Mariner Health Care, Inc. v. Estate of Edwards


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Docket Number: 2004-CA-01478-SCT
Linked Case(s): 2004-CA-01478-SCT ; 2004-CA-01478-SCT

Supreme Court: Opinion Link
Opinion Date: 09-13-2007
Opinion Author: WALLER, P.J.
Holding: Reversed and Remanded

Additional Case Information: Topic: Wrongful death - Proximate causation - Juror misconduct - M.R.E. 606(b) - Punitive damages - Evidentiary rulings - M.R.E. 401 - M.R.E. 103(a)(1) - M.R.E. 801(d)(1) - M.R.E. 803(1) - M.R.C.P. 37 - M.R.E. 702 - Jury instructions - Liability of administrators and licensees - Bankruptcy stipulations
Judge(s) Concurring: SMITH, C.J., EASLEY, CARLSON, DICKINSON, RANDOLPH AND LAMAR, JJ.
Dissenting Author : GRAVES, J.
Dissent Joined By : DIAZ, P.J.
Procedural History: Jury Trial
Nature of the Case: CIVIL - WRONGFUL DEATH

Trial Court: Date of Trial Judgment: 02-18-2004
Appealed from: LEFLORE COUNTY CIRCUIT COURT
Judge: Richard Smith
Disposition: Jury found each of the Appellants liable
Case Number: 2001-0172-CI

  Party Name: Attorney Name:  
Appellant: MARINER HEALTH CARE, INC.; GRANCARE, INC.; EVERGREEN HEALTHCARE, INC.; NATIONAL HERITAGE REALTY, INC.; GEORGE D. MORGAN; M. SCOTT ATHANS; J. D. LEE; CHARLIE R. SINCLAIR, JR.; ANGELA M. WHITTINGTON; AND JOHN H. MERRELL




WILLIAM W. McKINLEY, JR., LORRAINE BOYKIN



 

Appellee: ESTATE OF CHARLES E. EDWARDS, BY AND THROUGH NEVONNIA TURNER, ADMINISTRATRIX OF THE ESTATE OF CHARLES E. EDWARDS, FOR THE USE AND BENEFIT OF THE ESTATE OF CHARLES E. EDWARDS, AND FOR THE USE AND BENEFIT OF THE WRONGFUL DEATH BENEFICIARIES OF CHARLES E. EDWARDS, DECEASED D. BRYANT CHAFFIN, SUSAN NICHOLS ESTES, KENNETH L. CONNOR  

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Topic: Wrongful death - Proximate causation - Juror misconduct - M.R.E. 606(b) - Punitive damages - Evidentiary rulings - M.R.E. 401 - M.R.E. 103(a)(1) - M.R.E. 801(d)(1) - M.R.E. 803(1) - M.R.C.P. 37 - M.R.E. 702 - Jury instructions - Liability of administrators and licensees - Bankruptcy stipulations

Summary of the Facts: The family of Charles Edwards brought suit for compensatory and punitive damages against National Heritage Realty, the owner of Greenwood Health and Rehabilitation Center, its parent companies, Grancare, Inc., Evergreen Healthcare, and Mariner Healthcare, Inc., and against five individuals in their capacities as administrators or licensees of Greenwood Health. The complaint alleged negligence, medical malpractice, gross negligence, fraud, and breach of fiduciary duty. After Edwards’s death, the family amended its complaint to include a claim for wrongful death. The jury found each of the defendants liable for Edwards’s death, and awarded $1.5 million in compensation. The trial judge determined that the jury should be allowed to consider punitive damages, and, after considering the evidence, the jury awarded $5 million in punitive damages. Greenwood Health appeals.

Summary of Opinion Analysis: Issue 1: Proximate causation Greenwood Health argues that Edwards’s estate failed to present a prima facie case for liability because the Estate’s expert did not establish that the negligence of the nursing home was the proximate cause of Edwards’s death. In cases alleging that death was caused by the negligence of a health care provider, proximate cause must be established by a medical doctor. Expert testimony must, at a minimum, show that deviations from the standard of nursing care caused or contributed to the decedent’s death. The Estate’s expert testified that Greenwood Health breached the standard of care in failing to monitor Edwards’s nutritional needs and bowel movements, in failing to recommend intravenous feeding, known as “TPN feeding,” to the center’s medical director, and in not recommending that Edwards be transferred to a multiple-specialty facility to address his worsening condition. He further opined that the failure of the nursing home to recommend the TPN treatment was a contributing cause of Edwards’s death. His testimony did not conclusively establish the liability of the nursing home. However, considered as a whole, his testimony was sufficient to present a prima facie case for the liability of Greenwood Health. While he did not rule out the possibility that other parties were liable, his testimony that the negligence of Greenwood Health contributed to Edwards’s death is sufficient to establish proximate cause. Issue 2: Juror misconduct After the jury rendered a verdict for Edwards’s estate, Greenwood Health was contacted by one of the jurors who alleged that another juror had made prejudicial statements during the trial and in jury deliberations. Relying on the juror’s affidavit, Greenwood Health moved to contact additional jurors and to stay the judgment until an inquiry had been conducted. Greenwood Health argues that the trial court erred in denying its motion to contact additional jurors. M.R.E. 606(b) prohibits jurors from testifying to statements made during jury deliberations, subject to an exception for extraneous prejudicial information, not brought out at trial, that was improperly put before the jury. While a juror may testify whether outside influence or information was improperly presented before the jury, Rule 606(b) categorically prohibits testimony regarding specific statements made during jury deliberations or any influence such information had on his or her mental processes. A trial court is obligated to investigate an allegation of misconduct when the party alleging misconduct makes a showing of extrinsic evidence sufficient to overcome the presumption of jury impartiality. In the present case, the trial court found that the juror’s affidavit was not competent because it concerned the mental impressions of a juror during deliberations. In the alternative, the trial court held that a new trial was not warranted because information about the alleged mistreatment of other residents of the nursing home was not qualitatively different from the evidence put on by Edwards’s estate. While the affidavit did contain information regarding the mental impressions of both the speaker and the allegedly offending juror, it also specifically alleged that the juror failed to truthfully answer questions during voir dire. During voir dire there were at least two instances in which the juror withheld material disqualifying information. The question by defense counsel was relevant, unambiguous, and the juror had substantial knowledge of the information requested. If accurate, her statement on the first day of trial that she had already decided for Edwards’s estate clearly belied her implied impartiality. Thus, the judgment must be reversed. Issue 3: Punitive damages Greenwood Health argues that the trial court erred in not excluding prejudicial information during the compensatory phase of the trial and in relying on evidence introduced during the compensatory phase to determine whether consideration of punitive damages was warranted. Evidence which does not pertain to compensating the plaintiff but instead seeks to show the malicious or grossly negligent character of the defendant’s actions should not be heard by the jury until liability has been determined. Evidence may, of course, be probative of both liability and the assessment of punitive damages. The failure to conduct an evidentiary hearing on punitive damages, where the plaintiff has sought such damages and the jury has awarded compensatory damages, constitutes reversible error. Here, the trial court properly conducted an evidentiary hearing after the jury returned a verdict for compensatory damages in favor of Edwards’s estate. Greenwood Health argues that the trial court erred in admitting evidence relevant only to punitive damages during the compensatory phase of the trial, including testimony about various aspects of the Mariner corporate structure, such as a compensation system that was tied to economic efficiency and the company’s “four C’s”: care, cost, census, and cash, which were supposed to guide their business decisions. Although Edwards’s estate argues that evidence of general corporate practices was necessary to demonstrate that Mariner’s budgeting policies caused Edwards’s injuries and death, Edwards’s estate submitted no evidence that would establish a causal connection between the budgeting policies of Mariner and the injuries and death suffered by Edwards. The testimony was not probative to the issues of duty, breach, causation, or injury. Given the use of the testimony at trial to emphasize the “bad corporate character” of Mariner, admission of the testimony materially prejudiced the defendants. Issue 4: Evidentiary rulings Greenwood Health argues that the trial court erred in admitting evidence of short-staffing, wage rates, and alcohol consumption. Each of the nursing assistants who testified for Edwards’s estate had been responsible for Edwards’s care at some point during his time at Greenwood Health. Several assistants testified that they either provided or saw the effects of substandard care on Edwards. Such testimony is probative under M.R.E. 401. The arguments concerning wage rates and alcohol consumption are waived under M.R.E. 103(a)(1) for failure to object at trial. Edwards’s family kept a journal at the nursing home in which they would record their observations, thoughts, and feelings about Edwards and his care. Staff members were aware of and occasionally wrote in the journal. Edwards’s estate argues that, if the journal is not admissible under M.R.E. 801(d)(1) as a prior consistent statement, it is admissible under M.R.E. 803(1) as a collection of present-sense impressions. Under M.R.E. 801(d)(1), the availability of the witness is therefore a prerequisite for the introduction of a prior consistent statement. The Edwards’s family journal contains a number of entries by Edwards’s sister, who was deceased by the time of trial. Those portions of the journal could not have been introduced to rebut an inference of recent fabrication because there was no testimony at trial to rebut. Because the trial court did not distinguish between statements made by testifying family members and non-testifying family members, it was error to find that journal entries made by non-testifying family members were not hearsay under Rule 801. To be admissible as a present-sense impression under Rule 803(1), a statement must be made while the event or condition is being perceived by the declarant or “immediately thereafter”; the declarant must “perceive” the event or condition; and, the statement must describe or explain the event or condition. Most of the journal entries indicate the date and time of the entry so that the trial judge could reasonably have interpreted such entries as being spontaneous. However, Edward’s estate presented no evidence and the trial judge conducted no inquiry to verify that each entry in the journal was contemporaneous with family members’ observations of Edwards. While such an inquiry may be burdensome, “spontaneity” is required for the admissibility of any evidence under the present-sense impression to the hearsay rule and, as a general practice, should be more thoroughly inquired upon in the future. During discovery, Edwards’s estate requested all daily time sheets that documented the day-to-day staffing levels at Greenwood Health and filed a motion to compel production after the daily time sheets were not produced. Mariner maintained that the daily time sheets had not been preserved but produced them two days before trial. The court found that the failure to produce the daily time sheets materially prejudiced Edwards’s estate, and therefore excluded them. The remedy for failing to comply with the discovery requests when the trial court grants an order to compel falls under M.R.C.P. 37(a)(4) in the form of awarding the moving party the expenses for such motion. After such an order to compel has been granted under M.R.C.P. 37(a)(2), and the party ordered to answer fails to respond, then the remedy may be sanctions in accordance with M.R.C.P. 37(b). The exclusion of the labor-hour reports was well within the discretion of the trial court. There was significant contention whether the labor-hour reports accurately depicted the level of care at Greenwood Health, since the reports presented averages that did not preclude short-staffing on a given day. Given the importance of the issue of staffing at trial, and in light of the seriousness of Mariner’s discovery violation to the case, the trial court did not err in excluding the labor-hour reports from evidence. Edwards’s estate proffered a licensed doctor and psychiatrist as an expert on the effects Edwards’s profound handicaps had on his life and the limitations those handicaps would place on a caregiver’s ability to provide treatment to him. The trial court ruled that the expert was qualified to offer opinions about Edwards’s retardation, but could not testify to matters of general medicine. Edwards’s estate argues that the doctor has been accepted as an expert in general medicine in numerous cases, and that his qualifications have never been questioned. Nothing in M.R.E. 702 would prevent two trial judges in the exercise of seasoned consideration from coming to two different conclusions regarding the qualification of an expert. The parties conducted an extensive voir dire of the expert’s qualifications to testify to the treatment that should have been provided to Edwards in light of his extreme weight loss. There was no error in partially excluding his testimony. Issue 5: Jury instructions Greenwood Health argues that the trial court erred in granting three jury instructions. Two of the instructions defined “abuse” and “neglect” as those terms are found in the Mississippi Vulnerable Adults Act, and stated that the defendant or defendants were liable if the jury found that either abuse or neglect of Edwards had occurred due to that defendant’s or defendants’ actions. The other instruction listed a number of the federal regulations related to care that are applicable to long-term care facilities, and stated that any violation of those regulations could be considered as evidence of negligence. Though the use of the Minimum Standards might have been error had they been the only basis for establishing the standard of care, in the present case, the instructions given did not deviate significantly from the standard established by the expert testimony of Mariner’s expert witness and the director of nursing at Greenwood Health. In light of this expert testimony, the instructions were sufficiently accurate to withstand scrutiny regarding the standard of care. While the form of one of the instructions was flawed, particularly regarding the citations to federal regulations in the body of the instruction, it is not reversible error. Greenwood Health argues that the trial court committed reversible error by not instructing the jury to consider the separate defenses and standards of care applicable to the nursing home, the parent company and its subsidiaries, and the officers of those companies. The trial court erred in denying the proposed instruction on separate consideration. The statement was neither misleading nor an incorrect statement of the law, and the issue of which Defendant was liable for what conduct was the pivotal issue in the case. The denial of the proposed instruction, taken together with the ambiguity of several instructions regarding the separate conduct of each Defendant, failed to adequately present the law of the case. Issue 6: Liability of administrators and licensees In light of the recent case Howard v. Estate of Harper, 947 So. 2d 854 (Miss. 2006), the licensees and administrators must be dismissed from the suit. Since the record demonstrates that all of the licensees and administrators did not testify and those who did said little that advanced the case against Mariner, no tenable basis exists for dismissing the complaint against Mariner. Issue 7: Bankruptcy stipulation After Edwards entered Greenwood Health but before Edwards filed his original complaint and before he died, Mariner filed for bankruptcy. Edwards’s counsel and Mariner entered into a stipulation under which the plaintiffs could bring legal action, either pre-petition or post-petition, despite the automatic stay imposed on such actions by the Bankruptcy Code. Mariner argues that Edwards’s Estate was not named in the stipulation and was therefore barred from bringing suit. Questions regarding the scope of the stipulation and the possibility of recovery under the plan are ultimately matters more properly considered by the bankruptcy court.


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