Title: Travis v. Scott
Citation: 667 So. 2d 674
Docket Number: 1931697
State: Alabama
Issuer: Alabama Supreme Court
Date: June 30, 1995

667 So. 2d 674 (1995)
Marjorie Anne TRAVIS
v.
Henry Eldon SCOTT III, M.D., and Elmo Dodd Ozment, Jr., M.D.
1931697.

Supreme Court of Alabama.
June 30, 1995.
Rehearing Denied August 11, 1995.
Jeffrey C. Kirby of Pittman, Hooks, Marsh, Dutton &amp; Hollis, P.C., Birmingham, and Michael S. McGlothren of Olen &amp; McGlothren, P.C., Mobile, for appellant.
W. Boyd Reeves, Norman E. Waldrop, Jr. and Tara T. Bostick of Armbrecht, Jackson, DeMouy, Crowe, Holmes &amp; Reeves, L.L.C., Mobile, for appellees.
SHORES, Justice.
This is a medical malpractice/wrongful death case. The plaintiff, Marjorie Anne Travis, as executrix of the estate of Velma V. Lacy, sued in September 1992, alleging that the defendant doctors had failed to timely diagnose a bile duct leak in Velma Lacy's gallbladder bed and that, as a consequence, they had caused her death. The plaintiff appeals from a summary judgment in favor of the defendant doctors, Henry Eldon Scott *675 III, M.D., and Elmo Dodd Ozment, Jr., M.D.[1] We reverse and remand.
The trial court entered a summary judgment for Dr. Scott and Dr. Ozment on July 15, 1994, holding that the plaintiff had not produced substantial evidence that Velma Lacy would have survived if operated on some five days earlier and that the plaintiff had shown no causal relationship between the alleged acts of the defendants and the death of Velma Lacy. We must consider whether the trial court erred in so holding.
Rule 56, A.R.Civ.P., sets forth a two-tiered standard for determining whether to enter a summary judgment. In order to enter a summary judgment, the trial court must determine: 1) that there is no genuine issue of material fact, and 2) that the moving party is entitled to a judgment as a matter of law. In determining whether a summary judgment was properly entered, the reviewing court must view the evidence in a light most favorable to the nonmovant. See Turner v. Systems Fuel, Inc., 475 So. 2d 539, 541 (Ala.1985); Ryan v. Charles Townsend Ford, Inc., 409 So. 2d 784 (Ala.1981). In this case, Rule 56 must be read in conjunction with the "substantial evidence rule" set out in Ala. Code 1975, § 6-5-542(5), a part of the Alabama Medical Liability Act:
In medical malpractice cases, the plaintiff must prove that the alleged negligence "probably caused the injury." Parrish v. Russell, 569 So. 2d 328, 330 (Ala.1990). "The rule in Alabama in medical malpractice cases is that to find liability, there must be more than a mere possibility or one possibility among others that the negligence complained of caused the injury. There must be evidence that the negligence probably caused the injury. Pappa v. Bonner, 268 Ala. 185, 105 So. 2d 87 (1958)." McAfee v. Baptist Medical Center, 641 So. 2d 265, 267 (Ala. 1994), quoting Baker v. Chastain, 389 So. 2d 932, 934 (Ala.1980).
We thus look to the evidence presented by the plaintiff in support of her contention that the source of the bleeding that killed Velma Lacy was the "rather richly vascular undersurface of the liver in the area of the gallbladder bed," and the expert medical testimony offered in support of her allegations that Dr. Scott and Dr. Ozment breached the applicable standard of care and that the breach probably injured Velma Lacy.
The underlying facts are not disputed. On August 29, 1990, Velma V. Lacy was operated on at the Mobile Infirmary for the removal of her gallbladder. She remained in the hospital until September 21, 1990, when she was released. She was admitted to Providence Hospital on September 25, 1990, with a distended abdomen of unknown etiology. Her treating physicians were Dr. Scott and Dr. Ozment. Various tests were performed on her, including a paracentesis, which revealed bile-stained fluid. On October 3, 1990, Dr. Scott and Dr. Ozment performed surgery and found a slow bile leak in the gallbladder bed. The leak was sutured. Velma Lacy died on October 18, 1990. The cause of death was attributed to the effects of internal bleeding in the abdominal area. An autopsy was performed by Dr. Thomas Davis. In his autopsy report, Dr. Davis reported that the immediate cause of death was the exsanguinating intra-peritoneal hemorrhage. He reported: "The precise origin of this hemorrhage cannot be determined but it would seem most likely to have come from the rather richly vascular undersurface of the liver in the area of the gallbladder bed."
The evidence presented by the plaintiff included Dr. Davis's autopsy report and a subsequent deposition of Dr. Davis; the deposition of Dr. Boris Datnow; and the deposition of Dr. Stuart Battle. It is not disputed that Dr. Davis, having stated in his report the origin of the hemorrhage from which Velma Lacy died, later executed an affidavit *676 in which he attempted to recant this conclusion by stating:
In a later deposition, Dr. Davis stated that during the autopsy he was looking for a ruptured artery, because that was what he expected to find. Having found no ruptured artery, he said, he noted on his report the only other location from which the bleeding could have occurred, the "rather richly vascular undersurface of the liver in the area of the gallbladder bed." In his deposition, Dr. Davis acknowledged that his purported recanting of his first conclusion was based upon his frustration in not being able to confirm a ruptured artery and upon his reading of the deposition of the defendant doctors' designated pathology expert.
Dr. Boris Datnow testified by deposition for the plaintiff that he would have reached the same conclusion as that stated in the autopsy report. He observed that his own personal conclusion would have been that the source of the bleeding would have been "a fairly decent ooze" from the area of the surgerythe gallbladder bed.
Dr. Stuart Battle testified that Dr. Scott and Dr. Ozment breached the applicable standard of care when they failed to operate on Velma Lacy on September 27 and delayed operating until October 3 to stop the bile leak:
According to Dr. Battle, the medical records show that before September 27 the bile fluid was not infected. After that date, he said, the infectious component caused the bile to become far more irritating:
It was Dr. Battle's opinion that if surgery had been performed on September 27 Velma Lacy probably would have survived.
In entering the summary judgment for the defendant doctors, the trial judge held the plaintiff's expert testimony to be purely speculative and held that her expert witnesses had failed to create a genuine issue of material fact. We disagree.
The plaintiff's expert testimony supports her contention as to the source of the bleeding. Not only did Dr. Davis, in performing the autopsy, not find a ruptured artery, as he suspected he would, but he concluded that the only other plausible explanation was a slow leak or oozing from the gallbladder bed. Dr. Datnow reached the same conclusion. This expert medical testimony creates a genuine issue of material fact to be resolved by the jury. The plaintiff also created a genuine issue of material fact as to whether the alleged medical negligence probably harmed Velma Lacy. Dr. Stuart Battle testified that Dr. Scott and Dr. Ozment breached the applicable standard of care when they failed to operate on their patient on September 27. As noted in McAfee v. Baptist Medical Center, 641 So. 2d 265, 267 (Ala.1994), quoting Parker v. Collins, 605 So. 2d 824 (Ala.1992): "It is not necessary to establish that prompt care could have prevented the injury or death of the patient; rather, the plaintiff must produce evidence to show that [the patient's] condition was adversely affected by the alleged negligence. [Citations omitted.]" 605 So. 2d  at 827.
Having carefully studied the record, we conclude that the plaintiff produced substantial evidence creating a genuine issue of material fact. Thus, the summary judgment was improper. That judgment is due to be reversed and the cause remanded for a trial on the merits.
REVERSED AND REMANDED.
MADDOX, ALMON, KENNEDY, and COOK, JJ., concur.
[1]  The originally named defendants included Providence Hospital; Pulmonary Associates; Dr. Peter Chestnutt Coats; Dr. Marc Shane Gottlieb; Dr. Scott K. Saucier; and Dr. William Schulte. In the summer of 1993, the court entered final summary judgments for all those defendants. Only Dr. Scott and Dr. Ozment remained as defendants.