Source: https://carlockcopeland.com/Health-Law-and-Regulation-Update/category/medical-malpractice/
Timestamp: 2019-04-21 12:25:15+00:00

Document:
The Georgia Court of Appeals affirmed summary judgment in favor of a pharmacy provider on claims of professional negligence arising out of a misfilled prescription. In the case of Roberts v. Quick Rx, Mr. Roberts’ wife went to the pharmacy to pick up his prescriptions. The cashier handed Ms. Roberts two filled bottles through a drive-through window. However, the bottles were for a different patient and for different medications.
The following day, Ms. Bryant administered the medication to her husband, who was suffering from Alzheimer’s disease, diabetes, and high blood pressure. A little while later, she heard him call her name. She found her husband on the floor, confused. There was nothing in the area that would have caused him to fall. She called an ambulance and he was taken to the hospital for emergency surgery for a broken hip. The prescription error was later discovered and Plaintiffs sued Quick Rx for professional negligence, simple negligence, and punitive damages. The trial court granted summary judgment on the professional negligence and punitive damages claims.
Regarding the medical malpractice claim, Plaintiffs’ pharmacy expert testified the standard of care required a pharmacist or their delegate to counsel the person picking up the medication about the medication and to match the patient with the prescription. This is part of a Georgia regulation. However, the expert did not rely on any facts to show this was not done or that it was not done by the pharmacist or their delegate. Accordingly, the trial court did not err in granting summary judgment.
The Court held that the cashier’s failure to give the correct prescription to Ms. Bryant was a jury question on simple negligence. But, the same claim would not support a claim for punitive damages, so summary judgment was affirmed.
Quick Rx cross-appealed, claiming there was no evidence of causation to support Plaintiffs’ claims that the fall made Mr. Bryant develop Alzheimer’s or made it worse. In response, Plaintiffs argued they were not making such a claim, but Ms. Bryant actually testified to it and they did not affirmatively state in response to summary judgment that they were not seeking that as an item of damages. The Court affirmed the trial court’s grant of summary judgment on the issue.
Lastly, Quick Rx claimed Plaintiffs’ causation expert did not provide a scientific basis for his opinion that the administration of the misfilled medication caused the fall. The trial court denied the motion and the Court of Appeals affirmed, holding that the expert had sufficient facts and a reasonable scientific basis for his opinions.
The Georgia Court of Appeals has held that a partner in a medical practice group, called as a corporate witness under Rule 30(b)(6), is not an “expert witness” such that their opinion testimony is automatically admissible into evidence. In Yugeros v. Robles, the plaintiff alleged that Dr. Yugeros failed to diagnose and treat a complication of plastic surgery. When the patient presented to the hospital, Dr. Yugeros did a workup, but did not order a CT scan.
During the lawsuit, Plaintiffs took the deposition of Dr. Yugeros’ partner, Dr. Alexander, as the corporate representative of the practice group pursuant to Rule 30(b)(6). During her deposition, Dr. Alexander testified the standard of care would be to order a CT scan. Plaintiffs asked for the representative familiar with the records to testify. However, Dr. Alexander had not realized Dr. Yugeros did not order a CT scan.
Prior to trial, Dr. Yugeros moved to exclude Dr. Alexander’s testimony. The trial court granted the motion. After going up to the Supreme Court, the Court of Appeals held the trial court did not abuse its discretion in excluding the testimony because Plaintiffs failed to show that Dr. Alexander was qualified as an expert to opine on the standard of care. The reasoning was that, although Dr. Alexander was a corporate representative, to be admissible, her testimony still had to be otherwise admissible. Since standard of care testimony is expert testimony, the Plaintiffs bore the burden of qualifying her and they didn’t do so.
The Georgia Court of Appeals has affirmed the trial court’s denial of a motion to dismiss a complaint against an emergency physician in the case of Graham v. Reynolds. Plaintiffs claimed Dr. Graham, an emergency physician, failed to diagnose an acute coronary syndrome on presentation to an emergency department. Dr. Graham discharged the patient, who then suffered a massive heart attack and died.
Plaintiffs attached to their complaint the affidavit of a cardiologist specializing in electrophysiology. Dr. Graham moved to dismiss on the grounds that the affidavit expert was not qualified and because the affidavit did not opine on gross negligence. The trial court denied the motion.
The Court of Appeals affirmed, holding that plaintiff’s affidavit expert was not disqualified solely because he is a cardiologist and not an emergency physician. The Court held that the affiant demonstrated sufficient knowledge in the area of diagnosing a heart attack on EKG to survive a motion to dismiss.
The Court also rejected the contention that the affidavit was deficient because it did not contain facts showing gross negligence. The Court held that Section 9-11-9.1 only requires the affidavit set forth a negligent act or omission, which is a pleading required. Section 51-1-29.5, on the other hand, sets forth an evidentiary requirement, not a pleading requirement.
The take-home message is that it remains difficult to challenge an expert affidavit at the motion to dismiss phase.
The Georgia Court of Appeals reversed the grant of summary judgment to a physician group, holding that the liberal pleading rule does not require a plaintiff to name each individual provider for whom a named physician group may be liable. Plaintiff filed a wrongful death case against two named doctors, among others, including 24 On Physicians, PC (“24 On”).
Plaintiff dismissed and refiled under the renewal statute, naming the same two doctors and named their practice group on a theory of vicarious liability. The renewal complaint included a general allegation that “physicians” and other actual or ostensible agents of the group contributed to the death.
Initially, the group moved to dismiss on the grounds the expert affidavit did not specifically mention the group. Plaintiff filed an amended affidavit in response. Plaintiff then filed another affidavit, which broadened the claim against the group to include unnamed physicians, employees, and agents.
The case is Oller v. Rockdale Hospital, 2017 Ga.App. LEXIS 383 (August 14, 2017).
The Supreme Court of Georgia unanimously reversed the Court of Appeals’ decision in the case of Resurgens, P.C. et al. v. Elliott, decided May 30, 2017, and determined that the trial court did not abuse its discretion when it excluded a rebuttal witness, as a discovery sanction, whose name was deliberately withheld during discovery. Plaintiff was a patient of the Defendants, and filed suit in 2011 claiming that the Defendants failed to timely diagnose and treat an abscess in his thoracic spinal cord which resulted in paralysis. Following four years of discovery, the case went to trial and resulted in a defense verdict. The Plaintiff filed a direct appeal which challenged the trial court’s exclusion of a rebuttal witness in the case.
At trial, a Defendant, who was the treating physician, was asked by the Plaintiff’s attorney whether the Defendant was at the bedside of the Plaintiff at a particular time. The Defendant denied being present. The Plaintiff then excused the Defendant, and called a rebuttal witness who was a nurse that would purportedly testify that the Defendant was in fact bedside. Defendant’s counsel objected, based on the fact that the witness had not been previously disclosed in discovery, the pretrial order, or in any communication between counsel. Plaintiff counsel argued that this particular witness fell within its interrogatory response “catch-all,” that she was a “treating medical provider…a person named in the medical records…and an impeachment witness.” Therefore, while she was not specifically named, she was referenced. Furthermore, if the discovery response was not clear enough, the onus was on the defense to request clarity or move the Court to compel a different response. The trial court ruled in favor of the Defendants, stating that the Plaintiff had determined to call the nurse as a witness before trial and intentionally withheld the witness’s name. As such, the Defendants were entitled to the discovery sanction of excluding the witness in order to “allow the trial to proceed without surprise, without ambush.” The Plaintiff appealed to the Georgia Court of Appeals who reversed the trial court.
The Court of Appeals stated that in the event a previously undisclosed witness is called to testify, the only remedy is to move for a postponement for a sufficient length of time to allow the objecting party to prepare, or to move for a mistrial. The Court of Appeals further stated that it is never appropriate for a trial court to exclude such a witness, even in cases where there was clear deception. The exclusion of a witness with probative value was an extreme response, and the discovery sanctions found in O.C.G.A. § 9-11-37(d)(1) are not available. The Defendants applied for certiorari to the Supreme Court of Georgia who granted review.
The Supreme Court reversed the Court of Appeals. The Court held that when a party provides false or deliberately misleading discovery responses, the aggrieved party is entitled to more than mere postponement or mistrial. The aggrieved party is entitled to discovery sanctions found in O.C.G.A. § 9-11-37(d)(1) which includes, among others, exclusion of a witness. The Court explained that a party who receives a substantive answer to a discovery request is entitled to believe that answer, and are not required to file blind motions to compel in hope of discovering the opposing party’s deception. Furthermore, false or intentionally misleading responses are worse than a failure respond, because the aggrieved party may never learn that it failed to receive the truth. Therefore, the aggrieved party should be entitled to discovery sanctions, including exclusion of the undisclosed witness. To allow otherwise, simply because the witness may offer some probative value, would encourage and reward deceptive behavior.
The take-home is that parties who face deceptive tactics by opposing counsel during trial are no longer confronted with the only options being a continuance or a mistrial, which are burdensome and expensive. There are now a severe repercussions for those attorneys who intentionally deceive opposing parties during discovery.

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