In its opinion filed on March 6, 2017, the Court of Appeals of Georgia Fifth Division (“Appellate Court”) held that the Georgia medical malpractice plaintiff had failed to provide sufficient expert testimony to establish that the defendants’ alleged medical negligence caused the plaintiff’s alleged injury, and therefore affirmed the trial court’s grant of summary judgment to the defendants.
The plaintiff had a robotic-assisted laparoscopic prostatectomy (“RALP”) on December 3, 2009 that required that he be positioned in a steep Trendelenburg position (the patient’s head is low and the body and legs are on an elevated and inclined plane; the patient’s head is positioned below the patient’s pelvis at an angle greater than 30 degrees), with his left and right arms tucked to his side. The surgery lasted approximately 9 hours and 21 minutes, and at no time during the surgery was the plaintiff repositioned.
In the recovery room after surgery, the plaintiff complained of pain in both shoulders and arms. The plaintiff was diagnosed with compartment syndrome in his right arm the following day, and subsequent surgery to relieve the pressure did not result in the plaintiff in regaining full use of his right arm and hand.
The plaintiff (and his wife) filed a Georgia medical malpractice lawsuit against various defendants in which he alleged that the defendants’ medical negligence in failing to properly position his body initially and/or in failing to reposition his body during the surgery was the proximate cause of his right arm injury.
Causation in a medical malpractice case generally must be established through expert testimony because the question of whether the alleged professional negligence caused the plaintiff’s injury is generally one for specialized expert knowledge. The expert must state his or her opinion regarding proximate causation in terms stronger than that of medical possibility (e.g., to a reasonable degree of medical certainty or reasonable medical probability).
In the case the Appellate Court was deciding, the plaintiff was required to present expert testimony that showed to a reasonable degree of medical certainty that the defendants’ failure to adhere to the applicable standard of care caused the plaintiff’s injury, which the trial court and the Appellate Court found the plaintiff had failed to do, and therefore the defendants were entitled to judgment as a matter of law.
The Appellate Court stated that neither of the plaintiff’s medical experts opined to any degree of medical certainty that the initial positioning caused the plaintiff’s injury (one expert testified during trial that the initial positioning in some likelihood contributed to the injury, but could not say how much it contributed; both of the plaintiff’s medical experts conceded that there was nothing in the defendant nurse’s report that indicated there was any violation of the standard of care with respect to the initial positioning of the plaintiff). The Appellate Court held that the combined testimony of the plaintiff’s medical experts did not create a genuine issue of fact that the plaintiff’s initial positioning caused the injury.
The Appellate Court held with respect to the repositioning claim that even if the plaintiff had proven that the defendants were negligent for failing to insist on repositioning, the plaintiff was also required to show causation by more than a mere possibility that such insistence by the defendants would have avoided the plaintiff’s injury, which the plaintiff had failed to do. The Appellate Court held that the trial judge did not commit error in finding that the plaintiff’s expert’s testimony was wholly speculative and conjectural that had the defendants insisted that the defendant surgeon reposition the plaintiff, the defendant surgeon would have done so, and that had he done so, the plaintiff’s injury could have been avoided or lessened.
Source Swint v. Mae, A16A1759.
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