Court Opinion

ID: 9642606
Source: CourtListenerOpinion
Date Created: 2023-08-22 18:04:14.920423+00
Date Added: 2024-06-11T18:10:50.085700
License: Public Domain

Robert L. Brown, Justice, dissenting in part, concurring in part. This appeal concerns what caused Mr. Brady’s blood clot which led to his death. In my judgment, substantial proof was introduced to support a jury finding that the second fall was the proximate cause. The majority opinion states that no conclusion was reached by a medical doctor on the cause of Mr. Brady’s blood clot. But a medical conclusion concerning causation is not required for the matter to go to the jury. Here, Dr. Bell’s initial opinion was that trauma from one of the two falls “most likely” caused the blood clot. That testimony coupled with testimony from three witnesses concerning Mr. Brady’s condition before and after the second fall remove any bona fide suspicion that the verdict was premised on speculation. As the majority states, the boilerplate law regarding the required proof is clear. The evidence of causation must be substantial, which means that it must pass beyond suspicion and conjecture and compel a conclusion one way or the other. Hall v. Grimmett, 318 Ark. 309, 885 S.W.2d 297 (1994). Time and again we have said that that evidence must be viewed in the light most favorable to the appellee, in this case the Brady Estate, and given its highest probative value taking into account all reasonable inferences deducible from it. Id. When that is done, the Brady Estate must prevail. Dr. Keith Bell, the treating radiologist for Mr. Brady, testified for St. Paul and was questioned on direct examination about the cause of the blood clot: Q. And what was that opinion? What crossed your mind when you saw that CT Scan? A. Well, as I mentioned earlier, the first thing that crossed my mind was the possibility of an aneurysm that ruptured. It’s not unfrequent (sic) — or infrequent to see patients come over who-the only history we have is that they’ve fallen, and you do the scan and you find they’ve ruptured an aneurysm or they’ve had a stroke or any number of other things that could cause a person to fall. So that was the first thing that went through my mind. And I also considered the fact that it could well be caused from his trauma either that morning or from the fall that he had just sustained. In short, Dr. Bell testified on direct examination that there was a medical basis for Mr. Brady’s blood clot, it having been caused by either an aneurysm or a fall. That is far different from testimony that the cause of the blood clot was open completely to speculation. On cross-examination by counsel for the Estate, Dr. Bell admitted that his original opinion was that the cause of the blood clot was most likely the result of a blow to the head as opposed to an aneurysm. Reading from Dr. Bell’s medical report, counsel for the Estate inquired: Q. Now you did render an opinion as to what caused this blood clot, didn’t you? A. I did. Q. And if the jury can look at it, it’s what? [t]he third, fourth line down starting there, where it says under “Impression,” Dr. Bell, it says, “I believe this is most likely related to trauma with contusion of the brain against the tentorium, possibly tearing a small vein in this area; is that correct?” A. That’s correct. Thus, it is beyond dispute that on the date of the fall, May 11, 1988, Dr. Bell concluded in his medical report after the CT scan that trauma to the head most likely caused the bruising of the brain and the bleeding. Then there are Dr. Bart Throneberry’s progress notes on Mr. Brady the day of the two falls. After the first fall at home, Dr. Throneberry saw Mr. Brady in his office. He described him in his notes as “mumbling, confused, very weak and ataxic. PT did answer simple questions.” A CT scan was ordered. After the second fall at the hospital, Dr. Throneberry’s notes reveal that he found Mr. Brady with his “eye swollen shut” and a small laceration on his eyebrow, conditions, which he emphasized by underlining, that had not been present during his office visit. He added that Mr. Brady was “responsive only to pain.” After the second fall and the CT scan, Mr. Brady was ordered to St. Vincent Infirmary in Little Rock in an ambulance. The paramedic’s notes show him as unconscious and unresponsive to verbal or pain stimulation. At St. Vincent Infirmary, Dr. David Reding made progress notes on the same day of the fall that Mr. Brady had an “intracerebral bleed” and was “unresponsive” and that he had “no speech” and showed a “fresh” hemorrhage around the midbrain. The outlook was “guarded.” The records at St. Vincent Infirmary also stated that Mr. Brady had been in the hospital for a CT scan two months earlier in March and that there was “no definite aneurysm.” In addition to the medical testimony, there was the testimony of the widow, Opal Brady, and the son, Charles Brady, at trial. Both testified that before the fall in the hospital Mr. Brady was awake and responsive and after the fall, he was unconscious. Mr. Brady remained virtually unconscious until his death. In sum, although there was no specific medical testimony that the second trauma to the head caused the blood clot, there was certainly medical proof that trauma was the proximate cause of the clot. This was followed and supplemented by testimony of how Mr. Brady looked and reacted before and after the hospital fall. That testimony came from Dr. Throneberry and Opal Brady and Charles Brady and militated in favor of a conclusion that Mr. Brady’s condition was significantly worse after the second fall. He was found in a pool of blood, and his eye swelled shut after the second trauma. He was then rushed to St. Vincent Infirmary. He never regained full consciousness after the second fall. The evidence supporting a conclusion that the second fall caused the blood clot was manifestly substantial, especially when viewed in a light most favorable to the Estate and giving that evidence the highest probative value. This is not a case where the jury was left to speculate between two equally probable causes. See Hill v. Maxwell, 247 Ark. 811, 448 S.W.2d 9 (1969). It is a case where the proof preponderates in favor of the Estate’s theory of causation. This case was decided by a jury, as fact finder, and should have been as the determination of causation is ordinarily an issue of fact. See Stacks v. Arkansas Power & Light Co., 299 Ark. 136, 771 S.W.2d 754 (1989); Curbo v. Harlan, 253 Ark. 816, 490 S.W.2d 467 (1973); Chambliss v. Brinton, 229 Ark. 526, 317 S.W.2d 143 (1958). I respectfully dissent from the decision to reverse on this ground. I agree, however, with the majority’s decision to dismiss the cross-appeal for violation of Supreme' Court Rule 4-2(a)(6).