Opinion ID: 2283405
Heading Depth: 1
Heading Rank: 7

Heading: Summary Judgment on the Wrongful Death Claim

Text: The circuit court found that Dr. Jarvis' opinionsthat (1) Kivland took his life because he was in pain and (2) his suicide was not rationally chosen and, therefore, was not voluntarywere only personal, and not expert, opinions. The circuit court reasoned that Dr. Jarvis has no psychiatric diagnosis to explain Kivland's behavior on the day he died. The court concluded that Dr. Jarvis failed to testify that Defendants' alleged negligence caused Kivland to become insane or that Kivland's suicide was a result of an insane impulse. The court also concluded that [a]lthough Dr. Jarvis' affidavit and deposition testimony claimed to be within reasonable medical certainty, he admittedly had no basis, factually or scientifically, for his opinions. Instead, the court noted, all of the facts presented in the case showed Kivland was not insane or operating under any form of depression or psychosis during the time between Dr. Gaines' surgery and the date of his death. The court concluded by noting that, for Dr. Jarvis to be qualified as an expert, he needed to rely on facts and data that were reasonably relied on by experts in the field and the facts and data needed to be otherwise reasonably reliable: Without a medical diagnosis for Kivland, the statements in Dr. Jarvis's affidavit and deposition testimony become only personal opinions, not scientific conclusions. The admission of such an opinion would be highly prejudicial to the defendants and improper under Missouri law. Admission of the doctor's opinion would be an abuse of discretion. Applying the standards of section 490.065, this Court concludes that the expert's opinion is admissible. Dr. Jarvis is a board-certified psychiatrist who has experience and training in diagnosing and treating patients similar to Gerald Kivland. His testimony will assist the trier of fact in deciding whether Kivland's death was the direct result of the injury caused by Dr. Gaines' negligence, if such negligence is established by other evidence. He is qualified, therefore, to testify about the issue of whether Kivland's pain caused him to commit suicide. See section 490.065.1. The circuit court implies that the facts and data are not relied on by other experts in the field or are not otherwise reasonably reliable. [16] The circuit court order focused on the fact that Dr. Jarvis did not have a medical diagnosis for Kivland and that no facts existed that could have indicated to Dr. Jarvis that Kivland was insane. But, under the clarified standard set out herein, the Kivlands are not required to show that Gerald Kivland had an actual medical diagnosis or that he was actually insane. What is required is that the Kivlands offer evidence that Gerald Kivland's suicide was a direct result of Dr. Gaines' negligence. Similarly, the circuit court implied that Dr. Jarvis' opinions were not valid in terms of the data on which he relied because he did not have a medical diagnosis for Gerald Kivland. Again, under the clarified standard set out herein, Dr. Jarvis is not required to have a specific medical diagnosis to testify that Gerald Kivland's suicide was the direct result of Dr. Gaines' negligence. It adds nothing to the expert's analysis to opine that Kivland was insane. Insanity is not a medical term or a diagnostic label; it is a legal term. See AMERICAN PSYCHIATRIC ASSOCIATION, DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS DSM-IV-TR (4th ed.2000). Dr. Jarvis' treatment of patients similar to Kivland would give him the necessary qualification to be able to form an opinion as to the cause of Kivland's suicide. A medical diagnosis for Gerald Kivland may lead a jury to give an expert's testimony more weight than an opinion that does not name a specific medical or psychiatric diagnosis. Dr. Jarvis himself correctly noted that a jury may not believe him, which shows he understands the kind of factual questions that juries decide. The question of whether Kivland's death by suicide was the direct result of the injury that he suffered is one that is most suitable for a jury: The evidentiary facts surrounding his death are not seriously in disputewhat is in dispute is a question whose answer can be well informed by the life experiences of 12 jurors. It is akin to a question courts commonly assign to juriesthat of reasonable care, which, as Justice Scalia has written, is for the jury when legal rules have been exhausted and yield no answer. [17] Dr. Jarvis testified, based on a reasonable degree of medical certainty, that: (1) Gerald Kivland took his life because he was in pain that occurred as a result of his surgery and (2) his suicide was not chosen rationally and, therefore, was not voluntary. [18] The evidence showed that Kivland's paralysis and disability had caused him to change his lifestyle dramatically. Kivland's pain was excruciating. Dr. Jarvis testified that he had reviewed these facts and the other facts in the record to come to his opinions to a reasonable degree of medical certainty. But whether Dr. Jarvis' opinion is to be believed or accepted is for the jury, not the court. It does not matter if the circuit court disagrees with the expert's opinion and believes suicide was the decedent's voluntary decision. This is not a sufficient reason to exclude the testimony. The circuit court is not the trier of fact in this case. That the circuit court does not believe Dr. Jarvis' opinions are credible does not mean the jury could not find them to be credible. Factual determinations of matters in dispute, including the weighing of medical opinions, rest solely within the province of the jury. It is error for the court to declare as a matter of law a result or legal effect which is within the exclusive province of the jury to determine. Mitchell v. Kardesch, 313 S.W.3d 667, 682-83 (Mo. banc 2010) (internal citations omitted).