The Georgia Court of Appeals has affirmed a verdict in favor of the parents arising out of the death of a child born prematurely. In the case of Central Ga. Women’s Health Center v. Dean, Plaintiffs alleged that Dr. Henry Davis and Central Georgia Women’s Health Center were liable for failure to diagnose an incompetent cervix, leading to the premature delivery and death of their child. The jury returned a verdict of $4.5 million, but apportioned 50% of the fault to Dr. Davis. Defendants sought a directed verdict on causation and a motion in limine on Dr. Davis’ post-operative documentation. After verdict, the defendants sought JNOV, which was denied. The Court of Appeals affirmed.
Mrs. Dean became a patient of CGWHC at 6 weeks pregnant. She gave a history of two prior miscarriages and a loop electrosurgical excision procedure (LEEP), which put her at risk for an incompetent cervix. The first obstetrical provider ordered frequent ultrasounds throughout the pregnancy. At 22 weeks, an ultrasound showed a shortened cervical length and Ms. Dean was told to rest. Six days later, Mrs. Dean began to experience thick, dark vaginal discharge. She and her husband went to the emergency department at a local hospital. Along the way, they spoke with Dr. Davis and told him about Mrs. Dean’s history and the recent ultrasound. Dr. Davis told the Deans that the discharge was probably old blood and that the hospital would likely send them home. The Deans proceeded to the hospital, where she was examined by a nurse. The nurse called Dr. Davis, but he did not come to the hospital.
After discharge, Mrs. Dean continued to be symptomatic. In the early morning hours of the day after discharge, Mrs. Dean again called Dr. Davis to report the worsening symptoms. Dr. Davis asked Mrs. Dean to come to the office for a scheduled visit at 9:00 am. Mrs. Dean kept the appointment and was seen by a different provider, who recommended that Mrs. Dean see a maternal-fetal specialist that day. In between, Mrs. Dean was sent to the labor and delivery department at the hospital for complaints of increased pain. Mrs. Dean then went into premature labor and delivered the child at 23 weeks. The child then passed away due to extreme prematurity.
After delivery, Dr. Davis wrote two post-delivery notes about examining Mrs. Dean in the hospital. Mrs. Dean denied that Dr. Davis visited on the first day and Mr. Dean testified that a different provider was in the room that day. Dr. Davis later struck through the note to indicate it was written in error, indicating that Mrs. Dean was not in the room. The Deans testified they were in the room and a nursing note indicated they were. Dr. Davis also documented another note of an exam, which Mrs. Dean denied happened.
Causation – the question was whether Plaintiffs proved causation to a reasonable degree of medical probability. Plaintiffs’ expert testified that a “stitch would have saved this pregnancy” and resulted in a 2-4% better chance of survival each day the baby stayed in the womb. The Court held that despite some waffling by the expert, the inferences to be drawn were enough to survive directed verdict.
Motion in Limine – the Court held the trial court was within its discretion to allow cross-examination of Dr. Davis about the post-operative notes as indicative of his capacity to tell the truth under Rule 608. The Court held that the jury could determine whether Dr. Davis’s note “involved in deliberate deception rather than a simple mistake.”
The take-home from this case is that claimants can prove causation by multiple data points, not just single sentences from an expert witness. This is the prevailing trend on causation per the Court of Appeals, so causation attacks must address all of the data points, not just weak witness opinions.