Title: Oakden v. Roland

State: wyoming

Issuer: Wyoming Supreme Court

Document:

Oakden v. Roland1999 WY 137988 P.2d 1057Case Number: 98-304Decided: 10/18/1999Supreme Court of Wyoming
 
Gina 
T. OAKDEN, Appellant (Plaintiff),

v.

Norman ROLAND, M.D., 
Appellee (Defendant).

 

Appeal from the District 
Court, Uinta County, John D. Troughton, J.

Representing 
Appellant: Mark W Harris of Harris 
Law Firm, P.C., Evanston, Wyoming.

Representing 
Appellee: Robert G. Wright and 
Curtis J. Drake of Richards, Brandt, Miller & Nelson, Kemmerer, 
Wyoming.

Before 
LEHMAN, C.J., and THOMAS, MACY, GOLDEN and HILL, JJ.

MACY, 
Justice.

[¶1]      Appellant Gina 
Oakden appeals from an order granting summary judgment in favor of Appellee 
Norman Roland, M.D.

[¶2]      We 
affirm.

ISSUES

[¶3]      Oakden presents a 
lone issue for our review:

Did the district 
court err in determining that no genuine issue of material fact existed and that 
Roland was entitled to judgment as a matter of law?

FACTS

[¶4]      On October 14, 
1994, Dr. Roland was performing a laparoscopic procedure on Oakden in IHC 
Evanston Regional Hospital to remove her gall bladder when the electrosurgical 
irrigating suction probe that he was using became bent and inadvertently fired, 
causing a small defect in Oakden's common hepatic duct. The doctor was forced to 
convert the laparoscopic procedure to an open procedure. After the surgery, 
Oakden was transferred to LDS Hospital in Salt Lake City, Utah, where she was 
treated for the complications which arose from the injury to her common hepatic 
duct.

[¶5]      Oakden filed suit 
against Dr. Roland, alleging that his care and treatment fell below the 
applicable standard of care. Dr. Roland filed a motion for summary judgment, 
asserting that Oakden had failed to set forth expert testimony to establish the 
requisite elements of a prima facie case of negligence against him. The district 
court granted Dr. Roland's motion, and Oakden appeals from that 
decision.

STANDARD OF 
REVIEW

[¶6]      Summary judgment 
is appropriate when no genuine issue as to any material fact exists and the 
prevailing party is entitled to a judgment as a matter of law. Wolter v. 
Equitable Resources Energy Company, Western Region, 979 P.2d 948, 951 (Wyo. 
1999); see also W.R.C.P. 56 (c). A genuine issue of material fact exists when a 
disputed fact, if it were proven, would establish or refute an essential element 
of a cause of action or defense that the parties have asserted. Marchant v. 
Cook, 967 P.2d 551, 554 (Wyo. 1998). We evaluate the propriety of a summary 
judgment by employing the same standards and by using the same materials as were 
employed and used by the lower court. Kirkwood v. CUNA Mutual Insurance Society, 
937 P.2d 206, 208 (Wyo. 1997).

[¶7]      The movant bears 
the initial burden of establishing a prima facie case for summary judgment. 
Marchant, 967 P.2d  at 554. If the movant carries his burden, the party who is 
opposing the motion for a summary judgment must present specific facts to 
demonstrate that a genuine issue of material fact does exist. Id. We review the 
record in the light most favorable to the nonmoving party, giving that party the 
benefit of all favorable inferences which may be drawn from the facts. Austin v. 
Kaness, 950 P.2d 561, 563 (Wyo. 1997).

DISCUSSION

[¶8]      The district 
court found that the evidence which Oakden relied upon in opposing Dr. Roland's 
motion for summary judgment was inadmissible and, even if admitted, would not 
demonstrate that Dr. Roland was negligent in treating Oakden. Oakden insists 
that, when the evidence is viewed in the light most favorable to her, it 
establishes a question of fact as to whether Dr. Roland deviated from the 
applicable standard of care. Dr. Roland counters that Oakden failed to come 
forward with expert witness or other admissible testimony to establish the 
requisite elements of a prima facie case of negligence against 
him.

[¶9]      In order to 
defeat a motion for summary judgment in a medical malpractice action, a 
plaintiff:

"has the 
obligation to establish (1) the accepted standard of medical care or practice, 
(2) that the doctor's conduct departed from the standard, and (3) that his 
conduct was the legal cause of the injuries suffered." Orcutt v. Miller, Nev., 
[95 Nev. 408] 595 P.2d 1191, 1193 (1979).

Harris v. 
Grizzle, 625 P.2d 747, 751 (Wyo. 1981). In medical malpractice cases, "expert 
medical testimony is ordinarily required to establish negligence or lack of 
reasonable care on the part of a physician or surgeon in his medical diagnosis, 
his performance of surgical procedures, and his care and treatment of patients." 
625 P.2d  at 753. The mere fact that an injury or bad result occurred is not 
proof that negligence occurred. 625 P.2d  at 749.

[¶10]   In order to settle this issue, we 
must examine the evidence which Oakden relies upon in arguing that she 
established a prima facie case of negligence. She directs our attention to the 
testimony of two physicians who testified about comments that a third physician 
apparently made to them. Gary T. Baldwin, M.D., an obstetrician/gynecologist, - 
testified that Gregory M. Yasuda, a general, vascular, and laparoscopic surgeon, 
told him he "didn't feel that Roland knew what he was doing with the 
laparoscope." Michael Adams, M.D., a family practitioner, testified that Dr. 
Yasuda "did not feel, in retrospect, that it was appropriate for a relatively 
inexperienced person in the laparoscopic arena to [attempt a laparoscopic 
procedure]."

[¶11]   Oakden also relies upon a written 
evaluation submitted by Dr. Yasuda concerning Dr. Roland's hospital privileges 
and whether they should be renewed in which he stated that he did not feel Dr. 
Roland was "qualified by training and experience to perform the privileges 
requested." He further explained:

[M]oderately 
complex surgical problems or complications proved to be a somewhat more 
difficult situation for him to handle. I am uncertain as to his CME credits or 
programs but there appears to be a significant deficit in several areas 
including pediatric trauma and laparoscopic surgical techniques. Questions have 
also been raised about his intraoperative surgical judgment from at least one 
other respected medical staff member. One of these situations which arose while 
I was out of town has culminated in a formal lawsuit at the present time and 
there are formal inquiries from yet another. For these and other reasons I have 
chosen not to continue utilizing Dr. Roland's services and have very strong 
reservations in having him cover my patients in the future should his privileges 
somehow be renewed.

[¶12]   Dr. Roland directs our attention to 
the evidence which he contends established that no genuine issues of material 
fact existed with regard to his care of Oakden. He points out that Oakden's 
designated expert witness, Scott Leckman, M.D., a general surgeon, testified 
that his care of Oakden did not violate or fall below the applicable standard of 
care:

A. I'm sure - 
well, I imagine what I told [Oakden's counsel] was that I didn't see too much in 
the case.

Q. What do you 
mean by you "didn't see too much in the case"?

A. As far as he 
was interested in whether there had been malpractice 
committed.

. . . 
.

Q. After you 
reviewed that material, you did opine to [Oakden's counsel] you saw no - what 
you termed as malpractice; is that correct?

A. 
Correct.

Q. So, I would 
assume you did opine to [Oakden's counsel] that you did not see anything Dr. 
Roland did or did not do that would be a breach of the applicable standard of 
care?

A. 
Correct.

. . . 
.

Q. During any of 
your conversations with [Oakden's counsel], Dr. Leckman, have you ever offered 
him opinions that Dr. Roland breached the applicable standard of care in any of 
his care of Gina Oakden?

A. 
No.

Q. So do you 
have any opinions, whatsoever, that Dr. Roland breached any applicable standard 
of care in any of his treatments of Gina Oakden?

A. 
No.

Dr. Leckman 
explained that an injury to the common hepatic duct is a risk associated with 
the laparoscopic removal of a gall bladder:

A. Injury to the 
bile ducts -

Q. 
Right.

A. - occurs with 
this type of surgery and occurs about one percent of the 
time.

Q. 
Right.

A. And it was 
clearly stated on the consent form that that was a risk of the 
operation.

Q. So, the fact 
that the injury to the bile duct occurred does not constitute a breach of the 
applicable standard of care?

A. 
Correct.

Q. I would 
assume you have no opinions, then, that you're willing to offer that anything 
Dr. Roland did operatively during the laparoscopic portion of it or during the 
open portion of the [removal of the gall bladder] was a breach of the standard 
of care?

A. 
No.

Dr. Leckman 
further testified that Dr. Roland's use of sutures to repair the hepatic duct, 
his postoperative follow-up care, his use of a Jackson Pratt drain, and his 
decision to not use preoperative or intraoperative cholangiogram fell within the 
applicable standard of care. Dr. Leckman summed up his opinion regarding the 
incident as follows:

Q. Give me, 
then, if you have any opinions in this matter, what those opinions would be as 
far as what you've reviewed or from what you've reviewed, what you've learned, 
or what you've been told or otherwise. You've been designated as an expert and 
I'm curious as to what opinions you are willing to offer in this 
matter.

A. Okay. My 
summary would be that . . . Dr. Roland had an unintentional injury to the bile 
duct and that postoperatively the - it appears that the - that there was a bile 
leak from where the injury occurred. It was controlled with a drain, and that 
postoperatively the patient had problems which ultimately led to her transfer to 
LDS Hospital. And there she had, again, some unintended complications related to 
her treatment there and all of these complications were risks that related to 
the procedures that she received.

Q. Anything 
else?

A. My other 
opinion would be that while I can - that there would be other options, as far as 
additional care, other than what she received at LDS Hospital. Another 
alternative would be to have left things alone, just left the drain in place to 
control the bile leak until it healed, which is also - which also would have 
been an option in the case.

[¶13]   Dr. Roland also emphasizes that 
neither Dr. Baldwin, Dr. Adams, nor Mark E. Boschert, M.D., an interest and 
gastroenterologist, rendered an opinion that his care fell below the applicable 
standard of care or that his treatment was the proximate cause of Oakden's 
damages. Dr. Roland finally cites the testimony of his designated expert, Steven 
Mintz, M.D., a general surgeon who testified that, on the basis of his thorough 
review of the relevant records, it was his opinion that "Dr. Roland met the 
standard of care in all aspects in the treatment provided to Ms. 
Oakden."

[¶14]   We will not conduct a tortured 
analysis about whether the evidence which Oakden relied upon was admissible 
because we agree with the district court's finding that the evidence, even if 
admitted, would not establish the accepted standard of medical care or practice, 
show that Dr. Roland departed from that standard in treating Oakden, or prove 
that Dr. Roland's treatment was the legal cause of Oakden's injuries. Instead of 
producing evidence regarding these three required elements, Oakden attempts to 
demonstrate the existence of a genuine issue of material fact by presenting 
evidence that another doctor might have felt Dr. Roland was not sufficiently 
experienced in the procedure he performed on Oakden. This evidence is not 
helpful in this particular situation because it does not pertain to the 
applicable standard of care nor does it demonstrate how Dr. Roland might have 
deviated from that standard during the procedure.

[¶15]   We hold that Oakden has failed to 
demonstrate that genuine issues of material fact existed. The district court 
properly granted a summary judgment in favor of Dr. 
Roland.

[¶16]   Affirmed.