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Hackman v. Christiana Care Health Services11/15/2004
Submitted: September 8, 2004
Upon appeal from the Superior Court. AFFIRMED.
In this appeal, we consider whether the Superior Court erred in excluding expert testimony in a medical malpractice case. Appellant's expert was prepared to testify that it would have been a breach of the applicable standard of care if the appellee surgeon had punctured the patient's duodenum during surgery. But there was no evidence that the surgeon did puncture the duodenum, and even appellant's expert did not believe that the perforation that later proved fatal to the patient occurred during the surgery. Given these facts, we conclude that the trial court acted within its discretion in excluding the disputed expert testimony. Since appellant had no other medical expert to opine that there was a breach of the standard of care, the trial court properly granted the surgeon's motion for judgment as a matter of law.
Factual and Procedural Background
On November 24, 1998, William J. Schickler, M.D., a board certified vascular surgeon, operated on Charles Hackman to repair an abdominal aortic aneurysm. Due to the size and location of the aneurysm, the surgery took almost ten hours, twice as long as expected. Schickler had to use surgical scissors to separate the duodenum, which is part of the bowel, from the aorta. There were no reported complications immediately following the surgery.
The next day, Schickler examined Hackman, and saw no evidence of bleeding. Hackman's vital signs were stable and his femoral pulses indicated that the aortic repair was functioning properly. That evening, Schickler went off-call for Thanksgiving. For the next five days, Hackman was transferred to the care of surgical residents at Christiana Care Health Services, Inc. and Bruce A. Fellows, M.D., also a board certified vascular surgeon. By Saturday, November 28th, Hackman was suffering increased pain, labored breathing, difficulty speaking, and abdominal swelling and tenderness. The attending physician believed that Hackman had developed pneumonia, which is not an unusual complication. On the evening of November 29th, Fellows telephoned Schickler and reported that Hackman had been placed back on a ventilator because he had developed pneumonia. Fellows reported no evidence of a breakdown of the bowels or any other abdominal problem.
When Schickler returned on November 30th, he immediately recognized serious deterioration in Hackman's condition. Hackman had no bowel sounds, his abdomen was distended, and he was complaining of significant abdominal pain. Schickler called Dr. Zern, a general surgeon, to perform emergency surgery. During that surgery, Zern and Schickler found bile-stained fluid in the abdomen and a hole in the duodenum. Zern attempted to repair the perforation, but due primarily to the level of infection and leakage that had already occurred, the repair failed.
On December 3rd, Zern attempted a second repair of the duodenum, but Hackman's condition continued to deteriorate. He remained in the Christiana Care hospital, undergoing multiple procedures, until February 10, 1999, when he was transferred to the University of Pennsylvania hospital for further abdominal surgery. Dr. Jeffrey Carpenter performed emergency surgery that day, but Hackman died on the operating table.
Hackman's wife and son filed suit against Schickler, his professional corporation, Vascular Consultants, Christiana Care Health Services Inc., Fellows, and his professional corporation, Vascular Surgery Associates. Appellants alleged that Schickler negligently: (1) perforated Hackman's duodenum during the November 24th surgery; and (2) failed to leave adequate instructions for the o
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