July 29, 2005, but he was on vacation so she was referred to the Benefis Hospital emergency room. Madeleine was admitted to the hospital the same day with a diagnosis of metastatic breast cancer with liver and bone metastases. Her cancer had spread to her liver, skull, vertebrae, spleen, lymph nodes, and uterus.

¶ 3 Her attending physician, Dr. Hong, consulted with an oncologist, Dr. Warr. Dr. Warr felt Madeleine's condition was grave and she should be admitted to hospice. Dr. Warr ordered palliative care, including medications for pain. He felt her prognosis was measured in days or weeks at the most. On August 3, 2005, Dr. Addison cut short his vacation and returned to see Madeleine. After examining Madeleine, Dr. Addison told Robert that Madeleine could die at any time. After consulting with Dr. Addison, Robert agreed to admit Madeleine to Peace Hospice.

¶ 4 Dr. Addison prepared the orders for Madeleine's admission to hospice, which included orders for the administration of medication for anxiety and pain on an as-needed basis. Dr. Addison maintains that Robert never told him that Madeleine did not want narcotic pain medication. Dr. Addison recalls conversations over his 20 years as Madeleine's physician where she told him she wanted to be comfortable when she died. Madeleine also wrote a letter to her oncologist, stating she wanted a doctor to help alleviate her pain as she approached death. Madeleine also signed a living will, indicating that she did not want any procedures “that merely prolong the dying process and are not necessary to my comfort or freedom from pain.”

¶ 5 Madeleine was admitted to Peace Hospice on August 4, 2005. While at Peace Hospice, Madeleine was given medication for pain and anxiety. In August 2008, while Madeleine's case was pending before the Montana Medical Legal Panel, Benefis destroyed a Narcotic Count Record (“NCR”) kept by Peace Hospice relating to medications given to Madeleine during her brief (less than 24 hour) stay at Peace Hospice. The NCR was destroyed pursuant to Benefis's three year record retention policy. The NCR is not a patient record, but documents the count of narcotic drugs at Peace Hospice to ensure they are not diverted. It also documents the destruction of any remaining narcotics after a patient is discharged. Doses administered to patients are documented in the specific patient's medical chart.

¶ 6 In the early hours of August 5, 2005, Madeleine became unresponsive and her respiratory rate declined. A hospice nurse called Dr. Addison at Robert's insistence. Robert felt that Madeleine's unresponsiveness was due to medication and he wanted Madeleine transferred back to the emergency room. Dr. Addison agreed to the transfer, even though it went against Madeleine's do not resuscitate order, because Robert was adamant. At the emergency room, Dr. Addison ordered the administration of Narcan, a drug that reverses the effects of narcotics. Madeleine did not respond to the drug.

¶ 7 Madeleine was then admitted to Benefis Hospital. She never regained consciousness and died on August 10, 2005. An autopsy concluded Madeleine died of metastatic breast cancer and acute aspiration pneumonia. Robert requested that the pathologist send samples to the Mayo Clinic for analysis of a possible overdose. The Mayo Clinic determined Madeleine did not suffer an overdose.

¶ 8 Robert filed his complaint on January 5, 2009, alleging medical malpractice—that the administration of medication “expedite[d]” Madeleine's death and that Madeleine did not give informed consent regarding the administration of the medications. After discovery was conducted, Benefis filed two motions for summary judgment. The first argued that Robert had failed to establish causation through qualified expert testimony, which Dr. Addison joined; ³ the second argued that Robert did not establish breach of the standard of care through qualified expert testimony. Robert also filed a motion for summary judgment seeking default judgment in his favor as sanction for Benefis' alleged spoliation of evidence.

¶ 9 The District Court held a hearing on the motions, and after reviewing the record and the experts' depositions, ultimately granted summary judgment on the issue of causation in favor of Benefis and Dr. Addison. The District Court found that “Plaintiffs have failed to produce any testimony that Defendants' alleged breach of the standard of care caused Ms. Willson to have a shorter life.” The District Court did not rule on Benefis' motion for summary judgment regarding standard of care. It denied Robert's motion for summary judgment regarding spoliation of evidence. Judgment was entered in favor of Benefis and Dr. Addison on all Robert's claims.

¶ 10 Robert appeals the grant of summary judgment on causation and the denial of his motion for summary judgment on spoliation. Benefis cross-appeals the non-ruling on its motion for summary judgment regarding standard of care. Because we affirm both the grant of summary judgment to Benefis and Dr. Addison on the issue of causation and the denial of Robert's motion for summary judgment on the issue of spoliation, we do not reach Benefis' cross-appeal.

STANDARD OF REVIEW

¶ 11 We review summary judgment rulings de novo. Goettel v. Estate of Ballard, 2010 MT 140, ¶ 10, 356 Mont. 527, 234 P.3d 99. Applying the same M.R. Civ. P. 56 criteria as the district court, we determine whether the moving party has established both the absence of any genuine issues of material fact and entitlement to judgment as a matter of law. Id. We review a district court's conclusions of law for correctness. Id. at ¶ 11. We review a district court's findings of fact to determine whether they are clearly erroneous. Id.

¶ 12 We review a District Court's decision related to discovery sanctions for an abuse of discretion. Eisenmenger v. Ethicon, Inc., 264 Mont. 393, 402, 871 P.2d 1313, 1319 (1994).

DISCUSSION

¶ 13 Summary judgment is appropriate when the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law. M.R. Civ. P. 56; Old Elk v. Healthy Mothers, Healthy Babies, Inc., 2003 MT 167, ¶ 15, 316 Mont. 320, 73 P.3d 795; Montana Deaconess Hospital v. Gratton, 169 Mont. 185, 188, 545 P.2d 670, 672 (1976). The initial burden is on the moving party to establish that no genuine issue of material fact exists. Old Elk, ¶ 15. The burden then shifts to the non-moving party, who must “set forth specific facts showing that there is a genuine issue for trial.” Id.

¶ 14 To raise a genuine issue of material fact, the proffered evidence must be “material and of a substantial nature, not fanciful, frivolous, gauzy or merely suspicious.” Id. at ¶ 16. The opposing party must present substantial evidence, as opposed to mere denial, speculation, or conclusory statements, that raises a genuine issue of material fact. Peterson v. Eichhorn, 2008 MT 250, ¶ 13, 344 Mont. 540, 189 P.3d 615.

¶ 15 Did the District Court err when it granted summary judgment to Benefis and Dr. Addison on the issue of causation and denied Robert's motion for summary judgment on the issue of spoliation?

A. Grant of Summary Judgment on Causation

¶ 16 Benefis, joined by Dr. Addison, sought summary judgment on the issue of causation. They argued that Robert failed to meet his burden of establishing this element by expert testimony. Robert opposed the motion. The District Court granted Benefis's and Dr. Addison's motion, finding that Robert failed to meet his burden of demonstrating a genuine issue of material fact regarding causation. It found that Robert failed to produce testimony that Defendants' alleged breach of the standard of care caused Madeleine to have a shorter life.

¶ 17 It is well settled Montana law that the plaintiff in a medical malpractice action must establish the following elements: (1) the applicable standard of care, (2) the defendant departed from that standard of care, and (3) the departure proximately caused plaintiff's injury. Gratton, 169 Mont. at 189–90, 545 P.2d at 672. Without expert testimony to establish these elements,⁴ no genuine issue of material fact exists and the defendant is entitled to judgment as a matter of law. Id.; Falcon v. Cheung, 257 Mont. 296, 303, 848 P.2d 1050, 1055 (1993); Estate of Nielsen v. Pardis, 265 Mont. 470, 473–74, 878 P.2d 234, 235–36 (1994).

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