Opinion ID: 389269
Heading Depth: 2
Heading Rank: 1

Heading: The Hospital's Appeal

Text: 9 The hospital argues that the award of $25,000 for loss of consortium must be reversed in light of the intervening decision of the New York Court of Appeals in Liff v. Schildkrout, 49 N.Y.2d 622, 427 N.Y.S.2d 746, 404 N.E.2d 1288 (1980). We agree. At the time this case was tried, New York law was unsettled as to whether damages for loss of consortium could be recovered in a wrongful death action. Compare Ventura v. Consolidated Edison Co., 65 A.D.2d 352, 411 N.Y.S.2d 277 (1st Dep't 1978), rev'd, 49 N.Y.2d 622, 427 N.Y.S.2d 746, 404 N.E.2d 1288 (1980) (allowing recovery) with Grant v. Guidotti, 66 A.D.2d 545, 555 n.10, 414 N.Y.S.2d 171 (2d Dep't 1979), aff'd, 49 N.Y.2d 622, 427 N.Y.S.2d 746, 404 N.E.2d 1288 (1980) and Osborn v. Kelley, 61 A.D.2d 367, 402 N.Y.S.2d 463 (3d Dep't 1978) (forbidding recovery). The Court of Appeals has since settled the matter in Liff, supra, in an emphatic opinion which underscored the prerogative of the legislature to control the content of the statutorily created wrongful death action. The court held that the statute does not contemplate recovery for loss of consortium and that the very existence of the statutory right precludes the possibility of a separate common law cause of action for that loss. Liff v. Schildkrout, supra, 49 N.Y.2d at 632, 427 N.Y.S.2d 746, 404 N.E.2d 1288. 10 It is well settled that on direct review an appellate court must apply the law in effect at the time it renders its decision, United States v. Schooner Peggy, 5 U.S. (1 Cranch) 103, 109-11, 2 L.Ed. 49 (1801); Thorpe v. Housing Authority of Durham, 393 U.S. 268, 281-82, 89 S.Ct. 518, 525-526, 21 L.Ed.2d 474 (1969), unless doing so would cause manifest injustice, 5 Bradley v. School Board of Richmond, 416 U.S. 696, 716, 94 S.Ct. 2006, 2018, 40 L.Ed.2d 476 (1974). The basis for the rule was first explained by Chief Judge Marshall, and remains the same today: 11 It is, in the general, true, that the province of an appellate court is only to inquire whether a judgment, when rendered, was erroneous or not. But if, subsequent to the judgment, and before the decision of the appellate court, a law intervenes and positively changes the rule which governs, the law must be obeyed, or its obligation denied. If the law be constitutional, and of that no doubt, in the present case, has been expressed, I know of no court which can contest its obligation. 12 United States v. Schooner Peggy, supra, 5 U.S. at 110, 2 L.Ed. 49. Since a federal court sitting in diversity must apply the governing state law, see Erie Railroad Co. v. Tompkins, 304 U.S. 64, 58 S.Ct. 817, 82 L.Ed. 1188 (1938), we must abide by intervening decisions handed down by New York's highest court. See Vandenbark v. Owens-Illinois Glass Co., 311 U.S. 538, 61 S.Ct. 347, 85 L.Ed. 327 (1941); Huddleston v. Dwyer, 322 U.S. 232, 64 S.Ct. 1015, 88 L.Ed. 1246 (1944) (per curiam); 1A J. Moore, Federal Practice P 0.307(3) (2d ed. 1980). 6 13 The plaintiff argues, however, that (e)ven though the Court of Appeals had not resolved the consortium issue, there was sufficient basis to object at that time, and that the hospital's failure to object to the charge bars appellate review. See Fed.R.Civ.P. 51. We find this contention to be meritless for several reasons. First, the very purpose of Rule 51 is to alert the trial judge to errors in the charge so they can be corrected before the jury retires. See 5A J. Moore, Federal Practice P 51.04 at 51-30 through 51-35 (2d ed. 1980). At the time the loss of consortium charge was given, New York authority was divided on whether such damages were recoverable. We feel that the policies supporting the rule are far less compelling under these circumstances. See General Beverage Sales Co. v. East-Side Winery, 568 F.2d 1147, 1152 (7th Cir. 1978) (failure to object does not bar appellate review where applicable law had changed in the interim). Moreover, the purposes of Vandenbark v. Owens-Illinois Glass Co., supra, would be largely frustrated by a literal application of Rule 51 in these circumstances, since the intervening state decision would be applied only in those rare cases where counsel had the foresight to predict the change. General Beverage Sales Co. v. East-Side Winery, supra, 568 F.2d at 1152. Finally, even accepting the plaintiff's argument that the hospital should have objected to the charge, we would reverse the award on our own initiative under the plain error exception to Rule 51, see Cohen v. Franchard Corporation, 478 F.2d 115 (2d Cir.), cert. denied, 414 U.S. 857, 94 S.Ct. 161, 38 L.Ed.2d 106 (1973), in light of the demonstrable deviation of the court's instruction here from the appropriate standard and the remediability of this error without a new trial below. See Williams v. City of New York, 508 F.2d 356, 362 (2d Cir. 1974) (reversing punitive damage award based on erroneous statement of New York law). We therefore hold that the award for loss of consortium must be set aside. 14 The hospital also claims that the award for conscious pain and suffering must be set aside, inasmuch as there was absolutely no evidence that the decedent suffered any pain before he died. St. Luke's argues that under New York law, a plaintiff must produce some evidence of actual pain, such as gesturing or moaning, to recover damages for pain and suffering; mere speculation is insufficient. See, e. g., Cook v. Erwin, 30 A.D.2d 579, 289 N.Y.S.2d 730 (3d Dep't 1968); Kinner v. Kuroczka, 12 A.D.2d 383, 212 N.Y.S.2d 479 (3d Dep't 1961). In this case, however, the hospital did not move pursuant to Fed.R.Civ.P. 50(a) for a directed verdict on this issue, nor did it object pursuant to Fed.R.Civ.P. 51 to the court's charge advising the jury that they could award damages for actual pain and suffering. Under these circumstances, where the appellant failed to move for a specific directed verdict, failed to request a peremptory charge, and failed to object to the instruction submitting the issue to the jury, appellate review of the sufficiency of the evidence on that point is inappropriate. See Rochester Civic Theatre, Inc. v. Ramsay, 368 F.2d 748, 752 (8th Cir. 1966); Sanford Bros. Boats, Inc. v. Vidrine, 412 F.2d 958, 967-68 (5th Cir. 1969); Lee v. Pennsylvania R. Co., 192 F.2d 226, 229 (2d Cir. 1951) ((T)o preserve such a contention for the consideration of the appellate tribunal, the matter must be specifically called to the attention of the trial judge in order that he may have the opportunity to consider the asserted insufficiency as to one specification and correct it himself, if necessary, by removing it from the jury's consideration.). 15 After the jury returned a verdict awarding the plaintiff $25,000 for the decedent's pain and suffering, the hospital moved pursuant to Fed.R.Civ.P. 59(e) to amend the jury award against it of $25,000 for decedent's conscious pain and suffering, or in the alternative, alter its percentage of fault, or, finally, amend the jury award as excessive. Memorandum Opinion and Order at 5. The court ruled that Rule 59(e) was an improper device to set aside a jury verdict based upon evidentiary insufficiency, declined to treat the motion under Rule 50(b), and denied the motion as improper. We agree that Rule 59(e) is an improper basis for a motion such as the hospital's. Moreover, even assuming that St. Luke's could have made a motion for judgment n. o. v., compare House of Koscot Development Corporation v. American Line Cosmetics, Inc., 468 F.2d 64, 67-68 (5th Cir. 1972) (general directed verdict motion insufficient predicate to j. n. o. v. challenging sufficiency of damage evidence) with Mosley v. Cia. Mar. Adra S.A., 362 F.2d 118, 121-22 (2d Cir.), cert. denied, 385 U.S. 933, 87 S.Ct. 292, 17 L.Ed.2d 213 (1966) (generalized directed verdict preserves specific issue for j. n. o. v.), we conclude that Judge Motley did not abuse her discretion in declining to treat the motion under Rule 50(b), particularly in light of the hospital's failure to move for a directed verdict or object to the charge on this issue.
16 St. Luke's argues that the plaintiff's negligence case against it never should have been submitted to the jury, and that Judge Motley erred in refusing to grant a directed verdict or judgment n. o. v. More specifically, St. Luke's contends that the plaintiff failed to establish negligence on the hospital's part in its supervision and control of the decedent and that even if negligence could be shown, there was no evidence that any of the hospital's acts or omissions caused Hegger's demise. For the reasons stated below, we agree with the hospital's contention and therefore reverse the judgment against it. 17 The plaintiff's claim based on the hospital's failure to prevent Hegger from smoking or climbing stairs suffers from a number of defects. In the first place, there was insufficient evidence that the hospital's medical or nursing staff knew or should have known of Hegger's alleged transgressions. Mrs. Hegger testified that, while she knew her husband was smoking at St. Luke's, she did not relay this information to his attending physician or the nursing staff. (J.App. 229-30) She did testify that (s)ome of the attendants brought her husband an ashtray, but there was no evidence that these attendants were medical personnel or that their knowledge should be imputed to the hospital. With respect to Hegger's stair climbing, Mrs. Hegger testified that he did this (o)nly once (J.App. 209), and there was no evidence that St. Luke's had either constructive or actual notice of this lapse. 18 Further, even assuming that St. Luke's was negligent in failing to control its patient, there was no evidence that Hegger's misdeeds proximately caused his death. Under New York law, except where the common experience and knowledge of a jury of laymen can bridge this scientific gap, DeFalco v. Long Island College Hospital, 90 Misc.2d 164, 170, 393 N.Y.S.2d 859 (1977), a plaintiff has the burden of producing expert medical testimony showing proximate cause in medical malpractice actions. Myers v. County of Nassau, 36 A.D.2d 633, 319 N.Y.S.2d 268 (2d Dep't 1971); DeFalco, supra. We think that determining whether a single trip up a flight of stairs or a small amount of cigarette smoking can be the proximate cause of heart failure in a patient suffering from occluded coronary arteries is beyond the ken of the average juror. And although plaintiff's expert produced a great deal of standard-of-care evidence tending to show that Dr. Green should have restricted Hegger's activities and that such activities are counterproductive among cardiac patients, there was no evidence that Hegger's smoking and/or his ambulations caused his death. On the one occasion plaintiff's counsel came close to asking his expert about causation, the answer was distinctly evasive. The sum total of causation evidence concerning Hegger's smoking and stair climbing is contained in the following testimony elicited from plaintiff's expert on direct examination: 19 Q. In terms of the condition that Mr. Hegger came in for treatment for at St. Luke's Hospital, what type of risk, if any, was presented for the eventual development of myocardial infarction by his being out of bed, walking stairs, smoking? 20 A. Well, the risk of sudden death is always present in somebody with unstable angina. That's what we're always concerned about. 21 The plaintiff's case based upon the hospital's assertedly negligent nursing care likewise must fail. Under New York law, a plaintiff in a medical malpractice action must produce medical testimony to establish the proper standard of care. Tobias v. Manhattan Eye and Ear Hospital, 28 A.D.2d 972, 283 N.Y.S.2d 398 (1st Dep't 1967), aff'd, 23 N.Y.2d 724, 296 N.Y.S.2d 368, 244 N.E.2d 59 (1968). In this case, no standard of care was established concerning the frequency of nursing visits. Thus, that Hegger was not seen by a nurse from 1:00 a. m. until 6:30 a. m. was not shown to be a deviation from acceptable medical practice and, absent medical testimony, the jury could not permissibly infer negligence from this fact. Moreover, there was no evidence that more frequent attendance would have saved Hegger. Indeed, most of the expert testimony in this regard revealed that a heart attack victim needs instantaneous care and that the only effective way to ensure prompt detection of a heart attack is to electronically monitor the patient a procedure which only Dr. Green could order. 7