Case Name: Dorothy PONDER v. Don Leroy CARTMELL, et al.
Court: Arkansas Supreme Court
Jurisdiction: Arkansas
Decision Date: 1990-02-26
Citations: 301 Ark. 409
Docket Number: 89-170
Parties: Dorothy PONDER v. Don Leroy CARTMELL, et al.
Judges: Holt, C.J., Hays and Turner, JJ., concur in part and dissent in part.
Reporter: Arkansas Reports
Volume: 301
Pages: 409–416

Head Matter:
Dorothy PONDER v. Don Leroy CARTMELL, et al.
89-170
784 S.W.2d 758
Supreme Court of Arkansas
Opinion delivered February 26, 1990
[Rehearing denied April 16, 1990. ]
Steven L. Festinger, for appellant.
Wright, Lindsey & Jennings, for appellees.
Hays and Turner, JJ., would grant rehearing.

Opinion:
Darrell Hickman, Justice.
Dorothy Ponder was injured when the bus in which she was riding was involved in an accident. She sued the bus driver, Don Cartmell, and Ozark Coaches Sales and Service, the owner of the bus. The case went to trial on the sole issue of damages, liability having been admitted. The jury awarded Mrs. Ponder $25,000. On appeal, she challenges certain evidentiary rulings by the trial court which affected the jury's assessment of damages. We find error and reverse and remand.
In her complaint, Mrs. Ponder claimed she sustained injuries to various parts of her body, including her back, neck, and left breast. Immediately following the accident, she was examined by Dr. Livingstone, a general practitioner. The doctor prescribed treatment for her injured breast, then referred her to specialists for a mammogram. Apparently, there was no other treatment of the breast injury until nearly two years later when Mrs. Ponder was examined by Dr. Pike. Dr. Pike discovered fibrocystic disease in the breast and performed surgery. In a letter to Mrs. Ponder's attorney, Dr. Pike said he doubted the accident had any relation to the development of the disease. The first issue involves the appellees' use of this letter at trial.
The appellees had filed a motion in limine asking that the breast injury not be mentioned. The trial judge agreed that evidence of the breast surgery and Mrs. Ponder's resulting fear of developing breast cancer should not be admitted. However, he did not prohibit evidence of Mrs. Ponder's treatment by her general practitioner and the doctors who performed the mammogram.
During Mrs. Ponder's testimony about her injuries, she did not mention the breast surgery performed by Dr. Pike nor did she ask the jury to award her damages for the expenses incurred in Dr. Pike's treatment. However, on cross-examination, the appellees introduced Dr. Pike's opinion letter and attempted to discredit Mrs. Ponder's testimony with it. Mrs. Ponder objected, saying that she had not presented any evidence of her treatment by Dr. Pike.
The court allowed the letter to be introduced into evidence because the appellant had "opened the door" on the subject. In fact, it was the appellees who first mentioned the surgery performed by Dr. Pike. Their use of the letter created the impression that Mrs. Ponder was seeking damages for injuries which her own doctor realized were not caused by the accident. The appellees introduced a collateral matter into evidence, then used it to impeach Mrs. Ponder's testimony. The court should not have allowed this to take place. See Garst v. Cullum, 291 Ark. 512, 726 S.W.2d 271 (1987).
This error alone would be sufficient to warrant reversal, but we also base our decision on another evidentiary error committed by the court. Mrs. Ponder's treating physician, Dr. Richard Jordan, testified that Mrs. Ponder had a degenerative disc disease in her neck which was aggravated by the accident. He performed two surgical procedures on her — an anterior scalenotomy and a discectomy — and testified that the treatment was necessitated by the injury she received in the accident.
The appellees presented an expert witness, Dr. Thomas Fletcher, who disagreed with Dr. Jordan's testimony. Dr. Fletcher's testimony emphasized three things. First, he said the appellant had only suffered a neck sprain and lower back sprain in the accident; second, he said the accident did not cause or aggravate the appellant's degenerative disc problem. In other words, he disagreed that the bus accident caused the injuries to the discs in the appellant's neck. There is no problem with this aspect of Dr. Fletcher's testimony. Certainly, a defendant's medical expert may testify that the physical injuries for which the plaintiff seeks compensation were not caused by the accident. See Shemman v. American Steamship Co., 89 Mich. App. 656, 280 N.W.2d 852 (1979). But Dr. Fletcher's testimony went beyond this. In the third aspect of his testimony, Dr. Fletcher told the jury that Dr. Jordan misdiagnosed the appellant's symptoms and that this misdiagnosis led to unnecessary surgery. He disagreed that the scalenotomy was the proper treatment for the appellant's continuing complaints of neck pain, saying an anterior scalenotomy was "not indicated for muscle spasm alone or pain alone." He also said that the discectomy was not a proper treatment for the appellant's neck problems, saying "discectomy is not indicated for degenerative disc disease alone." Dr. Fletcher said he would not have performed either operation. It is this part of Dr. Fletcher's testimony that the appellant says should not have been admitted into evidence, and we agree.
The appellant's recovery should not be diminished because Dr. Jordan's misdiagnosis, if indeed that was the case, led to the use of extreme medical procedures. Given Dr. Fletcher's testimony, the jury might have determined that the appellant should have been treated more conservatively and that surgery was an extreme or unnecessary measure. This violates the principle that, so long as an individual has used reasonable care in selecting a physician, she is entitled to recover from the wrongdoer to the full extent of her injury, even though the physician fails to use the remedy or method most approved in similar cases or adopt the best means of cure. See Am. Jur.2d Damages, § 536. This principle is also recognized in Restatement (2d) Torts, § 457, Illustration 1:
A's negligence causes B serious harm. B is taken to a hospital. The surgeon improperly diagnoses his case and performs an unnecessary operation. . . A's negligence is the legal cause of the additional harm which B sustains.
See also O'Quinn v. Alston, 213 Ala. 237, 104 So. 653 (1925) (where treating surgeon amputated finger, it was error to ask defense expert whether amputation was necessary); Whitaker v. Kruse, 495 N.W.2d 223 (Ind. App. 1986) (Plaintiff may recover expenses of unnecessary surgery).
It is true that a plaintiff who seeks to recover medical expenses must prove the expenses are reasonable and necessary. Kay v. Martin, 300 Ark. 193, 777 S.W.2d 859 (1989). "Necessary" means causally related to the tortfeasor's negligence. See Bell v. Stafford, 284 Ark. 196, 680 S.W.2d 700 (1985). If a plaintiff proves that her need to seek medical care was precipitated by the tortfeasor's negligence, then the expenses for the care she receives, whether or not the care is medically necessary, are recoverable.
We will briefly address two issues which may arise upon retrial. Two exhibits entered into evidence by the appellees clearly mentioned the appellant's insurance coverage. Reference to insurance should be deleted if the exhibits are used on retrial.
A surveillance tape, showing some of the appellant's daily activities, was entered into evidence by the appellees over the appellant's objection. We find the tape was admissible. The tape showed the appellant walking past a Social Security benefits sign, but she explained that she was procuring benefits for her mother, not herself. That the tape depicted only a selected portion of two days of appellant's life is not an argument against admissibility of the tape, but a factor to be weighed by the jury. Also, on retrial, appellant should receive any tapes to which she was not previously given access.
Finally, there was no error in the court's failure to compel the appellees to answer certain interrogatories and deposition questions.
Reversed and remanded.
Holt, C.J., Hays and Turner, JJ., concur in part and dissent in part.