Title: In Re Med. Rev. Panel of Cl. of Englert

State: louisiana

Issuer: Louisiana Supreme Court

Document:

605 So. 2d 1349 (1992) In re MEDICAL REVIEW PANEL OF the CLAIM OF Connie ENGLERT, Individually and on Behalf of her Minor Child, Kortnei Kent. No. 92-C-0580. Supreme Court of Louisiana. October 19, 1992. Opinion Concurring in Part, Dissenting in Part October 22, 1992. James Burnett Aime, New Orleans, for applicant. Stephen M. Pizzo, Blue, Williams & Buckley, Metairie, for respondent. Opinion of Justice Dennis Concurring in Part, Dissenting in Part October 22, 1992. HALL, Justice. In this malpractice action brought by Connie Englert, individually and on behalf of her minor child, Kortnei, against Dr. Byung Moon Chin, the trial court, after a bench trial, found that the defendant doctor breached the applicable standard of care in failing to earlier diagnose a tumor in the child's head, and awarded damages totalling $225,000. On defendant's appeal, the court of appeal in an unpublished opinion affirmed the finding of liability, 592 So. 2d 515 (1992) but reduced the amount of damages to $10,000, concluding that the only adverse effect of the failure to diagnose the tumor six months earlier was continued headaches and vomiting for the six-month period and perhaps some mental anguish. One judge dissented from the finding of liability. Plaintiff's writ application was granted to consider whether the substantial reduction in the amount of damages was warranted. 596 So. 2d 541 (La.1992). We amend the court of appeal judgment to increase the award to $50,000. Plaintiff urges that the evidence supports a finding that the child was taken to the doctor with complaints of headaches more than a year and a half prior to the time that he referred her to a specialist and the tumor was diagnosed. Plaintiff further argues that the evidence supports a finding that had surgery to remove the tumor been done sooner, the entire tumor could have been removed and the risk of future recurrence would have been reduced, thereby justifying the damage award made by the trial court. Defendant, in support of the reduction in the award made by the court of appeal, first reurges its argument made in the courts below that plaintiff failed to establish liability because she failed to establish by expert testimony the appropriate standard of care and a breach thereof. More directly to the issue of quantum, defendant argues that $10,000 adequately compensates the child for the minimal damages occasioned by a not more than six-month delay in diagnosis and surgery. The court of appeal correctly summarized the facts and resolved the liability issue as follows: The court of appeal based its reduction in the amount of damages on the following findings: In awarding $100,000 for pain and suffering, $100,000 for physical and mental disability, and $25,000 for future medical expenses, the trial court found that Dr. Chin's unreasonable delay in diagnosing the tumor allowed it to grow for another year, worsening her injury, the damage to her brain, and her prognosis. The evidence does not support that finding or the awards made by the trial court. Accepting the mother's testimony about the complaints to Dr. Chin, the frequency of the headaches accompanied by vomiting was not sufficient under the standard of care enunciated by Dr. Sterne to suggest a CAT scan until six months or less before the tumor was finally diagnosed and surgery performed. There is no medical evidence that the six-month delay worsened the child's condition or prognosis. Dr. Nadell testified that the child was more at risk than she would have been if, at the time of surgery, the tumor had been smaller and not into the brain stem, and if he had been able to get it all. But he did not tie this statement into any particular time frame or testify that the delay in diagnosis and surgery to remove the tumor, which had been growing for several years, prevented the removal of all of the tumor or worsened the prognosis. Dr. Nadell's testimony did establish that the part, if any, that he was unable to remove because of its proximity to the brain stem was the youngest part or most recent growth of the tumor. He also said he could not tell when the part which may have been left in grew to that location. Tests conducted during the four years postsurgery show no evidence of the tumor or recurrence. There is a paucity of medical evidence linking the child's poor performance in school to the delay in diagnosis or to the residual part of the tumor which was not removed. Any present disability the child has was not proved to have been caused by the delay in diagnosis. Nevertheless, it stands to reason that the new and additional growth of the tumor during the six-month period which necessarily forms part of the residual which could not be removed, increased the risk of future recurrence to some extent. The reduction in the amount of the award by the court of appeal does not take into account this element of damage. We also conclude that the severity of the pain and suffering endured by the child during the six-month period was somewhat understated by the court of appeal. Thus we believe that the child is entitled to be compensated not only for the pain and suffering she endured during the six-month period, but also for the increased risk, although perhaps somewhat minimal, and its accompanying mental anxiety resulting from the delay in diagnosis and surgery. Considering these factors, we find that the award for pain, suffering and disability should not have been reduced beyond $50,000, the highest amount within the range of discretion of the trier of fact. The court of appeal correctly deleted the trial court award of $25,000 for future medical expenses. Dr. Nadell testified no future treatment was indicated. The child will need yearly check-ups which would have been necessary after this type of surgery regardless of when it was performed. For the reasons assigned, the court of appeal judgment is amended to increase the award from $10,000 to $50,000, and as amended is affirmed. AMENDED and AFFIRMED AS AMENDED. LEMMON, J., concurs. DENNIS, J., concurs in part and dissents in part. *1352 DENNIS, Justice, concurring in part, dissenting in part. In view of the fact that the medical malpractice resulted in the child's worsened condition, the greater difficulty in removal of the tumor, and the child's more gloomy prognosis, I cannot agree that the trial court abused its discretion in assessing damages to the extent found by the majority.