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Walker v. Giles11/18/2005
ty Hosp. Auth., 145 Ga. App. 113, 114 (243 SE2d 269) (1978). This appellants were able to do through the expert testimony that they offered at trial.
Appellees do not challenge appellants' further contention that they presented expert testimony showing to a reasonable degree of medical certainty that Walker's ruptured appendix caused her septic infection, which caused her to develop ARDS, which caused her to require mechanical ventilation, which caused her to have a stroke, leading to cognitive and physical deficits. However, appellees do contend that appellants failed to present any evidence of a causal link between Walker's ruptured appendix and the subsequent loss of her fetus.
After reviewing the record, we disagree. Dr. Williams testified about the effects that a ruptured appendix can have on a fetus:
nce the appendix has perforated, then the infection is loose in the abdomen. It causes an inflammatory process in the peritoneum, which is the lining of the abdominal cavity. That can set up a seeding to the blood stream which can cause a mother to become septic. With that released infection in the abdomen, it irritates the uterus causing the uterus to then respond and there's a potential for premature labor and premature delivery of a fetus.
Dr. Williams opined that because of the threat it poses to a pregnancy, intra-abdominal infections " ost definitely [require] surgical intervention." Dr. Williams, who had reviewed Walker's medical records, went on to testify that it was her professional medical opinion that Walker's fetus in this case would have survived, had Walker's appendix been removed prior to rupture.
COUNSEL: Dr. Williams is it your opinion that had surgery taken place before rupture of Kim's appendicle abscess that their baby would have survived?
DR. WILLIAMS: Yes, that is my opinion.
Additionally, the medical records admitted at trial reflect that an obstetrical ultrasound of Walker's fetus was ordered by the emergency room physician early Saturday morning (prior to when Walker's appendix ruptured according to the expert testimony offered by Dr. Tobin ), and Dr. Williams testified that the ultrasound reflected no acute findings at that time. It was not until later on early Sunday morning - in the window of time in which Dr. Tobin opined that Walker's appendix ruptured - that Walker's membranes ruptured, evidencing a pregnancy problem and leading Dr. Gingrey to note in his progress notes that a spontaneous miscarriage was "anticipate ." .
The expert opinions provided by Dr. Williams, combined with the medical records introduced at trial when viewed in light of Dr. Tobin's expert testimony concerning the time line for when Walker's appendix ruptured, created a genuine issue of material fact as to whether the rupture of Walker's appendix caused the death of her fetus. Causation may be established by linking the testimony of several different experts. See Sinkfield v. Oh, 229 Ga. App. 883, 886-887 (2) (495 SE2d 94) (1997). Furthermore, whether or not a genuine issue of fact has been created with regard to causation must be determined in light of the evidentiary record as whole. See id.
Accordingly, for all these reasons, we cannot say that appellants failed to create a genuine issue of fact as to whether appellees' alleged deviations from the standard of care caused Walker's physical and cognitive deficits and the loss of her fetus. To the extent that the trial court based its decision to grant a directed verdict on this ground, the trial court's decision was erroneous.
2. Proximate Cause
"The requirement of proximate cause constitutes a limit on legal li
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