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HCRA of Texas11/3/2005
I. Introduction
This is a nursing home liability case. The trial court rendered judgment on the jury's verdict for Appellees Margie Faye Johnston, Tommy Lloyd Johnston, Gary Wayne Johnston, and Douglas Lee Johnston, individually and on behalf of the estate of Lloyd Thomas Johnston, deceased (collectively Appellees or Johnstons) and against Appellant HCRA of Texas, Inc. The primary issues we address involve the sufficiency of the evidence to support the jury's damage awards and malice finding. Because we hold that legally insufficient evidence exists to support the jury's malice finding, we will reverse the judgment's exemplary damages award and render judgment that Appellees take nothing on their exemplary damages claim. Because the evidence is legally and factually sufficient to support the jury's damage findings, we will affirm the remainder of the trial court's judgment.
II. Factual Background
Lloyd Thomas Johnston, a seventy-one-year-old man, underwent bypass surgery and, as a result of complications from that surgery, was hospitalized for eighty-four days. During this time a feeding tube, a J-tube, assisted in feeding Lloyd. Lloyd was steadily recovering but needed additional rehabilitation. On May 21, 1999, the hospital discharged Lloyd to HCRA for rehabilitation.
Lloyd had colonized MSRA when he was admitted to HCRA. Lloyd initially made progress at HCRA. According to Lloyd's son, HCRA employees worked well with Lloyd and provided successful physical therapy rehabilitation to Lloyd; the family saw an improvement in Lloyd's mobility and strength about every two days. But around June 10, 1999, after approximately three weeks at HCRA, Lloyd's health took a turn for the worse. On June 15th, after twenty-five days at HCRA, Lloyd's condition had severely deteriorated; Dr. Aziz Klavon ordered Lloyd transferred immediately by ambulance to the hospital emergency room. Lloyd died less than twenty-four hours later. Lloyd's death certificate indicates that he died of multi-system organ failure secondary to sepsis, septic shock. Lloyd's death certificate listed ischemic colitis as a tertiary cause of death. Lloyd's family and experts presented evidence that at HCRA Lloyd was not properly cleaned or repositioned--causing him to develop decubitus ulcers, he was not properly nourished, he was not given his medicines, his urine output and body temperature were not measured, his room was not cleaned, and HCRA kept inadequate records and fabricated some records.
Appellees explain that their theory of the case at trial was that HCRA injured Lloyd "by, among other things, allowing the formation of decubitus ulcers, causing serious infection, and knowingly allowing [Lloyd] to lie unattended in his own excrement." HCRA's theory of the case was that Lloyd's sepsis and death were the result of a new and independent cause--ischemic colitis.
III. Procedural Background
The negligence special question submitted to the jury was segregated into two subparts: did HCRA's negligence proximately cause injuries to Lloyd and did the negligence of HCRA proximately cause the death of Lloyd. The trial court also gave the jury an instruction on new and independent cause. The jury determined that HCRA's negligence did proximately cause injuries to Lloyd and determined that $17,805 for medical expenses and $75,000 for physical pain and mental anguish would have fairly and reasonably compensated him for those injuries. The jury also found that HCRA's alleged negligence did not proximately cause Lloyd's death and, consequently, the jury did not answer any of the wrongful death damages questions.
The jury further found that HCRA's director
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