Opinion ID: 1672318
Heading Depth: 1
Heading Rank: 3

Heading: Did the trial court err in directing a verdict in favor of defendant?

Text: At the conclusion of the plaintiffs' case in chief, the trial court granted a directed verdict for defendants because of its view that the evidence regarding the standard of care as to emergency medical treatment and the absence of any competent medical evidence was insufficient as a matter of law. The standards by which we review such a ruling are familiar. At the conclusion of plaintiff's proof in a medical malpractice case, upon motion by the defendant for a directed verdict, the trial court is required to consider the evidence in the light most favorable to the plaintiff, giving the plaintiff the benefit of all reasonable favorable inferences that may be drawn therefrom. Hardy v. Brantley, et al, supra ; Hall v. Hilbun, 466 So.2d at 878-880; Pharr v. Anderson, 436 So.2d 1357, 1361 (Miss. 1983). Unless the plaintiff's evidence is so lacking that no reasonable juror could find for plaintiff, the motion must be denied. We take the same view of the evidence when on appeal there has been assigned as error the trial judge's granting of a directed verdict at the end of the plaintiff's case. In the presentation of a case for medical malpractice, a plaintiff is generally required to present expert medical testimony, first, identifying and articulating the requisite standard of care under the circumstances, and thereafter, establishing that the defendant physician or hospital failed in some causally significant respect to conform to the required standard of care. Hardy v. Brantley, supra; Hall v. Hilbun, 466 So.2d at 874; Kilpatrick v. Mississippi Baptist Medical Center, 461 So.2d 765, (Miss. 1984) (medical malpractice cannot be established without expert medical testimony that the doctor failed to use ordinary skill and care). On the other hand, matters which are within the common knowledge of laymen are exceptions to the rule that expert medical testimony is required. Radiology of Tupelo, P.A. and Dr. James T. Trapp v. Cayson, 471 So.2d 375 (Miss. 1985). It is necessary to examine the record and the precise charge of negligence made here to determine if this is one of those rare cases which forms an exception to the general rule, especially on a motion for directed verdict challenge. As we understand it, the core of the negligence claim here is that the defendants became aware of the nature and extent of Mrs. Hammond's head injuries early on and that they simply administered no meaningful treatment. Dr. Warren's initial evaluation at 4:45 showed an irreversible condition. Apart from the exclusion of Dr. Cockrell's testimony as a medical expert, this record contains lay testimony of family members who had more than ordinary knowledge of medical care, and additionally the hospital record of Mrs. Hammond, and the testimony of Dr. Forest Brantley as to the cause of death. Two of Mrs. Hammond's daughters were constantly with and assisted their mother after x-rays in the emergency room. One daughter, Mrs. Rita Watkins, had become a licensed vocational nurse. Both testified as to the absence of any medical attention from 2:20 p.m. until 4:45 p.m., except the insertion of an intravenous drip at 4:15. No one monitored their mother's condition, even though bleeding from the right ear, nose, mouth, and back of the skull was apparent. Another daughter, Mrs. Nancy Bowers, who had been in nurses training, asked Dr. Grissom three or four times to telephone the neurosurgeon for assistance. Dr. Grissom responded that her mother was drunk and that the best thing he could prescribe for her mother was to discharge her and let her sleep it off. [3] Mrs. Hammond was described by Dr. Grissom as uncooperative. Dr. Grissom was observed by Mrs. Bowers drinking a soft drink, talking with another doctor about a fishing trip, with nurses, and on the telephone, and treating the only other observed emergency room patient with a bandaged hand. Mrs. Bowers asked nurses ten or twelve times for assistance and was informed that Dr. Grissom was in charge. One nurse going off duty assisted to provide a bed pan for Mrs. Hammond, and this nurse reported to the on-duty nurses of Mrs. Hammond's condition, also being informed that Dr. Grissom was in charge. A witness overheard Dr. Grissom's telephone call at about 2:00 p.m., presumably to the neurosurgeon, stating that Mrs. Hammond's condition was not serious and to come after his office hours. Mrs. Hammond's deteriorating condition resulted in her falling into a sleep and, upon arrival of the neurosurgeon, was pronounced neurologically irreversible at 4:45 p.m. She died at 1:00 a.m. on February 24, 1976. Medical testimony in the form of hospital records support the failure to administer any care to Mrs. Hammond for the two hour period. The testimony of the pathologist was that a pressure cone of blood developed within the patient's head which caused respiratory and cardiac failure. The plaintiffs' testimony, although largely non-expert, support an absence of medical care for a crucial two hour period. This negative non-care inaction period is also supported by the medical hospital records. Additionally, there was an improper denial by the court of the proffered expert to support the plaintiff's prima facie case. We view all of these facts and circumstances in the light most favorable to the plaintiff. We give the plaintiff the benefit of all reasonable favorable inferences which may be drawn from the evidence. So viewed, the evidence establishes that at least by 2:45 p.m. Dr. Grissom and the employees of the hospital became aware, or in the exercise of ordinary care should have become aware, of the fact that Mrs. Hammond had a serious head injury. They did essentially nothing. Ten or twelve times thereafter one of Mrs. Hammond's daughters asked the nurses to do something. They did nothing. The testimony of the pathologist suggests that the continuous intracranial bleeding unchecked for a number of hours was a major factor causing death. These peculiar facts exhibit an absence of medical care, rather than the misfeasance of some complex medical diagnosis or treatment. Being so, this Court reasons that this case is one of those rare cases in which weight may be afforded the lay testimony of observers who had, not only common sense observations, but who also possessed training in the specialized medical profession. Mrs. Bowers, who had had nurses training, said that her mother was allowed to literally bleed to death in the emergency room. Applying to the evidence the standards discussed above, this Court holds that the granting of a directed verdict in favor of each defendant was improper, requiring reversal and remand for a new trial. In so doing, we do not wish to be understood as adjudging that either Dr. Grissom or the Mississippi Baptist Hospital were guilty of negligence. We have not yet heard their side of the case. All we hold today is that as to each defendant the plaintiffs presented evidence of such quantity and quality that they were entitled to survive the defendants' motions for a directed verdict made at the conclusion of the plaintiffs' case. Hall v. Hilbun, 466 So.2d at 880; Hardy v. Brantley, et al., supra . REVERSED AND REMANDED. PATTERSON, C.J., ROY NOBLE LEE, P.J., and HAWKINS, ROBERTSON, SULLIVAN and ANDERSON, JJ., concur. WALKER, P.J., concurs in result only. DAN M. LEE, J., takes no part.