In an unreported opinion of the Court of Special Appeals of Maryland (“Appellate Court”) dated November 5, 2014, which is Maryland’s intermediate appellate court, the Appellate Court overturned a verdict in favor of the Plaintiff in the amount of $620,000 that had been rendered by a Baltimore City medical malpractice jury after a six-day trial.
The Alleged Underlying Facts
The Plaintiff had gone to the emergency room of the University of Maryland Medical System Corporation (“UMS”) during the evening on May 30, 2007, complaining of a persistent headache for several days. At about 7:00 a.m. on May 31, the plaintiff had a lumbar puncture (commonly referred to as a “spinal tap”). The parties to the medical malpractice lawsuit disputed whether the plaintiff was administered narcotic pain medication at that time.
The plaintiff’s medical records indicated that the plaintiff had no complications with regard to the lumbar puncture, that she reported no pain to the nurses for several hours after the procedure, and that she was discharged to home at about 12 noon that day. Nonetheless, the Plaintiff alleged that one of the physicians pushed down on her neck during the lumbar puncture procedure and that she shouted out in pain as a result.
Later in the day on May 31, while the Plaintiff was climbing steps in her home, she had severe pain in her neck, shoulders, and upper back, for which she visited her primary care provider at UMS the next day and was admitted to the hospital. She was subsequently diagnosed with cervical spondylosis/degenerative disc disease and an acute herniated disc at C4-C5, for which she had several surgeries over the next year without complete resolution of her pain.
The plaintiff subsequently filed her Maryland medical malpractice lawsuit, alleging that her herniated disc and the resulting pain was caused by the negligent performance of her lumbar puncture.
The Defendant hospital contended on appeal that the trial court erred when it admitted into evidence an un-redacted medical bill which was used as substantive evidence regarding whether narcotic medication was administered to the Plaintiff during her lumbar puncture on May 31, 2007. Prior to trial, the parties had stipulated to the authenticity of the medical charges from June 1 to June 6, 2007 as part of the Plaintiff’s alleged damages claim, but the hospital’s printed bill included charges from May 30 to May 31, 2007 in addition to charges from June 1 to June 6, 2007. The trial court therefore required that the Plaintiff redact the medications and charges from May 30 and 31, 2007, before the document would be admitted into evidence.
Later in the trial, the Plaintiff’s attorney attempted to question one of the Defendant’s experts regarding hospital billing charges from May 31, in an attempt to substantiate the Plaintiff’s claim that she was administered narcotics on that date because narcotics appeared on the bill. The defense objected but the trial court reversed its original ruling and allowed the Plaintiff to introduce the un-redacted May 30 and 31, 2007 bill, after which the Plaintiff’s attorney questioned the defense witness regarding narcotic medications listed on the bill.
The Appellate Court stated that at no point did the Plaintiff lay a foundation or authenticate the bill – the parties’ stipulation was intended to establish damages that the Plaintiff incurred on June 1 – 6, 2007 and the parties did not stipulate to the authentication of the May billing charges. Furthermore, the Appellate Court said that the bill also lacked a proper foundation because the defense witness through whom the bill was admitted into evidence stated that he could not testify as to what the dates and charges meant.
The Appellate Court stated that introducing the medical bill as substantive evidence that the Plaintiff was given a narcotic became a significant piece of evidence that likely impacted the jury’s deliberations because the defense had argued that the Plaintiff injured herself when she returned home from the emergency room and began climbing her stairs (she had reported a pain level of 0/10 for several hours before she was discharged from the emergency room) and the Plaintiff had countered that the reason she did not feel any pain was because she had been administered narcotic pain medication (yet the treating doctors testified that the Plaintiff was not administered a narcotic and her medical records do not document that she was prescribed a narcotic).
The Appellate Court held: “introducing the medical bill as substantive evidence that she was given a narcotic became a significant piece of evidence that likely impacted the jury’s deliberations. Whether appellee was injured in the emergency room or at home was central to a finding of negligence in this case. Accordingly, the error of permitting the medical bill as substantive evidence to support appellee’s claim that she was injured on May 31 was prejudicial. Furthermore, we conclude that the error substantially injured UMS’ defense because of the timing at which appellee chose to raise this argument … Accordingly, we conclude that the error was substantially prejudicial and therefore, mandates reversal.”
University Of Maryland Medical System Corporation v. Roshell Blue, No. 1541 September Term, 2013.
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