Valdez v. Lyman-Roberts Hosp., Inc.
| Decision Date | 24 June 1982 |
| Docket Number | No. 1894,LYMAN-ROBERTS,1894 |
| Citation | 638 S.W.2d 111 |
| Parties | Santiago and Guadalupe VALDEZ, et al., Appellants, v.HOSPITAL, INC., et al., Appellees. |
| Court | Texas Court of Appeals |
Peter Steiner, Tony Bonilla, Bonilla, Read, Bonilla & Berlanga, Inc., Corpus Christi, for appellants.
C. Dean Davis, David M. Davis, Davis & Davis, Austin, Lola L. Bonner, Rockport, for appellees.
Before NYE, C.J., and YOUNG and GONZALEZ, JJ.
This is an appeal from a judgment granting defendants-appellees' Motions for Instructed Verdicts at the conclusion of plaintiffs-appellants' case. Appellants are Santiago and Guadalupe Valdez, et al (Valdez), and appellees are Lyman-Roberts Hospital, Inc.; Aransas Hospital, Inc.; Mary Murphy and Sonja Rodriguez. Suit was originally filed by the parents and children of Juanita Valdez, seeking damages for the death of their daughter and mother. At the time of her death, Juanita Valdez was eight months pregnant and seeking medical and nursing assistance. The timetables leading up to Ms. Valdez' death are not entirely clear, but the following review is supported by the record.
At approximately 11:00 p.m., on the night of March 7, 1979, the decedent awakened ill and vomiting at her home in Rockport. The appellants, thinking the decedent was beginning labor pains, took her, in accordance with a prearrangement, to a midwife's house in Gregory, Texas. Upon arriving at the midwife's house, the decedent was examined; and it was determined that she was not in labor, but was seriously ill. The midwife so instructed the family and suggested that they take the decedent to a hospital. The family left Gregory, Texas, and proceeded to the Aransas Hospital in Aransas Pass. At this hospital, the decedent was taken by wheelchair to the labor room where a nurse, Sonja Rodriguez, attempted to take her vital signs. While Nurse Rodriguez was attempting to take the decedent's vital signs, a member of the Valdez family placed a call to Dr. Kumm of the Aransas Hospital. Dr. Kumm was not the doctor on call at that time, but was the Chief of Obstetrics at Aransas Hospital. Dr. Kumm spoke with Nurse Rodriguez. As to this conversation, Nurse Rodriguez testified that Dr. Kumm instructed her to inform the family of the limited facilities located at Aransas Hospital and that if the patient was seriously ill, they should take her to another hospital where she could receive the best possible care as quickly as possible. Nurse Rodriguez informed the family as to what Dr. Kumm had told her. The family left. (They had been there approximately 25-30 minutes.) Nurse Rodriguez testified that when the Valdez family left Aransas Hospital, she was not sure whether they were going to Lyman-Roberts Hospital a few blocks away or to Memorial Medical Center in Corpus Christi.
After leaving Aransas Hospital, the family took the decedent to Lyman-Roberts Hospital, arriving somewhere between 1:30 a.m. and 2:00 a.m. Their stay at Lyman-Roberts Hospital also lasted approximately 25 minutes. The record reflects that Nurse Murphy was the nurse in charge at Lyman-Roberts Hospital on the night in question. When the family arrived at Lyman-Roberts, Nurse Murphy informed them that they would have to go to Corpus Christi because the decedent was not a patient of any doctor at the hospital. This first encounter took approximately 10 minutes. After being turned away, the family went back to the car where they discovered that Juanita was in even greater pain, so they once again went to the emergency door and requested an ambulance. This time Nurse Murphy went to the car and said that she observed the following: That the decedent was in advanced pregnancy; that she was very large; that she had vomitus on her clothing; that she was lethargic; that her skin was pallid and moist; and that she was not perspiring freely. The decedent's breathing was in excess of normal, but it was not labored nor was she hyperventilating. Nurse Murphy testified that the decedent was ill and that she was fearful that the decedent was going into premature labor. However, upon examination, Nurse Murphy could not find any signs that decedent was in premature labor. The family requested that Nurse Murphy call a specialist. Nurse Murphy in turn informed the family that the quickest way they could get help for the decedent was to go to Memorial Medical Center in Corpus Christi. Nurse Murphy stated that she recommended that the family go to Memorial Medical Center because she knew that the decedent needed further evaluation.
The family, upon leaving Lyman-Roberts, returned to Rockport, Texas, and arrived home at 2:30 a.m. The autopsy report established that the decedent died at approximately 2:30 a.m. of a ruptured uterus.
At the close of appellants' testimony, the trial court entered a directed verdict in favor of both appellees, Aransas Hospital and Lyman-Roberts Hospital, based upon their finding that there was no evidence to prove that the negligence of the appellee hospitals proximately caused the death of Juanita Valdez. 1
In an instructed verdict case, the appellate court must determine whether there is any evidence of probative force to raise fact issues on the material question presented. In doing this, the court must consider the evidence in the most favorable light in support of plaintiff's position and disregard all contrary evidence and inferences. Collora v. Navarro, 574 S.W.2d 65 (Tex.1978); Henderson v. Travelers Insurance Company, 544 S.W.2d 649 (Tex.1976). When reasonable minds may differ as to the truth of controlling facts, the issue must go to a jury. Collora, supra.
The question in the present case is whether or not the negligence of the hospital(s) proximately caused either the death of Juanita Valdez or injuries which resulted in damages to her estate. The proof that must be met to establish this causal relationship is easily stated, but is often difficult to ascertain when a sufficient showing has been made to warrant submission of the issue to the jury. Since liability cannot turn upon speculation or conjecture, it is essential that the evidence establish causal connection beyond the point of conjecture. Allied Stores of Texas, Inc. v. McClure, 595 S.W.2d 165 (Tex. Civ. App.--Tyler 1980, rev'd on other grounds, 608 S.W.2d 901 [Tex.1980].
The mere possibility that an act of negligence might have been the proximate cause of damages from a medical viewpoint is not sufficient to support recovery. It must be shown that the act probably caused the injury. Bellaire General Hospital, Inc. v. Campbell, 510 S.W.2d 94 (Tex. Civ. App.--Houston [14th Dist.] 1974, writ ref'd n.r.e.).
The trier of fact is usually allowed to determine the issue of causation when probable causal relationship is shown by expert testimony. Lenger v. Physicians' General Hospital, Inc., 455 S.W.2d 703 (Tex.1970). However, expert testimony that an event is a possible cause of the condition cannot ordinarily be treated as evidence of reasonable medical probability except when, in the absence of other reasonable causal explanations, it becomes more likely than not that the condition did result from the event. Lenger, supra.
Turning now to the evidence in the record of this case, 2 Dr. Leslie Archer, appellants' expert medical witness, testified to the following: When questioned on whether or not stabilization of a patient with symptoms like those of the decedent would improve the patient's chances of survival, Dr. Archer responded that "it was essential." Dr. Archer also testified that, while a ruptured uterus is not a common occurrence, the symptoms that occur with it are common in that they are similar to an abruptio placenta. Dr. Archer also stated that any modern obstetric unit should have the facilities to handle the same. Dr. Archer stressed throughout his testimony that proper diagnosis was imperative, meaning that the quicker the abdomen is opened to find out where the bleeding is, the better the chance of surviving. Dr. Archer also testified that any modern obstetrics unit, including small ones, should have the facilities to handle a surgical catastrophe involving a pregnant woman within a 35-40 minute time frame. With regard to the decedent, Dr. Archer stated:
When asked if an improper nursing assessment was made at Lyman-Roberts Hospital, Dr. Archer responded:
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