Bryan v. Luverne Community Hospital

Peterson, Justice

(dissenting).

I fully agree with the court’s conclusion that the trial court erred in directing a verdict for defendant surgeons on the issue of negligence in leaving a laparotomy sponge in decedent patient. I do not agree that it was prejudicial error, however, in view of the trial court’s critical finding that the negligence of any member of the surgical team was not the cause of decedent’s death. I would therefore affirm.

This court’s rationalization that the error of exculpating the surgeons from liability “set in motion a chain of events which could only lead to an inequitable result” necessarily assumes that a jury could and would find causal negligence on the basis of the opinion evidence of two expert witnesses testifying on behalf of plaintiff. The opinion of these medical experts was so patently based upon demonstrated misassumptions of medical fact, however, that a finding by judge or jury based on their testimony could hardly stand in view of the fundamental principle that the plaintiff in a medical malpractice action must prove that the harm resulted from the negligence of a defendant rather than *30from some other cause. Hoffman v. Naslund, 274 Minn. 521, 530, 144 N. W. 2d 580, 588 (1966).

It is undisputed that the decedent had an acutely inflamed gallbladder, a condition ascertained upon the initial opening of decedent’s abdomen. There was a general concurrence among the medical experts testifying for plaintiff and defendants that such a highly infected gallbladder contains dangerous bacteria and that the immediate cause of her death was peritonitis and septecemia. The critical medical issue was whether the post-surgical presence of the sponge contributed to that condition. Both the surgeon called by plaintiff and the pathologist called by defendants testified that they were familiar with sponge retention cases where the sponge had not caused death. The precise medical issue, then, was whether this retained sponge caused this death.

The first of two witnesses for plaintiff, a retired general practitioner, was of the opinion that the sponge was the cause of death because the sponge provided a medium for bacterial growth. He admitted, however, that he had overlooked the pathologist’s report that the gallbladder itself was acutely infected and deferred to the pathologist’s better position to state the cause of death.

The second witness for plaintiff, a surgeon, stated his opinion that the sponge was the cause of death, basing that opinion on the assumption that an abscess developed around the sponge and subsequently ruptured. And he added that, because decedent was a diabetic, she had lessened resistance to resist infection or to wall off abscesses. But the truth of these twin assumptions was not established. The pathologist who performed the autopsy of decedent testified that there was no evidence of an abscess in the vicinity of the sponge, and other witnesses disputed that decedent was a diabetic. Given the undisputed findings of the pathologist, therefore, the opinion of the surgeon was lacking in essential foundation and amounted to little more than a conjectural statement of possible, rather than probable, causes.

*31The pathologist, called by defendants, described decedent’s peritonitis as diffuse or generalized. He concluded from this observed fact and the lack of localized inflammation or abscess around the sponge “that the sponge was just an incidental thing there and was not related to the cause of this peritonitis.” The competence of this opinion stands unchallenged.

Except to assert that the trial court’s decision “emasculated” plaintiff’s case, the views of the majority concerning this medical testimony related exclusively to causation are not articulated in the court’s opinion. It may be that the majority believes that a contrary finding would be supported by such testimony. Or it may be that the majority contemplates that at another trial plaintiff might successfully challenge the pathologist’s findings or might find medical experts to give better supported opinions of causal relationship even in the face of such pathological findings. If not, the grant of a new trial is less generous to this plaintiff than might be supposed.

Mr. Chief Justice Sheran, not having been a member of this court at the time of the argument and submission, took no part in the consideration or decision of this case.