Court Opinion

ID: 9849677
Source: CourtListenerOpinion
Date Created: 2023-09-24 04:44:07.096679+00
Date Added: 2024-06-11T09:20:23.296421
License: Public Domain

DAVID T. PROSSER, J.
¶ 50. (dissenting).
*172¶ 51. "Post hoc, ergo propter hoc" is Latin for: "after this, therefore because of this." Black's Law Dictionary 1186 (7th ed. 1999).
¶ 52. "Post hoc, ergo propter hoc" is a logical fallacy that assumes that if one event occurs after another, then the first event caused the second event.
I. INTRODUCTION
¶ 53. The majority purportedly applies the rule set forth in Selleck v. Janesville, 100 Wis. 157, 75 N.W 975 (1898). The Selleck rule provides that "a defendant who causes injury is responsible for any aggravation that results from improper medical treatment, as long as the plaintiff has 'exercised good faith and due care' in selecting his or her treating physicians." Lievrouw v. Roth, 157 Wis. 2d 332, 358, 459 N.W.2d 850 (Ct. App. 1990). In Fouse v. Persons, 80 Wis. 2d 390, 259 N.W2d 92 (1977), the court commented that "[t]he rule for awarding damages for injuries aggravated by subsequent mistaken medical treatment was established in Selleck." Id. at 397 (emphasis added); see Selleck, 100 Wis. at 163.
¶ 54. Although the Selleck rule remains good law, the issue presented in this case is whether the Selleck rule is applicable. In my view, the Selleck rule does not apply until the plaintiff establishes a causal connection between the defendant's negligence and the injury or condition for which a physician renders improper medical treatment. Stated differently, it is not enough to show that the defendant caused an injury. The plaintiff must establish a chain of causation between the defendant's negligence and any injuries for which the defendant seeks damages. A coincidental correlation is not sufficient.
¶ 55. These principles are recognized in existing jury instructions. (1) If a defendant causes injury A, the *173defendant is responsible for all the damages arising from injury A, including improper medical treatment that aggravates injury A. See Wis JI — Civil 1710. (2) If a defendant causes injury A and injury A aggravates existing injury or condition B, the defendant is responsible for all resulting damages. See Wis JI — Civil 1715. (3) If a defendant causes injury A, the defendant is responsible for all damages arising from injury A but not damages arising from injuries that are not in the chain of causation. See Wis JI — Civil 1720, which provides:
[Y]ou cannot award any damages for any (preexisting disease, condition, or ailment) (predisposition to disease) except insofar as you are satisfied that the (disease, condition, or ailment) (predisposition to disease) has been (aggravated) (activated) by the injuries received in the accident on (date). If you find that the plaintiff had a (pre-existing disease or condition which was dormant) (predisposition to disease) before the accident but that such (disease or condition) (predisposition to disease) was (aggravated) (brought into activity) because of the injuries received in the accident, then you should include an amount which will fairly and reasonably compensate (plaintiff) for such damages (plaintiff) suffered as a result of such (aggravation) (activation) of the condition.

Any ailment or disability that the plaintiff may have had, or has, or may later have, which is not the natural result of the injuries received in this accident, is not to be considered by you in assessing damages. You cannot award damages for any condition which has resulted, or will result, from the natural progress of the preexisting disease or ailment or from consequences which are attributable to causes other than the accident.

If the plaintiff was more susceptible to serious results from the injuries received in this accident by reason of a (pre-existing disease or condition) (predis position to disease) and that the resulting damages have *174been increased because of this condition, this should not prevent you from awarding damages to the extent of any increase and to the extent such damages were actually sustained as a natural result of the accident.
Wis JI — Civil 1720 (emphasis added).
¶ 56. This case is changing the law. If a defendant causes injury A, is the defendant responsible not only for injury A but also for injury or condition B, which is not related to injury A, simply because injury or condition B was treated after injury A? The majority's answer appears to be "yes." Notably absent from the majority opinion is any discussion of whether the accident caused the injury for which Hanson received surgery. Instead, the majority directs its analysis to two questions: "[1] whether the surgery arose from an initial injury that itself was caused by the accident and [2] whether Hanson used ordinary care in selecting her physician." Majority op., ¶ 25.1
¶ 57. The second question is not critical in this case, the first question is. Wisconsin JI — Civil 1720 unquestionably creates a jury question about whether the surgery "arose from an initial injury." In this case, credible evidence supports the jury verdict. The jury verdict is consistent with the inference to a finding that the bodily injury or condition for which Jo-El Hanson underwent surgery was not caused by the defendant's negligence.
¶ 58. The majority disagrees. The majority concludes that because the plaintiff experienced neck pain after an accident, the accident caused the neck pain. Post hoc, ergo propter hoc.
*175¶ 59. Consequently, the majority opinion either absolves the plaintiff from proving causation as an element of her negligence claim as a matter of law, or it completely undermines the sanctity of the jury verdict. To respect trial by jury, the court ought to draw all reasonable inferences in favor of the verdict instead of substituting its own inferences and fact determinations for those of the jury. See Wis. Stat. § 805.14(1); Morden v. Cont'l AG, 2000 WI 51, ¶ 38, 235 Wis. 2d 325, 611 N.W.2d 659.
II. BACKGROUND
¶ 60. The facts of this case are as follows. On June 22, 2000, Kevin Caldwell, while driving a truck, struck Jo-El Hanson's car in the rear at a speed of five to seven miles per hour. The next day, Hanson visited her doctor, Dr. Kenneth Saydel, because she was experiencing lower back, neck, and rib pain. About a month after the accident, in July 2000, she was diagnosed with post-traumatic cervical dorsal strain. Although the rib and lower back pain went away after some months with physical therapy, the neck pain remained. In November 2000 Dr. Lynn Ma diagnosed the plaintiff with acute mild right C5-C6 radiculopathy and referred the plaintiff to a neurosurgeon, Dr. James Lloyd. Dr. Lloyd recommended surgery and performed the surgery in February 2001.
¶ 61. The plaintiff filed a lawsuit against the defendants, and the case proceeded to trial. The issues before the court were whether Hanson was injured in the accident and, if so, the extent of those injuries. The evidence adduced at trial reveals conflicting testimony from various doctors as to whether the accident caused the structural damage (the radiculopathy) in Hanson's neck, which led to the surgery.
*176¶ 62. The jury awarded Hanson past medical expenses in the amount of $25,000 — roughly the amount of her medical expenses incurred after the accident but before the surgery. Hanson filed a post-verdict motion requesting that she be awarded all past medical expenses, $79,123.97, including the expenses of surgery. After the trial court denied Hanson's motion, she appealed. Applying the Selleck rule, the court of appeals reversed the circuit court's order and granted Hanson all her medical expenses, including the cost of surgery, and granted a new trial on the issue of other damages.
III. SUFFICIENCY OF THE EVIDENCE
¶ 63. This case requires the court to decide whether the evidence is sufficient to sustain the jury's determination. The standard of review for sufficiency of the evidence is narrow: "Appellate courts in Wisconsin will sustain a jury verdict if there is any credible evidence to support it." Morden, 235 Wis. 2d 325, ¶ 38. Thus, "if the evidence gives rise to more than one reasonable inference, [the court must] accept the particular inference reached by the jury." Id., ¶ 39. Similarly, the court must accept the jury's inference even if stronger and more convincing evidence supports a contradictory inference. Id.
¶ 64. In this case, the standard of review "is even more stringent because the circuit court approved the jury's verdict." Id., ¶ 40. Thus:
We afford special deference to a jury determination in those situations in which the trial court approves the finding of a jury. In such cases, this court will not overturn the jury's verdict unless "there is such a complete failure of proof that the verdict must be based on speculation."
Id. (quoting Coryell v. Conn, 88 Wis. 2d 310, 315, 276 N.W.2d 723 (1979)).
*177¶ 65. With this standard of review firmly in mind, an appellate court must "search the record for credible evidence that sustains the jury's verdict, not for evidence to support a verdict that the jury could have reached but did not." Morden, 235 Wis. 2d 325, ¶ 39. After having reviewed the record, I conclude credible evidence supports the jury verdict.2
¶ 66. At trial, the defendants contested the causal connection between the accident and Hanson's radicu-lopathy. Causation turns on "whether the defendant's negligence was a substantial factor in producing the injury." Nieuwendorp v. Am. Family Ins. Co., 191 Wis. 2d 462, 475, 529 N.W.2d 594 (1995). The jury's decision to limit Hanson's recovery of medical expenses to pre-surgery medical expenses is consistent with a finding that the accident caused some of Hanson's medical problems, but that neither the accident nor Dr. Lloyd's allegedly negligent treatment of Hanson's accident-related injury caused the structural damage (radicul-opathy), which prompted Dr. Lloyd to operate.
¶ 67. Credible evidence presented at trial supports the inference that the jury determined the accident caused temporary soft tissue damage but did not cause, and was otherwise completely unrelated to, any structural damage. Accordingly, the jury could have correctly awarded Hanson the medical expenses she incurred after the accident but before the surgery without violating the rule set forth in Selleck.
*178¶ 68. In his closing argument, defense counsel forcefully argued that Hanson suffered two distinct injuries or conditions caused by two different sources. He stated:
[I]t is from a biomechanical standpoint impossible that she could have had any structural damage causing surgery. It may be your judgment as a jury that she had some temporary soft tissue discomfort as a result of the accident. We are not saying, we are not trying to claim that that's impossible. But if that's the case, her damages should be limited accordingly. (Emphasis added.)
¶ 69. The closing argument was not the first instance where the record displays evidence of two distinct injuries. In defense counsel's opening statement, he stated: "The evidence is going to show with someone like [the plaintiff], an accident like this at the most is going to cause some temporary soft tissue soreness in the neck.... And that's the extent of what this accident had caused." Defense counsel also stated to the jury that he was going to present a witness, Dr. Alfred Bowles, who was going to testify that, "from a physical standpoint... there was [not] enough force or even injury in the accident to cause any sort of structural problem in the spine that would give rise to surgery."
¶ 70. Defense counsel fulfilled the promise he made to the jury in his opening statement. The record is replete with evidence that the plaintiff suffered from two distinct injuries or conditions. For instance:
(A) When cross-examined, Dr. Lloyd stated that the initial injury from the accident was "post-traumatic cervical dorsal strain" or muscle strain. The muscle strain was of the type one would receive by lifting something too heavy, but it did not involve any prob*179lems with the spinal cord or nerve root associated with structural damage. From this evidence, the jury could have inferred that there were two distinct injuries, one caused by the accident and one not caused by the accident.
(B) During re-direct examination, Dr. Lloyd stated that Hanson had two distinct injuries: permanent nerve root injury and muscle and soft tissue injury. Again, the jury could have found different causes for each distinct injury.
¶ 71. The record also contains evidence that the accident did not cause or lead to treatment that caused the structural damage:
(A) Hanson testified that she had done some horseback riding and sledding before the accident and had done some shoveling after the accident. From this statement, the jury could have inferred that these other activities, not the accident, caused the structural damage that led to the surgery.
(B) Upon direct examination, Dr. Lloyd stated that since the time of the accident, Hanson had "complained of posterior neck pain radiat[ing] into her right arm and numbness into her hand, and that she also noticed weakness of her right arm." Upon cross-examination, however, Dr. Lloyd acknowledged that even before the accident, Hanson had complained of some hand numbness. The jury could have inferred from these statements that because Hanson experienced some of the same symptoms of structural damage before the accident, the structural damage existed before the accident, and that the accident did not cause the structural damage.
(C) Upon direct examination, one of the defendant's experts, Dr. Bowles, stated that there was no evidence of a causal relationship between the accident and the structural damage:
*180I can't find a... causal relationship between the impact, the impact related movement of the car and her body that would lead to the types of medical problems that are seen and treated down the road, especially related to the cervical spine and cervical nerve roots and pain and symptoms in the upper extremity.
He acknowledged, however, that the accident could have caused some kind of minor injury, such as muscle strain. The jury could have determined that the accident caused the muscle strain but not the structural damage.
(D) Upon cross-examination, Dr. Bowles stated that the structural damage could have been caused by an impact-related injury, but that it could also have been caused by a non-impact-related injury. Dr. Bowles stated that there are other factors that cause nerves not to conduct well.
¶ 72. While the record contains evidence contrary to the inference that the accident caused structural damage,3 an appellate court must "view[] the evidence in a light most favorable to the jury verdict and... accept[] the particular inferences drawn by the jury." Morden, 235 Wis. 2d 325, ¶ 41. The majority fails to search the record for evidence supportive of the jury verdict and dismisses the possibility that the jury could have reasonably found that there were two distinct injuries or conditions, one caused by the accident and one unrelated to the accident or the subsequent treatment. By ignoring this possibility and awarding full damages as a matter of law, the majority either usurps *181the role of the jury or effectively eliminates one element of negligence: causation.4 By allowing Hanson to recover damages for an injury that may not have been caused by the accident or by subsequent treatment of an accident-related injury, the majority expands the Selleck rule and embraces a fallacy.
¶ 73. The Selleck court stated: "The plaintiff is not held responsible for the errors or mistakes of a physician or surgeon in treating an injury received by a defect in the street or sidewalk, providing she exercises ordinary care in procuring the services of such physician." Selleck, 100 Wis. at 163 (emphasis added). The Selleck rule, therefore, recognizes liability for unnecessary medical treatment, but only for treatment of injuries caused or aggravated by the accident.
¶ 74. The importance of first establishing a causal connection between the defendant's negligence and the injury aggravated or caused by a treating physician's negligence was made clear in Butzow v. Wausau Memorial Hospital, 51 Wis. 2d 281, 285-86, 187 N.W.2d 349 (1971). The court explained that the Selleck rule reflects a public policy determination as to "where the line of causation should end." Id. at 286. Thus, the Selleck rule presupposes causation and becomes relevant once a plaintiff establishes a causal connection between the defendant's negligence and the plaintiffs bodily injury for which treatment is provided. See id.
*182¶ 75. Whether the defendant's negligence caused the structural damage to Hanson's cervical vertebrae was hotly disputed at trial. Nevertheless, the majority assiduously avoids the question of whether the surgery was causally related to the accident. Rather, the majority focuses its discussion on "whether the surgery arose from an initial injury that itself was caused by the accident." Id. Under this extension of the Selleck rule, a plaintiff is able to recover damages for any medical treatment as long as the treatment was prescribed as a result of inquiry about an accident-related injury.
¶ 76. To illustrate, imagine that a plaintiff is injured in a car accident and immediately experiences pain in her big toe and then, a couple days later, experiences inflammation and discomfort in the ball of her foot. She visits a doctor who finds that she has fractured her big toe, and who diagnoses her as in need of surgery to remove an extra bone in the ball of her foot.5 The doctor reasons that the accident probably aggravated the tendon that attaches to this extra bone. It turns out, though, that the doctor was wrong in two regards: (1) the surgery was not necessary, and (2) the aggravation of the plaintiffs tendon was caused not by the accident but by the plaintiff having run a marathon three days before the accident.
¶ 77. Under the majority's interpretation, if the jury were to find that the accident caused the fractured toe, then, as a matter of law, the defendant would be liable not only for the damages associated with the fractured toe, but also for the damages associated with the inflamed tendon, including the resulting surgery, *183even though there was no causal connection between the accident and the presence of the extra bone.6
¶ 78. Thus, the majority effectively eliminates the need to prove causation in certain situations. This makes Wis JI — Civil 1720 a dead letter, replacing it with the reasoning of post hoc, ergo propter hoc.
IV THE JURY INSTRUCTIONS
¶ 79. The majority concludes the jury instruction "was an erroneous statement of Wisconsin law[]" and that it "probably misled the jury." Majority op., ¶¶ 40, 42. Ultimately, its analysis of this issue proves conclu-sory and unconvincing.
¶ 80. A circuit court "has broad discretion when instructing a jury." Fischer v. Ganju, 168 Wis. 2d 834, 849, 485 N.W.2d 10 (1992). "A challenge to an allegedly erroneous jury instruction warrants reversal and a new trial only if the error was prejudicial." Id. "An error is prejudicial if it probably and not merely possibly misled the jury." Id. at 850. "If the overall meaning communicated by the instructions was a correct statement of the law, no grounds for reversal exist." Id.
¶ 81. The majority uncritically adopts the court of appeals' analysis that the jury instruction misstated Wisconsin law because it allowed the jury to "decide that the treatment [the jury] concluded was unnecessary was not caused by the accident, and was therefore not compensable." Majority op., ¶ 40 (quoting Hanson *184v. Am. Family Mut. Ins. Co., No. 2004AP2065, unpublished slip op., ¶ 25 (Wis. Ct. App. Nov. 8, 2005)).
¶ 82. The jury instruction did not misstate Wisconsin law. Wisconsin JI — Civil 1710 sets forth the rule that a defendant is liable for the damages for injuries aggravated by subsequent mistaken medical treatment. See also Fouse, 80 Wis. 2d at 397. Instruction 1710 includes three concepts: (1) The plaintiff must have exercised ordinary care in selecting the doctor who allegedly committed malpractice; (2) The doctor's malpractice must have aggravated injuries caused by the defendant's negligence; and (3) The defendant is liable for the entire amount of damages, including damages attributable to the doctor's malpractice.
¶ 83. All three of these concepts were clearly present in the instructions read to the jury.
(1) The jury was told Hanson "used ordinary care in selecting her treating doctors." The first concept in Instruction 1710 was conveyed to the jury.
(2) The jury was told "that a defendant who causes injury is responsible for any aggravation that results from... the alleged improper medical treatment for that injuryi.Y (Emphasis added.) The second concept in Instruction 1710 was conveyed to the jury.
(3) The jury was told, "[i]f you relate them to the accident, the injuries, she should receive the entire amount of damages she sustained for that, those procedures." Moreover, the jury was told that the damages "should not be decreased because a defense doctor questions the procedure used by the plaintiffs treating doctors." In other words, even if there were testimony that the surgery was unnecessary, the jury would have to award damages for the surgery if the injury for which the surgery was performed were caused by the defendant's *185negligence. The third concept in Instruction 1710 was conveyed to the jury.
¶ 84. Although the circuit court did not read Instruction 1710 word-for-word, its content was adequately conveyed to the jury.
¶ 85. The fault the majority finds in the jury instructions reflects its failure to acknowledge that there are more than two possible causes for Hanson's structural damage. While the accident or subsequent negligent treatment of the muscle strain could have caused or aggravated the structural damage, something unrelated to the accident or to treatment of the accident-related injury also could have caused the structural damage.
¶ 86. Before the Selleck rule even comes into play, there must be a causal relationship between the injury for which treatment is given (i.e. the radiculopathy) and the defendant's negligence. It is not sufficient that the defendant's negligence caused "an injury," majority op., ¶ 20; the defendant's negligence must have caused the injury that the doctor's malpractice aggravates, or the doctor's malpractice in treating the accident-related injury must cause another injury. When the majority concludes that the jury instructions probably misled the jury, it effectively absolves Hanson of proving that the accident caused the radiculopathy.
¶ 87. The instructions advised the jury to award damages only if the jury found a causal connection between the accident and the injury for which Dr. Lloyd performed surgery and not to reduce damages if it found that Dr. Lloyd was negligent in his treatment of that injury. Contrary to the majority's conclusory statement, the instruction was a correct statement of the law. Accordingly, I disagree that the jury instructions "probably misled the jury."
*186V REMEDY
¶ 88. The majority remands for a new trial on Hanson's damages for past and future pain and suffering and loss of earning capacity. The majority concludes, "the jury's verdict arose from an erroneous and confusing jury instruction such that there is a reasonable probability of a different outcome on the remaining damages at issue." Majority op., ¶ 3. The majority remands for a new trial on damages only, even though the part of the jury instructions the majority condemns deals with causation and even though there was sufficient trial testimony to allow the jury to conclude that the accident did not cause Hanson's radiculopathy. If the case is to be remanded, it should be remanded for a new trial on liability and damages.
VI. CONCLUSION
¶ 89. In its decision, the majority significantly expands the Selleck rule, transforming it into another exception to the need to prove causation in a negligence claim. The smokescreen put up by the concurrence cannot obscure the fact that the majority creates a new rule of law.
¶ 90. On these facts and under the law of negligence as it existed prior to today's decision, there is no justification for an appellate court to award damages not awarded by the jury or the circuit court. In my view, the judgment of the circuit court should be affirmed.
¶ 91. For the reasons stated, I respectfully dissent.

 Stated otherwise, the majority's opinion means that if a plaintiff can prove a coincidental correlation she can satisfy the causation element of a negligence claim.

 Although the majority correctly states the standard of review, it fails to apply the standard. Instead, the majority replaces its own inferences for those of the jury. By doing so, the majority undermines the function of the civil jury trial, a function that has long been stated "as an essential bulwark of civil liberty." Galloway v. United States, 319 U.S. 372, 397 (1943).

 Interestingly, it was not until the plaintiffs closing argument that the plaintiff asserted the theory that negligent treatment of the muscle strain caused the structural damage to the neck. The evidence adduced at trial does not support this assertion.

 The majority's view of this case stands in stark contrast to how the circuit court perceived this case. After hearing all the evidence at trial and before instructing the jury, the circuit court judge explained: "[T]his court has an obligation to direct this jury and keep their eye on the ball here and this is a causation case. It's nothing more than that on these facts." (Emphasis added.)

 This is an actual medical condition called accessory nav-icular syndrome.

 This scenario is different from a scenario where the doctor was negligent and aggravated the tendon while treating the fractured toe. In that case, the defendant would be hable for the damage to the tendon under the Selleck rule because the doctor aggravated a pre-existing injury while treating an accident-related injury.