Directed verdicts are appropriate during a trial when there is no conflict in the evidence about any important issues and the evidence requires a specific verdict. A directed verdict may not be granted in cases where there is evidence that supports a different verdict.
In a recent case, a plaintiff appealed after a motion for directed verdict in favor of a doctor and medical practice in a medical malpractice and wrongful death case. The case arose when a woman with diabetes and end-stage renal disease hit her knee on a door and had to be transported to the ER. She had a contusion on her knee, a sprained ankle and had trouble walking or standing. No fracture was found on her knee and she was discharged by Dr. Singh, a nephrologist.
The next morning, her husband found her unconscious in bed. She was transported to the ER. She came back to consciousness and complained about pain in her leg. She was assessed by the defendant doctor and a physical therapist, but no further x-rays or scans were ordered in connection with her knee.
The woman continued to have difficulty walking or standing because of her knee pain. She kept seeing doctors for diabetes-related ailments. A few months later, she sought help from a different doctor who found she had a fracture in her tibia and it had healed in a displaced position. She was sent to an orthopedist who operated on her leg, breaking the partially healed bone to put it in the right position for further healing.
Later she died and her estate brought suit. Her estate put forward an expert testifying that a nephrologist would concentrate on the status of her bones at the time of the fall. He also testified that Dr. Singh’s notes from that visit did not meet the standard of care because they didn’t adequately or precisely describe the pain in connection with a specific part of her leg. All Dr. Singh had noted was severe pain in the left leg and swelling there.
The expert also testified that a chart must be able to stand alone to allow other medical providers to assess what another doctor has found on a particular date and what has been ruled out. Failure to make precise and complete notes on a chart can lead to misdiagnosis. The expert also noted that Dr. Singh’s differential diagnosis should have included the possibility that a fracture was the diagnosis and should have included an order for a scan or orthopedic consult.
The doctor seen by the woman a few months later testified that the fracture was six weeks old by the time she came to see him. He also testified that the only explanation for the displaced and re-healed fracture was that it was after the fall in December after which Dr. Singh had not diagnosed her. He also testified that if Dr. Singh had caught the fracture, it could have been treated without surgery.
In spite of this testimony, the trial court found the plaintiff did not present adequate testimony from a qualified expert on a breach of standard of care proximately causing the plaintiff’s injury. The estate appealed, arguing that the trial court had erred in granting the directed verdict for the defendants. He argued that he presented evidence of damages, but the trial court had improperly limited its view of damages as an issue of needing surgery.
The appellate court explained that a plaintiff complaining of medical malpractice must show that a deviation from the standard of care was the proximate cause of the injury suffered. “Proximate cause” is different than actual cause. A proximate cause must be causally and closely enough connected to claimed damages that it is recognized by the law. Causation can be established through multiple experts testifying together.
The appellate court concluded that the plaintiff had presented enough evidence to create a jury issue on the question of whether Dr. Singh would have found the fracture if she had complied with the proper standard of care. The trial court had erred in granting the defendant’s motion for directed verdict.
If you are hurt or a loved one is killed by a medical professional, you may have grounds for a medical negligence lawsuit. Experienced Atlanta personal injury attorney Terrence R. Bethune can evaluate your case and fight for any compensation you may deserve. Contact us at 404-875-7800 or via our online form.
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