Wilson v. Ashley Women's Ctr., P.A.
| Decision Date | 02 May 2017 |
| Docket Number | No. COA16-1004,COA16-1004 |
| Citation | 798 S.E.2d 815 (Table) |
| Court | North Carolina Court of Appeals |
| Parties | Karyn WILSON and Thomas Baumgardner, Individually, and Walter L. Hart, IV, Guardian Ad Litem for B.B., a Minor, Plaintiffs, v. ASHLEY WOMEN'S CENTER, P.A., George Daniel Jacobs, M.D., and Nancy Kuney, CNM, Defendants. |
Dugan, Babij, Tolley & Kohler, LLC, by George S. Tolley III, and Charles G. Monnett III & Associates, Charlotte, by Charles G. Monnett III, for plaintiff-appellants.
Parker Poe Adams & Bernstein LLP, by John H. Beyer, Charlotte, and Jonathan E. Hall, Raleigh, for defendant-appellees.
Karyn Wilson ("Ms. Wilson") and Thomas Baumgardner, individually, and Walter L. Hart, IV, guardian ad litem for B.B., (collectively "plaintiffs") appeal from judgment entered in favor of Ashley Women's Center, P.A. ("Ashley Women's Center"), George Daniel Jacobs, M.D. ("Dr. Jacobs"), and Nancy Kuney, CNM ("Kuney") (collectively "defendants") and dismissing plaintiffs' claims with prejudice. For the reasons stated herein, we hold no error.
On 29 September 2011, plaintiffs filed a complaint against Gaston Memorial Hospital, Incorporated ("Gaston Memorial"), Caromont Medical Group, Inc., Ashley Women's CMG, LLC, and defendants. The complaint alleged that Ms. Wilson came under the medical care of defendants and Gaston Memorial for medical management of her pregnancy. On 12 March 2007, she was admitted to Gaston Memorial for medical induction of labor for her pregnancy which had progressed one week past her expected delivery date of 5 March 2007. Ms. Wilson was under the care and responsibility of the agents, servants, and/or employees of Ashley Women's Center and Gaston Memorial. On 12 March 2007, a plan of "Pitocin induction of labor next several days" was noted in the medical chart. On 13 March 2007, Pitocin was continued with increasing dosages throughout the day. On the morning of 14 March 2007, Dr. Jacobs "assumed responsibility for the obstetrical care and treatment" of Ms. Wilson during her labor at Gaston Memorial and Kuney assumed responsibility for providing midwifery care to Ms. Wilson.
Plaintiffs also alleged that at approximately 13:33 hours on 14 March 2007, Kuney made a record in the medical chart that, after consultation with Dr. Jacobs, Pitocin would be administered again to Ms. Wilson. At approximately 15:00 hours, it was noted that Kuney had ordered that the dosage of Pitocin should remain at six mu/min. At 17:16 hours, Kuney conducted a vaginal exam of Ms. Wilson and noted that her cervix was six centimeters dilated and consulted with Dr. Jacobs in regard to Ms. Wilson. At approximately 18:09 hours, Dr. Jacobs performed a vaginal examination of Ms. Wilson and noted that she was fully dilated at ten centimeters. The administration of Pitocin was stopped and Kuney was paged. Ms. Wilson began pushing at 18:22 hours. At approximately 19:48 hours, Kuney assessed that Ms. Wilson was "making slow progress with pushing."
At approximately 21:21 hours, B.B.'s head was delivered. B.B.'s delivery was complicated by shoulder dystocia. For two minutes, Dr. Jacobs and Kuney made several unsuccessful attempts to deliver the body of B.B. At 21:23 hours, the entire body of B.B. was successfully delivered by Dr. Jacobs. B.B.'s medical chart stated the following: "Prolonged fundal pressure, nuchal x 1, shoulder dystocia." Gaston Memorial's admission summary contained a note that B.B. "had significant head molding with caput/bruising with excoriation, and also had bruising of the face, lips and chest near the left nipple area, and also that there was no movement noted in the left arm." On 15 August 2007, B.B. was seen by Dr. Scott H. Kozin at Shriners Hospital in Philadelphia, Pennsylvania. B.B. was diagnosed with a brachial plexus palsy and Horner's syndrome on the left side, requiring nerve graft surgery. Dr. Kozin performed Based on the foregoing allegations, plaintiffs brought a medical negligence claim against defendants.
Plaintiffs voluntarily dismissed, without prejudice, all claims against Caromont Medical Group, Inc., Ashley Women's CMG, LLC, and Gaston Memorial.
On 4 August 2015, plaintiffs filed a motion to bifurcate the trial, which was granted.
The liability phase of this case came on for trial at the 17 August 2016 session of Gaston County Civil Superior Court, the Honorable Linwood O. Foust presiding. On 3 September 2015, a jury returned a verdict in favor of defendants. Judgment was entered 16 September 2015. Plaintiffs appeal.
Plaintiffs advance three issues on appeal. First, plaintiffs argue that the trial court erred by excluding Robert Allen's causation opinions. Second, plaintiffs contend that the trial court erred by excluding evidence regarding prior lawsuits and claims against Kuney. Third, plaintiffs argue that the trial court erred in using North Carolina's Civil Pattern Jury Instruction 809.00 to instruct the jury. We address each argument in turn.
Plaintiffs contend that the trial court erred by excluding Robert Allen's causation opinions. Specifically, plaintiffs contend that the trial court abused its discretion by concluding that only medical doctors may opine on the issue of causation. Plaintiffs cite to Maloney v. Wake Hospital Systems, Inc. , 45 N.C. App. 172, 262 S.E.2d 680 (1980), in support of their argument.
When reviewing the ruling of a trial court concerning the admissibility of expert opinion testimony, the standard of review for an appellate court is whether the trial court committed an abuse of discretion. An [a]buse of discretion results where the court's ruling is manifestly unsupported by reason or is so arbitrary that it could not have been the result of a reasoned decision.
State v. Davis , 239 N.C. App. 522, 528, 768 S.E.2d 903, 907 (2015) (citation and internal quotation marks omitted).
It is well established that "[o]ur courts rely on medical experts to show medical causation because the exact nature and probable genesis of a particular type of injury involves complicated medical questions far removed from the ordinary experience and knowledge of laymen[.]" Azar v. Presbyterian Hosp. , 191 N.C. App. 367, 371, 663 S.E.2d 450, 453 (2008) (internal quotation marks and citation omitted).
Here, Robert Allen ("Dr. Allen") was tendered and accepted by the trial court as an expert in biomedical engineering and the assessment of forces employed in the management of shoulder dystocia. Dr. Allen testified during voir dire that he is not a medical doctor but has a Ph.D. in engineering; has never delivered a baby; has never been in a delivery room where a live shoulder dystocia event has occurred; has never measured the forces during a live birth where a permanent shoulder dystocia or permanent brachial plexus injury has occurred; was not qualified to offer any medical opinions; and was not qualified to offer standard of care opinions.
Although plaintiffs contend that the trial court did not allow Dr. Allen to testify as to causation based on a conclusion that only medical doctors may opine on the issue of causation, this is a mischaracterization of the trial court's holding. In the present case, the trial court concluded as follows:
Therefore, the trial court concluded that Dr. Allen could not render an opinion on medical causation in this case because he did not have medical training.
In Maloney , the plaintiff alleged nurse malpractice after the defendant nurse administered undiluted potassium chloride intravenously. Maloney , 45 N.C. App. at 172, 262 S.E.2d at 680-81. At trial, the plaintiff offered the testimony of Judy Atkins, a nurse who had been specially trained in intravenous therapy, to show that the defendant nurse had breached her duty of care to the plaintiff and did cause the plaintiff's injuries. Id. at 173, 262 S.E.2d at 681. The trial court did not allow Judy Atkins to testify as to the causation issue, stating that "he did not believe an individual not licensed to diagnose or prescribe medical treatment could testify as to injury causation." Id. On appeal, the issue before our Court was "whether an expert who is not a medical doctor may give expert opinion testimony as to the cause of a physical injury." Id. at 174, 262 S.E.2d at 681. Our Court held as follows, in pertinent part:
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