Title: Fiedler v. Steger

State: wyoming

Issuer: Wyoming Supreme Court

Document:

Fiedler v. Steger1986 WY 26713 P.2d 773Case Number: 85-185Decided: 01/30/1986Supreme Court of Wyoming
ELIZABETH 
L. FIEDLER, EDWIN G. FIEDLER AND KATHERINE ELIZABETH FIEDLER AND DOUGLAS GLENROY 
FIEDLER, BY AND THROUGH THEIR NEXT FRIENDS ELIZABETH L. FIEDLER AND EDWIN G. 
FIEDLER, APPELLANTS (PLAINTIFFS), 

 
 
v. 

 
 
DAVID J. 
STEGER, APPELLEE (DEFENDANT).

 
 
Appeal 
from the District Court, Fremont County, Robert R. Ranck, 
J.

 
 
 
 
Representing 
Appellants:

Edwin G. 
Fiedler, Laramie, pro se, appeared in oral argument; Cary R. Alburn III, 
Laramie, filed a brief (but was permitted to withdraw as counsel prior to oral 
argument).

 
 
Representing 
Appellee:

David E. 
Westling, Casper, appeared in oral argument; Ann Rochelle of Vlastos & 
Brooks, P.C., Casper, filed a brief.

 
 
Before 
THOMAS, C.J., BROWN, CARDINE and URBIGKIT, JJ., and GUTHRIE, J., 
Retired.

 
 

URBIGKIT, 
Justice.

 
 

[¶1.]     Appellant Elizabeth 
Fiedler, seven and one-half months pregnant, who was in fact suffering from 
appendicitis, and without personal examination, was prescribed an antinausea 
medication over the telephone by appellee Dr. Steger. Her appendix eventually 
ruptured and was removed several weeks after she delivered her baby prematurely. 
In the resulting medical malpractice action against Dr. Steger for misdiagnosis, 
a motion for summary judgment was sustained, and we will now 
affirm.

 
 

[¶2.]     Mrs. Fiedler telephoned 
her doctor's office on September 7, 1982, to complain of nausea and other 
symptoms. Dr. Steger was the physician on call; his associate in a medical 
practice was Mrs. Fiedler's regular doctor. By telephone, and without personal 
contact, Dr. Steger prescribed phenergan, an antinausea drug, for injection at 
the Riverton Memorial Hospital emergency room. After the injection, Mrs. Fiedler 
apparently felt better; she was not examined by Dr. Steger, nor were other 
arrangements made for her to be seen by any doctor.

 
 

[¶3.]     Early in the morning of 
September 9, 1982, emergency room personnel at the hospital contacted Dr. Steger 
by telephone, since Mrs. Fiedler had then returned to the emergency room with 
similar complaints of nausea and other symptoms. Again, Dr. Steger prescribed 
phenergan over the telephone, and did not conduct any personal examination. 
Later that day, her regular doctor, Dr. Kent Stockton,1 examined her, determined that 
premature labor and delivery were imminent, and arranged transportation from 
Riverton, Wyoming, to the University of Utah Medical Center in Salt Lake City, 
Utah, where she delivered a premature baby. No diagnosis of appendicitis was 
made either by Dr. Stockton or the group of doctors participating in the 
delivery in Utah.

 
 

[¶4.]     Mrs. Fiedler's pain 
continued after the delivery, when she returned to her home in Riverton. Later 
that month, exploratory surgery revealed that she had suffered a ruptured 
appendix which had consequently abscessed. Extensive treatment 
followed.

 
 

[¶5.]     Mrs. Fiedler, her 
husband and their children filed this medical malpractice action against Dr. 
Steger, alleging misdiagnosis and failure to examine and properly treat. Steger 
filed a motion for summary judgment with supporting affidavits, and, by motion, 
Fiedler arranged for her expert to testify orally at the summary-judgment 
hearing.

 
 

[¶6.]     The issue of the case, 
simply stated, is the propriety of the entry of summary 
judgment.

 
 

[¶7.]     Summary judgment is 
properly granted when there is no genuine issue as to any material fact and the 
moving party is entitled to judgment as a matter of law. Rule 56(c), W.R.C.P.; 
Greaser v. Williams, Wyo., 703 P.2d 327 (1985); Rompf v. John Q. Hammons 
Hotels, Inc., Wyo., 685 P.2d 25 (1984); Matter of Estate of Brosius, Wyo., 683 P.2d 663 (1984).

 
 

[¶8.]     A succinct and 
conclusive critique of the Wyoming summary-judgment law is afforded by the court 
in Garner v. Hickman, 709 P.2d 407 
(1985):

 
 
"When 
reviewing a summary judgment on appeal, we review the judgment in the same light 
as the district court, using the same information. Randolph v. Gilpatrick Construction Company, 
Inc., Wyo., 702 P.2d 142 (1985); and Lane Company v. Busch Development, Inc., 
Wyo., 662 P.2d 419 (1983). A party moving for summary judgment has the 
burden of proving the nonexistence of a genuine issue of material fact. Dudley v. East Ridge Development Company, 
Wyo., 694 P.2d 113 (1985). Material fact has been defined as one which, if 
proved, would have the effect of establishing or refuting an essential element 
of the cause of action or defense asserted by the parties. Samuel Mares Post No. 8, American Legion, 
Department of Wyoming v. Board of County Commissioners of the County of 
Converse, Wyo., 697 P.2d 1040 (1985). Upon examination of a summary 
judgment, we view the record from the vantage point most favorable to the party 
opposing the motion, giving him all favorable inferences which may be drawn from 
the facts. Bancroft v. Jagusch, Wyo., 
611 P.2d 819 (1980)." 709 P.2d  at 410.

 
 
See also 
Harden v. Gregory Motors, Wyo., 697 P.2d 283 (1985).

 
 

[¶9.]     Fiedler argues that a 
material fact is at issue in this case by her claim that she told Dr. Steger 
over the telephone on September 7, 1982, that abdominal pain accompanied her 
nausea. As an evidentiary conflict, Steger's personal affidavit indicates that 
he did not recall the patient's complaint of lower abdominal pain. This 
affidavit conflict does create a factual dispute.

 
 

[¶10.]  The finite question for this court is 
whether the conflict as to what the patient told the doctor is sufficient to 
create a material fact issue rendering an order granting summary judgment 
improper. We will review the evidentiary conflict in determining whether there 
is a material fact question so that Steger would meet his burden of showing "an 
absence of genuine issues of material fact." Metzger v. Kalke, 709 P.2d 414, 420 
(1985); Timmons v. Reed, Wyo., 569 P.2d 112 (1977); Wood v. Trenchard, 
Wyo., 550 P.2d 490 (1976); Seay v. 
Vialpando, Wyo., 567 P.2d 285 (1977); Shrum v. Zeltwanger, Wyo., 559 P.2d 1384 
(1977).

 
 

[¶11.]  As this court has frequently stated, 
there are four essential elements in a medical-malpractice action. The plaintiff 
must prove (1) that there is a duty owed by the defendant to the plaintiff, (2) 
that the defendant failed to perform the duty, and (3) that failure to perform 
the duty proximately caused (4) damage to the plaintiff. Vassos v. Roussalis, Wyo., 625 P.2d 768 
(1981). Proximate cause means that the accident or injury must be the natural 
and probable consequence of the act of negligence. McClellan v. Tottenhoff, Wyo., 666 P.2d 408 (1983). See Harris v. Grizzle, 
Wyo., 625 P.2d 747 (1981).

 
 

[¶12.]  Medical evidence was presented by both 
litigants, and we consider the case in the context of the evidence as available 
to the trial court. No actual conflict is found in either the affidavits as 
filed in support of the motion or the oral testimony as afforded by the medical 
witness for the plaintiff. The testimony directly established that any claimed 
violation of the duty of Steger to examine was not the proximate cause of the 
damages which Fiedler (as the plaintiff) subsequently sustained. It was 
specifically stated in the sworn testimony that the appendicitis could not have 
been diagnosed on either September 7 or September 9, 1982. Kent F. Argubright, 
M.D., in an affidavit for Dr. Steger, opined:

 
 
"Making a 
diagnosis of a ruptured appendix during a pregnancy is a very difficult 
diagnosis to make. Symptoms of a ruptured appendix are very similar to premature 
labor during a third trimester pregnancy. Twenty-five percent of the diagnoses 
of ruptured appendix are made post partum. From a review of the records, 
plaintiff was seen by seven doctors prior to her delivery and immediately post 
partum. At least four of those doctors performed physical examinations. None of 
those seven doctors diagnosed appendicitis."

 
 

[¶13.]  More determinative of the issue before 
us, appellants' medical expert, Dr. Shine, orally testified at the 
summary-judgment hearing that the diagnosis of appendicitis could not have been 
made on September 7 or September 9, 1982, after earlier having refused to sign 
an affidavit which stated otherwise. Additionally, the experts for plaintiffs 
and defendant agreed that the appendix probably ruptured post 
partum.

 
 

[¶14.]  Accepting Mrs. Fiedler's version of the 
telephone conversation as true, Dr. Steger's failure to examine her did not 
cause the injury she sustained, in view of the uncontroverted medical testimony 
that the condition could not have been diagnosed on September 7 or 9 even with 
personal examination. In this case, an essential element, the causal connection 
between the breach of a duty owed and the injury sustained, is 
missing.

 
 

[¶15.]  Summary judgment goes to the merits of 
the case and affects the substantive rights of the litigants. Siebert v. Fowler, Wyo., 637 P.2d 255 
(1981); Prakash v. American 
University, 234 U.S.App.D.C. 75, 727 F.2d 1174 (D.C. Cir. 1984). Because it 
is a final judgment which denies parties the right to a trial before a jury of 
their peers, summary judgment must be applied with great care after a review of 
the record and the law. Yuba Goldfields, 
Inc. v. United States, 723 F.2d 884 (Fed. Cir. 1983). We find that the trial 
court properly exercised that care in granting this motion for summary 
judgment.2

 
 

[¶16.]  This court, as did the trial court, takes 
the record as presented for the summary-judgment hearing, and cannot recreate 
the facts which may have been or do not appear. The record presented no issue as 
to any material fact, and Dr. Steger, on that basis, was entitled to judgment as 
a matter of law.

 
 

[¶17.]  Affirmed.

 
 
FOOTNOTES

 
 

1 Stockton 
was originally named as a defendant, but was then released from the litigation 
by stipulation.

 
 

2 This 
decision should not be viewed in any way as an indication that this court 
determined the appropriate standard of care as involving the practice of a 
physician who is on call in prescribing medicine over the telephone to a 
pregnant patient. Dr. Shine spoke to that subject in his 
testimony.