Thompson v. Presbyterian Hospital, Inc.

SIMMS, Justice,

concurring in part; dissenting in part:

I concur in Part II of the majority opinion for in my view this issue was long ago settled in M & D Motor Freight Lines v. Kelly, 201 Okl. 121, 202 P. 215 (1949), cited in Footnote 25 by the majority.

However, I respectfully dissent from Part I of the Court’s views expressed today for the reasons expressed in the dissent of Justice Wilson; and I must recede from the majority’s treatment of res ipsa loquitur because of views articulated in my dissenting opinion in Martin v. Stratton, Okl., 515 P.2d 1366, 1372 (1973).

WILSON, J.,

concurring in part; dissenting in part:

I concur with the majority opinion on most points of this appeal. I dissent from the Court’s decision to affirm the trial court’s sustention of the surgeon’s demurrer to the plaintiffs’ evidence. I have no quarrel with my learned colleague’s articulation of the general rules governing this point. I depart from the majority when it comes to applying these rules and reaching a conclusion on the record before us today.

The issue is whether, taking the evidence and inferences from it in the light most favorable to the plaintiffs, reasonable *270minds could differ in deciding whether the plaintiffs established actionable negligence on the part of the surgeon. Viewing the evidence through this lens, I am convinced that reasonable minds could indeed have differed, first, on whether the surgeon fell below the standard of care, and then, on whether the surgeon’s actions were a proximate cause of the injury.

Regarding the first two elements of the plaintiffs’ cause against the surgeon — a standard of due care and breach of that standard — the majority says there was no evidence of either. I disagree. Dr. G, called as an expert medical witness, specifically testified that the choice of Demerol as a pre-operative medication “is not indicated” for a patient in Dorothy Thompson’s situation, and that he would have chosen other drugs for the purpose. He also expressed his opinion that “deviation from accepted medical practice” was a cause or factor contributing to the injury.

Granted, this evidence was slight. Nevertheless, even the slightest evidence is enough to withstand a demurrer and require sending the case to the jury, just so long as reasonable minds could reach differing conclusions from that evidence. Hillcrest Medical Center v. Wier, 373 P.2d 45 (Okl.1962). In my view, Dr. G’s expert testimony alone was enough to justify submitting to the jury, under appropriate instruction, whether or not the surgeon’s conduct fell below the applicable standard of care.

The third element of the action, causation, raises more complicated questions. Discussing the proximate cause issue, the majority opinion analyzes the law of intervening and superseding causes, sometimes couched in terms of condition-versus-cause. The majority states that foreseeability is the key to the causation issue. It then goes on to hold, as a matter of law, that the surgeon could not have reasonably foreseen the anesthesiologist’s actions or the harm to the patient.

I do not think the causation issue could be decided in this case, one way or the other, as a matter of law. Again, I believe that the plaintiffs’ evidence, including Dr. G’s testimony, required submitting the question to the jury.

Dr. G explained that the surgeon’s choice of Demerol, a narcotic which depresses breathing, started “the chain of events,” that it was an “essential factor,” a “contributing factor,” which bore “a direct causal connection” to patient Dorothy Thompson’s brain damage from lack of oxygen.

My brethren of the majority discount this testimony entirely, stressing that proximate causation is a legal question, not a medical one, and warning against allowing an expert opinion to “preempt” the proximate cause question. Any expert medical testimony which establishes that surgeon-defendant’s conduct was a “deviation from accepted medical practice” together with testimony linking this “deviation” to the injury complained of requires the trial court to submit this evidence to the jury under appropriate instructions.

Just as an expert opinion should not usurp the Court’s role, neither should a judge usurp the jury’s role. On the contrary, as held in Pepsi-Cola Bottling Co. of Tulsa, Oklahoma v. Von Brady, 386 P.2d 993 (Okl.1963), if there is any evidence tending to show a causal connection between the defendant’s conduct and the injury, the question goes to the jury. This “any evidence” standard was met in the case at bar.

Further support for submitting this cause to the jury comes from Long v. Ponca City Hospital, Inc., 593 P.2d 1081 (1979). There, the hospital staff negligently inserted a catheter in the patient’s rectum before surgery. During surgery, the doctor yanked the catheter out, thus contaminating the surgical field. The proximate cause issue was whether the surgeon’s action was unforeseeable, and hence whether it superseded the hospital staff’s action. This Court held the question could not be answered as a matter of law. Rather, it called for a determination by the jury.

I would hold likewise in the case at bar. I believe it was improper to sustain the surgeon’s demurrer to the plaintiff’s evidence because I am convinced that, viewing *271the evidence in a light favorable to the plaintiffs, reasonable minds could have reached different conclusions in deciding whether the surgeon was negligent and whether his negligence, if any, was actionable.