I N T H E SUPR EM E C O UR T O F M I SS I SS I PPI NO. 2 0 0 8 - CA- 0 1 9 9 7 - S CT TH E CI TY O F JACKSON , M I SS I SS I PPI
v. T HE ES T AT E O F O T

HA S T EWAR T , DE CE AS ED , BY AND THROUGH I TSADM I NI S TRA TOR, EM M A WOM ACK
D A T E O F JU D G M E N T : 05/ 20/ 2008 T RI AL J UDGE : HON. W I NS T ON L . KI DD COURT F ROM W HI CH APP EAL ED: HI NDS COUNTY CI RCUI T COURT AT T OR NE YS F OR AP P E L L ANT : P I E T E R J OHN T E E UW I S S E N CL AI RE BA RK E R H AW KI NS ATT ORNEYS F OR APP EL LE E: J AM ES A. BOBO M A R K C . B A K E R , S R . BERNARD C. J ONES , J R. NATURE OF THE CAS E: CI VI L - P ERS ONA L I NJ URY D I SPO SI T I O N : A FFIRM E D - 10/ 14/ 2010 M OT I ON F OR RE HE AR I NG F I L E D: M ANDAT E I S S UE D:
B E F O R E W A L L E R , C . J. , L A M A R A N D P I E R C E , JJ. PI ERCE, J UST I CE, FOR TH E COU RT: ¶1. I n 2002, the C i r cui t C our t of H i nds C ounty i n a bench tr i al f ound the C i ty of

J acks on l i abl e f ora f al l s us t ai ned by an e l der l y w om an, w hi ch the pl ai nt i f f al l eged c aus ed a s t r oke. F i nd i ng that a stroke w as notf oreseeabl e, w e r em and ed t he case for a new tri al on dam ages. Th e tr i a l c o u r ta wa r d e d th e ma x i mu m a mo u n to f d a ma g e s u n d e rth e M i s s i s s i p p i To r tCl a i ms A ct , $250, 000, af

t erhear i ng t es t i m ony f

r om D r . St ephen H ayne, expertf orthe pl ai nt i f

f , t hat

### Ex cept where o th erw is e cited, th ese facts are tak en fro m our prio r op inio n inthis 1 

### case, Cit y of Jacks on v. Ste wart

ex rel . Womack , 908 So. 2d 703 (Mi ss . 2005)
. 2 the f al l had ca us ed a “traum at i c br ai n i nj ury” and nota s tr oke. B eca us e of ourgr eat d e f e r e n c e t o tr i a l c o u r t s , we a f f i r m. STA TE M EN T O F T H E C A SE 1 ¶2. O tha S t ew art , l ef t di s abl ed by a str oke i n 1978, att ended an adul t day car e cent erat the U ni ver s i ty of

M i s s i s s i ppi M edi cal C ent er( U M M C ) f r om 1993 t o 1997. T he C i ty of Jackson provided tr anspo rt at i on forthe i nfi rm , li ke S t ew art , t o an d fr om U M M C . O n A ug ust 11, 1997 , S t ew artf

el l af t ert aki ng a f

ew s t eps t ow ar d the ce nt er . D or i s Spi l l er , w ho dr ove the C i ty’ s tr ans por tvan, att empt ed uns ucce s s f ul l y t o br eak St ew art ’ s f al l
. St ew arthi ther head on the pave m entand w as t aken t o the emer gency r oom , w her e, acc or di ng t o t he
emer gency r oom doct or , she had no sw el l i ng, herbl ood pre s s ur e w as normal , and she s eemed f i ne. She w as r el eas ed, butherdaught er , E m m a W om ack, w as t ol d t o w at ch herf ors ever al day s. ¶3. T he next tw o days , s he s t ayed at hom e, but r eturned t o the cent er on A ugus t 14 even though s he had t ol d herdaught er , W om ack, t hat“she w as st i l l hurt i ng and herhead a nd l egs
w er e s t i l l bother i ng her
. ” She f el l i n the bathr oom thatday atthe ce nt er , butthe f al l w as not
cons i der ed s er i ous . She di d nots l eep w el l thatni ght , and the nextm orni ng s he r egur gi t at ed h er b rea k fast. W o m ac k , h er d au g h ter, too k h er to the em erg en cy roo m , w h ere the s taff
ex am ined h er, ga v e h er p resc ri p ti o n s for p ain a n d m u scle relax ers, an d release d h er.

### A cons er vat ors hip wa s e st abl is hed f or Mrs. Ste war

t wi th Wom ac k being nam ed 2 

### cons er vat or. When Mr s. Ste wart di ed during t he l itigati on, Wom ac k was subs ti tut ed a s plaintif f. Ste wart ex rel . Womack , 908 So. 2d at

709. 3 

### 3 ¶4. B eca us e St ew artcont i nued t o have pr obl ems, W omac k t ook hert o D r . C al vi n R amsey and D r. D on G i pson , w ho beli eved S t ew arthad suff ered ano ther m assi ve st roke “farw orse than the one s he had i n t he 70' s . ” ¶5 . S tew art su ed the C ity an d U M M C i n A u g u st o f 19 9 8 on brea ch -of-co n tr ac t an d tort l i abi l i ty theor i es . D r . R amsey t es t i f i ed attr i al that he beli eved t hi s s tr oke had happened 2 betw een St ew art ’ s A ugus t11, 1997, f al l and herA ugus t19 vi s i tw i t h hi m . T he daught er t es t i f i ed that , pr i ort o the f

al l M rs . S t ew artcoul d w al k w i th a quad c ane a nd had l i m i t ed sp e e c h . A c c o rd in g to W o m a c k , s h e b e c a m e “ p ra c tica lly a to tal in v a lid ” a fte r th e fa ll – unabl e t o e at , w al k, s t and, orc om m uni cat e. D r . Ram s ey not ed otherpr obl ems – s he had di f f i cul ty s w al l ow i ng w hi ch may have ca us ed herbout s w i th pneumon i a, i m m obi l i ty t hat
caus ed beds or es , and ur i nary tr acti nf ect i on – w hi ch mo t i vated m any hos pi t al i zat i ons and
w er e ca us ed, acc or di ng t o D r . R am sey, b y a se cond s tr oke. Pl ai nt i f f’ s couns el ’ s openi ng s t at ements um s up i t s theory ni cel y: “ . . . [ A ] s a r es ul tof thi s f al l and the r es ul t i ng ext ens i on o f t h e s tr o k e , M s . S te w a rt [w a s ] to ta lly in c a p a c ita te d .” ¶ 6 . T h e trial c o u rt a w a rd e d S tew a rt’s E sta te $ 5 0 0 ,0 0 0 o n th e to rt c laim (sp lit e q u a lly betw een U M M C and the C i ty) and $500, 000 on the br eac h- of
- contr actcl ai m . U M M C and the C i ty appeal ed. W e r ever s ed and r ender ed j udgm entf orthe hos pi t al , r eas oni ng thatt hey had br eac hed no duty ow ed t o St ew art . Fur ther , w e hel d thataw ar di ng damages on t or tand 3 contr acttheor i es of

l i abi l i ty amount ed t o doubl e r ecove ry, and s o w e l i m i t ed damages t o the

### Id. at 711-12. 4 

### Mis s. Code Ann. § 11-46- 15(1) (b) (Re v. 2002)
. 5 

### Id. at 715. 6

### Id. at 716. 7 

### Defin ed as: 1. the act of inhalin g; 2. Th e removal o f fluid s or g ases from a cav ity 8 

### bythe ap plicatio n o f suctio n. Dorland’sIllus trated M e dic al Dic ti on ary152 (25th Ed. 1974)
. We think, in c onte xt, he m eans that Mr s. Ste wart wa s una bleto avoid inhal ing bi ts of f ood or drop s of liquid , leadin g to pn eumo nia. 4 sta tu to ry m a x im u m , $ 2 5 0 ,0 0 0 . F in a lly , w e h e ld th a t “[b e c a u se ] stro k e is n o t a f o re se e a b le 4 5
cons equenc e o f t he al l eged ne gl i gence w hi ch l ed t o M r s . St ew art ’ s f al l
. . . the Est at e may no trecov er dam ages rel at ed to the st roke, w hetheror not i tw as caused b y the f al l on A ug ust 11, 1997. ” W e r emanded f ora new t r i al on damages w i th i ns truct i ons t o “l i m i tany damage 6
a w a rd a g a in st th e C ity to $ 2 5 0 ,0 0 0 , a n d to e x c lu d e fro m its a w a rd a n y d a m a g e s a ttribu tab le to th e s tr o k e .” 7 ¶ 7 . A t th e n e w trial o n d a m a g e s, D r. S tev e n H a y n e tes tified fo r th e p lain tiffs th a t th e fa ll

“ in ju re d [S te w a rt ’s ] c e n tr a l n e rv o u s s y s te m . . . c o n s is te n t w ith th e d if f u s e a x o n a l in

ju ry .” F u rt h e r, h e te s ti f

ie d t h a t “ M s . S te w a rt u ltim a te ly e n te re d a d o w n h ill c o u rs e o v e r t im e . . . . [ H ] erdi m i ni s hed ment al capa ci ty, di m i ni s hed abi l i ty t o avoi d as pir at i on , [ and] her 8 di m i ni s hed phys i cal condi t i on ul t i m at el y caus ed the demi s e o f t hi s pat i ent . ” Fi nal l y, he t es t i f i ed thatnone of

the i nj ur i es descri bed w er e ca us al l y r el at ed t o any s tr oke s uf f er ed by M rs. S tew a rt. B o th sid e s stip u late d to th e intro d u c tio n o f th e first tria l tran sc rip t, bu t th e C ity of f er ed no new t es t i m ony orevi dence
.

### Fo rtun e v. Lee C ou nty B d. o

f Su perviso rs , 725 So. 2d 747, 751 ( Mis s. 1998). 9 

### Ste wart ex rel . Womack , 908 So. 2d at

716. 10 

### 5 A N A L Y S IS A
. D i d the tr i alcour t ’s j udgm ent vi olat e the doctr i ne of

the law of

the cas e? ¶8 . T h e q u esti o n p rese n ted b y the C ity is so m ew h at u n w iel d y : “W h ethe r the low er c o u rt
e rre d in fa ili n g to lim it d a m a g e s to th o se fro m th e fa ll o n th e c u rb .” T h e C ity a rg u e s th a t th is
aw ar d vi ol at es the doctr i ne of the l aw of

the ca s e: W hat everi s once e s t abl i s hed as t he contr ol l i ng l egal rul e of deci s i on, bet w een the sa m e par t i es i n t he sa m e cas e, cont i nues t o be the l aw of t he case, s o l ong as ther e i s a s i m i l ar i ty of f act s . A nd the j udgm entof the tr i al 9
courtw as , atl eas trhe t or i cal l y, l i m i t ed t o damages caus ed by the f al l
. T he opi ni on or ders ai d: [ D r . H ayne] t es t i f

i ed t hat .
. . i tw as hi s opi ni on . . . thatthe condi t i on and tre a tm e n t re fle c ted b y th e m e d ica l re c o rd s o f M rs. S tew a rt[] w e re c a u s a lly rel at ed to the plai nti ff

h i t t i ng h er head o n pav em ent w hen she fel l on A ug ust 11, 1997. H e al s o t es t i f i ed thatthe pl ai nt i f

f’ s s tr i ki ng he rhe ad i nj ured her br ai n and l ed t o the cont i nuous decl i ne of hercogni t i ve and phys i cal abi l i t i es u n ti l he r de ath o n N o v em b er 4 , 2 0 0 2 . . . . T h e C o u rtfi n d s D r. H ay n e’s t est i m on y credi ble on t he is sue of l i abil i ty an d d am ages. O u r in stru c tio n s w e re m e re ly tha t be c a u se an y stro k e w a s n o t a fo re se e a b le re su lt o f th e fa ll, i njur i es r esul t i ng fr om that s troke ou gh tno tbe co nsi dered i n calcul at i ng dam ages. 10 ¶9. T he pl ai nt i f

f s f ai l ed underthei rol d l ogi c ( a f al l caus ed a s tr oke w hi ch ca us ed var i ous o th e r m a lad ies ) b e c a u se th e stro k e w a s n o t fo re se e a b le. T h e y h a v e c ra fte d a n e w lo g ic: a f al l caus ed a tr aumat i c br ai n i nj ury w hi ch caus ed var i ous otherm al adi es . O urpr i ordeci s i on cert ai nl y di d nots ugges tthattr aumat i c br ai n i nj ur i es ar e unf or es eea bl e r es ul t s of

head i nj ur i es , s o thei rnew theory does notvi ol at e any l aw of the cas e. E s s ent i al l y, the C i ty as ks
w h ethe r th e tri al j u d g e o u g h t t o h av e g iven cre d en ce to a n ew theo ry a b o u t w h ethe r th e irP h ill ip s v . Miss . D e

p ’t o f P u b lic S a

fe ty , 9 7 8 S o . 2 d 6 5 6 , 6 6 0 (M iss. 2 0 0 8 ). 11 

### 6 n e g lig e n c e c a u s e d m u c h o f M rs . S te w a rt ’s s ic k n e s s a n d s u ff e ri n g in h e r f

in a l y e a rs . W e i nt erpr etthi s as a cha l l enge t o t he overw hel m i ng w ei ghtof the evi dence
. B
. W as the tr i alcour t ’s j udgm ent agai ns tthe overw helm i ng w ei ghtof the ev i dence ? ¶10. T he f

i ndi ngs of

f actby a ci r cui tcour tj udge, s i t t i ng w i thouta j ury, w i l l notbe r ever s ed on appea l w her e t hey ar e s uppor t ed by s ubs t ant i al , cr edi bl e, and r eas onabl e evi dence
. T he 11
so le e v id e n c e o ffe re d a t th e n e w tria l o n d a m a g e s – th e tes tim o n y o f D r. S tev e n H a y n e – is
u n a v o i d a b l y c o n tr a d i c t o r y t o e x p e r tt e s t i mo n y o f f e r e d b y th e p l a i n t i f

f a tth e f i r s ttr i a l
. On th e o th e r h a n d , W o m a c k ’s u n d isp u ted tes tim o n y fro m th e first trial is tha t he r m o th e r’s fa ll i m m edi at el y pre ci pi t at ed herdet er i or at i ng heal th, pai n and s uf f er i ng, and ext ens i ve medi cal b il ls. In to tal , the tri al co u rt ’s de term ination s are n o t so m an if estl y w ron g that w e c an d istu rb th e m. ¶1 1 . T h e inc o n sist en cies in th e e v iden ce are tr o u b li n g . In th e o ri g inal tr ial , the P lai n ti ff pr es ent ed ext ens i ve evi dence thatSt ew art ’ s f al l had ca us ed an e xt ens i on of her1978 s tr oke. D r . C al vi n R amsey t es t i f i ed thatSt ew art ’ s “cons t el l at i on of s ym pt om s [ af

t erA ug ust11, 1997] coul d have onl y been caus ed by a str oke. ” D r . H ayne, of cour s e, t es t i f

i ed that , bas ed
u p o n h is e d u c a tio n , train in g , ex p e rie n c e , an d a c tiv iti e s in the ca se , th e c a u se o f th e se a ilm e n ts “w as notan ex ace rbat i on orext ens i on of a s tr oke. ” H e t es t i f

i ed thatthe f

al l pr oduced “s ever e” br ai n i nj ur i es thatw er e notuncom m on i n elder l y p eop l e exp eri encing si m i l ar bl ow s, re s u ltin g in m e n ta l a n d p h y s ic a l d e te ri o ra tio n e n d in g in d e a th
.

### Dr. Hayneca ll ed hi s m ethodology “ [c ] linic alby exc lus ion.” D r. R am se y li st ed 12 

### det eriorating phys ic alsym ptom s a ss oci at ed wi th s troke and rel ie d upon an Augus t 19, 1997, ho spital d ischarg e repo rt. Sted ma n’s M edica l Dictio na ry49 2 (2 7thEd .) 13 Ci t y of Ja c ks on v. Spa nn , 4 S o . 3 d 1 0 2 9 , 1 0 4 2 (M iss. 2 0 0 9 ). 14 

### 7 ¶1 2. W e t hink bo t h doct or s f orthe pl ai nt i f

f us ed t he “dif

fer enti al diagnosi s”
m ethodol ogy, though D r . Ram s ey’ s met hodol ogy w as notve ry c l ear l y art i cul at ed. 12 D if feren ti al diag n o sis i s a p roc ess w h ere b y m ed ical do ctors d eterm ine w h ich o f tw o o r m o re d ise a se s w ith s im ilar sy m p to m s is th e o n e fr o m w h ich th e p a tien t is su ffe rin g , b y a sy ste m a tic
co m p arison an d co n tr asti n g of cli n ical fi n d ing s. B y de fi n it ion an d by D r. H ay n e’s 13 ad m issi o n , the p lai n ti ff’ s ex p erts ruled o u t th e c red ibil ity an d ac cu rac y o f ea ch o ther’s d ia g n o s e s . ¶ 1 3 . B u t th is in c o n sis ten c y d o e s n o t di s q u a lif y D r. H a y n e ’s o p in io n . W e h a v e sa id

“ [ w ] h e r e th e r e i s c o n f

l i c t i n g e v i d e n c e , t h i s C o u r tm u s tg i v e g r e a td e f e r e n c e t o th e tr i a l j u d g e 's f i nd i ng s . ” The i nc on s i s t e nc i e s b e tw e e n the s e e xp e r t s t e s t i mony a bo utwhy St e w ar tt ook

14
s uch a dr as t i c dow nturn s o s oon af t erthe f al l doe s nota l t erthe uncont es t ed f actthats he di d. ¶14. W om ack t es t i f

i ed that her m other w as nonr es pon si ve and un abl e t o s t and j us tf i ve days af t erthe f al l , a nd thats he beca m e pr act i cal l y a n i nval i d, t aki ng no pl eas ur e i n l i f e. T he
rec o rd is v ery c lea r th at, tho u g h S tew art w as d isab led b efo re the fall , h er d if fi cu lt ies w ere exac erbat ed i n t he neart erm fol l ow i ng herfa l l
. A nd base d upon the m edi cal r ecor ds ent er ed in to ev id e n c e , th e tri a l co u rt fo u n d tha t S tew a rt’s m e d ica l ca re co st m o re th a n $ 4 0 0 ,0 0 0 in thos e f i nal ye a r s . D r . H ayne of f er ed an opi ni on w hi ch ca us al l y l i nked St ew art ’ s det er i or at i on and r i s i ng medi cal c os t s t o the negl i genta ctof the C i ty. The tr i al courtf ound thatopi ni on

### Singl ey v. Singl ey , 846 So. 2d 1004, 1007 ( Mis s. 2002). 15 

### 8 cr edi bl e. Forus t o deci de ot herw i s e w oul d be t o say thatthe tr i al courtw as unm i s t akabl y, cl ear l y, pl ai nl y, ori ndi s put abl y w r ong. W e w oul d have t o re pl ace the tr i al court ’ s j udgm ent 15
w i th o urs. ¶15. I n s um , the tr i al c our t w as f ace d w i th the r eal i ty that i n the near t erm af t er a f al l t hat
s enthert o t he hos pi t al , St ew artbegan t o decl i ne i n phys i cal an d m ent al heal th. I tf ound
cr edi bi l i ty i n the opi ni on of a n e xpertope r at i ng unde ra w el l
- es t abl i s hed met hodol ogy t hat the f al l and the det er i or at i ng he al th w er e caus al l y r el at ed. T he C i ty of f er ed no new evi dence to re b u t th a t o p in io n tes tim o n y . A n d th e tria l c o u rt fo u n d fo r th e p lain tiff w ith in its di s cr et i on. W e w i l l notdi s turb t hatf i ndi ng. ¶ 1 6 . AF F I RM ED . W AL LE R, C. J . , CARL S ON, P . J . , DI CKI NS ON, RANDOL P H, LA M AR, KI T CHEN S AND CHANDL ER , J J . , CO NC UR . GR AV E S , P . J . , NO T P AR T I CI P AT I NG .