Court Opinion

ID: 9666546
Source: CourtListenerOpinion
Date Created: 2023-08-24 01:19:07.139058+00
Date Added: 2024-06-11T18:15:30.021045
License: Public Domain

CLIFFORD H. AHRENS, Judge,
dissenting.
I respectfully dissent. Where a “claimant” fails to prove each and every element of its cause of action, summary judgment may be properly entered in favor of the “defending party.” ITT Commercial Fin. Corp. v. Mid-America Marine Supply Corp., 854 S.W.2d 371, 381 (Mo.1998). In the present case, plaintiff failed to prove what the Missouri Supreme Court has termed the “essential prerequisite” to the application of the doctrine of res ipsa lo-quitur in medical malpractice cases,1 that laypersons are able to find, based on their common knowledge and experience, that the plaintiffs injuries ordinarily would not have occurred in the absence of negligence.
Among the types of injuries which bespeak negligence to laypersons are “unusual injuries,” that is, those to an area of the body unconnected with the surgery or treatment, especially where the patient is unconscious. See Hasemeier v. Smith, 361 S.W.2d 697, 700 (Mo.1962). Missouri courts have found such injuries to exist in the following cases: Graham v. Thompson, 854 S.W.2d 797 (Mo.App.1993) (burn to calf following surgery to foot); Calvin, 746 S.W.2d 602 (nerve injury to arm following surgery to spine); Swan, 669 S.W.2d 590 (burn to chest following vaginal surgery); and Goodenough v. Deaconess Hosp., 637 S.W.2d 123 (Mo.App.1982) (injury to neck during proctoscopic examination). Although plaintiffs injury was to an area of the body unrelated to the area of surgery and allegedly sustained while she was under general anesthesia, I do not find it to be sufficiently unusual such that negligence could be inferred on the basis of lay knowledge and experience. Accordingly, I find the foregoing cases distinguishable.
Regarding the burn cases, Graham and Swan, laypersons know that burns do not occur absent the application of heat or radiation. The procedure or treatment causing the injury in both cases involved the application of heat — an exothermic reaction produced by the setting of the cast plaster in Graham; a cauterizer in Swan. Given this evidence, laypersons were certainly able to determine that burns to a part of the body unconnected with the area of treatment ordinarily would not have occurred absent negligent use of the cast plaster and cauterizer, respectively. Conversely, in the case at bar, neither the nature of the injury nor the surgical procedure involved are commonly understood by laypersons. Accordingly, laypersons are not equipped to determine the former is caused more often than not when the latter is performed negligently.
Goodenough is distinguishable because, although the plaintiff pleaded res ipsa lo-quitur, she knew the event which caused her neck injury (sliding head-first into the headboard of the proctoscopic table when the table was tilted for the examination) resulted from improper positioning on the proctoscopic table prior to the examination. “The effect of gravity on the human body is one which must be held to be within the ken of the average juror.” Goodenough, 637 S.W.2d at 126-127. There was no commonly understood force like gravity at work in the case at bar.
Calvin is distinguishable in that there was evidence of specific negligence of the parties in control. Moreover, the court’s finding that such injury was “unusual” is dicta. The only issues raised in Calvin *171were whether the plaintiff was precluded from submitting her case under res ipsa loquitur because she either failed to prove the defendant’s exclusive control or because she proved specific negligence. The defendant-appellant did not contest the un-usualness of the plaintiffs injury; the court was therefore not required to resolve that issue to dispose of the case.
I do not believe the injury suffered by plaintiff in the case at bar is so unusual that a layperson could find it ordinarily does not occur absent negligence on the basis of common knowledge and experience. To the contrary, resolution of the issues of negligence in this case requires knowledge of medical science and operative procedures. These are areas of un common knowledge, possessed only by those trained in medicine, not by the average layperson.
In addition to the nature of the injury itself, I am also persuaded that res ipsa loquitur is not available to plaintiff in this case by the following deposition testimony of plaintiffs expert, Dr. Berkin (with emphasis added):
Q: You’re not here to say that anyone did anything wrong to cause this injury that you rated, are you?
A: No, and I go one step further to say no one did do (sic) anything wrong.
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... I have no explanation as to what caused her to have this problem in her arm, and I don’t think it’s anything that happened to her during the course of her surgery. It just is there. I can’t explain it. She’s got these symptoms. She has some pathology apparently from an EMG study, but I have no explanation for it.
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Well, again, you know, I’m taking this as something that I have no explanation for how it occurred. I don’t look at it as an injury — unless I can give a mechanism or someone can inform me of one, I don’t look at it as an injury. I look at it as something that developed without any explanation. ...
If plaintiffs own medical expert cannot explain the circumstances surrounding plaintiffs injuries, I doubt that a lay juror, armed only with his or her own common knowledge and experience, could find that plaintiffs injuries ordinarily would not have occurred in the absence of negligence.
I would affirm the trial court’s summary judgment in favor of defendants.

. See Hasemeier v. Smith, 361 S.W.2d 697, 701 (Mo.1962).