FOURTH DIVISION

DILLARD, P. J.,

BROWN and PADGETT, JJ.

NOTICE: Motions for reconsideration must be

physically received in our clerk’s office within ten

days of the date of decision to be deemed timely filed.

https://www.gaappeals.us/rules

August 2, 2024

In the Court of Appeals of Georgia

A24A0749. KATHY BOONE et al v. VASCULAR SURGICAL

ASSOCIATES, P.C., et al.

DILLARD, Presiding Judge.

Paula Thacker suffered debilitating injuries and ultimately died following

medical treatment for a series of small strokes. Thereafter, Kathy Boone—Paula’s

daughter—filed a medical-malpractice suit against numerous individuals and

companies, including Vascular Surgical Associates, Northwest Neurology, P.C., Dr.

Sandy McGaffigan, Dr. Arun Chervu, and Dr. Gary Jacobson.1 The case proceeded

to a jury trial, after which a verdict was entered in favor of the appellees. Boone

appeals, arguing the trial court erred by (1) permitting an unqualified defense expert

1 Vascular Surgical Associates will referred to as “VSA” throughout this

opinion, and VSA, Northwest Neurology, P.C., Dr. Sandy McGaffigan, Dr. Arun

Chervu, and Dr. Gary Jacobson will be collectively referred to as “the appellees.”
to testify, and (2) giving “no-guarantee”and“differing-views”jury instructions.For

the following reasons, we affirm.2

Viewing the evidence in the light most favorable to the jury’s verdict,3the

record shows that, in 2016, Thacker was diagnosed with carotid artery disease in her

left and right carotid arteries. Generally, the symptoms of the disease are “some sort

of stroke-like event that could be related to those carotids[,]” but at the time she was

diagnosed, Thacker was asymptomatic. Nevertheless, as a preventative measure,

Thacker was prescribed aspirin and a high-dose statin medication.

On March 25, 2018, Thacker began feeling numbness on the right side of her

face, and Boone took her to Wellstar Paulding Hospital. Once they arrived, Thacker

was evaluated by a doctor who determined she had suffered a series of “small

2 Oral argument was held on May 1, 2024, and is archived on this Court’s

website. See Court of Appeals of the State of Georgia, Oral Argument, Case No.

A24A0749 (May 1, 2024), available at https://vimeo.com/942076478. Of note, two

appellee briefs were submitted in this case, one by VSA, Dr. Chervu, and Dr.

Jacobson, and another by Northwest Neurology and Sandy McGaffigan.

3

 See Amu v. Barnes, 286 Ga. App. 725, 725 (650 SE2d 288) (2007) (“[When]

a jury returns a verdict, the same must be affirmed on appeal if there is any evidence

to support it, and the evidence is to be construed in a light most favorable to the

prevailing party with every presumption and inference in favor of sustaining the

verdict.” (punctuation omitted)).

2
strokes[,]”which can cause damage to parts of the brain. As a result, on March 26,

2018, she was transferred to Cobb Hospital for a vascular consult. Later that day,

Thacker was seen by Dr. McGaffigan, a neurologist, as well as other

physicians—including a cardiologist and a vascular surgeon. Following these

evaluations, Thacker was diagnosed with “crescendo TIAs,” which is a “situation

where a patient is having multiple events more and more often.” Thacker was then

placed on an “IV or intravenous heparin infusion drip.” And that night, even though

Thacker was taking heparin, aspirin, and was receiving IV fluids, she suffered an

episode of right facial drooping, numbness in her right hand, and had difficulty

speaking.

Initially, Dr. Jeffrey Winter—a vascular surgeon—scheduled Thacker to

undergo a carotid endarterectomy.4 But the next day, on March 27, 2018, Dr.

Chervu—another vascularsurgeon—evaluatedThacker anddeterminedthat,instead,

she needed to have a transcarotid artery revascularization (“TCAR”) procedure,

which is a technique by which a metal stent is placed in the patient’s carotid artery.

4Carotid endarterectomy is “a procedure to treat carotid artery disease.” Mayo

Clinic, https://www.mayoclinic.org/tests-procedures/carotid-endarterectomy/

about/pac-20393379 (Last visited July 30, 2024).

3
And the next morning, on March 28, 2018, Chervu performed the TCAR procedure.

Relevant here, Chervu admitted that he deviated from his medical training by waiting

to administer Plavix5to Thacker until approximately three hours afterthe procedure,

rather than beforehand. And in the context of this case, this practice involved

combining aspirin and Plavix, and is referred to as dual-antiplatelet therapy

(“DAPT”).6 Chervu did not administer this therapy to Thacker prior to surgery

because he was concerned about combining these medications due to the heightened

risk of bleeding.

Shortly after the procedure, Dr.Chervu told Boone he was concerned Thacker

might have experienced a new stroke because her blood pressure repeatedly spiked

during surgery. But the doctors who assessed Thacker that afternoon concluded she

had not suffered a new stroke. Additionally, Chervu asked Dr. McGaffigan for help

5

 Plavix is “used alone or together with aspirin to lessen the chance of a heart

attack or stroke.” May o Clinic, https://www.mayoclinic.org /

drugs-supplements/clopidogrel-oral-route/description/drg-20063146 (Last visited

July 30, 2024).

6 Dual antiplatelet therapy “with aspirin and oral P2Y inhibitors remains the

cornerstone of therapy for patients with acute coronary syndrome (ACS).” Mayo

C l i n i c , h t t p s : / / w w w . m a y o c l i n i c p r o c e e d i n g s . o r g

/article/S0025-6196(22)00127-6/fulltext (Last visited July 30, 2024) (footnote

omitted).

4
evaluating Thacker because she was a neurologist; and after doing so,she likewise did

not believe Thacker had suffered another stroke. Thacker’s condition improved

throughout the day, and when Chervu evaluated her at 6:30 p.m., she was more alert,

her speech had improved, and she had increased range of motion in her right arm.

Nevertheless, Thacker’s condition worsened over the next several hours, and

by 8:00 p.m., the nurse on duty found her unresponsive. The nurse immediately

performed an “NIH Stroke Scale assessment,” which required him to assign a score

to various categories of symptoms. Thacker’s total score indicated that she had

suffered a “severe stroke.” The nurse also calculated a “Glasgow Coma Score,” and

found that Thacker’s score had fallen from 15 to 10, which suggested she was

experiencing neurological problems. Then, around 8:55 p.m., the nurse called Dr.

Jacobson—whowas the vascular surgeon on call—to tell him about the situation. But

according to Jacobson, during the call, he was not informed of the scores Thacker

received on the foregoing scales or anything else suggesting the stent implanted in her

artery was blocked. After Thacker was released from the hospital, her symptoms got

“worse and worse over time”; and tragically, she passed away.

5
Thereafter, on December 19, 2018, Thacker—by and through her next friend,

Boone—filed a malpractice suit against VSA, Dr. Chervu, and Dr. Jacobson.7 Boone

later amended her complainttoincludemedical-malpractice claims against Northwest

Neurology and Dr. McGaffigan.8 On February 11, 2022, Boone filed a second

amended complaint “in anticipation ofthe upcoming trial . . . .”Relevant here, Boone

alleged that Chervu was negligent in failing to administer DAPT to Thacker prior to

the TCAR procedure.Followingprotracteddiscovery, the case proceeded to trial, and

the jury rendered a verdict in favor of the appellees. Boone filed a motion for a new

trial, raising, inter alia, the same arguments she does now on appeal; but following a

hearing on the matter, the trial court denied it. This appeal by Boone follows.

7 Despite the voluminous 4,465 page record, none of the parties provide a

description, along with record citations, of the procedural history underlying this

appeal. And Boone’s failure to do so is in violation of our rules. See CT.APP.R. 25 (a)

(5) (requiring an appellant, in her brief, “to describe[ ] the relevant proceedings below

. . .with appropriate citations to the record). Needless to say, this Court will not “cull

the record on behalf of a party, particularly in a case such as this where the record is

voluminous.” Callaway v. Willard, 351 Ga. App. 1, 5 (1) (830 SE2d 464) (2019)

(punctuation omitted). So, while it appears our independent review of the record has

likely identified the relevant procedural history, “if we have missed something in the

record . . . the responsibility rests with appellant[’s] counsel.” Pneumo Abex, LLC v.

Long, 357 Ga. App. 17, 18 n.3 (849 SE2d 746) (2020) (punctuation omitted).

8 Boone also named defendants who are not parties to this appeal. All of the

appellees filed responses to each of Boone’s pleadings.

6
When a jury returns a verdict, it must be affirmed on appeal “if there is any

evidence to support it, and the evidence is to be construed in a light most favorable to

the prevailing party with every presumption and inference in favor of sustaining the

verdict.”

9

Put another way, a jury verdict, “after approval by the trial court, and the

judgment thereon will not be disturbed on appeal ifsupported by any evidence, in the

absence of any material error of law.”

10 And we review a denial of a motion for a new

trial “according to this same standard.”11 With this deferential standard of review in

mind, we turn now to Boone’s specific arguments.

1. Boone first argues the trial court erred in allowing Dr. Karen Quirk—a

vascular surgeon and defense expert—to testify as to the standard of care for

9Yash Sols., LLCv.New York Glob. ConsultantsCorp., 352 Ga.App. 127, 132 (1)

(834 SE2d 126)(2019) (punctuation omitted); accordGreen v. Key CustomHomes, Inc.,

302 Ga. App. 800, 802 (1) (692 SE2d 56) (2010).

10 Yash Sols., LLC, 352 Ga.App. at 132 (1) (punctuation omitted); accord Green,

302 Ga. App. at 802-03 (1).

11Yash Sols., LLC, 352 Ga.App. at 132 (1) (punctuation omitted); accord Green,

302 Ga. App. at 802 (1).

7
administering medicine for patients prior to a TCAR procedure because she was

unqualified to do so.

12

 We disagree.

OCGA § 24-7-702 (“Rule 702”) concerns the “admissibility of opinion

testimony by expert witnesses in civil cases.”

13 And the usual standard for the

admissibility of such testimony is “found in Rule 702 (b) . . . .”

14 The version of Rule

702 (b) applicable in this case provides as follows:

If scientific, technical, or other specialized knowledge will assist the trier

of fact to understand the evidence or to determine a fact in issue, a

witness qualified as an expert by knowledge, skill, experience, training,

or education may testify thereto in the form of an opinion or otherwise,

if:

(1) The testimony is based upon sufficient facts or data;

(2) The testimony is the product ofreliable principles and methods; and

12 Dr. Quirk’s testimony had no bearing on Boone’s negligence claims against

Dr. McGaffigan. As explained infra, Quirk testified about the standard of care for

medicating a patient prior to a TCAR procedure, and McGaffigan was not involved

in any decisions regarding Thacker’s medication.

13 Dubois v. Brantley, 297 Ga. 575, 580 (2) (775 SE2d 512) (2015).

14

Id.

8
(3) The witness has applied the principles and methods reliably to the

facts ofthe case which have been or will be admitted into evidence before

the trier of fact.15

Importantly, the issue of the admissibility or exclusion of expert testimony “rests in

the broad discretion of the court, and consequently, the trial court’s ruling thereon

cannot be reversed absent an abuse of discretion.”

16

Indeed, the Supreme Court of

Georgia has explained that “[t]he whole premise of Rule 702 is that a trial court must

act as a ‘gatekeeper’ to ensure the relevance and reliability of expert testimony.”

17

Nevertheless, our Supreme Court has held that “disputes as to an expert’s credentials

are properly explored through cross-examination at trial and go to the weight and

credibility of the testimony, not its admissibility.”

18

15 Former OCGA § 24-7-702 (2022) (effective from January 1, 2013 to June 30,

2022). The trial underlying this case occurred in early May 2022.

16Cleveland v.Sentinel Ins.Co., Ltd., 354 Ga.App. 795, 796-97 (1) (a) (840 SE2d

738) (2020) (punctuation omitted); accord Agri-Cycle LLCv.Couch, 284 Ga. 90, 93 (5)

(663 SE2d 175) (2008).

17 Dubois, 297 Ga. at 585 (2); see Howell v.Cochran, 365 Ga.App. 80, 84 (a) (877

SE2d 625) (2022) (“Under Rule 702, it is the role of the trial court to act as a

gatekeeper of expert testimony.” (punctuation omitted)).

18 Agri-Cycle LLC, 284 Ga. at 93 (5) (punctuation omitted); accord Savannah

Cemetery Grp., Inc. v. DePue-Wilbert Vault Co., 307 Ga. App. 206, 211 (3) (704 SE2d

9
Turning to the instant case, Boone argues that Dr. Quirk was not qualified to

testify as to the standard of care applicable to medicating a patient prior to a TCAR

procedure. And Boone correctly notes that, at the time of trial, Quirk had only

performed eight or nine TCARprocedures, all ofwhich took place after Boone’s 2018

TCAR. Undoubtedly, the easiest way to demonstrate that an expert “has an

appropriate level of knowledge in performing a procedure or teaching others how to

perform a procedure is by proof that the expert actually has done these things . . . .”

19

But our Supreme Court has explained that Rule 702 “do[es] notrequire that an expert

actually have performed or taught the very procedure at issue” to be qualified to

testify.20

And here, prior to trial, Boone filed a motion to exclude “certain opinions of

Karen Quirk, M. D.[,]” contending that she was not qualified to testify regarding the

858) (2010).

19 Dubois, 297Ga. at 585 (2) (punctuation omitted); accordMekoya v.Clancy, 360

Ga. App. 452, 459 (1) (861 SE2d 409) (2021).

20 Dubois, 297 Ga. at 584 (2) (punctuation omitted) (emphasis supplied); see

Mekoya, 360 Ga. App. at 459 (1). “[B]y the plain terms of [Rule 702], the pertinent

question is whether an expert has an appropriate level of knowledge in performing the

procedure or teaching others how to perform the procedure, not whether the expert

himself has actually performed or taught it.” Id. (punctuation omitted)).

10
standard of care for medicating patients prior to a TCAR procedure. But the trial

court denied the motion shortly thereafter. In doing so, the trial court expressed

concern that Quirk might not be as knowledgeable or experienced as plaintiff’s

experts, but it nevertheless found she was qualified to testify as to the administration

of medicine prior to a vascular or arterial procedure. The court further noted that the

jury would decide which of the experts they found more experienced and

knowledgeable.

At trial, Boone reasserted her objection to Dr. Quirk testifying to the standard

of care for the administration of medicine prior to the procedure at issue. And during

the discussion of the issue, the trial court stated the following:

I think it really goes— I don’t remember what was asked of her, but—I

mean it goes to a fact question for the jury of whether or not she is qualified.

It appeared that she is and to what extent there [may be] testimony from

other people who performed more of these [TCAR procedures], [the

jurors] can certainly consider that. So that’s just part of the jury’s job.21

Suffice it to say, the trial court misstated the law in asserting that it is the province of

the jury to determine whether an expert is qualified to testify. Indeed, whether an

21

 (Emphasis supplied).

11
expert is qualified to testify on a particular subjectis within the trial court’s discretion,

and the court serves as the gatekeeper in making such a decision.22 But on appeal, an

appellant must show harm as well as error;23and in this case, the trial court made it

clear both before and after trial, that it had independently made the determination that

Dr. Quirk was qualified and it was for the jury to determine which experts were more

knowledgeable and experienced.

24

22 See supra notes 16-17 & accompanying text.

23 See Madison v. State, 281 Ga. 640, 642 (2) (b) (641 SE2d 789) (2007)

(“[H]arm as well as error must be shown to authorize a reversal by this [C]ourt.When

a plaintiff in error brings a case here, he must show error which has hurt him. This

court is not an expounder of theoretical law, but it administers practical law, and

corrects only such errors as have practically wronged the complaining party.”

(punctuation omitted)); accord Isbell v. Credit NationLendingServ.,LLC, 319Ga.App.

19, 22 (735 SE2d 46) (2012). Significantly, Dr.Chervu admitted that he deviated from

the applicable standard of care by failing to give Thacker dual-platelet therapy.

24

In denying Boone’s pre-trial motion to exclude Dr. Quirk’s testimony, the

trial court found Quirk was qualified to testify regarding the standard of care for

administering medicine to patients prior to TCAR surgery and that the jury would

decide which of the experts they found more experienced and knowledgeable. And

again, in denying Boone’s motion for a new trial, the court noted that Boone’s

argument that it shifted the duty to determine whether Quirk was qualified was

“incorrect and taken out of context.” So, despite the trial court’s statements

regarding the jury at trial, the court made clear that it made the qualification decision.

12
Turning to Dr. Quirk’s qualifications,

25

she—like Dr. Chervu— is a vascular

surgeon,26and is board certified in general and vascular surgery. Furthermore, while

Quirk had not performed any TCAR procedures at the time of Thacker’s surgery, her

practice is one hundred percent vascular surgery. She is also experienced in treating

carotid artery disease, seeing approximately 15 patients a month during her eight-year

residency and around 10 patients per month since the conclusion of her training. And

throughout her career, Quirk regularly treated patients who take anti-platelet

medication—the type of medication at issue in this case—for purposes of stroke risk

reduction. So, Quirk is familiar with the risks of this medicine, including

hemorrhaging or bleeding.

25Boone complains that Dr.Quirk’strial testimony regarding her qualifications

was inconsistent with her deposition testimony during discovery. But to the extent

Quirk’s testimony was inconsistent in this regard, it was within the trial court’s broad

discretion to determine which testimony was credible. See Dabdoub v. Glob. Home

Image, LLC, 291 Ga.App. 298, 299 (661 SE2d 669) (2008) (noting that, when the trial

court is the fact finder, “[t]he trial court—not this Court—resolves issues of witness

credibility, and conflicting evidence in the record . . . .”).

26

In its order denying Boone’s motion for a new trial, the trial court stated that

Dr. Quirk was not a vascular surgeon, but it is undisputed throughout the record and

the parties’ briefs that she was indeed a vascular surgeon.

13
Dr. Quirk testified that she performed over 200 surgeries involving carotid

artery disease during her training under supervision and between 160 and 180

surgeries following that training. Significantly, a TCAR procedure involves

endovascular stenting, and Quirk regularly performs endovascular stenting

procedures. And according to Quirk, she is experienced in making decisions about

medications for patients who are about to have surgery for carotid artery disease to

minimize the risk of a stroke or blood clot.

Relevant here, Dr. Quirk testified she was familiar with Dr.Chervu’s concerns

about administering DAPT to Thacker prior to surgery. And in this case, DAPT

would only have entailed adding Plavix to the medications Thacker was already taking.

Quirk believed it was reasonable under the applicable standard of care for a surgeon

to be concerned about adding Plavix to those medications. But Quirk testified that

another, safer way to administer DAPT would have been to substitute Plavix for

heparin. Nevertheless, Quirk believed Chervu’s “plan was in compliance with the

medical standard of care.” And Quirk acknowledged that DAPT was the usual

treatment for TCAR patients, but she testified there are always exceptions to “the

rule in medicine.”

14
Given the foregoing, although Dr.Quirk had not performed a TCARprocedure

before 2018, she was a long-time vascular surgeonexperienced in performing the same

typeof procedure—i.e.,proceduresinvolving endovascularstenting—onpatients who,

like Thacker, were diagnosed with carotid artery disease. She also regularly managed

the medication administered to those patients. Again, under Georgia law, to be

qualified as a medical expert, the expert is not required to have performed or taught

the exact surgery as the one at issue.27 And significantly, as to the impact of Quirk’s

testimony, although Dr. Chervu explained his reasons for doing so, he admitted to

deviating from the applicable standard of care in his treatment ofThacker.Simply put,

given the foregoing, we cannot say the trial court abused its discretion in qualifying

Quirk as an expert to testify as to the applicable standard of care when medicating

patients prior to TCAR procedures.28

27 See supra note 20 & accompanying text.

28 See Robles v.Yugueros, 343 Ga.App. 377, 384-85 (2) (a) (807 SE2d 110) (2017)

(“Given [the expert’s] medical background and experience, which included reading

the exact type of x-ray at issue here—and doing so in collaboration with emergency

medicine physicians, the trial court did not abuse its discretion in rejecting [the

appellant’s] contention that, because [the expert] was a radiologist who had never

practiced emergency medicine, he was not qualified under OCGA § 24-7-702 . . . to

render opinions regarding [a doctor’s] interpretation of [the appellant’s wife’s

abdominal x-ray].”); Graham v. Reynolds, 343 Ga. App. 274, 278-79 (2) (a)-(b) (807

15
2. Next, Boone contends the trial court gave two non-pattern jury instructions

that improperly placed “a thumb on the scale” in favor of the appellees.29 Again, we

disagree.

We review de novo an allegedly erroneous jury instruction, which is “a legal

question.”

30 And in assessing the assertion that a jury instruction was erroneous, it

SE2d 39) (2017) (holding that a doctor was competent to testify as an expert regarding

the standard of care applicable to a doctor in another specialty when the expert had the

requisite knowledge and experienceunderRule 702to give expert testimony regarding

the acts or omissions of a doctor in another specialty); Cotten v. Phillips, 280 Ga.App.

280, 282-83 (633 SE2d 655) (2006) (holding that trial court did not abuse discretion

in finding that vascular surgeon was qualified to testify as to orthopedic surgeon’s

failure to properly assess, monitor, and respond to patient’s vascular condition during

orthopedic treatment and surgery).

29 Trial courts are not legally bound to use the exact language in Georgia’s

suggested pattern jury instructions when charging a jury.See Bailey v.Edmundson, 280

Ga. 528, 534 (7) (630 SE2d 396) (2006), superseded by statute on other grounds as

acknowledged by Chrysler Grp., LLC v. Walden, 303 Ga. 358 (812 SE2d 244) (2018)

(“There is no requirement that only verbatim pattern charges are permissible.”);

Showers v. State, 353 Ga. App. 754, 760 (2) (b) (ii) (839 SE2d 245) (2020) (“It is

well-established that jury instructions do not need to track, exactly, the language of

pattern jury instructions.” (punctuation omitted)). In fact, in some cases, this Court

has disapproved oflanguage in a pattern instruction. See,e.g.,White v.Stanley, 369Ga.

App. 330, 337-38 (1)(893 SE2d 466) (2023) (holding that the trial court erred in giving

Georgia’s then-current pattern jury instructionon“preponderanceof the evidence”).

30 Wright v. State, 365 Ga. App. 288, 289 (1) (878 SE2d 137) (2022)

(punctuation omitted); see Walker v. State, 311 Ga. 719, 722 (2) (859 SE2d 25) (2021)

(“Whether the evidence was sufficient to warrant the requested [jury] instruction is

16
must be evaluated in “the context of the trial court’s jury instructions as a whole.”

31

Indeed, the only requirement regarding jury charges is that they were, as given,

“correct statements of the law and, as a whole, would not mislead a jury of ordinary

intelligence.”

32An erroneous charge, then, “does not warrant a reversal unless it was

harmful and, in determining harm, the entirety of the jury instructions must be

considered.”

33 Even so, erroneous charges are “presumed to be prejudicial and

harmful, but this is not conclusive because the presumption of harm which arises from

a legal question, which we review de novo.” (punctuation omitted)).

31 Wright, 365 Ga. App. at 289 (1) (punctuation omitted); see Walker, 311 Ga. at

724 (3) (“When we are presented with a claim that a particular instruction is

misleading, we do not evaluate jury charges in isolation, but rather consider them as

a whole to determine whether there is a reasonable likelihood the jury improperly

applied a challenged instruction.”(punctuation omitted));Fassnacht v.Moler, 358 Ga.

App. 463, 475 (1) (b) (855 SE2d 692) (2021) (explaining that jury charges and

recharges must be read as a whole).

32Wright, 365 Ga.App. at 289 (1) (punctuation omitted); accord Pye v.State, 322

Ga. App. 125, 129 (2) (742 SE2d 770) (2013).

33 Wright, 365 Ga. App. at 289 (1) (punctuation omitted); accord Williams v.

State, 267 Ga. 771, 773 (2) (a) (482 SE2d 288) (1997); Mubarak v. State, 305 Ga. App.

419, 421 (2) (699 SE2d 788) (2010).

17
a charging error may be overcome by a review of the record as a whole.”

34 With these

guiding principles in mind, we turn to the specific charges being challenged.

(a) Boone claims the trial court erred in giving the jury a “no-guarantee”

instruction.

As an initial matter, it is undisputed that the version of the no-guarantee

instruction shown to the jury on a PowerPoint presentation differs slightly from the

version contained in the trial transcript. Specifically, the instruction shown to the jury

in writing was as follows:

Physicians do not guarantee the results of treatment, and in the absence

of a breach of the standard of care, proof that the outcome of treatment

was different than that expected neither establishes [n]or supports an

inference that the standard of care was violated.

35

.

34

Payne v.Thompson, 234 Ga.App. 533, 533 (507 SE2d 257) (1998) (punctuation

omitted); see McCorkle v. Dep’tof Transp., 257 Ga. App. 397, 404 (4) (571 SE2d 160)

(2002) (“When an errorin the charge of the court is shown to exist, it is presumed to

be prejudicial and harmful, and this court will so hold unless it appears from the entire

record that the error is harmless.” (punctuation omitted)).

35

 (Emphasis supplied).

18
And the trial transcript reflects that the instruction was as follows:

Physicians do not guarantee the results of treatment and an absence of

a breach of the standard of care proves that the outcome of the treatment

was different that expected, neither establishes or supports an inference

that the standard of care was violated.

36

On appeal, Boone acknowledges the instruction notedin the transcript “simply

does not make any sense”and is “almost certainly incorrect[.]”So, Boone focuses her

argument instead on the instruction as “requested or intended[,]”37rather than “the

clearly erroneous instruction in the record.” And because it is unclear whether the

transcript contains a typographical error(although Boone certainly seems to presume

it does), we address the written jury instruction that was indisputably shown to the

jury.

36

 (Emphasis supplied).

37

 The instruction as requested by the defendants, which is nearly identical to

the instruction on the PowerPoint reads, “I charge you that a medical provider does

not guarantee the results of treatment and that in an absence of a breach of the

standard of care, proof that the outcome of treatment from that expected or was

followed by disastrous instead of beneficial results neither establishes nor supports an

inference that the standard of care was violated.”

19
Specifically,Boonemaintainsthatthe no-guarantee instruction is “functionally

an argument that bad outcomes are not to be considered in determining whether or

not the standard of care was violated.”

38 This is simply not the case. Instead, the

instruction plainly states that even if a medical decision has a negative outcome, a

plaintiff must also establish that the applicable standard of care was breached. And

needless to say, such a breach is an essential element of a medical-malpractice claim.39

Put another way, the jury charge instructs that a bad outcome cannot be the sole basis

for a malpractice claim if it is not shown the medical professional breached the

relevant standard of care. This comports with our “well-settled principle of

38 Boone contends that in cases (like this one) involving the lack of medical

treatment, the no-guarantee instruction is inappropriate. But she provides no legal

authority suggesting that medical-malpractice claims involving an affirmative decision

to administer or not to administer certain medical treatment are different in any

material way, much less as to a doctor’s ability to guarantee positive outcomes.In fact,

Boone’s entire claim is that Dr. Chervu’s decision not to administer DAPT prior to

Thacker’s surgery violated the standard of care and produced negative results.

39 See Zwiren v. Thompson, 276 Ga. 498, 499 (578 SE2d 862) (2003) (“Three

essential elements to establish liability in a medical[-]malpractice action have emerged

from the statute: (1) the duty inherent in the doctor-patient relationship; (2) the

breach of that duty by failing to exercise the requisite degree ofskill and care; and (3)

that this failure be the proximate cause of the injury sustained.” (punctuation

omitted)).

20
negligence law that the occurrence of an unfortunate event is not sufficient to

authorize an inference of negligence.”

40

Regardless, this Court approved a nearly identical jury instruction in Hodges v.

Effingham County Hospital Authority:

41

[A] hospital does not guarantee the results ofits care and proof alone that

the outcome of the care is different from that expected or is followed by

disastrous instead of beneficial results neither establishes nor supports

an inference of want of proper care, skill or diligence on the part of the

hospital nurses.42

And in Hill v.Hospital Authority of Clarke County,

43

this Court approved the following

jury instruction:

40 Wilson v. Guy, 356 Ga.App. 509, 511 (1) (848 SE2d 138) (2020) (punctuation

omitted); see Wolfe v. Carter, 314 Ga. App. 854, 859 (2) (b) (726 SE2d 122) (2012)

(“[I]t is a well settled principle of negligence law that the occurrence of an

unfortunate event is not sufficient to authorize an inference of negligence.”

(punctuation omitted)); Hill v. Hosp. Auth.of Clarke Cnty., 137 Ga. App. 633, 639-40

(II) (4) (224 SE2d 739) (1976) (noting that, in regards to a no-guarantee instruction

similar to the one at issue here, “[t]he language of the charge is in accord with the

general principles of negligence lawthat the occurrence of an unfortunate event is not

sufficient to authorize an inference of negligence”).

41

 182 Ga. App. 173 (355 SE2d 104) (1987).

42

Id. at 177 (5) (punctuation omitted).

43

 137 Ga. App. 633.

21
I charge you that a hospital does not guarantee the results of a treatment

or operation, and that in the absence of negligence as a matter of fact or

as a matter of law on the part of the hospital or its employees or agents,

proof simply that an operation or treatment is different in its outcome

from that expected, or is followed by disastrous instead of beneficial

results neither establishes nor supports an inference of lack of proper

care, skill or diligence on the part of the employees of the hospital.44

Finally, in Brannen v. Prince,

45

 we approved the following jury instruction:

[P]ysicians do not guarantee the results of treatment or operation, and

that in the absence of negligence on the part of the physicians, proof

simply that an operation or treatment is different in its outcome from

that expected or is followed by disastrous results instead of beneficial

results neither establishes nor supports an inference of lack of proper

care, skill or diligence on the part of the physicians.46

Simply put, because we have repeatedly approved of jury instructions that are

substantively the same as the one at issue here, Boone has not established that the no44

Id. at 639 (4).

45

204 Ga. App. 866 (421 SE2d 76) (1992),overruled on other grounds by Gillis v.

City of Waycross, 247 Ga.App. 119 (543 SE2d 423) (2000), and Smith v. Finch, 285 Ga.

709 (681 SE2d 147) (2009).

46

Id. at 871 (8).

22
guarantee jury instruction was an incorrect statement of law or had the potential to

confuse the jury. As a result, the trial court did not err in giving this jury charge.47

(b) Boone also argues the trial court erred in giving this “differing-views” jury

instruction:48

Testimony showing a difference of views between physicians regarding

the medical judgment exercise is insufficient to support an action for

malpractice where it is shown that the procedure preferred by each or the

judgment exercised is an acceptable and customary method under the

standard of care I have given you.

47 See Sagon v. Peachtree Cardiovascular & Thoracic Surgeons, P.A., 297 Ga.App.

379, 382-83 (677 SE2d 351) (2009) (holding the trial court did not err in giving a

certain jury instruction when, “viewed in their entirety, the trial court’s jury

instructions gave a full and correct statement of the lawregarding the standard of care

that applied to all of the professional health care providers and were not confusing in

defining the professional negligence issue”); West v.Breast Care Specialists, LLC, 290

Ga. App. 521, 522 (1) (659 SE2d 895) (2008) (holding a jury charge was proper when

it “gave a full and correct statement of the law regarding the care and skill required

of a physician and the proof required at trial to support a claim of medical

malpractice”);see alsoWhite, 369Ga.App. at 332 (“[T]he only requirement regarding

jury charges is that they were, as given, correct statements of the law and, as a whole,

would not mislead a jury of ordinary intelligence.” (punctuation omitted)).

48 The appellees and portions of the record also refer to this instruction as a

“personal-practices” charge.

23
Specifically, Boone contends the foregoing charge instructed the jury to

presume the absence of negligence and that the plaintiff’s “experts’ testimony of

standard of care violations is insufficient to support a malpractice claim if there is any

evidence on the other side.” But this instruction did not direct the jury to presume

anything or in any way suggest it should disregard a plaintiff’s expert if a defense

expert testifies. Instead, it simply acknowledged that there can be more than one way

to satisfy the applicable standard of care, and the mere fact that medical experts

disagree on how to do so does not, in and of itself, prove medical malpractice.

Moreover, the Supreme Court of Georgia has advised that a differing-views

instruction should be given when medical experts testify. Specifically, in Condra v.

Atlanta Orthopaedic Grp., P.C.,

49

our Supreme Court addressed an argument that

allowing experts in medical-malpractice cases to testify as to their personal practices

is “likely to confuse the jury by conflating the standard of care with an expert’s

personal protocols.”

50

49

 285 Ga. 667 (681 SE2d 152) (2009)

50

Id. at 672 (1).

24
In doing so, the Condra Court explained,

any potential confusion created by the admission of such evidence may

be remedied through the use of careful jury instructions. Such

instructions should, for example, clearly define the legal meaning of

standard of care; enunciate the principle that a mere difference in views

between physicians does not by itself prove malpractice.

51

And here, Boone has not identified any material distinction between the trial court’s

differing-views instruction and the language our Supreme Court suggested that trial

courts should use in Condra.

Boone further claims the trial court improperly suggested it provided the jury

with the applicable standard of care when it is for the jury tomake that determination.

Specifically, Boone challenges the portion of the instruction noting that, “. . . where

it is shown that the procedure preferred by each or the judgment exercised is an

51

Id. Boone claims the trial court’s differing-views jury instruction is similar to

one this Court disproved of in Byrd v. Medical Center of Central Georgia, Inc., 258 Ga.

App. 286 (574 SE2d 326) (2002). But even if that were arguably true, we are

nevertheless bound by our Supreme Court’s decision in Condra. See Thompson v.

State, 358 Ga. App. 553, 557 (1) (855 SE2d 756) (2021) (“Although [the appellant]

argues that this well settled authority should no longer be followed in Georgia, we are

bound by the opinions of the Supreme Court.”); Whorton v. State, 321 Ga. App. 335,

339 (1) (741 SE2d 653) (2013) (noting that “vertical stare decisis dictates that we

faithfully adhere to the precedents established by the Supreme Court of Georgia”).

25
acceptable and customary method under the standard of care I have given you.”

52 But

this statement cannot be read in a vacuum. Boone has not identified anywhere in the

record, transcript, or jury instructions where the trial court provided the jury with the

specific medical standard of care for medicating TCAR patients.And just prior to the

jury charge at issue, the trial court instructed the jury on the general legal definition of

“standard of care.” So, considering the jury instructions as a whole (as we must), it

is clear the trial court was referencing the legal definition of the phrase, not the

specific medical standard of care applicable in this case. The trial court did not err,

then, in giving a differing-viewsinstruction nearly identical to the one approved of in

Condra.

53

For all these reasons, we affirm the jury’s verdict in favor of the appellees.

Judgment affirmed. Brown and Padgett, JJ., concur.

52

 (Emphasis supplied).

53 See supra note 47.

26