In a New York medical malpractice appeal decided on April 2, 2013 by the highest court in New York (New York Court of Appeals), the Court of Appeals stated that a new trial on damages for pain and suffering was necessary because the lower courts erred in holding that causation issues could not be litigated during a damages-only trial.
The Underlying Facts
On July 18, 1998, the medical malpractice plaintiff suffered a sudden, severe headache that was accompanied by vomiting and sensitivity to light. His headache persisted for three weeks. As the trial evidence established, the headache and other symptoms were due to an aneurysm (a bulge) in a blood vessel near the man’s brain that was undetected until it ruptured on August 7, 1998, causing a severe stroke that permanently disabled him.
Between July 18 and August 7, 1998, the man had consulted with several doctors and had a brain CT scan at a local hospital. The evidence provided by the medical malpractice plaintiff at trial supported the jury’s determination that the CT scan was either misread or not read at all, and that if the CT scan had been read properly and timely, the aneurysm could have been detected and the stroke prevented.
The man and his wife filed a medical malpractice lawsuit in 2000 against various doctors and the hospital where the CT scan was performed. The medical malpractice trial was not held until 2008, at the conclusion of which the jury found two of the defendant doctors and the hospital negligent and that their negligence was a substantial factor in causing the man’s injuries. The jury determined that one doctor was 5% at fault, the other was 1% at fault, the hospital was 75% at fault, and the neurology group that was responsible for reading the CT scan on behalf of the hospital was 19% at fault for the man’s injuries. The jury awarded damages that totalled approximately $5.1 million.
Post-trial motions resulted in a new trial being ordered on the issue of damages only (the issue of causation having been decided by the first jury). The second jury trial was in 2009 and resulted in the jury awarding damages totaling approximately $16.7 million, in addition to the undisturbed $1.1 million portion of the first verdict. The defendants appealed the verdict of the second jury.
The Court of Appeals held that the trial court erred in prohibiting the defendants from litigating issues of causation at the second, damages-only trial because causation issues are relevant both to liability and to damages — in a medical malpractice case, liability cannot be established unless it is shown that the defendant’s malpractice was a substantial factor in causing the plaintiff’s injury. Therefore, even where liability is established, the plaintiff may recover only those damages proximately caused by the malpractice (where a condition existing before the malpractice occurred may have contributed to the plaintiff’s injury, the plaintiff is not entitled to recover those damages that the preexisting condition would have caused in the absence of malpractice).
In the present case, the Court of Appeals noted that the plaintiff had a preexisting condition, an aneurysm in a blood vessel near his brain, and that the defendants’ malpractice did not cause the aneurysm. Therefore, the defendants should have been allowed to show that, even with appropriate medical care, some of the injuries that the plaintiff suffered were inevitable. The Court of Appeals held that the first jury did decide that the malpractice was a substantial factor in causing the plaintiff’s stroke, but the defendants were entitled to show during the second trial that some of the pain and suffering that the plaintiff suffered was not preventable.
The Court of Appeals thus reversed the second jury’s awards (totaling $9.6 million) for pain and suffering but upheld the awards of the second jury in the other categories of damages that were submitted to it: custodial care and supportive services for the plaintiff, the plaintiff’s wife’s past and future loss of her husband’s services and society (the plaintiff died during the appeal), and the wife’s future loss of household services (the plaintiffs’ damages in these categories are attributable simply to the fact that the plaintiff had a disabling stroke).
Source: Lisa M. Oakes, Individually and as Executrix of the Estate of Daniel C. Oakes, Deceased, Respondent, v. Rajnikant Patel, M.D., et al., Appellants. No. 51.
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