The December 1, 2017 majority opinion of the Appellate Court of Illinois First District (“Illinois Appellate Court”) upheld the $7,884,761.76 medical malpractice judgment entered against the medical malpractice defendants despite finding that the trial court erroneously denied the defendants’ motion in limine to bar the plaintiff from introducing evidence of the defendant physician’s alleged lack of privileges to perform a celiac plexus block procedure on the decedent at the surgical center where the procedure was performed, and despite the trial court erroneously granting the plaintiff’s motion in limine which barred the defendants from introducing evidence of, or making any reference to, the decedent’s smoking history.
The Underlying Facts
On October 5, 2012, the defendant physician performed a celiac plexus block procedure on the decedent at an Illinois surgical center. Following the procedure, the decedent complained of numbness in her legs, and she was taken by ambulance to a hospital where it was determined that she had experienced a vasospasm, resulting in paraplegia. The decedent died on June 9, 2014. The decedent’s death certificate listed stroke as the cause of her death.
The Illinois medical malpractice lawsuit alleged, in part, that the defendant physician “was negligent in one or more of the following respects:
a. Performed a celiac plexus neurolytic block with absolute alcohol even though it was not indicated; or
b. Injected absolute alcohol into the artery Adamkiewicz or arteries that flow into the artery of Adamkiewicz; or
c. Failed to properly identify the landmarks during the performance of his [sic] celiac plexus neurolytic block; or
d. Failed to recommend and/or attempt to treat [the decedent’s] abdominal pain using more conservative therapeutic modalities such as an intrathecal spinal catheter pump; or
e. Failed to take a radiographic image after injecting dye in her spinal cord as part of a test dose prior to performing the celiac plexus neurolytic block; or
f. Failed to properly manipulate/position the spinal needle inserted into her spinal canal; or
g. Failed to possess privileges to perform celiac plexus block surgical procedures at [the surgical center], or
h. Failed to possess the privileges to perform celiac plexus block procedures at any Illinois hospital.”
The Illinois medical malpractice wrongful death complaint alleged that one or more of the defendant physician’s alleged negligent acts or omissions proximately resulted in the death of the decedent and the damages sustained by her prior to her death. The Illinois medical malpractice jury was instructed that the plaintiff claimed that one or more of the negligent acts or omissions attributed to the defendant physician proximately caused the decedent’s injury and death.
The Illinois Appellate Court ruled that evidence addressed to the defendant physician’s privileges was irrelevant to the issue of whether he deviated from the standard of care in his treatment of the decedent, and such evidence should not have been admitted.
The Illinois Appellate Court further held that the defendants’ offer of proof clearly established the relevance of the decedent’s smoking to the issue of whether the defendant physician deviated from the standard of care by recommending a celiac plexus block as opposed to alternative treatment modalities.
The Illinois Appellate Court stated: “The trial court’s errors in barring the defendants from eliciting evidence of [the decedent’s] smoking directly hampered their ability to defend against two of the allegations of negligence alleged by the plaintiff and contained in the issues instruction given to the jury — namely, that [the defendant physician] performed a celiac plexus block with absolute alcohol when it was not necessary and that he failed to recommend and/or attempt to treat [the decedent’s] abdominal pain using more conservative modalities. By permitting the plaintiff to introduce irrelevant evidence addressed to [the defendant physician’s] privileges, the trial court enabled the plaintiff to place before the jury the allegation that [the defendant physician’s] performance of a celiac plexus block in the absence of privileges to perform the procedure was a breach of the standard of care which, standing alone, proximately caused [the decedent’s] injury and death.”
Nonetheless, the Illinois Appellate Court stated: “In this case, however, the jury was instructed that the plaintiff claimed that [the defendant physician] was negligent in one or more of five enumerated acts or omissions, proximately resulting in [the decedent’s] injury and death. The allegations of negligence were asserted in the disjunctive. And although the evidentiary errors noted were prejudicial and directly affected three of those allegations of negligence, the errors do not directly impact the remaining two allegations of negligence on the part of [the defendant physician] in the performance of the celiac plexus block procedure on [the decedent]; namely, his having injected absolute alcohol into an artery and having failed to place the spinal needles in front of the L-1 vertebral body … the record before us fails to reflect that the defendants ever asserted that [the decedent’s] smoking was the sole proximate cause of her death. They argued that smoking was relevant to [the defendant physician’s] election to perform a celiac plexus block as opposed to other treatment modalities … they never argued or made an offer of proof that, if allowed, they were prepared to present evidence that [the decedent’s] smoking was the sole proximate cause of her vasospasm which resulted in paraplegia or that smoking was the sole proximate cause of the stroke which led to her death … there is nothing in the record supporting a conclusion that the defendants pursued, or intended to pursue, a sole proximate cause defense based upon [the decedent’s] smoking … [t]o support a verdict in a negligence action, a defendant’s actions need not be the only cause of an injury, it is sufficient if they are a cause.”
The Illinois Appellate Court held: “In this case, the jury returned a general verdict, and because the defendants did not submit special interrogatories, we have no way of knowing upon which of the acts of negligence alleged against [the defendant physician] the jury based its verdict. Our earlier analysis leads us to conclude that the trial court’s evidentiary errors in no way hampered the defendants from presenting a defense on two of the acts of negligence charged against [the defendant physician], and the defendants have not argued that the jury’s verdict was in any respect against the manifest weight of the evidence. We, therefore, apply the general verdict rule and affirm the judgment of the trial court.”
Source Arient v. Alhaj-Hussein, 2017 IL App (1st) 162369
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