Opinion
2:00-CV-191-J
September 14, 2001
Memorandum Opinion
In this medical malpractice suit, Plaintiffs Clyde Ingram and Linda Ingram claim that Defendant Richard Katseres, M.D. negligently failed to timely and properly diagnose and treat Clyde Ingram for post-operative surgical complications caused by the perforation of the small bowel and resulting abdominal sepsis and multiple abdominal abscesses after laparoscopic gallbladder surgery. Plaintiffs do not contend that the perforation of the bowel during surgery was negligence.
A jury found that negligence of Dr. Katseres proximately caused injury to Clyde Ingram. It found damages of $50,000.00 for mental pain and anguish in the past and $351,335.49 for past medical expenses. It found no other damages. The matter is before the Court on the parties' motions for judgment. Defendant contends that the evidence is insufficient to support the verdict and that it is entitled to judgment as a matter of law.
Discussion
This Court concludes, first, that the evidence is sufficient to support the jury's findings of negligence proximately causing injury and damages of $50,000.00 for past mental pain and anguish. It will next address the question of the sufficiency of the evidence to support the jury's finding that $351,335.49 in past medical expenses were proximately caused by Dr. Katseres' negligence.
Dr. Katseres performed the initial gallbladder surgery at the Childress Regional Medical Center. One week later, Mr. Ingram was transferred to the care of Dr. Richard Franklin at Northwest Texas Hospital in Amarillo. He was later transferred to SSCI, a rehab unit which gives particular attention to pulmonary problems. No evidence was offered of medical bills before the transfer to Northwest Texas Hospital, and none were offered for the period after the release from SSCI. There is testimony that the charges for services at Northwest Texas Hospital and SSCI, as well as the charges of Dr. Franklin, were reasonable and necessary charges for treatment rendered to Clyde Ingram. Those bills totaled $351,335.49, the amount found by the jury.
Defendant contends that the evidence will not support a finding that those expenses were proximately caused by the negligence of Dr. Katseres. He contends that plaintiff failed to meet his burden to differentiate between medical expenses, if any, resulting from Dr. Katseres' negligence and those that would have been incurred as a result of Mr. Ingram's pre-existing condition and the unfortunate (but not negligent) perforation of the small bowel.
In Texarkana Memorial Hospital v. Murdock, 946 S.W.2d 836 (Tex. 1997), the Texas Supreme Court held "that a plaintiff should recover only for medical expenses specifically shown to result from treatment made necessary by the negligent acts or omissions of the defendant, when such differentiation is possible."
In the case before this Court, it is undisputed that Plaintiff suffered chronic obstructive pulmonary disease before he went in for gallbladder surgery. There is evidence that a person with that condition is more likely to suffer pulmonary complications with surgery. There is no suggestion in the evidence that Dr. Franklin's surgery would not have been necessary, even in the absence of negligence on the part of Dr. Katseres. The evidence also shows that at the time of the surgery by Dr. Franklin, the patient suffered a pneumothorax when a central line was being put in, and it was necessary to put in a chest tube. Pneumothorax is air out of the lung in the chest, a complication that occurs about three percent of the time. Further, during that corrective surgery, the jejunum gave way and it was necessary for Dr. Franklin to remove a section and put the jejunum back together.
Dr. Franklin testified as follows:
Q. Okay. Do you have an opinion whether or not the failure to follow that patient more closely resulted in an injury to Clyde Ingram's bowels?
A. It didn't result in the injury.
Q. I understand the perforation didn't result. The failure to find the complication?
A. It made things worse.
Q. Okay. And how did it make those things worse?
A. The delay and the formation of an established abscess.
Q. And what problems did that delay cause Mr. Ingram?
A. More extensive surgery, more difficult surgery.
That testimony, along with other evidence, supports the jury finding of damages for past mental pain and anguish. It is not, however, testimony that additional medical expense was incurred because of the more difficult or more extensive surgery. Nor does it differentiate between any of such expenses if, in fact, they occurred and those that would have occurred because of the initial puncture of the bowel. There was no evidence that any specific medical expense was incurred after transfer to Northwest Texas Hospital because of the more extensive, more difficult surgery. It should be noted that there was no delay after the transfer to Northwest Texas Hospital. Dr. Franklin promptly performed surgery. Further, there is no evidence at all of the medical expense before the transfer to Northwest Texas Hospital.
Conclusion
Judgment will be entered for Clyde Ingram for $50,000.00 for mental pain and anguish, plus pre-judgment interest at ten percent (10%) per annum from June 8, 2000, to date of judgment, plus costs and statutory post-judgment interest.
It is so ORDERED.