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Hackman v. Christiana Care Health Services11/15/2004
ther attending physicians during the period that Schickler was on vacation. They also alleged that the hospital and its attending physicians should have detected the duodenal perforation before the November 30th emergency surgery, in light of symptoms that were apparent no later than November 29th.
On the first day of the trial, Schickler moved to exclude certain testimony of Dr. Novin, appellants' only medical expert. Novin was prepared to testify that, although he did not believe that Schickler had done so, if Schickler had perforated the bowel during the November 24th surgery, then that would have been a breach of the standard of care. The trial court granted Schickler's motion, reasoning that Novin's testimony was merely hypothetical, since there was no evidence that the perforation occurred during that surgery. The court concluded that the testimony would be unduly prejudicial and confusing.
The trial court also excluded Carpenter's Report of Operation. The Report, which had been admitted into evidence without objection, included a statement that," here was a duodenal injury at the time of the aneurysm repair, which went unrecognized; and patient developed abdominal sepsis." As appellants' counsel was asking Schickler to read that sentence, appellees objected on hearsay grounds and the objection was sustained.
At the close of all the evidence, the trial court granted Schickler's motion for judgment as a matter of law. The court found that there was no evidence from which a jury could find that Schickler's alleged lack of instructions to the other attending physicians caused any harm. The jury returned verdicts in favor of the remaining appellees. This appeal followed.
DISCUSSION
In order to survive a motion for judgment as a matter of law, appellants must produce medical expert testimony that specifies (1) the applicable standard of care, (2) the alleged deviation from that standard, and (3) the causal link between the deviation and the alleged injury . Appellants attempted to meet this burden by having Novin testify that, if Schickler had perforated the duodenum during the November 24th surgery, Schickler would have breached the applicable standard of care. Appellants then intended to rely on other evidence, including Schickler's admissions, to establish that he did, in fact, puncture the duodenum. There was no dispute about the fact that the perforated duodenum caused the serious injuries that culminated in Hackman's death.
Having excluded Novin's surgery standard of care testimony, the trial court did not even consider the negligent surgery claim when ruling on Schickler's motion for judgment as a matter of law. The trial court found that the remaining claim -- that Schickler negligently failed to provide Fellows with enough information about Hackman's condition after the surgery -- was unsupported in the record. Accordingly, the trial court granted Schickler's motion for judgment as a matter of law.
Appellants did not appeal the decision on the "lack of information" claim, and they only suggest in passing that the surgery claim remained viable despite the exclusion of Novin's testimony. The crux of their appeal is that Novin's testimony should have been allowed. They argue that Novin's testimony, combined with the note in Carpenter's report and Schickler's trial testimony, provided enough evidence to defeat a motion for judgment as a matter of law. We disagree.
Viewing the evidence in the light most favorable to appellants, one could conclude that Schickler "nicked" or "bruised" the duodenum during the first surgery. There is no evidence, however, that Schickler punctured it. This distinction is critica
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