Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca10-87-02151/USCOURTS-ca10-87-02151-0/pdf.json

Parties Involved:
Donald G. Bible
Appellant
Lacey Dawn Bible
Appellant
Susan L. Bible
Appellant
Jane Phillips Episcopal Hospital, Inc.
Appellee

Document Text:

.. 

UNITED STATES COURT OF APPEALS 

FOR THE TENTH CIRCUIT 

FILED 

United States C.Ourt of Appeals 

Tenth circuit 

LACEY DAWN BIBLE, a 

through her parents 

Donald G. Bible and 

DONALD G. BIBLE and 

individually, 

minor, by and ) 

and next friends, ) 

Susan L. Bible, and ) 

SUSAN L. BIBLE, ) 

Plaintiffs-Appellants, 

v. 

JANE PHILLIPS EPISCOPAL HOSPITAL, INC., 

a corporation, 

Defendant-Appellee. 

) 

) 

) 

) 

) 

) 

) 

) 

) 

) _____________________ ) 

CONNIE BORN, MARY MCGARRY, DEE COLLINS, 

and JUDY AVERILL, 

Non-Party Appellees. 

) 

) 

) 

) 

) 

_____________________ ) 

OKLAHOMA NURSES ASSOCIATION, 

Amicus Curiae. 

) 

) 

) 

) 

ORDER AND JUDGMENT* 

JUN 1 5 1990 

ROBERT L. HOECKER 

Clerk 

No. 87-2151 

No. 87-2640 

No. 87-2899 

(D.C. No. 86-C-461-B) 

( N. D. Ok la. ) 

Before TACHA, MCWILLIAMS, and EBEL, Circuit Judges. 

These three appeals arise out of a diversity action for 

medical malpractice. Plaintiffs basically allege that their 

infant daughter contracted genital herpes ("Herpes II") from the 

defendant hospital's personnel sometime during or after the baby's 

* This order and judgment has no precedential value and shall not 

be cited, or used by any court within the Tenth Circuit, except 

for purposes of establishing the doctrines of the law of the case, 

res judicata, or collateral estoppel. 10th Cir. R. 36.3. 

Appellate Case: 87-2151 Document: 010110036210 Date Filed: 06/15/1990 Page: 1 
delivery. The hospital contends that the baby contracted 

Herpes II from her mother during the birth process. After a trial 

ending in a hung jury, the district court directed a verdict in 

favor of the hospital. Plaintiffs appeal, and we affirm. 

APPEAL NO. 87-2151 

Case No. 87-2151 is an appeal from the directed verdict · in 

favor of the hospital. Plaintiffs raise six issues in that 

appeal: (1) whether the district court erred in preventing 

discovery, until after trial had begun, of a list of nurses that 

had been generated as part of the hospital's internal 

investigation of the incident; (2) whether the district court 

erred in preventing plaintiffs' expert from testifying about 

certain medical tests that had been performed shortly before trial 

and the results of which were not disclosed to the hospital until 

after the trial had begun; (3) whether the district court erred in 

granting the hospital's motion in limine seeking to exclude all 

reference to another baby who was born in the same hospital 47 

days later and who subsequently contracted Herpes II; (4) whether 

the district court erred in preventing plaintiffs from impeaching 

a hospital employee who denied that there were any other cases of 

Herpes II among babies born at the hospital; (5) whether the 

district court erred in refusing to give a res ipsa loquitur 

instruction to the jury; and (6) whether the district court erred 

in directing a verdict for the hospital. 

1. Discovery of nurse list. Plaintiffs contend that they 

were prejudiced by their inability to discover the contents of a 

handwritten list of nurses (Pl. Exh. 48(b)) that was created 

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Appellate Case: 87-2151 Document: 010110036210 Date Filed: 06/15/1990 Page: 2 
during the hospital's internal investigation. Although plaintiffs 

had deposed 43 nurses and hospital staff members before trial, the 

list included the names of 13 nurses whom plaintiffs allegedly did 

not know about earlier and had not deposed. The 13 nurses were 

identified at trial as having worked in the obstetrics department 

and as having possible contact with the Bible baby. (Tr. at 682.) 

We conclude that plaintiffs' inability to discover the nurse 

list did not constitute reversible error because plaintiffs did 

not request a continuance of the trial in order to obtain 

depositions from the 13 nurses. As we have held previously, "the 

remedy for coping with surprise is not to seek reversal after an 

unfavorable verdict, but a request for continuance at the time the 

surprise occurs." LeMaire v. United States, 826 F. '2d 949, 953 

(10th Cir. 1987) (quoting Szeliga v. General Motors Corp., 728 

F.2d 566, 568 (1st Cir. 1984)). The 13 depositions likely would 

have been brief. Perhaps some or all of them could have been 

conducted while the trial have moved onward. By failing to seek a 

continuance, plaintiffs waived any objection. 

2. Exclusion of testimony about recent tests. Plaintiffs 

assert that the district court erred by limiting the testimony of 

Dr. Roizman, one of plaintiffs' rebuttal witnesses. Shortly 

before trial, Dr. Roizman performed some additional medical tests 

on Mr. and Mrs. Bible. However, plaintiffs did not disclose to 

the hospital the existence or results of the new tests until the 

eighth day of trial. 

The district court held that plaintiffs improperly had 

withheld the new test results from the hospital and, consequently, 

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Appellate Case: 87-2151 Document: 010110036210 Date Filed: 06/15/1990 Page: 3 
prohibited Dr. Roizman from testifying about them. Dr. Roizman 

eventually testified that he could not determine whether the Bible 

baby's Herpes II came from the hospital or her mother. 

We believe that the district court properly limited Dr. 

Roizman's testimony to previously-discovered topics. We have held 

that permitting an expert to testify about matters that have not 

been disclosed before trial can constitute reversible error. 

Smith v. Ford Motor Co., 626 F.2d 784, 794 (10th Cir. 1980) 

(plaintiff's expert should not have been allowed to testify about 

the cause of plaintiff's injury when pretrial submissions stated 

that the expert would testify only "as to his medical treatment of 

the Plaintiff, as well as to his prognosis"), cert. denied, 450 

U.S. 918 (1981). We emphasized in Smith that litigants have a 

duty under Fed. R. Civ. P. 26(e) to seasonably supplement their 

interrogatory responses concerning expert testimony. 626 F.2d at 

794. Plaintiffs failed to do so here. 

3. Exclusion of evidence about Padgett baby. Plaintiffs 

contend that the district court erred by excluding all evidence 

about another baby, the Padgett baby, who contracted Herpes II 

after being born 47 days later in the same hospital. The district 

court held that the evidence regarding the Padgett baby was 

prejudicial and had little probative value. Fed. R. Evid. 403; 

see Tr. at 310-11; 736-37. Our standard for reviewing the 

district court's evidentiary ruling is whether it constituted an 

abuse of discretion. See,~' United States v. Alexander, 849 

F.2d 1293, 1301 (10th Cir. 1988). 

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Appellate Case: 87-2151 Document: 010110036210 Date Filed: 06/15/1990 Page: 4 
We do not think that the district court abused its 

discretion. In light of the record evidence showing that the most 

probable source of Herpes II in newborn infants is the infant's 

mother (~, Tr. 1578), the probative value of the Padgett-baby 

evidence is affected by whether the Padgett parents had Herpes II. 

If the Padgett parents did not have Herpes II, then we might agree 

with plaintiffs that the existence of a second Herpes II incident 

within 47 days may be probative as to whether the hospital caused 

the Bible baby's Herpes II. However there was no evidence in the 

record as to whether the Padgett parents had Herpes II. Because 

plaintiffs did not present any evidence on that issue and instead 

relied on mere coincidence to make the causal connection, we do 

not think that the Padgett baby incident was particularly 

probative or that the district court's decision constituted an 

abuse of discretion. 

4. Impeachment about Padgett baby. Plaintiffs further 

assert that the district court wrongly prevented them from 

impeaching a hospital witness who denied that there were any other 

cases of Herpes II among babies born at the hospital. Plaintiffs 

accuse defendant's infectious disease nurse, Nurse Fields, of 

committing outright perjury. 

After reviewing Nurse Fields' testimony, we think that a more 

innocent view might be that the Padgett incident occurred after 

she had completed her investigation (see Tr. at 734-36) and that 

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Appellate Case: 87-2151 Document: 010110036210 Date Filed: 06/15/1990 Page: 5 
Nurse Fields did not consider the Padgett baby's Herpes II as 

having anything to do with the hospital. 1 

1 

We need not resolve that question because Nurse Field's 

The relevant testimony by Nurse Fields was as follows: 

Q [Plaintiffs' counsel:] You did, as a matter of 

fact, talk about having cultures done on the nurses, 

didn't you? 

A I mentioned to Dr. Zyters (phonetic). 

Q All right. 

A We did not have two cases which did not make an 

epidemic. And it was three weeks later, and it wouldn't 

show up what was relevant at that time. 

Q Okay. So, you have to have two cases to make an 

epidemic, is that right? 

A Yes. 

Q So, if you don't have an epidemic, you're not 

going to test, is that right? 

A You're not going to test, no, when you feel like 

there is an isolated case. 

Q And that's the reason you didn't test, right? 

A You don't generally test for herpes. It's very 

hard to determine who has herpes and who doesn't. 

Q I didn't ask you that. Is that the reason you 

didn't test? Because you didn't think you had an 

epidemic? 

A We didn't have an epidemic. 

Tr . 707-08. 

Q [Plaintiff's counsel:] Were you the least bit 

curious then as to whether or not you might have missed 

some names on this list? 

A I really never thought about it. I was busy 

checking other things and I asked Dorothy to do this. 

Q Well, but two and a half years have gone by. 

We're in trial today, and I'm just wondering if, at any 

time, the thought had occurred to you, well, maybe there 

are some other nurses that I need to talk to. Has that 

thought ever occurred to you? 

A No. 

Q As a matter of fact, you didn't -- you never 

did, at any time, in two and half years -- you didn't go 

ahead and talk to every nurse on that list, did you? 

You already told us that. 

A No. And we haven't had any herpes. 

Tr. 733-34. 

[Footnote continued . . ] 

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credibility does not affect the issue of whether plaintiffs made 

out a prima facie case on the issue of causation. Even if Nurse 

Fields were untrustworthy, that fact would not help plaintiffs 

establish a prima facie case on the question of causation. 

Because we conclude that the district court properly granted a 

directed verdict in favor of the hospital on the causation issue 

(see Issue 6 below), it does not matter that the jury did not hear 

impeachment evidence challenging Nurse Fields' credibility. 

5. Res Ipsa Loquitur instruction. Plaintiffs argue that the 

district court erred by refusing to give the jury a res ipsa 

loquitur instruction. In light of the plain language of 

Oklahoma's res ipsa statute, plaintiffs' argument is without 

merit. The statute provides that a res ipsa loquitur presumption 

applies only when the injury was caused by something "solely 

within the control of the defendant" and was the sort of injury 

that "does not ordinarily occur ... absent negligence'' on 

defendant's part: 

In any action arising from negligence in the rendering 

of a medical case, a presumption of negligence shall 

arise if the following foundation facts are first 

established: 

[ ... footnote continued] 

Q [Defendant's counsel:] Ma'am, why is infection 

control important to you, in particular, in the newborn 

nursery? 

A Because babies are very vulnerable to infection. 

And, we keep close track on those babies down there. 

And, two cases make an epidemic and we do an all out 

check-up on employees and babies in the nursery through 

their doctors offices and if need be, do [quarantine] 

and move the patients to other floors and everything. 

But, we don't do it if there's just one case. 

Tr. at 816. 

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1. The plaintiff sustained any injury; 

2. Said injury was proximately caused by an 

instrumentality solely within the control of the 

defendant or defendants; and 

3. Such injury does not ordinarily occur under the 

circumstances absent negligence on the part of the 

defendant. 

Okla. Stat. tit. 76, § 21. 

Here, there was evidence that the "instrumentality" causing 

the injury may have been Mrs. Bible's birth canal, and thus the 

second test was not met. Moreover, the third test was not 

satisfied because the evidence showed that the contraction of 

Herpes II by newborn· children can ordinarily occur without medical 

negligence. (~, Tr. at 1509.) Therefore, the district court 

properly denied the requested instruction. 

6. Directed verdict. Plaintiffs argue that the district 

court wrongly excluded Nurse Spencer's expert testimony and 

improperly directed a verdict in favor of the hospital as a 

result. Our standard of review for the district court's 

evidentiary ruling concerning Nurse Spencer's expert testimony is 

whether the district court abused its discretion. See,~, 

Aspen Highlands Skiing Corp. v. Aspen Skiing Co., 738 F.2d 1509, 

1523 (10th Cir. 1984) ("We begin with the general rule that we 

review a district court's admission or exclusion of expert 

testimony for abuse of discretion only''), aff'd, 472 U.S. 585 

(1985). 

We conclude that the district court's exclusion of Nurse 

Spencer's testimony did not constitute an abuse of discretion. 

The district court's principal concern was that, despite Nurse 

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Spencer's training and experience, she was not qualified "to 

express her causation and negligence opinion from the limited 

facts and evidence presented to her." (June 29, 1987 Order at 7; 

emphasis added.) The district court held that the major defect in 

Nurse Spencer's expert analysis was that, as she testified on voir 

dire, she had not been shown "anything that indicates that [Mrs. 

Bible] is a carrier of Herpes II." (Tr. at 1010.) Nurse Spencer 

testified at trial that she had not previously been given a copy 

of Mrs. Bible's antibody test (Defendant's Exhibit 7). That test 

established conclusively that Mrs. Bible was infected with 

Herpes II as of January 30, 1985. (Tr. at 488, 1479, 1584-85.) 

When shown a copy of Exhibit 7, Nurse Spencer testified that she 

was not qualified to interpret the test and that she would need a 

virologist's interpretation of it before she could reach an 

opinion "concerning the more probable cause or source of this 

child's simplex II": 

THE COURT: In other words, you agree that in your 

analysis Defendant's Exhibit 7 is playing no part? 

MS. SPENCER: Not in my opinion, it can't. I'm not 

allowed to interpret that. 

(Tr. at 1017-18, 1020; see also Tr. at 1056.) When the district 

court allowed Nurse Spencer to render an opinion on the ultimate 

issue of causation (after assurances that plaintiffs would also 

present confirming testimony by a virologist, Tr. at 975), Nurse 

Spencer made clear that her opinion was based only on the evidence 

that she had seen up to that point: "Well, based on the evidence 

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Appellate Case: 87-2151 Document: 010110036210 Date Filed: 06/15/1990 Page: 9 
that I've seen so far, I think that the Bible baby acquired herpes 

from the hospital." (Tr. at 1033-34.) 2 

Because Nurse Spencer's opinion was based upon limited facts, 

the district court did not abuse its discretion in excluding it. 

Cf. Gates v. United States, 707 F.2d 1141, 1145 (10th Cir. 1983) 

("In light of Dr. Phillips' admission that an opinion on causation 

is primarily a medical diagnosis rather than an opinion within his 

area of expertise, and because Dr. Phillips admitted that he was 

not qualified to examine plaintiff's medical records, we conclude 

that the trial court's exclusion of Dr. Phillips' opinion 

regarding causation of plaintiff's GBS was not an abuse of 

discretion."). 

Consequently, the district court was correct in directing a 

verdict in favor of the hospital because, without Nurse Spencer's 

testimony, plaintiffs did not make out a prima facie case on the 

critical issue of causation. 

APPEAL NO. 87-2640 

Case No. 87-2640 is an appeal from an award of $12,320.50 in 

attorneys fees and expenses to various non-party nurses who 

successfully moved to quash plaintiffs' deposition subpoenas. The 

nurses worked in Tulsa for hospitals not connected with the 

defendant and had no dealings with plaintiffs' baby. The district 

2 The inadequate basis for Nurse Spencer's opinion is confirmed 

by the fact that (1) Nurse Spencer reached her opinion without 

seeing the results of any Herpes II testing performed on the 

baby's father (Tr. at 1074), and (2) Nurse Spencer reached her 

opinion without being presented with evidence showing that any 

hospital personnel had Herpes II, let alone active Herpes II 

lesions, during the time that the Bible baby was in the hospital 

(Tr. at 1005-07; 1089). 

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court, affirming the magistrate's ruling, essentially held that 

the nurses were not fact witnesses, but rather were non-party 

experts who were not subject to discovery subpoenas. 

On appeal, plaintiffs contend that they were "substantially 

justified" in opposing the non-party nurses' motion to quash the 

subpoenas served on them. Fed. R. Civ. P. 37(a)(4). Plaintiffs 

do not argue that the district court was wrong in quashing the 

subpoenas. They assert only that their contention was reasonable 

and that the magistrate (affirmed by the district court) should 

not have awarded fees against them. Plaintiffs assert that they 

had five reasons for deposing the Tulsa nurses: (1) the "Tulsa 

hospitals had infectious disease control nurses"; (2) one of the 

Tulsa hospitals diagnosed the Bible baby as having Herpes II; 

(3) the Tulsa hospitals' "infectious disease control nurses had 

relevant information regarding the practices and procedures 

followed in daily routines in their hospitals, thus providing a 

rounded picture of the operation of a hospital infectious disease 

control unit"; ( 4) the "Bibles had reason to believe that some of 

these nurses were familiar with [plaintiffs' expert] Linda 

Spencer, R.N." and "could provide independent verification of 

Spencer's qualifications as an expert"; and (5) the "Bibles did 

not designate the Tulsa nurses as experts but as fact witnesses.'' 

(Pl. Br. at 14-15.) 

Our standard of review is whether the magistrate's 

determination was clearly erroneous. 28 U.S.C. § 636(b)(l)(A). 

None of the reasons suggested by plaintiffs for subpoenaing the 

Tulsa nurses demonstrates to us that the magistrate's ruling was 

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clearly erroneous. Therefore, we affirm the rulings of the 

magistrate and the district court on this issue. 3 

At oral argument, plaintiffs' counsel chose not to address 

any issues relating to the non-party nurses. We conclude that the 

non-party nurses are entitled to their costs for attending the 

oral argument which was needless as to them. We remand this case 

to the district court for the limited purpose of determining and 

awarding to the non-party nurses their costs incurred in attending 

the appellate oral argument. 

APPEAL NO. 87-2899 

Case No. 87-2899 is an appeal from the district court's award 

of $5,826.80 in costs to the defendant hospital. Plaintiffs 

basically challenge two items of costs: $2,925.00 in costs 

stemming from plaintiffs' depositions of the hospital's experts 

and $1,293.10 in consultation fees charged by the hospital's 

experts. 

With regard to the $2,925.00 in expert deposition fees, the 

law is clear that the party seeking discovery must pay the other 

side's experts: 

Unless manifest injustice would result, (i) the court 

shall require that the party seeking discovery pay the 

expert a reasonable fee for time spent in responding to 

discovery under subdivisions (b)(4)(A)(ii) [which 

concerns depositions] and (b)(4)(B) of this rule .... 

Rule 26(b)(4)(C)(i). 

3 Appellants also claim that they were denied an adequate 

"opportunity for hearing" as permitted by Fed. R. Civ. Pro. 

37(a)(4) prior to the entry of the order awarding fees and costs 

against them. However, appellants were allowed a full opportunity 

to brief the issue, and considering the nature of the dispute 

involved, we hold that appellants were given an adequate 

[Footnote continued ... ] 

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As for the hospital's consultation fees, Rule 26(b)(4)(C)(ii) 

provides that the district court may force the party seeking 

discovery to pay the other party for fees incurred in obtaining an 

expert's opinion: 

[W]ith respect to discovery obtained under subdivision 

(b)(4)(A)(ii) of this rule the court may require, and 

with respect to discovery obtained under subdivision 

(b)(4)(B) of this rule the court shall require, the 

party seeking discovery to pay the other party a fair 

portion of the fees and expenses reasonably incurred by 

the latter party in obtaining facts and opinions from 

the expert. 

Here, the district court awarded 50 percent of the consultation 

fees that the hospital had paid to its own experts. The 50 

percent apportionment is reasonable. 

Therefore, we affirm the district court's cost award. The 

hospital requests that we award double costs for plaintiffs' 

appeal of the cost award because the appeal is frivolous. 

Although we agree that plaintiffs' arguments border on being 

frivolous, we conclude that plaintiffs' position was sufficiently 

arguable that the hospital's request for double costs should be 

denied. 

[ ... footnote continued] 

opportunity for a hearing. See Remington Products, Inc., v. North 

American Philips Corporation~.v., 107 F.R.D. 642, 644 (D. Conn. 

1985). 

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• 

Conclusion 

The judgment of the district court is AFFIRMED. With regard 

to Appeal No. 87-2640, the case is REMANDED to the district court 

for the district court to determine and award the non-party nurses 

their costs in attending the appellate oral argument. 

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Entered for the Court 

David M. Ebel 

Circuit Judge 

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