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Copass v. Monroe County Medical Foundation9/21/2001
As amended November 21, 2001.
TO BE PUBLISHED
OPINION REVERSING AND REMANDING
The Appellants are Duane Copass ("Copass") and Ruth Copass, his wife. Duane Copass became paralyzed as the result of an epidural bleed and hematoma which occurred during his convalescence from back surgery. The Copasses raise three issues on appeal claiming (1) the trial court abused its discretion by refusing to allow Copass's expert, Dr. Ravenscraft, to testify about the standard of care; (2) the trial court erred in concluding that if the jury had found the emergency room physician to be negligent, such negligence would have been too remote in time to constitute a causative factor; and (3) the trial court erred in directing a verdict against plaintiffs for failing to meet their burden of proof on standard of care.
On September 17, 1992, Copass underwent a lumbar fusion performed by Dr. Glassman in Louisville, Kentucky. Following his discharge from the hospital, Copass returned home to Tompkinsville. On the afternoon of Saturday, September 26, 1992, Copass experienced sudden, severe low back pain uncontrolled by medication. He was unable to urinate. Copass was taken by ambulance to Monroe County Medical Center in the early morning of Sunday, September 27, 1992.
Copass was seen in the emergency room by Dr. Steven Jensen, a urology resident, who had been licensed to practice medicine for three months. At the time, Dr. Jensen was moonlighting through National Emergency Services, Inc., which had contracted with the Medical Center to provide physicians to work in the E.R. Dr. Jensen drained Copass's bladder using a catheter and consulted with Dr. Kenneth Crabtree, Copass's family physician, by phone. Dr. Crabtree admitted Copass to the Medical Center. Approximately 26 hours after Copass's admission, his lower extremities became permanently paralyzed.
Dr. Jensen testified that he completed four years of medical school at the University of Utah and a one-year general surgery internship at the University of Kentucky (July 1991 to July 1992) before entering the urology (residency) program. Interns work under the supervision of an attending physician and are not licensed to practice medicine. During his internship, Jensen had rotated through different fields of surgery. Jensen told the jury that complications can occur with any type of surgery. As an intern, he would inform surgery patients of possible surgical complications using a standard form devised by the University. Jensen named several categories of surgical complications: death, respiratory complications, bleeding, infection, bowel difficulties, urinary retention/incontinence, pain and clots.
The Copasses contend that Dr. Jensen failed to recognize the signs and symptoms of a surgical complication -- an epidural hematoma -- when he saw Copass in the E.R. They further contend that had Dr. Jensen done so he could have transferred Copass to a surgeon in time to evacuate the hematoma, which would have prevented paralysis. According to Dr. Jensen, the Medical Center did not have MRI or myelogram capabilities, nor did it have a neurologist or neurosurgeon on call in September 1992.
At trial, the Copasses called Dr. Howard Ravenscraft as their expert witness to testify about the standard of care that Dr. Jensen should have exercised. Dr. Ravenscraft's discovery deposition had previously been taken. Dr. Ravenscraft testified at trial about his education, training and experience. A graduate of the University of Louisville School of Medicine, Dr. Ravenscraft, began practicing in 1956 and practiced continuously until his retirement in May 1998. He testified that he has more than 42 years of "
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