Caseflicks

Court of Civil Appeals of Oklahoma • 1996

Fritts v. McKinne

934 P.2d 371 | 86 O.B.A.J. 843 | 1996 OK CIV APP 132 | 1996 Okla. Civ. App. LEXIS 149

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Takeaway

In short, this case holds that a patient's fault in causing the accident that necessitated treatment generally cannot be used to reduce recovery for a physician's later malpractice; inflammatory evidence of that fault must not be used to distract the jury from the medical-negligence question.

Background

David Fritts suffered severe facial and chest injuries in a high-speed, one-car collision after he and his friend had been drinking. Five days later, while surgeons prepared to repair Fritts's facial fractures, Dr. Richard McKinne began a tracheostomy. Fritts suffered massive bleeding from the innominate artery, never regained consciousness, and died three days later.

Fritts's widow brought a wrongful-death medical-negligence action against Dr. McKinne. She alleged that he failed to identify and isolate the artery, injured it during the tracheostomy, and did not promptly control the bleeding. McKinne denied negligence, contending that Fritts had an unusually positioned artery that had been weakened by the automobile crash and ruptured when surgery began.

McKinne also asserted comparative negligence based on Fritts's alleged drunk driving, or his decision to ride with a drunk driver. Although Fritts's widow sought to exclude evidence of his intoxication and prior substance abuse, the trial court allowed it. The court also instructed the jury on comparative negligence, including a driver's general duty to use ordinary care. The jury found for Dr. McKinne, and the court awarded him $3,579.18 in costs. The widow appealed, and McKinne cross-appealed the amount of costs awarded.

Issues

Issue #1

Whether the jury could consider Fritts's possible negligence in causing the automobile accident as comparative negligence in the later medical-negligence action.

Holding

No. Fritts's conduct in causing the accident was not a proper basis for comparative negligence because it was unrelated to the medical treatment at issue.

Reasoning

A medical-negligence plaintiff must establish that the physician fell below the applicable standard of care and that the deficient treatment caused injury or death. McKinne properly could defend by arguing that Fritts's unusual anatomy and an accident-related arterial injury, rather than negligent treatment, caused the rupture. That defense directly concerned causation and the standard of care during surgery.

Comparative negligence may apply in limited malpractice settings when a patient's own conduct bears on the treatment itself, such as withholding material medical history, giving false information, ignoring medical advice, or delaying recommended care. But no comparable patient conduct existed here. Fritts's alleged intoxication and negligence occurred before he sought treatment and did not affect his duty or conduct during the tracheostomy.

A physician may not escape responsibility for negligent treatment merely because the patient negligently caused the injuries that made medical care necessary. Even a person who negligently injures himself is entitled to non-negligent subsequent treatment and an undiminished recovery for malpractice. Treating the crash as comparative negligence improperly shifted the trial from whether McKinne negligently treated Fritts to whether Fritts was blameworthy for the collision.

The erroneous comparative-negligence instructions were substantially prejudicial. Defense counsel repeatedly emphasized drinking, driving, and Fritts's prior substance-abuse problems, inviting the jury to decide where the tragedy began rather than whether the physician met the standard of care. The court found a strong probability that these instructions misled the jury and affected the verdict.

Issue #2

Whether evidence of Fritts's intoxication at the time of the crash and his prior substance abuse was improperly admitted and whether the objection was preserved.

Holding

Yes. The evidentiary issue was preserved, and the evidence was improperly used on liability; its inflammatory effect deprived the plaintiff of a fair trial.

Reasoning

Although a denied motion in limine ordinarily does not by itself preserve an evidentiary objection, the plaintiff made numerous trial objections and received a continuing objection to evidence of Fritts's substance-abuse history. She therefore did not waive her challenge merely because she did not object anew to every question or reference.

The fact that Fritts was in an automobile collision was relevant because McKinne contended that the collision caused a previously undetected injury to the artery. But the cause of the collision—particularly whether Fritts drank or drove while intoxicated—did not bear on whether McKinne negligently performed the tracheostomy. McKinne himself testified that alcohol was not a problem at the time of surgery.

Fritts's substance-abuse history could be relevant to damages if supported by evidence that it reduced his life expectancy and the plaintiff sought future-earnings damages. It was not relevant, however, to prove or disprove McKinne's negligence. Because the evidence was admissible, if at all, only for damages, the trial court should have given a limiting instruction. Bifurcating liability and damages would have eliminated the risk that the jury would misuse this highly inflammatory evidence on liability.

The repeated admission of this evidence and defense counsel's sustained focus on it were sufficiently prejudicial to prevent a full and fair trial. The absence of limiting instructions or a bifurcated trial made the error reversible.

Issue #3

Whether Dr. McKinne's award of costs could stand after reversal of the judgment in his favor.

Holding

No. The cost award had to be reversed because it depended on McKinne's prevailing-party status, and the court did not reach his challenge to the amount awarded.

Reasoning

McKinne received costs as the prevailing party after the jury returned a defense verdict. Once the appellate court reversed that judgment and ordered a new trial, the foundation for his prevailing-party cost award disappeared. The court therefore reversed the cost award without deciding whether the trial court should have awarded the larger amount McKinne requested.