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Guffey v. Columbia/Colleton Regional Hospital4/25/2005
Opinion
Heard November 18, 2004
AFFIRMED
Appellant commenced this wrongful death action as personal representative of her husband's estate alleging medical malpractice. She appeals a directed verdict and the exclusion of evidence. We affirm.
FACTS
James Guffey (Decedent) suffered cardiac arrest at age fifty on September 3, 1997, twenty-five hours after he was discharged from the emergency room at respondent Columbia/Colleton Regional Hospital (Hospital). Decedent had previously undergone two angioplasty surgeries in 1995 to treat unstable angina and subsequently was on medication, including nitroglycerin as needed for pain. He had a check-up every month with his cardiologist, Dr. Reeves.
Two years after his surgeries, on September 2, 1997, Decedent came home early from work complaining of a headache and indigestion. During the course of the evening, Decedent took three doses of nitroglycerin. Finally, at about 11:00 p.m., Decedent said he needed to go to the hospital because he "felt like he did the last time," referring to his 1995 cardiac episode. At Hospital's emergency room, Decedent was treated with nitroglycerin paste and discharged by Dr. William King.
Decedent stayed in bed the next day still complaining of headache and indigestion. During the night, he suffered cardiac arrest. He was brain-dead by the time he arrived at the hospital and died several days later.
Dr. King testified he had attempted to contact Decedent's cardiologist, Dr. Reeves, while Decedent was at the emergency room. The call was answered by Dr. Reeves's associate, Dr. Grayson. Dr. Grayson told Dr. King that it was reasonable to send Decedent home but to have him see Dr. Reeves in the morning. Dr. King told Decedent to return to the emergency room if he had pain during the night and if he had no pain, he should call Dr. Reeves's office in the morning for an appointment. Decedent did not seek further medical care before suffering cardiac arrest the next night.
Appellant's medical expert, Dr. Wood, testified that Decedent's symptoms indicated he had unstable, as opposed to stable angina, and therefore he should not have been discharged from the emergency room. Dr. Wood testified that the pain caused by stable angina is relieved with nitroglycerin whereas the pain from unstable angina is not. Decedent's history taken at the emergency room indicated he had "relief of the chest pain but still had tightness in his chest." From this history, Dr. Wood concluded Decedent was suffering unstable angina. It was his opinion that Dr. King deviated from the standard of care in not admitting Decedent to the hospital.
Hospital's medical experts, on the other hand, testified Decedent's symptoms indicated he had stable angina because he did have pain relief from the nitroglycerin with only "residual tightness."
The jury returned a verdict for Hospital on the issue of Dr. King's negligence in failing to admit Decedent to the hospital.
ISSUES
1. Did the trial court err in granting a directed verdict regarding conflicting discharge instructions? 2. Did the trial court err in excluding evidence of conflicting discharge instructions?
DISCUSSION
1. Directed Verdict
Appellant accompanied Decedent to the emergency room. On cross-examination, she denied Decedent was told at the time of his discharge to contact his cardiologist, Dr. Reeves, in the morning. On re-direct, counsel referred to a document entitled "Aftercare Instructions" which Decedent was given by Hospital's staff when he was discharged. The document states: "THESE ARE YO
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