Title: WYOMING MEDICAL CENTER, INC. v. MURRAY

State: wyoming

Issuer: Wyoming Supreme Court

Document:

WYOMING MEDICAL CENTER, INC. v. MURRAY2001 WY 6327 P.3d 266Case Number: 00-220Decided: 07/20/2001

 

APRIL 
TERM, A.D. 2001

 

                                                                                                            

 

WYOMING 
MEDICAL CENTER, INC.,

a 
Wyoming corporation,

Appellant(Defendant),

 

v.

 

MELISSA 
MURRAY,

Appellee(Plaintiff).

 

 

Appeal 
from the District Court of Natrona County

The 
Honorable David B. Park, Judge 

 

 

Representing 
Appellant:

Scott W. 
Skavdahl and Scott E. Ortiz of Williams, Porter, Day & Neville, P.C., 
Casper, Wyoming.  Argument by 
Mr. Skavdahl.  

Representing 
Appellee:

Tom 
Sedar and Mel Dunn, Casper, Wyoming.  
Argument by Mr. Dunn.

 

 

Before 
LEHMAN, C.J., and GOLDEN, HILL, and KITE, JJ.

 * 
This 
case was originally assigned to Justice Thomas on December 15, 2000, for the 
rendering of a proffered majority opinion.  
The case was reassigned to Justice Golden on February 5, 
2001.

  

GOLDEN, 
Justice. 

[¶1]           
Appellant 
Wyoming Medical Center, Inc. (WMC) appeals the district court's decision that a 
plaintiff having pre-existing conditions need not provide expert testimony to 
establish causation for personal injuries suffered in a slip and fall 
accident.  Appellee Melissa Murray 
received a jury verdict awarding damages in her negligence suit against WMC 
following her slip and fall in WMC's parking garage.

 

[¶2]           
We 
affirm.

 

 

ISSUES

 

[¶3]           
WMC 
presents this statement of the issues for review:

 

1.  Did the District Court err in failing to 
grant Appellant's Motion for Directed Verdict where Appellee had failed to offer 
any evidence to establish that the proximate cause of her claimed injuries was 
Appellant's conduct and not the result of pre-existing 
injuries?

 

2.  Did the District Court err in 
instructing the jury as to future damages in light of Appellee's pre-existing 
injuries and the absence of any expert testimony to support any future 
damages?

 

3.  Did the District Court err in 
instructing the jury, over Appellant's objection, as to the recovery of medical 
expenses where there was no evidence to show that the medical expenses allegedly 
incurred by Appellee were proximately caused by Appellant's 
conduct?

 

 

Murray 
does not restate or present issues for review.

 

 

FACTS

 

[¶4]           
On 
January 19, 1995, Murray arrived at WMC to visit her mother, a patient at the 
facility.  Murray parked her car on 
the fifth level of the parking structure connected to WMC, and as she walked to 
the elevator, Murray slipped and fell on black ice, suffering injuries to her 
knee and back. 

 

[¶5]           
She 
filed a negligence action against WMC, and a jury trial was held in January of 
2000.  The jury returned a verdict 
finding $71,500.00 in damages and apportioning WMC's fault at ninety percent and 
Murray's at ten percent.  The 
damages were further reduced by the amount of medical expenses that WMC had 
already paid.  WMC filed a motion 
for judgment as a matter of law or in the alternative a motion for new trial 
contending that insufficient evidence supported the jury's verdict that the fall 
caused Murray's injuries.  Those 
motions were denied, and this appeal followed.

 

 

DISCUSSION

 

 

[¶6]           
WMC 
contends that the trial court erred in denying its motion for judgment as a 
matter of law because Murray's injuries were pre-existing and required expert 
testimony to establish that the fall caused injuries.     W.R.C.P. 50(a)(1) 
provides:

 

(a) 
Judgment as a matter of law. -- 

(1) If 
during a trial by jury a party has been fully heard on an issue and there is no 
legally sufficient evidentiary basis for a reasonable jury to find for that 
party on that issue, the court may determine the issue against that party and 
may grant a motion for judgment as a matter of law against that party with 
respect to a claim or defense that cannot under the controlling law be 
maintained or defeated without a favorable finding on that 
issue.

 

"Despite 
the fact that judgment as a matter of law should be granted cautiously and 
sparingly, the district court has an obligation to direct entry of such a 
judgment where there is legally insufficient evidence to support a verdict on a 
particular issue.  The decision to 
grant or deny a motion for a judgment as a matter of law is reviewed de 
novo."  Sayer v. 
Williams, 962 P.2d 165, 167 (Wyo. 1998).  

 

[¶7]           
We 
undertake a full review of the record without deference to the views of the 
trial court.  The test to be applied 
is whether the evidence is such that, without weighing the credibility of the 
witnesses or otherwise considering the weight of the evidence, there can be but 
one conclusion as to the verdict that reasonable persons could have 
reached.  We view the evidence in 
the light most favorable to the nonmoving party, and give that party the benefit 
of all reasonable inferences that may be drawn from the evidence.  When the facts permit the drawing of 
more than one inference, it is for the jury to choose which will be used.  Sundown, Inc. v. Pearson Real Estate 
Co., Inc., 8 P.3d 324, 330 (Wyo. 2000); John Q. Hammons Inc. v. 
Poletis, 954 P.2d 1353, 1356 (Wyo. 1998).  If the inferences favorable to the 
movant are subject to doubt, or if parallel inferences can be drawn, the motion 
appropriately is denied.  
Sundown, 8 P.3d  at 330; Stauffer Chemical Co. v. Curry, 778 P.2d 1083, 1103 (Wyo. 1989); Ramirez v. Metropolitan Life Ins. Co., 580 P.2d 1136, 1138 (Wyo. 1978).

 

[¶8]      "In reviewing a 
sufficiency-of-the-evidence question, we assume the evidence in favor of the 
successful party to be true, leaving out of consideration entirely the evidence 
in conflict, and assigning every favorable inference to the evidence of the 
successful party that can be reasonably and fairly drawn from it."  Wal-Mart Stores v. Clark, 969 P.2d 550, 551 (Wyo. 1998); City of Kemmerer v. Wagner, 866 P.2d 1283, 
1285 (Wyo. 1993) (quoting Crown Cork & Seal Co. v. Admiral Beverage 
Corp., 638 P.2d 1272, 1274-75 (Wyo. 1982)).  We leave to the jury the duty of 
ascertaining the facts, reconciling conflicts therein, and drawing its own 
inferences if more than one inference is permissible.  Id.  When the facts permit the drawing of 
more than one inference, then it is for the jury to choose which one will be 
used; and, if supported by substantial evidence, the jury's choice will be 
conclusive.  Id.

 

 

[¶9]           
At trial, Murray 
testified that before her fall, she suffered occasional muscle strains from 
lifting a person for whom she was providing twenty-four hour home health 
care.    Chiropractic care 
provided relief from the pain caused by the muscle strains.  At the time she fell in WMC's parking 
structure, she hit the back of her head, her back, and dislocated her knee.  She was in pain, and her knee started to 
swell.  Her doctor testified that 
the fall injured her back and knee.  
Murray testified that since her fall, she has suffered constantly from 
back and knee pain, and migraines.  

 

[¶10]       
The 
proper rule of law is found in Wal-Mart Stores v. Clark, which 
said:

 

            
Wal-Mart claims that the evidence adduced at trial was insufficient to 
establish causation between Clark's fall and his claimed injuries.  In  
Mariner v. Marsden, 610 P.2d 6, 15 (Wyo. 1980), and again in 
Buttrey Food Stores Div. v. Coulson, 620 P.2d 549, 559 (Wyo. 1980), we 
held the testimony of the plaintiff may be sufficient, without the use of 
experts, to establish the element of causation between an accident and the 
plaintiff's injuries.  As we stated 
in Mariner, "[i]f the plaintiff, bearing the risk of nonpersuasion, 
chooses to present his claim of past pain without medical experts and the fact 
finder decides to credit his claim, most appellate courts perceive no impediment 
to upholding the award."  
Mariner, 610 P.2d  at 13; see also 1 Jacob Stein, Stein On Personal Injury 
Damages, § 2:8, at 32 n. 7 (2d ed.1991) and cases cited therein.  The jury may reasonably infer that an 
absence of pain prior to the accident, and the onset of pain afterwards, is 
evidence that the accident caused the pain.

 

Wal-Mart 
Stores v. Clark, 969 P.2d  
at 551-52. 

 

[¶11]       
WMC 
contends that Wal-Mart Stores v. Clark and the other cases are 
distinguishable because no pre-existing injuries existed, and the expert 
testimony requirement of Sayer v. Williams applies to Murray.  In Sayer, a medical 
malpractice claim, the plaintiff contended that the substandard care she 
received caused her symptoms of dizziness and fatigue.  The district court ruled that by failing 
to provide expert testimony on causation she had failed to prove it as a matter 
of law and directed a verdict in favor of the defendant.  We upheld the ruling that expert 
testimony is required to satisfy causation in all but extraordinary cases of 
medical malpractice.  Sayer, 
962 P.2d  at 168.  The rationale for 
this rule was discussed in Harris v. Grizzle, 625 P.2d 747, 753 (Wyo. 
1981):

 

The law 
of proximate cause in malpractice cases is clear.  Malpractice is a form of 
negligence.  Before a physician may 
be held liable for malpractice, it must be shown that he departed from 
recognized standards of medical practice.  
In addition, that departure must be the proximate cause of the incident 
or occurrence which is the subject of the litigation.  Schrib v. Seidenberg, 80 N.M. 
573, 458 P.2d 825, 826 (1969).

 

In an 
action for malpractice, the plaintiff must establish that an act or omission by 
a physician has breached a standard of care and that the breach was the cause, 
both in fact and proximately, of the damage suffered by the patient.  Keogan v. Holy Family Hospital, 
22 Wash. App. 366, 589 P.2d 310, 313 (1979).

 

Appellant 
failed to prove that the proximate cause of deceased's death was the negligence 
of appellees.  In Keller v. 
Anderson [554 P.2d 1253 (Wyo. 1976)], we held that it is not sufficient to 
point to bad results as providing the causal link.  In Keller we said that expert 
opinion is necessary to draw the causal link.  In the present case, appellant has failed 
to provide the causal link by expert testimony.

 

 

[¶12]       
The 
necessity for expert testimony in the typical medical malpractice action is not 
present in this slip and fall negligence action.  The trial court properly left it to the 
jury to decide the causal link between Murray's fall and her injuries based on 
the adequate evidence provided by her.  
We find no error.

 

 

 

[¶13]       
Over 
WMC's objection, the trial court submitted a jury instruction concerning loss of 
enjoyment of life.  WMC contends 
that expert medical evidence was required to apportion any loss of enjoyment of 
life caused by the pre-existing condition from that caused by the fall, and 
because Murray did not provide this expert testimony, the evidence did not 
support giving this instruction.  

 

[¶14]       
Before 
any instruction can be given, there must be evidence before the jury to which it 
may apply the rule of law encompassed by the instruction.  Rittierodt v. State Farm Ins. Co., 
3 P.3d 841, 844 (Wyo. 2000).  
Loss of enjoyment of life is a compensable damage that the fact finder 
may either make a separate award for, or take into consideration when arriving 
at the total general damages.  
Mariner v. Mardsen, 610 P.2d 6, 12 (Wyo. 1980).  An appellate court must look to 
determine if the damages awarded are supported by the evidence.  Id. at 13.  Medical testimony is not necessary to 
support the damages award; a plaintiff may establish these damages by her own 
testimony.  Id.   

 

[¶15]       
In this 
case, Murray and her mother testified concerning her pain and its effect on her 
life.  During the jury instruction 
conference, the trial court ruled that the plaintiff's testimony concerning her 
lack of ability to do certain things that she once did was sufficient to present 
to the jury an instruction on loss of enjoyment of life.  The trial court's decision properly 
reflected the applicable law on this issue, and we find no error.  As just discussed, the jury was properly 
allowed to determine any causation issues generated by her pre-existing 
conditions and was properly allowed to make apportionment decisions without 
benefit of expert testimony.

 

 

 

[¶16]       
WMC's 
final contention is also based upon the lack of expert testimony establishing 
causation, claiming insufficient evidence existed to instruct the jury on 
medical expenses.  We again find 
that the expert testimony was not necessary for the same reasons just 
discussed.  

 

 

 

[¶17]       
In this 
case, the plaintiff risked relying on evidence other than expert testimony.  The jury returned a total general 
damages amount that the trial court reduced by fault apportionment and offset by 
the medical expenses already paid by WMC.  
The evidence was sufficient to support the jury instructions and the 
damages awarded.  We affirm the 
judgment on the verdict.