United States Court of Appeals
Fifth Circuit
F I L E D
IN THE UNITED STATES COURT OF APPEALS
March 30, 2005
FOR THE FIFTH CIRCUIT Charles R. Fulbruge III
Clerk
No. 04-30368
PHYLLIS E. HOLLINGSHEAD; MICHAEL PATTERSON;
GERALD WAYNE PATTERSON, JR.,
Plaintiffs-Appellants,
versus
UNITED STATES OF AMERICA,
Defendant-Appellee.
Appeal from the United States District Court for
the Western District of Louisiana
(USDC No. 5:02-CV-1373)
_________________________________________________________
Before REAVLEY, DeMOSS and PRADO, Circuit Judges.
REAVLEY, Circuit Judge:*
In this medical malpractice case concerning the unfortunate death of Mr.
Patterson, Plaintiffs appeal the judgment in favor of the United States. We affirm for the
following reasons:
*
Pursuant to 5TH CIR. R. 47.5, the Court has determined that this opinion should
not be published and is not precedent except under the limited circumstances set forth in
5TH CIR. R. 47.5.4.
1. We review the district court’s findings of fact for clear error and its legal
conclusions de novo. Joslyn Mfg. Co. v. Koppers Co., 40 F.3d 750, 753 (5th Cir. 1994).
2. The parties agree that Louisiana substantive law governs. We believe the
district court correctly applied Louisiana law. The court understood that in a medical
malpractice case involving the death of a patient, Louisiana law does not require proof
that the patient would have survived, but instead imposes the lesser standard of proving
that “there would have been a chance of survival, and that the patient was denied this
chance of survival because of the defendant’s negligence.” Smith v. State, 523 So.2d
815, 820 (La. 1988) (internal quotation mark omitted). The district court recited the
Smith standard and we cannot agree with plaintiffs that the court ignored this standard
and legally erred in imposing a greater standard of proof of causation. Furthermore, if the
court did err in applying the law governing causation, this error was harmless since the
court correctly applied the law regarding the separate essential element of negligence, and
did not clearly err in finding that the government was not negligent.
3. Plaintiffs, Patterson’s survivors, do not persuade us that the district court
legally erred in failing to distinguish between doctor and hospital negligence. In its
memorandum opinion the district court detailed the treatment of Patterson by the treating
physicians and the hospital staff, and concluded that “the VA medical staff was not
negligent in treating Patterson’s coagulopathy.” We do not believe that the district court
erroneously thought that Louisiana law of medical malpractice is limited to physician
negligence or that Plaintiffs’ claims in this particular case were so limited.
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4. On appeal Plaintiffs focus on the coagulopathy that led to Patterson’s death.
We have reviewed the record and cannot say that the district court clearly erred in
rejecting their negligence claim relating to the treatment of this condition. “If the district
court’s account of the evidence is plausible in light of the record viewed in its entirety,
the court of appeals may not reverse it even though convinced that had it been sitting as
the trier of fact, it would have weighed the evidence differently.” Anderson v. City of
Bessemer City, N.C., 470 U.S. 564, 574 (1985).
5. The parties presented conflicting evidence on the issue of whether the treatment
of Patterson’s coagulopathy was negligent or denied him a chance of survival. The death
of a patient undergoing a colonoscopy is rare. Patterson’s coagulopathy was diagnosed.
The primary treatment for this condition is fresh frozen plasma (ffp). Patterson received
ffp and other fluids to treat his coagulopathy. Plaintiffs contend that Patterson did not
receive a sufficient quantity of ffp to stem the bleeding caused by the coagulopathy.
6. Plaintiffs point to evidence that a treating physician, Dr. Marr, had ordered four
units of ffp and the hospital staff had only delivered one unit. Plaintiffs also point to
evidence that more than one unit can in theory be administered to a patient at the same
time. There was however evidence that standard procedure is to thaw and deliver one or
two units of plasma at a time, that Patterson’s development of coagulopathy was
unusually rapid, and that Patterson died before sufficient ffp could be administered. Both
sides presented expert testimony on the issues of negligence and causation. The district
court found the testimony of Drs. Cole and Marr more credible than the testimony of Dr.
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Beck. Given the conflicting evidence and our standard of review, we cannot say that the
evidence was so overwhelming in Plaintiffs’ favor that the district court clearly erred in
finding that “the VA medical staff had no indication that Patterson’s coagulopathy would
develop so rapidly,” that the staff “followed the generally accepted protocol for treating
coagulopathy,” and that ultimately it was not negligent treating this condition.
AFFIRMED.
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