Opinion ID: 1604756
Heading Depth: 1
Heading Rank: 1

Heading: With reference to Dr. Mailliard, plaintiff relies on the following assignments:

Text: (1) Error in refusing to permit Dr. Graham, one of plaintiff's experts, to express his opinion that it was possible the delay in diagnosis caused additional residual or neurological damage; (2) Error in refusing to permit portions of Dr. Graham's deposition to be received on the ground his opinion was speculative, conjectural, and without probative value; and (3) Error in permitting defendants to cross-examine Dr. Graham by way of a hypothetical question which allegedly assumed facts not in the record and which were contrary to the record testimony. II. Dr. Graham is a radiologist, certified by the American Boards of Radiology and the American College of Radiology. He is on the staffs of nine hospitals as a radiologist in three states. His qualifications to testify as an expert were not challenged. His testimony was received by way of deposition. At the time the deposition was introduced, various portions of it were stricken upon objection. At one point the doctor was asked, Q.    Is it possible that had this dislocation fracture been diagnosed on July 14th, or within the matter of a day or two following July 14th, that there might not have been any of this residual or neurological deficit? This was objected to as calling for the opinion and conclusion of the witness and that it is improper and does not give a proper medical evaluation; anything is possible;    [there is no showing of] reasonable medical certainty on which a medical evaluation is based. This objection was sustained and the record shows the doctor would have answered, Yes, I think that's a fair statement. Although we need not reach the specific question raised for reasons hereafter stated, we point out the evidence rejected was admissible within the rule announced in Grismore v. Consolidated Products Co., 232 Iowa 328, 361, 5 N.W.2d 646, 663; Brower v. Quick, 249 Iowa 569, 580, 88 N.W.2d 120, 126; Bradshaw v. Iowa Methodist Hospital, 251 Iowa 375, 383, 101 N.W.2d 167, 172; Bostian v. Jewell, 254 Iowa 1289, 1299, 121 N.W.2d 141, 146; State v. Miller, 254 Iowa 545, 553, 117 N.W.2d 447, 452. Standing alone, of course, it would not be enough to make a jury question as to causation, but the above cases hold this does not make such evidence inadmissible. If an expert is qualified, he should be allowed to state his opinion, either as to probable or merely possible causation. The subsequent question of its sufficiency to establish a sufficient showing of causation to submit to the jury depends on the nature of the opinion given together with other evidence bearing on the question. However, any error in this regard was rendered harmless by the admission of almost identical testimony by Dr. Graham on at least two other occasions. He was permitted to testify without objection as follows: In my practice, I have come across cases where there has been a delay in a diagnosis of fractures and, as an end result, there was no additional harm which showed up by reason of the delay.    [I]t would be difficult to say with any degree of reasonable medical certainty that the delay caused any additional harm because had this been diagnosed immediately, and, again, making an assumption that a cervical decompression was done, it is feasible and possible that there would have been no neurological deficit or residual. There is a possibility, too, that there still would be a neurological problem. In another part of his deposition he also said, I think probably the delay [in diagnosing plaintiff's condition as a fracturedislocation of the cervical vertebra] contributed quite materially to the residuals. He explained this opinion by saying that in this type of injury the more quickly the pressure is relieved, the less damage results to the central nervous system and its secondary nerve tract outflow. To say the least, these two statements are not entirely consistent, but they nevertheless contain the very same information plaintiff sought to elicit by the rejected testimony. No objection was made to either question. In one place Dr. Graham seems to say the damage was only a possible result of the delay; in another that it was probable. The evaluation of this seeming conflict was, of course, for the jury. Since Dr. Graham testified to the same facts elsewhere, the refusal to permit his answer to the disputed question was not prejudicial.