McGee v. River Region Medical Center
| Docket Number: | 2009-CA-01384-SCT Linked Case(s): 2009-CA-01384-SCT |
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| Supreme Court: | Opinion Link Opinion Date: 03-03-2011 Opinion Author: Lamar, J. Holding: Reversed and remanded. |
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| Additional Case Information: |
Topic: Medical malpractice - Directed verdict - Expert testimony - Standard of care - Medical bills - Collateral source rule Judge(s) Concurring: Waller, C.J., Carlson, P.J., Dickinson, P.J., Randolph, Chandler and Pierce, JJ. Non Participating Judge(s): King, J. Concur in Part, Concur in Result 1: Kitchens, J. Procedural History: Directed Verdict Nature of the Case: CIVIL - MEDICAL MALPRACTICE |
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| Trial Court: |
Date of Trial Judgment: 08-21-2009 Appealed from: Warren County Circuit Court Judge: M. James Chaney, Jr. Disposition: At trial, the judge ruled that McGee's expert had failed to articulate the applicable standard of care and entered a directed verdict for River Region. Case Number: 08,0024-CI |
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| Party Name: | Attorney Name: | Brief(s) Available: | ||
| Appellant: | Virginia McGee, Individually; and Leroy Mitchell, as Conservator over the Estate of Virginia McGee |
KENYA R. MARTIN |
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| Appellee: | River Region Medical Center, et al | STUART B. HARMON, JAN F. GADOW |
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Synopsis provided by:  If you are interested in subscribing to the weekly synopses of all Mississippi Supreme Court and Court of Appeals hand downs please contact Tammy Upton in the MLI Press office. |
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| Topic: | Medical malpractice - Directed verdict - Expert testimony - Standard of care - Medical bills - Collateral source rule |
| Summary of the Facts: | Virginia McGee suffered an intravenous infiltration and burns on her arm while a patient at River Region Medical Center and filed a malpractice lawsuit against the hospital. The judge ruled that McGee’s expert had failed to articulate the applicable standard of care and entered a directed verdict for River Region. McGee appeals. |
| Summary of Opinion Analysis: | Issue 1: Directed verdict To establish a prima facie case of medical malpractice, the plaintiff must show that the defendant had a duty to conform to a specific standard of conduct for the protection of others against an unreasonable risk of injury, the defendant failed to conform to that required standard, the defendant’s breach of duty was a proximate cause of the plaintiff’s injury, and the plaintiff was injured as a result. The general rule is that medical negligence may be established only by expert medical testimony, with an exception for instances where a layman can observe and understand the negligence as a matter of common sense and practical experience. McGee argues that the trial judge erroneously prohibited her expert from rendering an opinion in this case. McGee reasons that, once the trial judge had accepted the witness as an expert in nursing care, she should have been allowed to render an opinion. River Region argues that the trial judge properly granted its motion for directed verdict, because McGee failed to elicit testimony from her expert showing that she was familiar with the applicable standard of care. River Region’s position seems to be, and the trial court apparently agreed, that the expert was required to articulate the standard of care before she could properly render an opinion as to whether the standard had been breached. The expert must identify and articulate the requisite standard that was not complied with. In this case, the expert testified more than once that she was familiar with the applicable standard of care. She should have been allowed to articulate her opinion as to whether that standard of care had been breached. Often, an expert’s discussion of the applicable standard of care is intertwined with his or her discussion of whether a breach occurred. The proffer offered by McGee’s counsel indicated that the expert successfully would have articulated the standard of care for IV infiltrations and would have opined that River Region’s staff had breached that standard. Thus, the trial judge erred when he prematurely struck the expert’s testimony. Although River Region argues that, as a nurse, the expert was not qualified to render an opinion as to medical causation, the record is insufficient for a determination of whether the erroneous striking of the expert’s testimony was harmless error. Issue 2: Medical bills Medicare paid a portion of McGee’s bills from Promise and River Region. Pursuant to their agreements as Medicare providers, both hospitals adjusted or “wrote off” the balance of those bills. The trial judge ruled that McGee would be allowed to introduce into evidence the total bill from Promise, but only approximately $5,000 of the River Region bill (the amount Medicare paid to River Region). McGee argues that the collateral-source rule allows her to introduce into evidence the entire amount of her medical bills from River Region, including those amounts “written off.” River Region argues that, because the amount it “wrote off” was not actually incurred, it is irrelevant, and thus inadmissible evidence. Jurors have a right to know what services and/or goods were provided for the charges made. This can serve as an aid in their deliberations with respect to the seriousness and extent of the injuries complained of. Provided he or she can demonstrate relevance, a plaintiff should be allowed to present evidence of his or her total medical expenses, including those amounts “written off” by medical providers. But the question presented by McGee is one of both evidence and recoverable damages. For decades, Mississippi has recognized the collateral source rule, under which a wrongdoer is not entitled to have the damages to which he is liable reduced by proving that plaintiff has received or will receive compensation or indemnity for the loss from a collateral source, wholly independent of him. In other words, a tortfeasor cannot use the moneys of others (insurance companies, gratuitous gifts, etc.) to reduce the cost of its own wrongdoing. In this case, the collateral-source rule simply does not apply to the “written-off” portion of the River Region bill. The rule, by its very language, applies only to prohibit the introduction of evidence of payments from collateral sources wholly independent of the tortfeasor. River Region, to whom the bill was owed, is also the alleged tortfeasor. River Region provided medical services, but was not paid by McGee, Medicare, or any other source for a large portion of those services. To accept McGee’s argument would require River Region to absorb the cost of the services rendered for which there was no reimbursement and then be potentially liable for those services again in damages. Although the entire medical bill may be relevant to aid the jury in assessing the seriousness and the extent of the injury, McGee may not recover as damages those amounts “written off” by River Region. |
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