Court Opinion

ID: 9953530
Source: CourtListenerOpinion
Date Created: 2024-03-22 14:19:05.33672+00
Date Added: 2024-06-11T08:01:14.247522
License: Public Domain

RENDERED: MARCH 15, 2024; 10:00 A.M.
                         NOT TO BE PUBLISHED

                 Commonwealth of Kentucky
                            Court of Appeals
                               NO. 2022-CA-1267-MR

SHANNON ASHCRAFT-EVANS                                                   APPELLANT

                   APPEAL FROM KENTON CIRCUIT COURT
v.                 HONORABLE MARY K. MOLLOY, JUDGE
                          ACTION NO. 19-CI-00768

ALLISON LIED, M.D. AND
MANGAT, HOLZAPFEL AND LIED
PLASTIC SURGERY, P.S.C.                                                   APPELLEES

                                      OPINION
                                     AFFIRMING

                                    ** ** ** ** **

BEFORE: CALDWELL, GOODWINE, AND LAMBERT, JUDGES.

CALDWELL, JUDGE: Shannon Ashcraft-Evans (“Ashcraft-Evans”) appeals from

a judgment on a jury verdict in favor of Appellees Allison Lied, M.D. and Mangat,

Holzapfel and Lied Plastic Surgery, P.S.C. (collectively “Dr. Lied”) on a medical

malpractice claim. Specifically, Ashcraft-Evans challenges the trial court’s denial

of her motion for a directed verdict, the trial court’s refusal to instruct the jury on
res ipsa loquitor, and the denial of her motion for judgment notwithstanding the

verdict (“JNOV”). We affirm.

                Before explaining our reasons to affirm with discussions of the facts

and the parties’ arguments, we first address instances of non-compliance with

appellate briefing rules.

We Decline to Impose Sanctions for Non-Compliance with Appellate Briefing
Rules but We Urge Greater Care to Comply with Rules in Future to Avoid
Serious Consequences

                  All briefs were filed in 2023 and are thus subject to the Kentucky

Rules of Appellate Procedure which took effect on January 1, 2023. But the red

appellant brief does not fully comply with requirements for appendices in our

appellate briefing rules.

                RAP1 32(E)(1) provides in pertinent part:

             (a) Documents required in appendix to appellant’s and cross-
                 appellant’s initial brief. An appellant and a cross-
                 appellant must attach an appendix to the party’s initial
                 brief. The first item of the appendix shall be a listing or
                 index of all documents included in the appendix. The
                 appellant shall place the judgment, opinion, or order
                 under review immediately after the appendix list so that it
                 is most readily available to the court. The appendix shall
                 contain copies of the findings of fact, conclusions of law,
                 and judgment of the trial court, any written opinions filed
                 by the trial court in support of the judgment, and the
                 opinion or opinions of the court from which the appeal is
                 taken.

1
    Kentucky Rules of Appellate Procedure.

                                             -2-
                ....

               (d) Required index and tabs for appendix. The first item
               of the appendix shall be a listing or index of all
               documents included in the appendix. The index shall set
               forth where each document may be found in the record.
               The items in the appendix shall be separated by
               appropriate extruding tabs.

               Contrary to these requirements, the appendix to the appellant’s red

brief does not contain an index or listing of all attached documents.2 See RAP

32(E(1)(a) & (d). Nor does it set forth where each attached document may be

found in the record or separate documents by extruding tabs. See RAP 32

(E)(1)(d).

               The appendix does not contain a copy of the trial court’s judgment on

the jury verdict.3 See RAP 32(E)(1)(a). Nor is any judgment, opinion, or order

under review placed first before the documents (other than any index or listing) in

the appendix. See RAP 32(E)(1)(a).

2
  A list of items in the appendix appears within the statement of points and authorities, but not at
the beginning of the appendix itself. And this list of items in the statement of points and
authorities does not indicate where items may be found in the record.
3
  Including copies of the judgment, opinion or order being reviewed within the appendix helps
ensure that all members of the appellate panel have access to and can easily read such judgments,
opinions and orders. The appendix to the appellant’s brief does contain the September 2022
order denying JNOV, but not the underlying judgment. Fortunately, in this case, copies of the
trial court’s June 2022 Trial Order and Judgment are available for the panel’s review on
CourtNet – as are the parties’ proposed jury instructions, the trial court’s actual instructions to
the jury and numerous other pleadings, motions, and other documents.

                                                -3-
                In addition to these problems with the appendix, the appellant red

brief does not comply with RAP 32(A)(4)’s requirement that it “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.”

                Such failures to comply with our appellate briefing rules can subject a

party to serious consequences. For example: “If a party fails to inform the

appellate court of where in the record his issue is preserved, the appellate court can

treat that issue as unpreserved.” Ford v. Commonwealth, 628 S.W.3d 147, 155

(Ky. 2021). This can affect the standard of review as unpreserved issues are

reviewed by appellate courts only for palpable error resulting in manifest injustice.

See id. (citing RCr4 10.26); CR5 61.02; Nami Resources Company, L.L.C. v. Asher

Land and Mineral, Ltd., 554 S.W.3d 323, 338 (Ky. 2018) (“The language of CR

61.02 is identical to its criminal law counterpart, RCr 10.26, and we interpret that

language identically.”). See also Progressive Direct Insurance Company v.

Hartson, 661 S.W.3d 291, 298 n.9 (Ky. App. 2023).

                In addition to our having discretion to treat issues for which no

preservation statement is provided as unpreserved and thus review only for

palpable error resulting in manifest injustice, see, e.g., Ford, 628 S.W.3d at 155;

4
    Kentucky Rules of Criminal Procedure.
5
    Kentucky Rules of Civil Procedure.

                                            -4-
we may also impose other penalties for substantial non-compliance with other

appellate briefing rules – including striking briefs and dismissing appeals. RAP

31(H). Yet we decline to impose any such sanctions despite deficiencies.

               Though the red appellant brief does not contain the required

preservation statement at the beginning of the argument, we are satisfied from our

review of the record that the issues raised on appeal were raised to and ruled on by

the trial court and are therefore preserved for our review. See Ten Broeck Dupont,

Inc. v. Brooks, 283 S.W.3d 705, 734 (Ky. 2009) (issue not raised to the trial court

was not preserved for review). So, despite the lack of preservation statement, we

decline to treat these issues as unpreserved, meaning that we will not review solely

for palpable error resulting in manifest injustice.

               And despite our authority to impose other sanctions such as striking

briefs for substantial non-compliance, we leniently elect not to impose any of these

sanctions for other forms of non-compliance with our appellate briefing rules6 –

including deficiencies in the appellant brief appendix. But we urge counsel to take

greater care to review and comply with our appellate briefing rules as we may not

be so lenient in the future. See, e.g., Hamburger v. Plemmons, 654 S.W.3d 99, 102

(Ky. App. 2022) (declining to fine counsel but striking briefs and dismissing

6
  Perhaps there may be differing opinions as to whether, for example, the noted deficiencies in
the appellant brief appendix amount to substantial non-compliance. In any event, whether the
non-compliance is considered substantial or not, we do not elect to impose sanctions here.

                                               -5-
appeal for various failures to comply with then-applicable appellate briefing rules).

We next address the facts of this case.

                                            FACTS

               Dr. Lied performed a chemical peel on Ashcraft-Evans’ face with an

acid known as TCA. Unfortunately, Ashcraft-Evans suffered injury due to acid

indisputably getting in one of her eyes during the chemical peel procedure.

Getting acid in a patient’s eye during a chemical peel was a rare event according to

the testimony of Dr. Lied and other doctors.7

               Ashcraft-Evans filed a medical malpractice lawsuit against Dr. Lied.

The parties engaged in discovery and the lawsuit proceeded to trial about three

years after suit was filed. Both parties came forward with deposition testimony

from experts prior to trial. Their experts expressed differing opinions about

whether acid could get in a patient’s eye during a chemical peel even if the doctor

performing the peel had complied with the standard of care.

7
  The written consent form signed by Ashcraft-Evans did not explicitly list eye damage as one of
the risks of the chemical peel procedure. Dr. Lied suggested this was because getting acid in a
patient’s eyes was such a rare event it was not considered a substantial risk of the chemical peel
procedure. However, according to a post-operative report prepared by Dr. Lied and Dr. Lied’s
testimony, Dr. Lied verbally informed Ashcraft-Evans of a risk of eye damage before performing
the chemical peel. Ashcraft-Evans alleged lack of informed consent and the jury was instructed
to consider whether there was a lack of informed consent. The jury found in Dr. Lied’s favor on
the question of informed consent. Ashcraft-Evans has not argued any error in the trial court’s
handling of informed consent issues in this appeal.

                                               -6-
             Shortly prior to trial, Ashcraft-Evans argued for the first time that the

doctrine of res ipsa loquitor applied to her case. The trial court entered an order

stating that res ipsa loquitor did not apply since there was evidence that the injury

could occur in the absence of negligence. The order further stated that the plaintiff

must support her negligence claims with expert testimony.

             The parties presented deposition and live testimony at trial. Ashcraft-

Evans’ expert, Dr. Strasser, testified that getting acid in a patient’s eye during a

chemical peel could not happen unless the doctor had done something wrong; in

essence, had breached the standard of care. But Dr. Lied and her expert expressed

opinions that acid could possibly get in a patient’s eye during a chemical peel even

if the doctor performing the procedure did not do anything wrong.

             These doctors all expressed the importance of properly squeezing out

excess liquid from the gauze used to apply TCA and perhaps taking additional

steps to make sure that the doctor performing a chemical peel could control the

acid and avoid contact with eyes. However, they noted that drops could often

simply be rubbed into the skin before getting near the eyes and that acid getting

into a patient’s eye during chemical peels was very rare. None of the doctors were

aware of any instances of acid getting in a patient’s eyes during a chemical peel in

their own experience or in the experience of other doctors they knew.

                                          -7-
              Dr. Lied also discussed her recollection of performing the chemical

peel on Ashcraft-Evans’ face in deposition and live testimony. She described how

she typically performed the procedure in deposition testimony. She would put a

small amount of TCA in a cup, dip some gauze in the cup, squeeze the cup to

moisten the gauze, and then squeegee and squeeze the gauze until it was moist but

not dripping. She noted the gauze must not be dripping because she wanted to be

able to control exactly where the TCA went.

             Dr. Lied testified she recalled seeing a small drop of acid going down

the side of Ashcraft-Evans’ nose after she applied the gauze and while the patient’s

eyes were closed. She recalled using a clean piece of gauze to rub the drop in and

initially thinking no acid went in the patient’s eye until she saw the patient wince.

She admitted that drops of acid should not get loose during the procedure, and that

some acid did get into Ashcraft-Evans’ eye.

             Although she did not recall performing the procedure any differently

than she would normally, Dr. Lied admitted in her deposition that somehow there

must have been more TCA on the gauze than she thought because a small drop

came out. She testified to thinking she had squeezed out the gauze adequately, but

admitted it was possible she had not. She opined that getting TCA into a patient’s

eyes was possibly preventable, but also stated sometimes things happened that

were out of one’s control. She admitted there was no third party whose intervening

                                         -8-
act would have caused something out of her control; instead, she was the only one

to control the TCA. Also, she testified there was nothing different about the gauze

or the acid used in Ashcraft-Evans’ procedure than that used at other times.

             Defense expert Dr. Kitzmiller admitted he had not been present to see

Dr. Lied perform the procedure so he could not say for sure if she had squeezed out

enough liquid from the gauze. But when asked if the only explanation for acid

getting in the eye was inadequate squeezing of the gauze or the doctor doing

something wrong, he disagreed – although he did not offer a clear explanation of

how the acid could get in a patient’s eye during a chemical peel despite a doctor

properly squeezing excess liquid from the gauze.

             Similarly, at trial, Dr. Lied did not offer a definitive explanation of

how acid could get in a patient’s eye during a chemical peel if the gauze was

properly squeezed out. However, she denied doing anything wrong, insisting she

had properly squeezed and squeegeed to make sure the gauze was moist but not

dripping as always. She testified that perhaps microscopic permeation or diffusion

had occurred after she wiped the drop away.

             Ashcraft-Evans moved for a directed verdict in her favor based on res

ipsa loquitor. She also tendered a jury instruction about res ipsa loquitor. The

                                          -9-
trial court denied her motion for directed verdict and refused to give the tendered

jury instruction about res ipsa loquitor.8

                 The jury returned a verdict in Dr. Lied’s favor. Ashcraft-Evans filed a

motion for JNOV or a new trial, which the trial court denied. Ashcraft-Evans then

filed a timely appeal. Further facts will be discussed as needed.

                                           ANALYSIS

Res Ipsa Loquitor Requirements and Application

                 A plaintiff has the burden to prove negligence and often lacks direct

evidence of negligence. But sometimes a plaintiff may be able to prove negligence

8
    Ashcraft-Evans’ tendered Instruction No. 3 read as follows:

         You Are instructed that if you should find that: (1) the accident alleged is of a
         kind that ordinarily does not occur in the absence of someone’s negligence; (2)
         the accident was caused by an instrumentality within the exclusive control of the
         defendant; and (3) the accident occurred without any voluntary act on the part of
         the plaintiff contributing to the result, then an inference that the defendant was
         negligent arises. The inference is called res ipsa loquitur. Res ipsa loquitur
         does not require that the plaintiff produce evidence excluding all possible causes
         other than the defendant’s negligence; the plaintiff need demonstrate only a
         “balance of probabilities” pointing to the defendant’s negligence as a cause of the
         accident. The requirement that the instrumentality be under the management and
         control of the defendant does not mean, or is not limited to, actual physical
         control, and you may find the doctrine applicable if the defendant had the right of
         control at the time of the accident.

         Question 1. Do you find for the Plaintiff Shannon-Ashcraft-Evans under this
         Instruction?

(Record on Appeal, “R,” p. 241). Ashcraft-Evans’ tendered instructions asked the jury to first
consider the res ipsa loquitor issue in Instruction No. 3, before determining whether Dr. Lied had
been negligent in providing treatment or failed to obtain Ashcraft-Evans’ informed consent in
tendered Instructions No. 4 through 6. (R, pp. 242-46.)

                                                -10-
through circumstantial evidence. Under certain circumstances, a rebuttable

presumption or permissible inference of negligence may arise. Bowers v. Schenley

Distillers, Inc., 469 S.W.2d 565, 568 (Ky. 1971).

             For example, sometimes a rebuttable presumption of negligence may

arise if the requirements of res ipsa loquitor are met. Id. at 568-69. For res ipsa

loquitor to possibly apply, the following requirements must be shown:

             (1) The defendant must have had full management of the
             instrumentality which caused the injury; (2): the
             circumstances must be such that, according to common
             knowledge and the experience of mankind, the accident
             could not have happened if those having control and
             management had not been negligent; (3) the plaintiff’s
             injury must have resulted from the accident.

Id. at 568 (quoting Vernon v. Gentry, 334 S.W.2d 266, 268 (Ky. 1960)).

             Naturally, a typical non-physician layperson often lacks the expertise

to know whether certain medical events generally occur in the absence of

negligence. So, often it is not appropriate to apply res ipsa loquitor to infer

negligence merely from undesirable results of medical treatment – at least in the

absence of expert testimony. See Perkins v. Hausladen, 828 S.W.2d 652, 654-55

(Ky. 1992). However, there are two limited exceptions to this general rule. These

two exceptions for possibly applying res ipsa loquitor to infer negligence in

medical malpractice cases are: 1) where the occurrence is one where even a

layperson can properly assume the occurrence generally results from a lack of care

                                         -11-
or skill – such as leaving a foreign object in a patient’s body during a medical

procedure – so that expert testimony is not required to infer negligence, and 2)

more complex situations where expert testimony may be required to provide a

foundation for applying res ipsa loquitor. Id. at 655.

               Perhaps addressing the second exception, our Supreme Court

discussed how sometimes medical testimony may provide support for applying res

ipsa loquitor to infer negligence even where there is no direct expert testimony that

the standard of care was breached. It reviewed precedent, summarizing: “In all of

these cases an inference of negligence was sufficiently supplied by medical

testimony of record even though the plaintiff had no expert witness to opine that

the conduct fell below the standard of acceptable professional care.” Id. (citing

e.g., Jewish Hospital Ass’n of Louisville, Ky. v. Lewis, 442 S.W.2d 299 (Ky.

1969)). And it specifically noted that sometimes the testimony needed to infer

medical negligence might come from an admission by the defendant doctor.

Hausladen, 828 S.W.2d at 655 (citing Jarboe v. Harting, 397 S.W.2d 775, 778

(Ky. 1965)).

               Often when no expert is located to testify to a breach of the standard

of care, medical malpractice plaintiffs raise the issue of res ipsa loquitor before

trial to avoid a summary judgment in favor of the defendant. See, e.g.,

Blankenship v. Collier, 302 S.W.3d 665 (Ky. 2010). However, as noted by the trial

                                          -12-
court, Ashcraft-Evans did not explicitly argue for the application of res ipsa

loquitor until shortly before trial and she came forward with expert testimony in

her favor prior to trial. Instead of the more typical scenario of a plaintiff arguing

res ipsa loquitor to avoid judgment for the defendant despite a lack of expert

testimony in the plaintiff’s favor, Ashcraft-Evans argued at trial that she was

entitled to a directed verdict based on application of res ipsa loquitor.

             Certainly, whether a party is entitled to a directed verdict may be

affected by the application of res ipsa loquitor – which permits an inference of or

even a rebuttable presumption of negligence when the requirements for its

application are met:

             Res ipsa loquitur is an evidentiary doctrine that would
             permit a jury to infer negligence from the state of the
             circumstances themselves. Sadr v. Hager Beauty School,
             Inc., 723 S.W.2d 886 (Ky. App. 1987). If the inference
             to be drawn is strong enough, it can create a rebuttable
             presumption of negligence, potentially resulting in a
             directed verdict. Id., citing Bowers v. Schenley Distillers,
             Inc., 469 S.W.2d 565 (Ky. 1971).

Bryan v. CorrectCare-Integrated Health, Inc., 420 S.W.3d 520, 524 (Ky. App.

2013). See also Baxter v. AHS Samaritan Hosp., LLC, 328 S.W.3d 687, 692 (Ky.

App. 2010) (noting medical malpractice plaintiff “could request the application of

the doctrine of res ipsa loquitur to avoid a directed verdict or to win a directed

verdict”). But even if res ipsa loquitor requirements are met by the facts of a case,

Kentucky precedent makes clear that a factfinder may, but is not required to, infer

                                         -13-
negligence. See Nazar v. Branham, 291 S.W.3d 599, 604 (Ky. 2009)

(Characterizing res ipsa loquitur as applied to medical malpractice cases in which

objects were left in patients’ bodies after medical procedures as “permitting juries

to infer negligence from the fact of the retained foreign object, while granting them

the latitude to analyze other facts and evidence relevant to liability.”). So, even if

facts are found to support the requirements for res ipsa loquitor, this does not

always mean that a plaintiff is entitled to judgment in his/her favor.

             As liability is not guaranteed by meeting the requirements for res ipsa

loquitor and as the medical evidence regarding res ipsa loquitor requirements was

conflicting based on our review of the record, we conclude the trial court did not

err in denying Ashcraft-Evans’ motions for directed verdict and for JNOV.

No Reversible Error in Trial Court’s Denying Directed Verdict and JNOV

             As we stated in long-standing precedent:

             In ruling on either a motion for a directed verdict or a
             motion for judgment notwithstanding the verdict, a trial
             court is under a duty to consider the evidence in the
             strongest possible light in favor of the party opposing the
             motion. Furthermore, it is required to give the opposing
             party the advantage of every fair and reasonable
             inference which can be drawn from the evidence. And, it
             is precluded from entering either a directed verdict or
             judgment n.o.v. unless there is a complete absence of
             proof on a material issue in the action, or if no disputed
             issue of fact exists upon which reasonable men could
             differ.

                                         -14-
Taylor v. Kennedy, 700 S.W.2d 415, 416 (Ky. App. 1985). See also Belt v.

Cincinnati Insurance Company, 664 S.W.3d 524, 530 (Ky. 2022); Louisville and

Jefferson Cnty. Metropolitan Sewer District v. T+C Contracting, Inc., 570 S.W.3d

551, 576 (Ky. 2018). On appeal, we review the denial of directed verdict and of

JNOV under essentially the same standards. Id. The trial court’s denial of JNOV

must be affirmed unless there is a complete lack of evidence on a material issue or

there is no issue of material fact on which reasonable people could differ. Savage

v. Three Rivers Medical Center, 390 S.W.3d 104, 111 (Ky. 2012). Similarly, the

trial court’s denial of directed verdict must be affirmed unless there is no way the

jury could have reasonably reached its verdict based on the evidence before it.

Belt, 664 S.W.3d at 530. See also T+C Contracting, Inc., 570 S.W.3d 551:

             Upon review of the evidence supporting a judgment
             entered upon a jury verdict, the role of an appellate court
             is limited to determining whether the trial court erred in
             failing to grant the motion for directed verdict. All
             evidence which favors the prevailing party must be taken
             as true and the reviewing court is not at liberty to
             determine credibility or the weight which should be
             given to the evidence, these being functions reserved to
             the trier of fact. The prevailing party is entitled to all
             reasonable inferences which may be drawn from the
             evidence. Upon completion of such an evidentiary
             review, the appellate court must determine whether the
             verdict rendered is palpably or flagrantly against the
             evidence so as ‘to indicate that it was reached as a result
             of passion or prejudice.

                                         -15-
Id. at 576 (quoting Lewis v. Bledsoe Surface Mining Co., 798 S.W.2d 459, 461-62

(Ky. 1990)) (internal quotation marks omitted).

             In short, we must take all evidence in Dr. Lied’s favor as true, apply

all reasonable inferences from the evidence in Dr. Lied’s favor, and defer to the

fact-finder’s judgment on the weight and credibility of the evidence. Viewing the

evidence of record in this manner, we conclude that the trial court did not err in

entering judgment in conformity with the jury’s verdict rather than granting

Ashcraft-Evans’ motion for a directed verdict or JNOV. While another factfinder

might reach a different conclusion, the jury could have reasonably reached its

verdict based on the evidence, there is not a complete lack of evidence to support

the jury’s verdict, and the verdict rendered was not so flagrantly against the

evidence as to indicate passion or prejudice. Though perhaps a better case for a

directed verdict in favor of a medical malpractice plaintiff might be established by

uncontradicted evidence establishing the required elements of res ipsa loquitor, the

medical evidence here was conflicting regarding the key issue of whether the

medical event (acid getting in the patient’s eyes during a chemical peel) could

occur in the absence of negligence.

             Ashcraft-Evans’ expert, Dr. Strasser, clearly disagreed with any

assertion that acid could get into a patient’s eye during a chemical peel even if the

doctor did nothing wrong because the acid was under the doctor’s control. In

                                         -16-
contrast, defense expert Dr. Kitzmiller expressly disagreed with the assertion that

acid could not get into a patient’s eye if the doctor did nothing wrong – even

though he could not explain exactly how this would occur if the gauze was

properly squeezed out and he admitted he could not say whether Dr. Lied properly

squeezed out the gauze until it was moist but not dripping since he did not observe

the procedure. And not only was this expert medical testimony conflicting on

whether acid could go in the patient’s eyes in the absence of negligence, but the

record does not conclusively support Ashcraft-Evans’ argument that Dr. Lied

admitted to a breach of the standard of care.

              Ashcraft-Evans notes Dr. Lied and Dr. Kitzmiller testified to the

standard of care being to squeeze out gauze enough for it to be moist but not

dripping. She suggests that Dr. Lied admitted to breaching this standard of care by

allowing the gauze to drip. But admitting to seeing a drop is not the exact same

thing as admitting to not squeezing out the gauze enough and letting it drip. And

Dr. Lied did not explicitly admit to having failed to control the acid.

             Ashcraft-Evans notes Dr. Lied admitted seeing a drop of liquid

traveling down the patient’s eyes to the patient’s nose and admitted being the only

one responsible for making sure enough liquid was squeezed out of the gauze. But

based on our careful review of Dr. Lied’s testimony, Dr. Lied did not admit to

seeing the gauze dripping or failing to control the acid. Dr. Lied testified to

                                         -17-
squeezing and squeegeeing the gauze just like she always did and to observing that

it did not appear to be dripping before she applied the gauze. Dr. Lied admitted

seeing a drop going down the nose and wiping it away, although she also admitted

acid went in the patient’s eye and the acid must have come from the gauze. She

testified that perhaps some microscopic permeation or diffusion occurred after she

wiped the drop away, and she denied having done anything wrong despite acid

admittedly getting in Ashcraft-Evans’ eye.

             In sum, there is no clear admission of breaching the standard of care

by Dr. Lied and there is conflicting expert testimony about whether acid could get

in a patient’s eye during a chemical peel in the absence of negligence. But given

its obligation to construe the evidence in the opposing party’s favor for purposes of

ruling on directed verdict or JNOV motions, the trial court did not err in denying

the motions for directed verdict or for JNOV. This is especially true because there

was not uncontroverted evidence of a breach of the standard of care nor even

uncontroverted evidence of all requirements for applying res ipsa loquitor. The

conflicting evidence meant that the jury alone had the right and ability to weigh the

evidence and to choose which evidence to believe and which to reject. We must

affirm the denial of the motions for directed verdict and JNOV.

             Next, we address the arguments about jury instructions.

                                        -18-
We are Compelled to Affirm as Trial Court’s Refusal to Instruct on Res Ipsa
Loquitor is Consistent with Binding Precedent

             Issues about the content of the trial court’s instructions given to the

jury must be reviewed de novo on appeal. Norton Healthcare, Inc. v. Disselkamp,

600 S.W.3d 696, 710 (Ky. 2020). However, the trial court’s refusal to give a

tendered jury instruction is reviewed for abuse of discretion. Id. at 733. See also

Sargent v. Shaffer, 467 S.W.3d 198, 203-04 (Ky. 2015), overruled on other

grounds by University Medical Center, Inc. v. Shwab, 628 S.W.3d 112, 129 (Ky.

2021).

             Regardless of the exact standard of review, our precedent makes clear

that a trial court cannot properly give a jury instruction about res ipsa loquitor

because “jury instructions should not explain evidentiary matters, evidentiary

presumptions, or contain unnecessary detail.” Baxter, 328 S.W.3d at 692 (citing

Meyers v. Chapman Printing Co., Inc., 840 S.W.2d 814, 824 (Ky. 1992)). Accord

Bryan, 420 S.W.3d at 524-25. See also Disselkamp, 600 S.W.3d at 723 (indicating

that jury instructions about evidentiary presumptions are forbidden under

Kentucky’s bare bones approach).

             There may be good arguments for rejecting the holding in precedent

such as Baxter or Meyers and instead allowing jury instructions about evidentiary

                                         -19-
matters9 – such as the fact finder’s prerogative to infer negligence if res ipsa

loquitor requirements are met. This may be especially true where, as here, there is

conflicting expert testimony about whether requirements for res ipsa loquitor are

met – especially whether an event such as acid getting in a patient’s eye during a

chemical peel could happen in the absence of negligence. But we lack the

authority to overrule precedent from our Supreme Court such as Meyers. SCR10

1.030(8)(a). And we decline to overrule our own precedent interpreting Meyers to

forbid jury instructions on res ipsa loquitor in Baxter and Bryan, since this Court

clearly followed and did not misconstrue Meyers’ clear and somewhat broad

language forbidding jury instructions about evidentiary presumptions and other

evidentiary matters.

                After all, Meyers clearly states that Kentucky’s bare bones approach

to jury instructions does not permit jury instructions about “evidentiary matters.”

9
  Some may suggest the trial court’s duty to instruct the jury on the law may be better met by
allowing a trial court, upon a similar evidentiary record, to give the jury a simple instruction
making clear that the jury may, but does not have to, infer negligence if the required elements for
res ipsa loquitor are met. Some might suggest different language or a shorter, less detailed
instruction than Ashcraft-Evans’ tendered instruction on res ipsa loquitor to inform the jury of its
prerogative to infer negligence if it finds facts supporting res ipsa loquitor requirements yet
comply with Kentucky’s bare bones approach to jury instructions. We need not reach whether
the exact language of the tendered instruction was appropriate, however, as we conclude the trial
court correctly followed binding precedent in declining to instruct the jury on res ipsa loquitor.
10
     Rules of the Kentucky Supreme Court.

                                               -20-
840 S.W.2d at 824. And it further flatly forbids jury instructions on presumptions,

which could arise if res ipsa loquitor is applied:

             In Kentucky jury instructions do not include evidentiary
             presumptions. Such presumptions alter the burden of
             going forward with the evidence, and thus may result in a
             directed verdict in the absence of countervailing
             evidence, but the jury instructions should be framed only
             to state what the jury must believe from the evidence in
             order to return a verdict in favor of the party who bears
             the burden of proof.

Id. See also Disselkamp, 600 S.W.3d at 723 (explaining how “bare-bones

instructions do not include unnecessary detail such as evidentiary presumptions”

because presumptions affect whether a trial court submits an issue to the jury while

jury instructions should focus on the jury’s determination of the ultimate issue of

fact, providing minimal detail yet “enough law and background knowledge so that

the jury comes to a decision that is supported by law”).

             In sum, Ashcraft-Evans could not prevail on her jury instruction

argument unless our Supreme Court limits, modifies, or clarifies its holding

forbidding jury instructions on evidentiary presumptions or other evidentiary

matters in Meyers and similar precedent such as Disselkamp. We must follow

precedent from our Supreme Court and affirm the trial court’s denial of Ashcraft-

Evans’ request for a res ipsa loquitor instruction. To the extent that our reasoning

differs from the trial court’s, we may affirm for any reason supported by the record

                                         -21-
and the law. See generally Mark D. Dean, P.S.C. v. Commonwealth Bank & Tr.

Co., 434 S.W.3d 489, 496 (Ky. 2014).

            Further arguments raised by the parties which are not discussed herein

have been determined to lack merit or relevancy to our resolving this appeal.

                                 CONCLUSION

            For the reasons set forth in this opinion, we AFFIRM the judgment of

the Kenton Circuit Court.

            ALL CONCUR.

BRIEFS FOR APPELLANT:                     BRIEF FOR APPELLEES:

David M. Blank                            Judd R. Uhl
Covington, Kentucky                       Cincinnati, Ohio

                                       -22-