May 29, 2022

The Connecticut Appellate Court held in its opinion dated February 4, 2022 that the trial court properly denied the defendant’s motion to set aside the over $3 million medical malpractice verdict, finding that the plaintiffs presented sufficient expert evidence for the jury to find that nurse Lapaan caused the perforation of plaintiff Bruce Cockayne’s rectum, as Lapaan administered an enema during the time frame in which the perforation likely occurred; an expert physician testified that the perforation was caused by the administration of an enema with excessive force and indicated that one of the nurses had caused it; and, a registered nurse, one of the plaintiffs’ experts, testified that nurse Kayne or Lapaan had used improper technique in administering the enemas and indicated that Lapaan had caused the perforation, although she later clarified her statement to indicate that she could not determine which individual nurse bore sole responsibility for causing the perforation.

The Underlying Facts

The plaintiffs, Bruce Cockayne and his wife, sought to recover damages from the defendant hospital for injuries Bruce allegedly sustained while he was receiving treatment from the defendant’s employees. Over a three day period, two of the defendant’s nurses, Kayne  and Lapaan, administered medication to Bruce rectally via enema a total of three times. On the day following the final administration, a physician discovered that Bruce’s rectum had been perforated. As a result, Bruce developed a necrotizing infection and sepsis, his health deteriorated, and he required multiple medical procedures.

At trial, after the plaintiffs had rested, the defendant hospital moved for a directed verdict, claiming that the plaintiffs had failed to present an evidentiary basis as to when the perforation occurred, which of the defendant’s employees had breached the applicable standard of care, and whether the tip of the enema was capable of causing the perforation. The trial court reserved its decision on the motion and permitted the issues to be submitted to the jury. The jury returned a verdict in favor of the plaintiffs and the defendant filed motions for judgment notwithstanding the verdict and to set aside the verdict. The trial court denied both motions and the defendant hospital appealed to the Connecticut Appellate Court.

The Connecticut Appellate held: “We conclude that the plaintiffs presented sufficient evidence for the jury to find that Lapaan caused the perforation. Korsten [plaintiff’s expert] testified that the administration of an enema with excessive force caused the perforation. The plaintiffs presented evidence that Lapaan, in the course of her employment duties and care of Bruce Cockayne, administered an enema on February 13, 2014, during the time frame in which the perforation likely occurred. Korsten initially testified regarding his uncertainty as to which nurse, Kaine or Lapaan, caused the perforation. On specific cross-examination, however, he stated that Kaine was more likely to have caused the perforation. He later clarified, however, that he had not previously considered which nurse was more likely responsible and that, regardless, one of the nurses had caused the perforation. Viewing the totality of his testimony, we conclude that the jury could have determined that, in Korsten’s view, Kaine was more likely to have caused the perforation, but he did not exclude Lapaan. Moreover, the jury was not required to accept any specific portion of Korsten’s testimony … The jury, therefore, could have credited his testimony that the administration of an enema by Lapaan caused the perforation in this case and that such perforation was the result of negligence.”

“[W]e conclude that the use of a differential diagnosis in the present case was proper and sufficient to establish the plaintiffs’ theory of causation; that is, that the defendant’s employees caused the perforation suffered by Bruce Cockayne during his February, 2014 hospitalization.”

“[W]e conclude that the plaintiffs presented sufficient expert evidence for the jury to find that Lapaan caused the perforation of Bruce Cockayne’s rectum. In considering the testimony from the plaintiffs’ experts, the jury reasonably could have determined that there was a reasonable probability that Lapaan’s conduct was a substantial factor in causing the perforation. On the basis of this evidence, the court properly denied the motion to set aside the verdict, and the defendant’s claim that the jury improperly was permitted to consider a theory of negligence unsupported by the evidence must fail. The judgment is affirmed.”

Source Cockayne v. The Bristol Hospital Incorporated, AC 44241.

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