Court Opinion

ID: 9674277
Source: CourtListenerOpinion
Date Created: 2023-08-24 04:25:53.087013+00
Date Added: 2024-06-11T18:16:26.564098
License: Public Domain

REID, Chief Justice,
concurring.
This medical malpractice case, in which the plaintiffs allege that the defendant negligently failed to diagnose breast cancer, presents for review the trial court’s award of summary judgment, affirmed by the Court of Appeals, finding that the record does not establish a disputed issue of fact as to causation. This Court’s review shows that the affidavits filed by the plaintiffs, Sandra K. Kilpatrick and William Kilpatrick, are sufficient to withstand summary judgment as to the plaintiffs’ claim for bodily injury, including pain and suffering, disfigurement, medical expenses, loss of earning capacity and loss of consortium, but not as to a claim for loss of a better chance of survival or an increase in the risk of harm.
The complaint alleges that the defendant Dr. James W. Bryant examined the plaintiff Ms. Sandra Kilpatrick in May 1987 and detected a lump in her right breast. He scheduled a mammogram, which was performed later that month. Ms. Kilpatrick alleges that Dr. Bryant advised her that the results of the mammogram were negative and that he did not suggest she “should participate in any type of follow-up treatment except on a routine basis.” Four months later, in September 1987, Ms. Kilpatrick was examined by another physician, who diagnosed cancer in the right breast and promptly performed a right radical mastectomy for its removal.
The complaint alleges Dr. Bryant was negligent in relying on the findings of the radiologists in May 1987, and in his failure to advise Ms. Kilpatrick of the need for a follow-up examination. The complaint also avers that “as a direct and proximate result of his negligence, the Plaintiff, Sandra Kilpa-trick, suffered more serious complications and a general worsening of her cancerous condition as a result of her cancer going undetected for approximately four months,” requiring her to “seek additional medical treatment ... at additional expense, pain and suffering to the Plaintiffs; and that the worsened medical situation mentioned herein-above may also be life-threatening.” The complaint asserts that as a result, Sandra Kilpatrick “suffered loss of earning capacity, she has been rendered ill, sometimes disabled, and is unable to engage in the useful and enjoyable pleasures of life, all as a direct and proximate result of [Dr. Bryant’s] negligence.” It further alleges that the patient’s husband, William Kilpatrick, has been deprived of the services, society, and consortium of his wife. In his answer, Dr. Bryant denies that he violated the applicable standard of care and further denies that the consequences which the plaintiff suffered were caused by any violation of the applicable standard of care.
The case is before the Court on this second defense, raised in a motion for summary judgment, the denial of any causal connection between the negligence alleged and the damages alleged. The plaintiffs, in opposition to the defendant’s motion for summary judgment, filed affidavits made by James A. Schell, M.D., and Lee Morisy, M.D. Dr. Schell states in his affidavit that he is familiar with the recognized standard of care for physicians in Memphis, Tennessee, and the care and treatment of patients with suspected breast cancer. He further states that based upon a review of the medical record pertaining to the treatment of the plaintiff, Sandra Kilpatrick, it is his opinion that the defendant failed to meet the accepted stan*605dard of medical care. In Ms affidavit, Dr. Morisy states that he operated on Ms. Kilpa-trick, for carcinoma of the right breast and performed a modified radical mastectomy. He further stated, specifically:
I am of the medical opinion, based on a reasonable degree of medical certainty, that the delay of four (4) months in the operation performed increased the likelihood of Ms. Kilpatrick suffering irreparable damage.
No other evidence was produced by either party.
The requirements for a successful medical malpractice action are stated in T.C.A. § 29-26-115 (1980). That statute provides, in part pertinent, as follows:
(a) In a malpractice action, the claimant shall have the burden of proving by evidence as provided in subsection (b):
(1) The recognized standard of acceptable professional practice in the profession and the specialty thereof, if any, that the defendant practices in the community in wMch he practices or in a similar community at the time the alleged injury or wrongful action occurred;
(2) That the defendant acted with less than or failed to act with ordinary and reasonable care in accordance with such standard; and
(3) As a proximate result of the defendant’s negligent act or omission, the plaintiff suffered injuries which would not otherwise have occurred.
Under tMs statute, a plaintiff is entitled to recover if the plaintiff proves negligence on the part of the physician, and, to a reasonable degree of medical certainty, the negligence was the proximate cause of the plaintiffs damages. See e.g., White v. Methodist Hosp. South, 844 S.W.2d 642, 648-49 (Tenn.App.1992).
At issue in tMs case, is whether the plaintiffs presented sufficient proof, in response to the motion for summary judgment, to create a disputed question of fact. Under Byrd v. Hall, 847 S.W.2d 208 (Tenn.1993),
When the party seeking summary judgment makes a properly supported motion, the burden then shifts to the nonmoving party to set forth specific facts, not legal conclusions, by using affidavits or the discovery materials listed in Rule 65.03, establishing that there are indeed disputed, material facts creating a genuine issue that needs to be resolved by the trier of fact and that a trial is therefore necessary.... The evidence offered by the nonmoving party must be taken as true.
Id. at 215. In order to establish causation, a plaintiff must show that, in the absence of the defendant’s negligence, it is more probable than not that the injury of wMch the plaintiff complains would not have occurred. Lindsey v. Miami Development Corp., 689 S.W.2d 856, 861-62 (Tenn.1985).
Consequently, in order to withstand a motion for summary judgment, the plaintiff must prove a causal relationsMp between the negligence alleged and the injury alleged. Also, the condition for wMch recovery is sought must constitute an injury for wMch damages may be recovered under Tennessee law. In tMs case, the plaintiffs contend that the harm sustained includes the loss of a better chance of survival. That alleged injury is described in the complaint as follows:
that likewise, as a direct and proximate result of Ms negligence, Plaintiff, Sandra K. Kilpatrick, suffered more serious complications and a general worsening of her cancerous condition as a result of her cancer going undetected for approximately four months.
And further:
the worsened medical situation mentioned hereinabove may also be life-threatening.
Assuming that these allegations are sufficient to state a claim for “loss of a better chance of survival” and/or “increase in the risk of harm,” the plaintiff is entitled to go to trial with regard to only compensable injuries encompassed within the physicians’ affidavits. The affidavits support causation of the traditional damages incident to bodily injury. However, Dr. Morisy’s affidavit provides no support for any claim other than that for bodily injury. He merely attests to the “likelihood” of “irreparable damage.” “Likelihood” means “probability” or “the quality or fact of being likely or probable.” *606The Oxford English Dictionary 948 (2d ed. 1989). The term, which may be read to mean “more likely than not,” asserts legal proximate causation. However, the phrase “irreparable damages” is less than precise. Since the plaintiff does not undertake to assert a claim for wrongful death, it is only another way of claiming permanent bodily injuries.
The further issue, then, is whether “loss of a better chance of survival, or an increase in the risk of harm” (loss of chance) is recognized as a bodily injury under Tennessee law. If it is an injury for which damages may be recovered, the motion for summary judgment must be denied because the complaint and the medical affidavit assert that “as a proximate result of the defendant’s negligent act or omission, the plaintiff suffered injuries which would not otherwise have occurred.” T.C.A. § 29-26-115(3).
It should be noted that even though the measure of damages is discussed in the traditional context of damages for bodily injury or death, the essential nature of the “injury” is chance or risk. The main opinion finds lack of causation because the proof does not show that the plaintiff “had a better than even chance of surviving or recovering from the underlying condition absent the physician’s negligence.” Supra at 602. The dissent would follow Perez v. Las Vegas Medical Center, 107 Nev. 1, 805 P.2d 589, 592 (1991) and discount the amount recoverable for the person’s wrongful death, but find,
Specifically “[the] amount of damages recoverable is equal to the percent of chance [of survival] lost [due to negligence] multiplied by the total amount of damages which are ordinarily allowed in a wrongful death action.”
Daughtrey, J., dissenting at 613 (quoting Perez v. Las Vegas Medical Center, 805 P.2d at 592). Under this formulation of the claim as a statistical probability, neither the plaintiffs complete recovery nor her death would affect the damages awarded. Recognizing loss of chance as an injury for which damages may be awarded would, at least in principle, revolutionize the traditional concept of bodily injury. And further, as stated by Chief Justice Phillips in Kramer v. Lewisville Memorial Hospital, 858 S.W.2d 397, 406 (Tex.1993),
assuming we adopt the loss of chance doctrine in the context of this medical malpractice action, it is doubtful that there is any principled way we could prevent its application to similar actions involving other professionals.
Accordingly, I concur that summary judgment as to the plaintiffs’ claims for damages for bodily injury be reversed and summary judgment, to the extent that the plaintiffs seek damages for loss of a better chance of survival or an increase in the risk of harm, be sustained.