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Guffey v. Columbia/Colleton Regional Hospital4/25/2005
itted to the hospital rather than discharged, he "more than likely would have survived." Wood testified "people have heart attacks and get hospitalized for it all the time, and, you know, these are general statistics, but probably ninety percent of people that get hospitalized with heart attacks live." A reasonable inference which may be drawn from this testimony is if Decedent had seen his cardiologist the next morning as directed by King, he could have been admitted to the hospital where he most likely would have survived his heart attack.
The expert's testimony that the proximate cause of Decedent's death was the lack of hospitalization at the time of his cardiac arrest was sufficient to submit to the jury the issue of Hospital's negligence, regardless of whether the lack of hospitalization occurred on the night of his visit to the emergency room or the morning after. Therefore, liberally construing the evidence Decedent did not return to his cardiologist the next morning as directed by King, Hospital gave Decedent discharge instructions stating he should wait two days to see his family doctor, and expert testimony he most likely would have survived had he been hospitalized at the time of his heart attack, it is reasonably probable a verdict would have been rendered in Appellant's favor had the jury been allowed to consider negligence allegations relating to the conflicting discharge instructions.
In addition, the record contains circumstantial evidence Decedent relied on Hospital's written discharge instruction (call family doctor "in 2 days if not much better. Call sooner if worsening.") instead of King's verbal instruction (see cardiologist the next morning). Appellant testified Decedent stated on September 3 he did not need to return to the hospital because, although King had told Decedent he would have a "terrible headache" from the nitroglycerin, he expected to "be better in a day or two." Thus Decedent told his wife he needed to give his condition a couple of days to improve - just like Hospital told him to do in its written discharge instructions. See e.g. Mahaffey v. Ahl, 264 S.C. 241, 247, 214 S.E.2d 119, 122 (1975) ("it is axiomatic in this State that issues of negligence and proximate cause may be resolved by direct or circumstantial evidence").
In pointing to circumstantial evidence surrounding Decedent's actions, I do not suggest expert testimony is not usually required to prove medical malpractice. I do conclude that expert testimony identifying the lack of hospitalization as a proximate cause of Decedent's death, combined with circumstantial evidence Decedent may have relied on discharge instructions in which he was not told to follow up promptly with a cardiologist who may have admitted him to the hospital before he suffered a fatal heart attack, are sufficient to create a jury question on whether Hospital and its admitted agent were negligent. See Green, 272 S.C. at 189-93, 249 S.E.2d at 912-13; Shelnitz, 509 A.2d at 1027.
II. EXCLUSION OF PLAINTIFF'S EXHIBITS PERTAINING TO DISCHARGE INSTRUCTIONS
Appellant contends the trial court committed prejudicial error in striking from evidence two exhibits relating to discharge instructions provided by Hospital and prohibiting testimony about those instructions. I agree.
The document titled "Aftercare Instructions," discussed above, was admitted in evidence by Appellant as Exhibit 18D. This document instructed Decedent to call his family doctor if he was not feeling better in two days. Appellant also offered Exhibit 22, which set forth Hospital's policies regarding discharge instructions. Based on its earlier, directed verdict ruling that Appellant had failed to present expert test
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