In its opinion filed on December 5, 2019, the Supreme Court of Mississippi (“Mississippi Supreme Court”) affirmed the directed verdict the trial court had entered in favor of the defendant neurosurgeon in a Mississippi medical malpractice case where the plaintiff alleged the defendant’s negligence during spine surgery caused her to wake up from the surgery suffering from quadriparesis, and then negligently performed a second surgery that did not help.
On July 14, 2011, the plaintiff went to the emergency room with complaints of extreme pain and was diagnosed with a severe cord compression in her spine. The defendant neurosurgeon recommended surgery due to her deteriorating condition. On July 17, 2011, the defendant neurosurgeon performed a fusion of the plaintiff’s cervical vertebrae, and she awoke suffering from quadriparesis. A second surgery intended to help the plaintiff did not fully resolve her condition.
The plaintiff’s Mississippi medical malpractice lawsuit alleged that a drop in her blood pressure during the first surgery caused the injury, and that the defendant neurosurgeon had failed to properly manage her mean arterial blood pressure during the first surgery. The plaintiff further alleged that the defendant neurosurgeon was negligent in conducting the second surgery.
The trial court directed a verdict in favor of the defendant neurosurgeon, finding that the plaintiff’s medical expert’s testimony regarding the standard of care and causation was unreliable and therefore struck it. The trial court then found that the plaintiff failed to offer admissible proof from which a reasonable juror could find that the defendant neurosurgeon had deviated from an objective standard of care. The plaintiff appealed.
Mississippi Supreme Court Opinion
The Mississippi Supreme Court stated, “When an expert offers an opinion that is challenged by the opposing party using published and peer reviewed data, the expert must support their opinion with some evidence that the opinion is accepted in the scientific community.” The plaintiff’s expert primarily relied on an article entitled Prevention, Identification, and Treatment of Perioperative Spinal Cord Injury by Henry Ahn and Michael Fehlings, which was published in the journal Neurosurgery Focus in 2008. The article, however, indicates that further studies are necessary. The article further suggests that no standard of care has been established for managing mean arterial pressure during neurosurgery: “No ideal MABP has been determined.”
The defendant neurosurgeon provided several articles refuting the plaintiff’s expert’s opinion. The articles indicated that there is no set standard of care for a preferred range for mean arterial pressure during spinal surgery. The plaintiff’s expert argued that these articles are not relevant, because they pertain to situations where the spinal cord was already injured; however, the articles cover a broad range of surgeries.
The Mississippi Supreme Court held: “During the voir dire, [the plaintiff’s expert] failed to adequately support his expert opinion related to the first surgery. [The plaintiff’s expert] admitted that “my opinion does not establish the standard of care.” Based on the deferential abuse-of-discretion standard of review and [the plaintiff’s expert’s] inability to articulate a specific standard of care, the trial court did not abuse its discretion by striking the testimony of [the plaintiff’s expert] and properly granted a directed verdict in favor of [the defendant neurosurgeon] with regard to the first surgery.”
The Mississippi Supreme Court further held: “[the plaintiff’s expert] admitted that the decision to perform the second surgery was really just a judgment call and that other neurosurgeons could have different opinions. He did not testify that the decision to perform the second surgery was a breach of the standard of care. Thus, the trial court directed a verdict in favor of [the defendant neurosurgeon] with regard to the second surgery … The law will not hold a physician liable for every bad result; some evidence of a violation of an objective standard of care must be shown … [The plaintiff] failed to articulate that the objective standard of care was breached with respect to the second surgery, thus failing to establish her prima facie case. The trial court did not abuse its discretion in striking the testimony of [the plaintiff’s expert] and properly granted a directed verdict in favor of [the defendant neurosurgeon] with regard to the second surgery.”
Source Thomas v. Lewis, No. 2017-CA-01169-SCT.
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