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Christensen v. Munsen2/10/1994
nformed the court that Dr. Mills might express expert opinions. On May 8, the trial court entered an order indicating that it would reserve, until the time of trial, the decision as to whether Dr. Mills would testify. On June 4 and June 20, the defendant again indicated his intent to have Dr. Mills testify as to expert opinions. After reciting these facts, the trial court concluded that the substitution of Dr. Drance by Dr. Mills was permissible:
It appears to me that the plaintiffs have known about Dr. Mills for a considerable period of time. He is a treating physician. They are free to talk to him at any time and arrange informal discovery. His opinions were evident to them as of March 28, 1991 and they were free to follow up on those if they chose to.
Report of Proceedings (June 24, 1991), at 30. When plaintiff pursued her objection, the court responded that she had shown no prejudice resulting from the decision to call Dr. Mills. Plaintiff cites no authority to show that the trial court abused its discretion in concluding that the switch from Dr. Drance to Dr. Mills did not prejudice her case. We conclude that the trial court properly allowed Dr. Mills to testify regarding medical facts and causation opinions and that his testimony neither violated the trial court's orders nor impermissibly prejudiced the plaintiff's case.
II
Plaintiff next argues that the trial court erred in denying her motion to limit closing argument concerning a possible cause of her eye pressure increases. Before closing arguments began, plaintiff brought a motion in limine seeking to prevent the defense from arguing to the jury that an increase in aqueous humor production caused by the steroid's suppression of inflammation could have caused plaintiff's eye pressure increases. The plaintiff argued that while two experts had testified regarding such a theory, the theory's application to her was pure speculation.
The court denied the plaintiff's motion, pointing out that it had instructed the jury that the remarks, statements, and arguments made were intended to help the jury understand and apply the law. The jury was further instructed that "you should disregard any remarks, statement or argument that is not supported by the evidence or the law as given to you by the judge." Report of Proceedings (July 8, 1991), at 17. The court added that it would be up to the jury to decide which party was correct and which had the more plausible explanation for the testimony.
An attorney's argument may include reasonable inferences from the evidence admitted at trial. State v. Ciskie, 110 Wash. 2d 263, 283, 751 P.2d 1165 (1988); State v. Hunter, 35 Wash. App. 708, 715, 669 P.2d 489, review denied, 100 Wash. 2d 1030 (1983). At trial, two ophthalmologists testified that the reduction of inflammation caused by steroids could cause increased aqueous humor production and an increase in eye pressures. Defense counsel was properly allowed to refer to this testimony during closing argument as a possible explanation of plaintiff's eye pressure increases.
III
Plaintiff next contends that the trial court erred in refusing her proposed instructions regarding standard of care and informed consent. At trial, plaintiff introduced a study which found elevated eye pressures following only 1 of 3,000 steroid injections. Plaintiff's reason for introducing the
study was that it cited a series of cases showing that Kenalog caused elevated pressures more often than other steroids. The defense pointed out, however, that other parts of the s
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