The United States District Court for the Western District of Missouri Central Division (“Federal Court”) held in its Order dated August 14, 2020: “In sum, on the facts, law, and arguments presented here, Mr. Campbell’s pre-treatment conduct and his medical conditions as described by Defendants “gave rise to [Mr. Campbell’s] condition and the occasion for [Defendants’] negligence,” and cannot be the “basis for the jury to apportion fault to [Mr. Campbell] for any injury caused by [Defendants’] negligence” under Missouri law. Van Vacter, 865 S.W.2d at 359. Defendants have not pointed to evidence that Mr. Campbell’s conduct is analogous to the examples described above wherein a patient’s comparative fault is submissible, nor have they cited any law indicating Mr. Campbell’s alleged prior conduct or conditions can form the basis for comparative fault in this case. Therefore, Plaintiff’s motion for summary judgment on Defendants’ affirmative defense of comparative fault is granted.”
The Underlying Facts
Fifty-eight-year-old Mr. James Campbell, Jr. visited defendant Lake Regional Medical Care – Eldon on the morning of June 24, 2016, complaining of shortness of breath, dizziness, and occasional cough with clear, thick mucus lasting for two days prior. Later that morning, Mr. Campbell was discharged and told to go to the ER immediately for further evaluation if he became increasingly short of breath, if he experienced heart palpitations, or if his heart rate became fast or felt as if it was racing. Nurse Revelle testified that Mr. Campbell was a cooperative patient and that she did not recall him failing to do anything she asked him to do.
Later that evening, Mr. Campbell’s wife and friends found him on the floor and called emergency services. Mr. Campbell was pronounced dead shortly after midnight.
Mr. Campbell’s surviving spouse, Michelle Campbell, filed her Missouri medical malpractice wrongful death lawsuit, alleging in part that Nurse Revelle breached the standard of care by failing to recognize that Mr. Campbell had symptoms and risk factors of acute coronary syndrome and that the defendants could not rule out an acute myocardial infarction. The plaintiff further contended that based on Mr. Campbell’s presentation at the clinic, the defendants failed to send him to the emergency room for appropriate diagnostics and treatment of acute coronary syndrome. The plaintiff contended that Mr. Campbell died of arteriosclerotic heart disease leading to acute myocardial infarction.
The defendants contended that the actual cause of Mr. Campbell’s death was respiratory arrest leading to cardiac arrhythmia resulting from decreased oxygen supply due to Mr. Campbell’s new onset pulmonary pathology combined with hypertension, on top of preexisting emphysema and prominent smoker’s bronchiolitis. The defendants argued that Mr. Campbell’s cardiac arrythmia then led to a type II myocardial infarction.
The plaintiff moved for partial summary judgment on the defendants’ affirmative defense of comparative fault, contending that (1) Missouri law does not permit Defendants to assert comparative fault for the condition which caused Mr. Campbell to seek medical treatment and (2) even if Defendants could assert this affirmative defense, there is no evidentiary support in the record for Defendants’ comparative fault allegations. The defendants responded that Mr. Campbell “presented with a lung condition and was treated for that condition. Decedent’s preexisting medical condition and his lifestyle choices for many years contributed to his lung condition and his ultimate cause of death, which is submissible to a jury.”
Federal Court Opinion
In 1983, Missouri adopted the system of pure comparative fault in tort actions, meaning “a plaintiff’s negligence that concurs with that of the defendant does not relieve the defendant from liability. It merely diminishes the amount of damages that the plaintiff can recover.” Comparative fault is an affirmative defense in which the defendant must prove that the actions or omissions of the plaintiff contributed to the plaintiff’s loss to negate or reduce the defendant’s legal responsibility. When it comes to medical malpractice actions, courts have been reluctant to impose joint liability upon a patient in a malpractice lawsuit for the condition which caused him to seek the physician’s assistance, even if the patient negligently imposed the condition upon himself.
The Federal Court stated that the defendants theory is that Mr. Campbell’s negligence and pre-existing medical and physical conditions—e.g. Mr. Campbell’s alleged “inhalation of particular matter” in conjunction with his “preexisting lung condition from years of smoking”—were the proximate cause of his death. The Federal Court stated that “even assuming Mr. Campbell was negligent in these ways, this conduct gave rise to the conditions for which he sought treatment. This conduct was not “simultaneous and cooperative” with Defendants’ alleged negligent acts occurring after Mr. Campbell sought treatment … Defendants do not explain, and the Court does not see, how Mr. Campbell’s alleged negligence in smoking cigarettes and sanding concrete without a mask, or his alleged “failure to follow up on health-related issues and his unhealthy lifestyle,” were any more “simultaneous and cooperative with” Defendants’ alleged negligence here than in Van Vacter. Rather, as stated above, these appear to be the conditions and conduct which gave rise to the condition for which Mr. Campbell sought treatment from the clinic.”
The Federal Court continued, “Defendants here have not provided any evidence from which a jury could conclude that Mr. Campbell failed to follow Defendants’ instructions. Rather, Plaintiff provides evidence that Mr. Campbell was cooperative during the appointment, that he took Defendants’ prescribed breathing treatments, and that Nurse Revelle does not recall Mr. Campbell failing to do anything that she asked of him. Therefore this theory of comparative fault is inapplicable here.”
A Missouri Court of Appeals has indicated that a jury could potentially apportion based on a patient’s fault where there is evidence that the patient’s condition caused or contributed to the cause the patient’s death, that the patient recognized that his symptoms were attributed to his condition, and that the patient knew his condition was out of control, yet failed to seek medical attention. However, “Here, while Defendants present evidence that Mr. Campbell’s lung condition and inhalation of particles while sanding concrete caused or contributed to his death, there is no evidence that Mr. Campbell knew his symptoms were indicative of a serious or life-threatening condition.”
Source Campbell v. Lake Regional Medical Management, Inc., Case No. 2:19-cv-04124-NKL.
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