Court Opinion

ID: 9388676
Source: CourtListenerOpinion
Date Created: 2023-04-21 14:04:25.677862+00
Date Added: 2024-06-11T17:18:21.828582
License: Public Domain

RENDERED: APRIL 14, 2023; 10:00 A.M.
                  NOT TO BE PUBLISHED

           Commonwealth of Kentucky
                  Court of Appeals

                     NO. 2021-CA-1175-MR

TAYLOR GIPSON                                       APPELLANT

           APPEAL FROM CALLOWAY CIRCUIT COURT
v.        HONORABLE JOHN L. ATKINS, SPECIAL JUDGE
                   ACTION NO. 13-CI-00462

LORAINE ELIZABETH COOK AND
CHARLES EUGENE COOK, JR., CO-EXECUTRIX/
EXECUTOR OF THE ESTATE OF CHARLES
EUGENE COOK, M.D., DECEASED;
ELLEN M. BURNETT, M.D.;
MURRAY WOMAN’S CLINIC, PLLC, A/K/A
MURRAY WOMAN’S CLINIC, PLLC F/K/A
MURRAY WOMAN’S CLINIC, P.S.C.;
AND MURRAY-CALLOWAY COUNTY
PUBLIC HOSPITAL CORP., d/b/a
MURRAY-CALLOWAY COUNTY
HOSPITAL                                            APPELLEES

                          OPINION
                         AFFIRMING

                        ** ** ** ** **

BEFORE: EASTON, ECKERLE, AND GOODWINE, JUDGES.
EASTON, JUDGE: Taylor Gipson (“Gipson”) appeals the Calloway Circuit

Court’s summary judgment dismissing the medical negligence claims she asserted

against the appellees, stemming from the circumstances of a miscarriage she

suffered in 2012. Upon review of this tragic case, we affirm.

                    FACTUAL AND PROCEDURAL HISTORY

              The material facts in this matter are not in dispute. On November 13,

2012, Taylor Gipson presented to the emergency department at Murray-Calloway

County Hospital (“MCCH”) with complaints of contractions and pressure in her

pelvis. At the time, Gipson was pregnant and at 21-and-5/71 weeks gestation. It is

important at the outset to recognize that all experts agree the child born, a boy

named Xaedyn, could not have survived from the moment Gipson arrived at

MCCH, no matter what any medical provider had done.

              Dr. Charles Cook2 was the on-call obstetrician. As set forth in his

progress notes, Dr. Cook examined Gipson around 7 p.m. and reported that the

baby was “at least partially in the vagina with a cord prolapse without visible

pulsation.” Dr. Cook also reported in his progress notes that he explained to

Gipson – along with her parents, Kimberly and Kristopher Gipson, who were with

1
 Some evidence of record, referenced in this Opinion, also indicates Gipson was at 21-and-6/7
weeks gestation. For our purposes, this distinction is irrelevant.
2
  Dr. Charles Cook died during the pendency of this appeal. As the caption of this Opinion
indicates, his estate and its representatives were substituted as appellees in his stead.

                                              -2-
her at the time – that “delivery is inevitable and [the] fetus by all evidence is not

living.” Understanding that she was in labor, that there was no way to stop it, and

that her baby was probably already dead, Gipson consented to a vaginal delivery.

At around 7:40 p.m., Dr. Cook noted the baby had begun to descend further and

that the cord was prolapsed. This was Dr. Cook’s only involvement in Gipson’s

care that evening.

                 Dr. Ellen Burnett, another obstetrician, took over Gipson’s care at or

about 8 p.m. At 9:50 p.m., Dr. Burnett examined Gipson and noted the baby was

low in the vaginal vault and there was no bleeding. She documented that Gipson

was tearful when asked if she wanted to see the baby after the delivery. Gipson

stated that she would decide after the baby was born. At 1:30 a.m. on November

14, 2012, Dr. Burnett’s examination revealed that the baby had not progressed

much and was still in the vaginal vault. Upon Dr. Burnett’s suggestion, Gipson

agreed to augment and expedite the progress of her labor with Cytotec, a utero-

tonic drug.

                 Xaedyn was delivered at 4:02 a.m. He was born with a heartbeat, but

his eyes were fused and his lungs fatally underdeveloped. He had a heart rate of

less than 100 bpm,3 and an APGAR4 score of 2. Observations support the

3
    Beats per minute.

                                            -3-
conclusion the amniotic sac had ruptured at least eight weeks earlier. At or

immediately after the time when Xaedyn was delivered, Gipson’s blood began

pooling on her chux5 pads, her pulse increased to 150, her blood pressure dropped

to 78/60, and she reported being lightheaded. Dr. Burnett’s progress note at 4:50

a.m. states:

               Pt rested and remained comfortable through night. Baby
               delivered at 04:02. + FHT [positive fetal heart tones].
               Baby to warmer. Eyes fused. Pts parents at her side.
               Blood was pooling at pads. Pts pulse increased to 150
               and BP dropped to 78/60. Pt reported feeling
               lightheaded. Blood was obtained and infusion started.
               Anesthesia at bedside as well. Pt stable. No further
               bleeding. But placenta not yet delivered.

               Gipson was closely monitored and began receiving two units of blood

at 4:20 a.m. The infusion was completed at 5:30 a.m. While Gipson was receiving

the infusion, the baby’s heart stopped. His time of death was 4:50 a.m. Xaedyn

had lived for 48 minutes. At 5:50 a.m., Gipson was with Xaedyn. Dr. Burnett’s

progress notes provide:

               No further bleeding. Placenta still undelivered. Pt with
               baby now. Pt and family understand that there is no need
               for OR procedure for placenta right now unless bleeding
               restarts. Time of fetal heart stopping was 04:50A.

4
 Named for Dr. Virginia Apgar, the APGAR score is an acronym standing for Appearance,
Pulse, Grimace, Activity, and Respiration. The highest score is a ten.
5
 A chux pad is a form of disposable underpads used in hospitals to collect bodily fluids such as
blood. The name is believed to have derived from the fact such pads are “chucked” into the trash
after use.

                                              -4-
             Xaedyn’s body was taken to the nursery at 6:27 a.m. Gipson had a

retained placenta, which needed to be removed. At 6:50 a.m., Dr. Burnett checked

on Gipson and reported in her progress notes: “No further bleeding but pt anxious

about placenta and wants it ‘over.’ OR crew aware. Cytotec was placed but no

results so far.” At 7:55 a.m., Gipson was taken to surgery to remove her retained

placenta.

             Dr. Burnett reported in her progress notes that later that day, near 1

p.m., she spoke with Gipson and her family to review Gipson’s delivery course;

Gipson was aware that the baby she had delivered had a heartbeat, but that the

baby’s lungs were not developed to support life; and Gipson understood they had

not previously discussed the baby’s condition at birth due to Gipson’s hemorrhage

and need for emergency medical intervention.

             Gipson, on the other hand, denies she had any such conversation with

Dr. Burnett prior to her discharge that day. Gipson’s mother, Kimberly, also

testified that they did not discover the baby had been born alive until the day

afterward, when the funeral director informed them of that fact after confirming it

over the telephone with the hospital.

             On November 12, 2013, Gipson filed civil claims in Calloway Circuit

Court against MCCH; Dr. Cook; Dr. Burnett; and Murray Woman’s Clinic, PLLC,

(“Murray Woman’s Clinic”) the entity that employed Drs. Cook and Burnett. The

                                         -5-
nature and substance of Gipson’s claims against these individuals, as well as

additional relevant facts, will be discussed below in our analysis.

               During the years of this litigation, now into its tenth year, the record

amassed totaled ten volumes of over 1,500 pages, many of which were

unnecessary repeat copies of the at least seventeen depositions in the record. After

thorough briefing and an oral argument in July 2021, the circuit court granted

summary judgment dismissing all Gipson’s claims. This appeal followed.

                                          ANALYSIS

               Gipson makes two overarching contentions of error on appeal: first,

the circuit court erred in dismissing claims she asserted against the appellees for

“intentional or reckless infliction of emotional distress”; and second, that it erred in

dismissing claims she asserted against the appellees for medical negligence.

    Gipson’s “intentional or reckless infliction of emotional distress” claims

               In violation of our civil rules, Gipson fails to indicate where, and in

what manner, she preserved any arguments below relating to “intentional or

reckless infliction of emotional distress.”6 We reviewed this entire record, and

6
  Kentucky Rule of Civil Procedure (“CR”) 76.12(4)(c)(v) was in effect at the time appellate
briefs in this case were filed, and the rule required Gipson’s brief to “contain at the beginning of
the argument a statement with reference to the record showing whether the issue was properly
preserved for review and, if so, in what manner.” A nearly identical provision about requiring
preservation statements is contained in the new Kentucky Rules of Appellate Procedure (“RAP”)
effective January 1, 2023. See RAP 32(A)(4) (An appellant brief “shall contain at the beginning
of the argument a statement with reference to the record showing whether the issue was properly
preserved for review and, if so, in what manner.”).

                                                -6-
Gipson asserted no such claims. Gipson specified her causes of action in

paragraphs 18 through 20 of her unamended complaint. There, she alleged:

            18. During his care and treatment of Plaintiff, Taylor
            Gipson and her unborn child, during their admission to
            Murray-Calloway County Hospital beginning on
            November 13, 2012, the Defendant, Charles Eugene
            Cook, M.D., acted negligently and failed to exercise the
            degree of care and skill that is expected of reasonably
            competent and prudent obstetrician [sic] acting under the
            same or similar circumstances, including but not limited
            to failing to order an ultrasound to confirm the diagnosis
            of an intrauterine fetal demise, and such negligence was a
            substantial factor in causing the Plaintiff, Taylor Gipson,
            to suffer from and to continue to suffer from severe
            emotional injury and distress which has significantly
            affected her life requiring ongoing treatment and
            counseling and expenses for the same.

            19. During her care and treatment of the Plaintiff, Taylor
            Gipson, and her unborn son, during their admission to
            Murray-Calloway County Hospital on November 13th
            and 14th of 2012, the Defendant, Ellen M. Burnett, M.D.,
            acted negligently and failed to exercise the degree of care
            and skill that is expected of reasonably competent and
            prudent obstetrician [sic] acting under the same or similar
            circumstances, including but not limited to failing to
            order an ultrasound to confirm the diagnosis of an
            intrauterine fetal demise, failing to monitor or otherwise
            evaluate for fetal status, failing to intervene on behalf of
            the fetus, including transferring mother and baby to
            another facility, failing to have a pediatrician in
            attendance to resuscitate the baby, and inducing the
            premature delivery of the baby with a utero-tonic drug,
            and such negligence was a substantial factor in causing
            the Plaintiff, Taylor Gipson, to suffer from and to
            continue to suffer from severe emotional injury and
            distress which has significantly affected her life requiring

                                        -7-
             ongoing treatment and counseling and expenses for the
             same.

             20. During Taylor Gipson’s admission to Murray-
             Calloway County Public Hospital Corporation from
             November 13, 2012 through November 14, 2012, the
             Defendant Hospital, acting by and through its agents
             and/or employees, acted negligently and failed to
             exercise the degree of care and skill ordinarily expected
             of a reasonable and prudent hospital acting under the
             same or similar circumstances, and such negligence was
             substantial factor [sic] in causing the Plaintiff, Taylor
             Gipson, to suffer from and to continue to suffer from
             severe emotional injury and distress which has
             significantly affected her life requiring ongoing treatment
             and counseling and expenses for the same.

(Emphasis added.)

             A plaintiff may not assert new causes of action during the pendency of

the proceeding which were not set out in the complaint unless they are tried by the

express or implied consent of the opposing party. See generally CR 15.02; Traylor

Bros., Inc. v. Pound, 338 S.W.2d 687 (Ky. 1960). Moreover, “[w]hen an issue has

not been addressed in the order on appeal, there is nothing for us to review. Our

jurisprudence will not permit an appellant to feed one kettle of fish to the trial

judge and another to the appellate court.” Owens v. Commonwealth, 512 S.W.3d

1, 15 (Ky. App. 2017) (citations and footnote omitted).

             Here, as set forth above, Gipson asserted only claims of medical

negligence in her complaint. Those were also the only claims that were

adjudicated below. Indeed, Gipson’s first mention of any claims of “intentional or

                                          -8-
reckless infliction of emotional distress” in this proceeding appears to be on page

10 of her appellate brief – notwithstanding the fact that she prefaced page 1 of the

same brief with the following statement: “This is a medical negligence action filed

by Plaintiff, Taylor Gipson, seeking to recover damages for the severe emotional

injury and distress she suffered related to the circumstances surrounding the death

of her son . . . shortly after his birth.” (Emphasis added.)

             In short, Gipson’s newly raised claims of “intentional or reckless

infliction of emotional distress” are not proper subjects of appellate review, and we

must disregard any arguments she now makes pertaining to them. Having failed to

raise any such claims below, Gipson has deprived this Court of any authority to

address them now. Regional Jail Authority v. Tackett, 770 S.W.2d 225 (Ky. 1989).

We note such a claim would not have been sustainable in these circumstances. See

Humana of Kentucky v. Seitz, 796 S.W.2d 1 (Ky. 1990).

                        Gipson’s medical negligence claims

             Gipson’s remaining contentions take issue with the circuit court’s

summary dismissal of the medical negligence claims she asserted against the

various appellees. Before delving into the specifics of her contentions, we turn to

our applicable standard of review:

             “The standard of review on appeal of a summary
             judgment is whether the circuit judge correctly found that
             there were no issues as to any material fact and that the
             moving party was entitled to a judgment as a matter of

                                          -9-
             law.” Pearson ex rel. Trent v. Nat’l Feeding Systems,
             Inc., 90 S.W.3d 46, 49 (Ky. 2002). Summary judgment
             is only proper when “it would be impossible for the
             respondent to produce any evidence at the trial
             warranting a judgment in his favor.” Steelvest, Inc., v.
             Scansteel Service Center, Inc., 807 S.W.2d 476, 480 (Ky.
             1991). In Steelvest, the word “‘impossible’ is used in a
             practical sense, not in an absolute sense.” Perkins v.
             Hausladen, 828 S.W.2d 652, 654 (Ky. 1992). In ruling
             on a motion for summary judgment, the court is required
             to construe the record “in a light most favorable to the
             party opposing the motion . . . and all doubts are to be
             resolved in his favor.” Steelvest, 807 S.W.2d at 480. A
             party opposing a summary judgment motion cannot rely
             on the hope that the trier of fact will disbelieve the
             movant’s denial of a disputed fact, but must present
             affirmative evidence in order to defeat a properly
             supported motion for summary judgment. Id. at 481.

Ryan v. Fast Lane, Inc., 360 S.W.3d 787, 789-90 (Ky. App. 2012).

                    “Appellate review of a summary judgment
             involves only legal questions and a determination of
             whether a disputed material issue of fact exists. So, we
             operate under a de novo standard of review . . . .” Adams
             v. Sietsema, 533 S.W.3d 172, 177 (Ky. 2017) (quoting
             Shelton v. Ky. Easter Seals Soc’y, Inc., 413 S.W.3d 901,
             905 (Ky. 2013)).

Phelps v. Bluegrass Hospitality Mgt., LLC, 630 S.W.3d 623, 627 (Ky. 2021).

             As for the law applicable to each of Gipson’s claims, a common law

negligence claim requires proof of: (1) a duty owed by the defendant to the

plaintiff, (2) breach of that duty, (3) injury to the plaintiff, and (4) legal causation

between the defendant’s breach and the plaintiff’s injury. Wright v. House of

Imports, Inc., 381 S.W.3d 209, 213 (Ky. 2012). Due to the complexity of medical

                                          -10-
procedures, proof of these elements, almost always, must take the form of expert

testimony. Johnson v. Vaughn, 370 S.W.2d 591, 596 (Ky. 1963) (explaining a

physician’s negligence must generally be established by expert medical testimony);

Baptist Healthcare Systems, Inc. v. Miller, 177 S.W.3d 676, 680-81 (Ky. 2005).

That is, only expert testimony can establish for the jury “the applicable medical

standard of care, any breach of that standard and the resulting injury.” Blankenship

v. Collier, 302 S.W.3d 665, 675 (Ky. 2010).7 That quotation embraces each of the

four elements of a medical negligence claim. It logically follows, then, that “[t]o

survive a motion for summary judgment in a medical malpractice case in which a

medical expert is required, the plaintiff must produce expert evidence or summary

judgment is proper.” Andrew v. Begley, 203 S.W.3d 165, 170, 173 (Ky. App.

2006).

                       Gipson’s negligence claim against MCCH

               In its motion for summary judgment, MCCH argued dismissal of

Gipson’s claim against it was warranted because, in its view, Gipson had failed to

adduce expert evidence supporting that it or any of its agents had: (1) deviated

from any applicable standard of care; or (2) caused or contributed to any of

7
  Of course, “[e]xpert testimony is not required . . . in res ipsa loquitur cases, where the jury may
reasonably infer both negligence and causation from the mere occurrence of the event and the
defendant’s relation to it, and in cases where the defendant physician makes certain admissions
that make his negligence apparent.” Love v. Walker, 423 S.W.3d 751, 756 (Ky. 2014) (internal
quotation marks and citations omitted).

                                                -11-
Gipson’s alleged damages. In its order summarily dismissing Gipson’s medical

negligence claim against MCCH, the circuit court, without elaboration,8 ultimately

cited this latter basis as dispositive. Gipson now appeals, but in doing so largely

ignores the former basis of MCCH’s motion.

               We agree with the circuit court’s ultimate judgment. However,

because we find the former basis of MCCH’s motion more compelling, we affirm

on that basis as well. See Emberton v. GMRI, Inc., 299 S.W.3d 565, 575-76 (Ky.

2009) (“[A]n appellate court may affirm a lower court’s decision on other grounds

as long as the lower court reached the correct result.”).

               In Paragraph 20 of her complaint, Gipson did not specify how MCCH

acted negligently toward her. She also made no allegation in her complaint – nor

does she make any argument on appeal – that the other appellees qualified as

MCCH’s agents, or that MCCH was otherwise vicariously liable for any other

appellee’s conduct.9 With that in mind, the only medical evidence Gipson adduced

below regarding MCCH’s applicable standard of care and alleged breach thereof

8
  We do not fault the circuit court for including little to no elaboration in its summary judgment
orders. For purposes of CR 56, findings of fact and conclusions of law – while often helpful to
this Court – are generally not required. See CR 52.01.
9
 Relevant to this point, Gipson specified in Paragraphs 4 and 5 of her complaint that Cook and
Burnett were both “a principal, member, shareholder, employee, and/or agent, actually,
ostensibly or otherwise of the Defendant Murray Woman’s Clinc [sic], PLLC a/k/a Murray
Woman’s Clinic, PLLC, and such Defendant is jointly and severally liable with” them. Gipson
made no such representations of agency or vicarious liability in her complaint regarding MCCH.

                                               -12-
derived from the deposition testimony of her medical expert, Mark B. Landon,

M.D. In relevant part, Dr. Landon testified:

            COUNSEL: All I really want to do in the short time I
            question you today is to find out each and every criticism
            you level against the hospital and its nursing staff. When
            I read your disclosure, it states you’re expected to testify
            that the nursing staff at Murray-Calloway County
            Hospital violated accepted standards of care by failing to
            question the labor management plan, including the order
            for Cytotec to augment labor without a diagnostic
            ultrasound performed to confirm the presumptive
            diagnosis of intrauterine fetal demise. Is that the extent
            of your opinions concerning the hospital and its nurses?

            LANDON: Right.

            COUNSEL: Anything else you want to add to that
            statement while we’re here today?

            LANDON: Not in terms of standard of care.

            COUNSEL: Okay. What exactly and which nurse
            specifically did you expect to question the labor
            management plan?

            LANDON: Right. So that would – I’m not good on the
            names, but that would be the bedside nurse at the time
            that Dr. Cook made a presumptive diagnosis of fetal
            demise or his assumed diagnosis of fetal demise, and
            then the nurse in the middle of the night.

            COUNSEL: That would have been Brandy Schiller;
            correct, Doctor?

            LANDON: Thank you. When Dr. Burnett decided to
            augment with Cytotec after many hours had gone by
            without delivery.

                                       -13-
COUNSEL: Okay. We can agree, between you and I,
that the diagnosis of intrauterine fetal demise is not a
nursing function; correct?

LANDON: Correct.

COUNSEL: We can also agree, can we not, that
augmentation of labor with Cytotec is not a nursing
decision; correct?

LANDON: As a general statement, that’s true.
However, if the nurses believe that a fetus is alive
potentially, then they can call into question whether you
want to augment the delivery or not and involve the
woman in that decision, simply.

COUNSEL: All right. To follow up with that, what
evidence did any nurse, especially Brandy Schiller –
because I think we’ve established that’s who the bedside
nurse would have been at that time when the Cytotec was
started. What evidence did she have that indicated that
the fetus was alive?

LANDON: She – to my best knowledge, the only
knowledge – the only thing she would have known
regarding that very issue was, again, that there was a
speculum exam performed that showed, quote/unquote,
no pulsation in the umbilical cord.

COUNSEL: Okay. And that would be an indicator of
fetal demise; correct?

LANDON: Well, it could be. And we’ve discussed, and
I think I’m on the record as saying, that that’s an
inadequate means by which to diagnose a fetal demise in
a 21 plus week gestation.

COUNSEL: Okay. And it’s –

                           -14-
LANDON: I mean, all you’d have – all I’d have to do is
show folks the size of the umbilical cord at 21 weeks,
and it’s sitting in the vagina in the dark speculum and,
you know, exam and how somebody is going to look at
that and know if that’s beating or not escapes me.

COUNSEL: Okay. But just to be clear, the speculum
exam was not performed by one of the nurses at Murray-
Calloway County Hospital that we’re talking about;
correct?

LANDON: Correct. But I think one of the nurses has
testimony that she observed as well as Dr. Cook.

COUNSEL: Okay. But she’s not – she’s observing Dr.
Cook perform the speculum exam; correct? That’s what
the testimony –

LANDON: We’d have to go back and look at her
testimony as to whether that is it or whether she
independently thought she could look at the cord and tell
whether it was pulsating or not.

COUNSEL: Could the nurses at Murray-Calloway
County Hospital have ordered the ultrasound, whether it
was transvaginal or transabdominal?

LANDON: I don’t think so.

COUNSEL: Could they have – could they have ordered
any other testing to have determined whether there was
intrauterine fetal demise or whether it was a live fetus?

LANDON: I don’t think they order tests. I think they
can suggest to the physician, quote/unquote, don’t you
think we should get an ultrasound and be sure this baby is
not alive –

COUNSEL: Okay.

                           -15-
             LANDON: – because it might make a difference in what
             we do here.

             COUNSEL: Okay. As you were being questioned, both
             – by both the other counsel, you mentioned that your
             criticisms was [sic] relative to the diagnosis and the
             management. And can we agree that the diagnosis is not
             a nursing function; correct?

             LANDON: I think, ultimately, physicians make the
             diagnosis. But I think – I believe that, too, how – nurses
             can help them along arriving at a diagnosis, or ruling out
             a diagnosis, for that matter.

(Emphasis added.)

             In other words, Dr. Landon believed MCCH was negligent because its

employee, Nurse Schiller, failed to “question the labor management plan, including

the order for Cytotec to augment labor without a diagnostic ultrasound performed

to confirm the presumptive diagnosis of intrauterine fetal demise.” In that vein, he

opined that if Schiller, as a nurse, “believe[d]” that the “fetus was alive

potentially,” she could have “call[ed] into question whether you want to augment

the delivery or not and involve the woman in that decision.” He indicated,

however, that if Schiller had made any such statement to the doctor she was

assisting, it would have at most only been a non-binding suggestion because: (1)

diagnosing intrauterine fetal demise is the function of a doctor, not a nurse; (2)

augmentation of labor with Cytotec is also not a nursing decision; and (3) as a

                                         -16-
nurse, Schiller had no authority to order an ultrasound or any other test regardless

of whether she disagreed with the doctor she was assisting.

             As discussed, it was Gipson’s obligation for summary judgment

purposes to present expert testimony establishing the applicable medical standard

of care and any breach of that standard. See Blankenship, 302 S.W.3d at 675.

Furthermore, Gipson could not defeat MCCH’s properly supported motion for

summary judgment by simply hoping that a trier of fact might disbelieve the

movant’s denial of a disputed fact; rather, she was required to produce affirmative

evidence. See Ryan, 360 S.W.3d at 790.

             With that in mind, we are unwilling to hold that a breach of the “duty”

Dr. Landon outlined in his testimony could be legally actionable. From his

description of it, this “duty” merely obligated Schiller to make a non-binding

suggestion regarding matters outside the scope of her duties and authority.

Moreover, even if Schiller had a duty to make that type of suggestion, no evidence

indicates her duty was triggered. Recall, Dr. Landon testified that Schiller, as a

nurse, could make this suggestion if she “believe[d]” that the baby was “alive

potentially.” However, Schiller has never made any representation that, prior to its

delivery, she believed the baby was alive or potentially alive. To the contrary, in

her deposition Schiller testified that after Dr. Cook examined Gipson and made the

determination that there were no signs that the baby was alive, the operative

                                        -17-
assumption going forward was that the baby was not living;10 that she consequently

canceled various procedures that would have been necessary if it had been

anticipated that the baby would be born alive;11 and that when the baby was

ultimately born alive, it surprised her.12

10
     To this effect, Schiller testified:

          SCHILLER: We had not seen the cord pulsing which would suggest – not to
          mention the fact that there was no heartbeat when we placed [Gipson] back on the
          monitor after.
          COUNSEL: Okay, all right. That’s – that’s – that helps me.
          SCHILLER: Okay.
          COUNSEL: After that point, was there anything else done to determine whether
          the baby was alive?
          SCHILLER: Not that I can recall.
          COUNSEL: And you didn’t note anything else done?
          SCHILLER: No.
          COUNSEL: From that point forward – we’ve gone through your notes. From
          that point forward it was – at least the assumption was that the baby was not
          living?
          SCHILLER: Correct.
11
     To this effect, Schiller testified:

          SCHILLER: I cancelled the Apgar score assessment for the infant, cancelled the
          L and D discharge transfer assessment, completed the notify physician, two
          different notify physicians that we have on ours, canceled kangaroo care, labor
          and delivery oxygen, airway charges, teaching record, and the 24-hour chart
          check.
          COUNSEL: So at this time, you’re – you’re operating under the, I’m not going to
          say assumption, but the belief is that the baby is going to be stillborn, correct?
          SCHILLER: Correct.
          COUNSEL: That’s why all of this has been cancelled, transfer, Apgar scoring, all
          of that was – had been cancelled?
          SCHILLER: Correct.
12
     To this effect, Schiller testified:

          COUNSEL: Were you surprised when the baby was delivered alive and when you placed
          the baby in the warmer the baby was showing signs of life –
          ...

                                                -18-
            As an essential element of her negligence claim against MCCH,

Gipson was required to demonstrate MCCH deviated from an applicable standard

of care. Gipson failed to do so. Accordingly, the circuit court committed no error

in granting summary judgment on Gipson’s claim against MCCH.

         Gipson’s medical negligence claims against Drs. Burnett and
                    Cook and Murray Woman’s Clinic

            Gipson appeals the circuit court’s summary dismissal of the medical

negligence claims she asserted directly against Drs. Burnett and Cook, and

vicariously against Murray Woman’s Clinic. In their respective motions for

summary judgment, these appellees argued dismissal of Gipson’s claims was

warranted because, in their view:

            (1) Gipson produced insufficient evidence demonstrating Drs. Burnett

                and Cook violated the applicable standard of care for determining

                whether, prior to inducing Gipson’s premature delivery, her baby

                had a heartbeat;

            (2) Gipson’s claims took issue with alleged failures to take several

                measures (including but not limited to detecting a fetal heartbeat)

                which undisputedly would not have prevented Gipson from

      COUNSEL:    – with a heartbeat and with reflexes?
      ...
      SCHILLER:   Yes.
      COUNSEL:    And why were you surprised?
      SCHILLER:   Because we had not found a heartbeat earlier in the evening.

                                           -19-
                 miscarrying and losing her baby, and the evidence did not

                 otherwise clearly link any of Gipson’s alleged emotional distress

                 with any actionable medical negligence; and

             (3) Gipson had asserted a “purely emotional injury.” The appellees

                 reasoned such an “injury” could not be compensable because

                 Gipson failed to adduce admissible “expert” evidence of “severe

                 emotional distress” as mandated in Osborne v. Keeney, 399

                 S.W.3d 1 (Ky. 2012).

             The circuit court granted these appellees’ motions with little

elaboration, but in any event “it will be assumed that it was upon any or all of the

grounds which the proof sufficiently established.” Sword v. Scott, 169 S.W.2d

825, 827 (Ky. 1943). The dispositive issue, for purposes of our review, is their

second ground.

             With respect to the first ground, we need not analyze the conflicting

expert evidence about breach of standard of care by these doctors in the failure to

determine Xaedyn had a heartbeat, although he still was not viable. For the third

ground, even if Gipson was not required to present expert evidence of her

emotional distress in the context of this case, she was nevertheless required to

present proof of emotional distress that is “clear and satisfactory. . . . [E]vidence

based on conjecture will not support a recovery for such damages.” The jury must

                                          -20-
be able to “infer that anxiety or mental anguish in fact occurred.” Motorists Mut.

Ins. Co. v. Glass, 996 S.W.2d 437, 454 (Ky. 1997) (cited with approval in Indiana

Ins. Co. v. Demetre, 527 S.W.3d 12, 39 (Ky. 2017). We choose not to analyze the

emotional upset Gipson no doubt suffered.

             To determine whether summary judgement was properly granted, we

must therefore determine only whether Gipson marshaled sufficient evidence to

demonstrate at trial that she suffered emotional injuries, to a “clear and

satisfactory” degree, attributable to or caused by what could be found to have been

the appellees’ actionable negligence. Upon review, we find she failed to do so.

             For purposes of framing our analysis, we return to the relevant

allegations of Gipson’s complaint:

             18. During his care and treatment of Plaintiff, Taylor
             Gipson and her unborn child, during their admission to
             Murray-Calloway County Hospital beginning on
             November 13, 2012, the Defendant, Charles Eugene
             Cook, M.D., acted negligently and failed to exercise the
             degree of care and skill that is expected of reasonably
             competent and prudent obstetrician [sic] acting under the
             same or similar circumstances, including but not limited
             to failing to order an ultrasound to confirm the diagnosis
             of an intrauterine fetal demise, and such negligence was a
             substantial factor in causing the Plaintiff, Taylor Gipson,
             to suffer from and to continue to suffer from severe
             emotional injury and distress which has significantly
             affected her life requiring ongoing treatment and
             counseling and expenses for the same.

             19. During her care and treatment of the Plaintiff, Taylor
             Gipson, and her unborn son, during their admission to

                                         -21-
                Murray-Calloway County Hospital on November 13th
                and 14th of 2012, the Defendant, Ellen M. Burnett, M.D.,
                acted negligently and failed to exercise the degree of care
                and skill that is expected of reasonably competent and
                prudent obstetrician [sic] acting under the same or similar
                circumstances, including but not limited to failing to
                order an ultrasound to confirm the diagnosis of an
                intrauterine fetal demise, failing to monitor or otherwise
                evaluate for fetal status, failing to intervene on behalf of
                the fetus, including transferring mother and baby to
                another facility, failing to have a pediatrician in
                attendance to resuscitate the baby, and inducing the
                premature delivery of the baby with a utero-tonic drug,
                and such negligence was a substantial factor in causing
                the Plaintiff, Taylor Gipson, to suffer from and to
                continue to suffer from severe emotional injury and
                distress which has significantly affected her life requiring
                ongoing treatment and counseling and expenses for the
                same.

                To be sure, Gipson represents that she has never claimed Drs. Burnett

and Cook should be liable for the wrongful death of Xaedyn. Nor, in any capacity,

could Gipson have asserted such a claim: every expert and medical professional

who provided evidence in this matter unequivocally testified that Xaedyn was not

viable; and in Kentucky, viability remains a prerequisite to maintaining an action

for an unborn child’s wrongful death. See Miller v. Bunch, 657 S.W.3d 890, 896

(Ky. 2022) (footnote omitted) (reaffirming that “a viable fetus is a ‘person’ for the

purposes of KRS[13] 411.130, and that a wrongful death suit may accordingly be

maintained for the negligent death of a viable fetus”).

13
     Kentucky Revised Statute.

                                           -22-
                  Nevertheless, under the auspices of at least part of her negligence

claim, Gipson has asserted what effectively amounts to an indirect wrongful death

action. For example, she seeks damages for emotional distress stemming from Dr.

Burnett’s alleged

                  failing to intervene on behalf of the fetus, including
                  transferring mother and baby to another facility, failing to
                  have a pediatrician in attendance to resuscitate the baby,
                  and inducing the premature delivery of the baby with a
                  utero-tonic drug[.]

                  In her brief, Gipson also asserts she had a “strong desire to give her

unborn child every chance to survive”; Burnett “cannot argue that Xaedyn’s

chance of survival at his gestational age was zero or otherwise impossible”; and

that Burnett’s purported failures cost her those chances, along with “peace of mind

that everything that could have been done was done.”

                  Insofar as Gipson is attempting to recover emotional distress damages

for any failure to prevent her miscarriage and the consequent death of her baby, we

agree with Drs. Burnett and Cook that Gipson cannot do so. The undisputed

evidence – even from Gipson14 and her own expert15 – demonstrates that even if

14
     Relative to this point, Gipson testified:

          COUNSEL: Did you understand either when that conversation took place or even
          before that the baby being in the – one, having a prolapsed cord and there kind of
          in the vaginal vault or halfway through the cervix, that the baby was going to be
          born, you couldn’t – there was no medical procedure whereby the baby could be
          pushed back upwards and somehow miraculously put inside a placenta?
          GIPSON: I knew that.

                                                 -23-
Burnett had not provided Gipson Cytotec to augment labor and induce the

premature delivery of the baby, Gipson would have naturally miscarried perhaps a

few hours later; and that even if Gipson had been transferred to another facility, or

if a pediatrician had been consulted or resuscitative measures had been

implemented, the baby would not have survived.

               Furthermore, even if some evidence of record demonstrated the baby

might have had a chance of a better outcome in the absence of Dr. Burnett’s or Dr.

Cook’s purported failures – and no such evidence exists – a lost or diminished

chance of recovery or better medical result due to negligence is not a compensable

injury in Kentucky. See, e.g., Kemper v. Gordon, 272 S.W.3d 146 (Ky. 2008). It

follows that Gipson’s emotional distress stemming from what she perceived was

her baby’s loss of such a chance (e.g., Gipson’s lost “peace of mind that everything

that could have been done was done”) is not compensable, either.

       COUNSEL: Okay. And you also knew that the baby at – was this 21 and –
       GIPSON: Six days.
       COUNSEL: – six-sevenths?
       GIPSON: Yes, sir.
       COUNSEL: Was not going to survive?
       GIPSON: I still believed that he could.
       COUNSEL: Just a matter of belief again? It’s not medically a fact? It’s not
       anything Dr. Lain told you, it’s just –
       GIPSON: No. Nobody told me that.
       COUNSEL: It’s just a belief?
       GIPSON: (Witness nods head in the positive.)
15
  At the start of his deposition, Gipson’s expert, Dr. Landon, bluntly stated: “I don’t think I’m
representing to you that this baby was salvageable, so to speak, on the 13th or 14th of November
2012.”

                                              -24-
             Gipson’s claim, as set forth in her complaint, also asserts emotional

distress damages stemming from the fact that Dr. Cook indicated prior to her

delivery that her baby was dead when it was still alive. It is uncontested that at all

relevant times Gipson explicitly and repeatedly voiced her wish not to induce labor

unless the baby inside her was dead or her life was threatened; and that she only

agreed to induce labor because she had been effectively informed through a

misdiagnosis that the baby was dead.

             But, even if Drs. Cook and Burnett had informed Gipson before

delivery that the baby was still alive, it is uncontested – particularly with the

benefit of hindsight – that any such information would have come with a morbid

caveat: shortly after being born, the baby would die. Gipson cites nothing in the

evidence indicating that if she had known that dire prognosis instead, it would have

been less emotionally distressing for her.

             The only other “emotional distress” Gipson purportedly sustained due

to the misdiagnosis of her baby’s death was described in Paragraph 13 of her

complaint. There, she alleged:

             At the time of delivery, the Defendant Burnett did not
             immediately tell Taylor Gipson that her son was born
             alive nor was Ms. Gipson given an opportunity to hold or
             see her son while he was alive.

             In her appellate brief, she characterizes this allegation as her resulting

inability to give her baby a “dignified death.” As indicated, Gipson appears to

                                          -25-
associate much, if not all, of her meaning of that phrase with her16 inability to be

with the baby during its 48-minute lifespan.

               To that point, however, even Gipson’s expert, Dr. Landon, agreed that

if Gipson was not medically stable during the baby’s 48-minute lifespan, it would

not have been medically appropriate to attempt any “bonding” between her and the

baby during that time. Dr. Landon also conceded that Gipson’s post-delivery

hemorrhage rendered her unstable; that Cytotec did not cause Gipson’s

hemorrhage; and that he could not say with any certainty that Gipson would not

have hemorrhaged – or hemorrhaged to any lesser degree – if she had miscarried

the baby naturally at some later point in time instead.

               Furthermore, the evidence that Gipson was medically stable during

the baby’s brief lifetime is tenuous if not wholly contradicted by the record. To the

extent Gipson cites any such evidence in her brief, she merely presents – in

footnote 84 of her brief – a general citation to eight pages of Dr. Landon’s

deposition. Upon review, those eight pages fail to demonstrate Dr. Landon offered

any relevant testimony. He had no personal knowledge of the underlying events

and was merely asked during his deposition whether he was aware if Gipson’s

parents, contrary to Dr. Burnett’s version of events, may have suggested in their

16
   In her appellate brief, Gipson now suggests she might have sustained less emotional distress if
Burnett had also told her parents that the baby was born alive and had given them an opportunity
to hold or see it while it was alive. We will not address this point because that is not the claim
Gipson asserted.

                                              -26-
separate depositions that there could have been a few minutes between the birth

and death of the baby where Gipson, despite her hemorrhage, could have been

lucid and medically stable. Dr. Landon indicated he was uncertain.

             To be clear, the two medical professionals who witnessed Gipson’s

delivery testified that Gipson could not have been with the baby during its 48-

minute lifespan because Gipson was hemorrhaging blood and required emergency

medical attention at that time. In her deposition, Burnett testified:

             COUNSEL: All right. In the delivery itself, is it your
             testimony that you recognized immediately there was a
             problem with the mother, or did that occur five or more
             minutes after the delivery?

             BURNETT: When I went in to cut the cord, take the
             baby to the warmer, the blood was pooling there.

             COUNSEL: Okay.

             BURNETT: So it was at that point I knew we needed to
             be assessing the [. . . ] mom. I don’t know the timing of
             when the blood pressure was taken, but it was pretty
             obvious looking at the amount of blood that was there.
             And it didn’t take long before the patient herself was
             getting pale; her blood pressure was going down and the
             pulse rate was going up. All that was happening pretty
             much concurrent at the time that that baby was born.

             Lisa Davis, a registered nurse who was in the room at the time of the

delivery, agreed that there was no time for Gipson to hold the baby during that 48-

minute window because “she was bleeding to death, hemorrhaging.”

                                         -27-
             Moreover, Gipson herself testified that she passed out after giving

birth due to the loss of blood:

             COUNSEL: Did you revive again between the time of
             4:00 and 4:50 when the baby passed?

             GIPSON: Not that I know of.

             COUNSEL: So for them to have informed you of what
             they knew, which was that the baby was still technically
             alive, they would have had to go to your bedside and/or
             demand Dr. Burnett or somebody to wake you up to give
             you something wake you up to give you the opportunity
             to say, “Oh, yes, I do want to hold the baby while it’s
             technically still alive,” or “I don’t,” right?

             GIPSON: I wasn’t woke up to do any of that.

             Upon extensive review of the record, the only evidence somewhat

deviating from what is set forth above appears in the deposition testimony of

Gipson’s mother, Kimberly Gipson. Kimberly was uncertain how soon after

delivery Gipson started hemorrhaging blood. She recalled her husband asked to

speak with Burnett in the hallway after the delivery at “probably maybe 4:15,

4:20” because her husband believed he saw the baby move. Kimberly testified that

upon her husband’s return to the room, she noticed Gipson was losing blood, and

that Burnett then ordered a blood transfusion. However, Kimberly indicated she

was uncertain about this chronology:

             COUNSEL: Did this conversation with Dr. Burnett in
             the hallway happen after Taylor said, Mom, I don’t feel
             good and had blood pooling?

                                        -28-
             KIMBERLY: I believe it was before. I’m thinking. I
             think we had already talked to Dr. Burnett out in the
             hallway, and then when I came in Taylor had said, Mom,
             I don’t feel good, something is wrong.

             By contrast, Kimberly’s husband – Kristopher Gipson – testified he

did not leave the room to speak with Burnett after the delivery:

             COUNSEL: And shortly thereafter you had a
             conversation with Dr. Burnett in that room right next to
             the baby?

             KRISTOPHER: Yeah. While the baby was laying there.

             COUNSEL: Was Dr. Burnett near the warmer where the
             nurses were treating the baby when this conversation
             took place?

             KRISTOPHER: Yes.

             COUNSEL: Okay. The conversation didn’t take place
             out in the hallway?

             KRISTOPHER: No.

             Kimberly’s timeline of events is not clear and satisfactory evidence

that Gipson’s inability to be with the baby during its 48-minute lifespan was

attributable to medical negligence. It is equivocal and would at most leave a

factfinder to speculate that Gipson might have been medically stable enough to

hold the baby at some point between its birth at 4:02 a.m. and her emergent blood

transfusion at 4:25 a.m. – a brief period when the nurses were otherwise tending to

                                        -29-
the baby on the warmer, and Gipson was pale, losing blood, and – as Gipson

herself testified – had lost consciousness.

             We have addressed the alleged sources of Gipson’s emotional distress

set forth in her complaint. We must concede Gipson experienced emotional

distress from the ordeal she suffered. That much is not in doubt. However, Gipson

has failed to present clear and satisfactory evidence that her emotional distress was

caused by actionable negligence. Glass, 996 S.W.2d at 454. The consequences of

the presumptive diagnosis of intrauterine fetal demise, including the steps taken

after that mistake, cannot be shown to have caused Gipson’s emotional distress

with any differentiation from the emotional distress which would otherwise have

been experienced if Gipson had been stable enough during the forty-eight minutes

during which Xaedyn’s heart was beating to hold him. Xaedyn could not see his

mother or otherwise interact with her as he struggled to breath with

underdeveloped lungs. While this case presents an unimaginably tragic situation, it

does not sustain an actionable claim of all the elements of negligence.

Accordingly, the circuit court did not err in dismissing Gipson’s medical

negligence claims against Drs. Burnett and Cook and Murray Woman’s Clinic.

                                  CONCLUSION

             For the reasons discussed above, we AFFIRM.

                                         -30-
            ALL CONCUR.

BRIEFS FOR APPELLANT:      BRIEF FOR APPELLEES LORAINE
                           ELIZABETH COOK AND
Paul A. Casi, II           CHARLES EUGENE COOK, JR.,
Jeff W. Adamson            CO-EXECUTRIX/
Michael R. Hasken          EXECUTOR OF THE ESTATE OF
Louisville, Kentucky       CHARLES EUGENE COOK, M.D.,
                           DECEASED; AND MURRAY
                           WOMAN’S CLINIC, PLLC:

                           Gerald R. Toner
                           Katherine Kerns Vesely
                           Leah T. Scharff
                           Louisville, Kentucky

                           BRIEF FOR APPELLEE ELLEN
                           BURNETT, M.D.:

                           Matthew S. Eddy
                           E. Frederick Straub, Jr.
                           Paducah, Kentucky

                           BRIEF FOR APPELLEE
                           CALLOWAY COUNTY PUBLIC
                           HOSPITAL CORP.:

                           Richard L. Walter
                           Paducah, Kentucky

                          -31-