Opinion
Case No. 98-2280-JWL.
June 15, 2001
MEMORANDUM ORDER
A trial to the court was held in this medical malpractice action arising out of defendant's care and treatment of plaintiff during plaintiff's hospitalization for complications associated with her pregnancy. As set out in detail in the court's March 20, 2001 memorandum and order, plaintiff presented with symptoms of preeclampsia, including high blood pressure and severe headache. In connection with his treatment of plaintiff's headache, defendant ordered the administration of Procardia and Imitrex. Plaintiff alleged that defendant was negligent in ordering the administration of these drugs and that the administration of Imitrex, either standing alone or coupled with the administration of Procardia, caused plaintiff to suffer a stroke.
On March 20, 2001, this court issued its findings of fact and conclusions of law pursuant to Federal Rule of Civil Procedure 52(a). In brief, the court entered judgment in favor of defendant on plaintiff's claim on the grounds that plaintiff failed to establish causation. Specifically, the court was not persuaded that plaintiff suffered a stroke within the time period soon enough after the drugs in question were given to attribute the event to any act or omission by defendant. See Maasen v. Zwibelman, No. 98-2280-JWL, 2001 WL 309119 (D.Kan. Mar. 20, 2001). This matter is now before the court on plaintiff's motion for new trial or, in the alternative, for amended findings of fact and conclusions of law (doc. #207). The court understands the frustration of plaintiff and her counsel in not prevailing after the expenditure of considerable time and effort to present a well-tried case. Nonetheless, plaintiff bore the burden of proof on causation, as on all elements of her claim, and the court, as trier of fact, was not persuaded. As set forth in more detail below, plaintiff's motion is denied.
In order for a stroke suffered by plaintiff to have been caused by administration of the drugs, the uncontroverted testimony was that the stroke would have had to have occurred within six hours of the drugs being administered to plaintiff, or no later than 2:00 a.m. on March 10, 1997. To support her argument that the stroke occurred after the administration of the drugs and before 2:00 a.m. on March 10, 1997, plaintiff relied in part on the testimony of her father-in-law, Gene Hanrahan. In her motion, plaintiff asserts that several of the court's conclusions relating to Mr. Hanrahan's testimony had no basis in fact or law. Mr. Hanrahan testified that he was in plaintiff's room on March 9, 1997 when plaintiff awoke between 11:00 p.m. and midnight "screaming with pain." Mr. Hanrahan further testified that plaintiff complained of pain in her left arm and left leg and that he observed plaintiff's left foot "drawing in." According to Mr. Hanrahan, a nurse was immediately called and the nurse, upon examining plaintiff, commented that plaintiff's symptoms were "signs of a stroke." The court discounted Mr. Hanrahan's testimony for a variety of reasons, including the fact that plaintiff's medical records did not contain any reference to the incident described by Mr. Hanrahan; the fact that no doctor was ever called regarding the incident; the symmetry of plaintiff's reflexes as measured during the relevant time period; and the fact that stroke presents with loss of strength or sensation rather than pain or cramping.
According to plaintiff, the evidence presented at trial does not support any of the court's reasons for not being persuaded by Mr. Hanrahan's testimony. Plaintiff, for example, argues that the medical records are "totally consistent" with Mr. Hanrahan's testimony in that the records reflect that Nurse Farajolah administered pain medication to plaintiff for headache shortly after midnight. As the court noted in its previous opinion, however, the records contain no reference to any left-sided pain experienced by plaintiff. Thus, while the records do contain references to plaintiff's worsening headache during the late evening hours of March 9 and the early morning hours of March 10, these references do not appear to relate to the incident described by Mr. Hanrahan. In other words, Mr. Hanrahan did not testify that plaintiff woke up screaming in pain from a headache. He very clearly testified that she woke up screaming with pain and that the pain was stemming from her left-arm and left-leg. This incident with alleged arm and leg pain, as noted earlier, is simply not memorialized in plaintiff's medical records. Indeed, the fact that the nurse was present to administer the headache medication as indicated makes it even more curious that there was no notation of the event, and certainly nothing recorded documenting the observation by a nurse of "signs of a stroke."
Plaintiff also contends in her motion that, despite the court's findings, a doctor was in fact called to plaintiff's room in the early morning hours of March 10. Plaintiff suggests in her papers that Dr. Zwibelman was called because there had been a "significant change" in plaintiff's condition. The court believes that plaintiff misses the point. Dr. Zwibelman was not called until 4:15 a.m. on March 10-several hours after the incident described by Mr. Hanrahan. Moreover, as Nurse Farajolah testified, Dr. Zwibelman was called only because plaintiff complained that her headache was getting worse. There is simply no evidence that Dr. Zwibelman, or any other physician, was contacted because of any left-sided problems that plaintiff had experienced.
Plaintiff also criticizes the court for "imposing on [Mr. Hanrahan] . . . the duty of demanding that a doctor come see his daughter in the early hours of the morning." While the court noted in its findings that Mr. Hanrahan never contacted a physician about the incident he described, it did not suggest that Mr. Hanrahan had a duty to do so. The court simply found Mr. Hanrahan's version of events less credible because he had not contacted a doctor (or, at the very least, asked the nurse about whether a doctor should be contacted) and because absolutely no other evidence supported the version of events described by Mr. Hanrahan.
Next, plaintiff maintains that the symmetry of plaintiff's reflexes as measured during the early morning hours of March 10 was not significant (as the court concluded) because of the subtle nature of the stroke and the "relatively small impairment of blood flow." As the court noted earlier, however, Dr. Dyll testified that the symmetry of plaintiff's reflexes was highly significant and indicated that plaintiff did not suffer a stroke on the evening of March 9 or the morning of March 10. The court found Dr. Dyll's testimony to be credible. Plaintiff's argument concerning the symmetry of plaintiff's reflexes, then, simply challenges the court's evaluation of the credibility of Dr. Dyll. As the trier of fact, however, the court "has the exclusive function of appraising credibility, determining the weight to be given to the testimony, drawing inferences from the facts established, resolving conflicts in the evidence, and reaching ultimate conclusions of fact." See Medlock v. Ortho Biotech, Inc., 164 F.3d 545, 551 (10th Cir. 1999); accord United States v. Rios, 22 F.3d 1024, 1027 (10th Cir. 1994) ("the credibility of a witness and weight of his [or her] testimony are for the trier of fact alone"). In fact, the court found Dr. Dyll's testimony extremely persuasive on this point and, taken together with Dr. Batnitsky's testimony concerning the significance of the radiological findings, made the medical case against plaintiff's contention that she suffered a stroke on that occasion very convincing to the court.
Finally, plaintiff challenges the court's conclusion that plaintiff did not suffer a stroke during the relevant time period to the extent the court relied on the fact that stroke presents with loss of strength or sensation rather than pain or cramping. According to plaintiff, this reason is invalid because "sensation loss and pain are in the same particular sensorial aspect of the nerves." At trial, however, plaintiff presented no evidence to support this argument. Moreover, as stated by the court in its findings of fact, no witness testified that pain or cramping was consistent with stroke and, in fact, several witnesses testified that such symptoms are inconsistent with stroke. Mr. Hanrahan's testimony lacked credibility and was not corroborated by any evidence (medical or otherwise) which the court found persuasive. The court is firmly convinced in its conclusion that plaintiff did not suffer a stroke during the relevant time period. IT IS THEREFORE ORDERED BY THE COURT THAT plaintiff's motion for new trial or, in the alternative, for amended findings of fact and conclusions of law (doc. #207) is denied.
In a related vein, plaintiff contends that the court gave too much weight to Mr. Hanrahan's use of the word "cramp" to describe the action of plaintiff's left foot. According to plaintiff, "Mr. Hanrahan is a lay individual and cannot be credited with describing what may be a cramp that the Court then says would be inconsistent with a stroke and yet the Court credits him with such categorization of what he saw." Of course, Mr. Hanrahan was the only witness at trial to testify about the alleged incident. Thus, in the absence of any other testimony concerning the nature of plaintiff's symptoms, the court properly relied on Mr. Hanrahan's description of the alleged events. In any event, regardless of whether plaintiff's left foot was indeed "cramping" as Mr. Hanrahan testified, it is uncontroverted that Mr. Hanrahan testified that plaintiff was experiencing left-sided pain-a symptom that is, according to the testimony at trial, inconsistent with stroke. In other words, regardless of whether plaintiff's foot was cramping, the court would nonetheless conclude that plaintiff did not suffer a stroke during the relevant time period.
Plaintiff's remaining arguments simply challenge the court's credibility determinations. Plaintiff, for example, criticizes the court for giving "great credence" to defendant's expert witnesses on causation. Similarly, plaintiff argues that it is conceivable that the nurses on duty during the evening hours of March 9 and the morning hours of March 10 simply did not record Mr. Hanrahan's observation that his daughter had experienced left-sided pain. As noted above, credibility assessments are the exclusive function of the trier of fact. See Medlock, 164 F.3d at 551; Rios, 22 F.3d at 1027. Thus, the court need not consider further plaintiff's arguments concerning the weight and credit the court should have given various witnesses.
IT IS SO ORDERED.