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Waterman v. Lanferman10/26/2005
Following an adverse jury verdict, plaintiffs appeal and assert the district court erred in excluding certain evidence. AFFIRMED.
Heard by Sackett, C.J., and Vogel and Eisenhauer, JJ.
David Waterman died on August 18, 2001, eighty-eight days after being diagnosed with lung cancer. In this medical malpractice action, Mr. Waterman's estate and surviving spouse allege Dr. Lonnie L. Lanferman failed to timely diagnose his lung cancer. A jury returned a verdict in favor of Dr. Lanferman, and the plaintiffs appeal. After considering the arguments of counsel and reviewing the record, we affirm the judgment of the district court.
Background Facts
Mr. Waterman first visited Morningside Family Practice on May 27, 1997. He was initially seen by Dr. Scott F. Gordon. At his initial office visit, Mr. Waterman complained of a cough that produced gray sputum and disclosed a family history of cancer. He was advised to quit smoking. A chest x-ray taken during his initial office visit had some "questionable abnormal findings," according to Dr. Gordon; however, the radiologist who read the film could find no evidence of active disease.
Dr. Lanferman saw Mr. Waterman on all subsequent visits. On November 18, 1999, Mr. Waterman complained of a cough producing blood-streaked mucus ("hemoptysis"). Dr. Lanferman indicated the blood in the mucus was likely caused by "irritation." On December 23, 1999, Mr. Waterman complained of "off and on" "right chest discomfort." Dr. Lanferman noted his patient's hemoptysis had resolved, and noted his right chest discomfort was "most likely musculoskeletal" due to lifting associated with his employment.
On May 15 and May 18, 2001, Mr. Waterman saw Dr. Lanferman, with complaints of right arm pain, pain in the flanks, weight loss, and chronic cough with hemoptysis. In his May 18 office note, Dr. Lanferman stated Mr. Waterman's hemoptysis was a result of a higher than necessary dose of an anticoagulation medicine, which Mr. Waterman required due to a heart valve replacement in 1981. On May 23, 2001, a CT scan revealed two masses in the right upper lobe of the lung. One mass was 3.0 cm in diameter, and the other measured 2.5 cm. This lung cancer had spread to Mr. Waterman's brain, right shoulder, back, and left hip. He died shortly thereafter.
The plaintiffs filed their petition on October 25, 2002. They assert Dr. Lanferman should have referred Mr. Waterman to a specialist for further diagnostic procedures, such as a CT scan or bronchoscopy, after the office visits in late 1999. They argue, had Dr. Lanferman done so, Mr. Waterman's cancer would have been discovered at a stage where he would have had a seventy percent chance of survival.
Dr. Lanferman designated Dr. William S. Shimp as one of his expert witnesses. In a letter to Dr. Lanferman's counsel dated on August 15, 2003, Dr. Shimp asserted that, in November 1999, the largest tumor had a "diameter of 0.76 cm," "might or might not have been visible" in a CT scan, and was "unlikely" to be "seen on bronchoscopy." Dr. Shimp arrived at his figures through extrapolation by (1) assuming Mr. Waterman's tumors doubled in size every twelve weeks, an assumption he described as a "best estimate," and (2) concluding that the time between November 1999 and May 2001 amounted to "a little over six doubling times."
The plaintiffs' expert witness was Dr. Dennis Citrin. In deposition testimony, he stated Dr. Lanferman should have referred Mr. Waterman to a specialist for a CT scan or bronchoscopy in November 1999. He stated that one would be able to identify a tumor of two millimeters in diameter on a CT scan. He further stated that a CT scan would h
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