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Yeubanks v. Methodist Healthcare-Memphis Hospitals6/10/2003
causation is not enough; and when the matter remains one of pure speculation or conjecture or the probabilities are at best evenly balanced, it becomes the duty of the court to direct a verdict for the defendant . . . ." Id. (quoting Lindsey v. Miami Dev. Corp., 689 S.W.2d 856, 861 (Tenn. 1985)). Thus, the supreme court continued,
proof of causation equating to a "possibility," a "might have," "may have," "could have," is not sufficient, as a matter of law, to establish the required nexus between the plaintiff's injury and the defendant's tortious conduct by a preponderance of the evidence in a medical malpractice case. Causation in fact is a matter of probability, not possibility, and in a medical malpractice case, such must be shown to a reasonable degree of medical certainty.
Id. (quoting Lindsey v. Miami Dev. Corp., 689 S.W.2d at 861-62).
In the case at bar, both nurse Cohen and Dr. Swetnam testified that the care by the nurses at Le Bonheur fell below the established standard of care. Cohen's testimony did not address the issue of causation. Dr. Swetnam, however, was questioned on direct examination regarding how the nurses' failure to properly document Sarah's record impacted her. Dr. Swetnam stated:
in my opinion, if the documentation had been adequate, then maybe somebody would have picked up sooner that she, indeed, was in shock and that she was not stable and she should not have been in CAT scan. At that point, it's possible that things could have been revved up and a different track taken so that she could have gotten to the operating room where she needed to be.
(Emphasis added). Moreover, on cross-examination, Dr. Swetnam acknowledged that no assessment, evaluation, examination, or decision made for Sarah was based upon anything that was either included or not included in the nurses' documentation.
Based on this testimony, the trial judge stated:
. . . I think that Dr. Swetnam's opinion was speculative as to what might have happened, what might not have been observed by the doctors. . . . he opinion of Dr. Swetnam that the deviation from the standard of care in the recording does not approach the degree of medical certainty as to causation that in the Court's mind can make this a case of controversy for the jury.
The question is causation. I have listened to the entire trial testimony, I've read the pages cited from the testimony of Dr. Swetnam, I've looked back at my notes, and I do not find in any of that proof presented by [Yeubanks] that would rise to the level sufficient to send to the jury the issue of proximate cause with regard to the claimed deviations under the standard of care by the two nurses as it relates to the death of Sarah Anderson. . . .
We find no error in the trial court's decision. Accordingly, the trial court's grant of Le Bonheur's motion for directed verdict on the claim against it arising out of the actions of its nurses and Dr. Dunavant is affirmed.
Yeubanks also argues that the trial court abused its discretion in awarding discretionary costs because they were punitive in nature and because she is proceeding as a pauper.
Near the conclusion of the trial, Yeubanks filed a pauper's oath. Subsequently, the defendants who had already been voluntarily dismissed moved to recover costs in the amount of $76,710.74. See Tenn. R. Civ. P. 54.04(2), 41.04. After a hearing, the trial judge awarded $36,401.35 in discretionary costs. Such costs are awarded at the trial court's discretion, and the award will not be overturned unless it evinces an abuse of that discretion. Stalsworth v. Grummons, 36 S.W.3d 832, 835 (Tenn. Ct. App. 2001) (ci
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